The Checkup with Doctor Mike - Meet Harvard's Professor Of "Happiness" | Dr. Robert Waldinger

Episode Date: May 31, 2023

Watch our full interview here: https://go.doctormikemedia.com/youtube/RobertWaldingerVOD Dr. Robert Waldinger is the leader of the Harvard Study of Adult Development, which for the last year has been obsessed with one single question: What makes people happy? I sat down with Dr. Waldinger to talk about what we've learned from this study, what mistakes Harvard has made in implementing it, and learn if there are actual things real people can do to improve their happiness. Turns out... there is! Buy Dr. Waldinger's new book "The Good Life" here: https://www.simonandschuster.com/books/The-Good-Life/Robert-Waldinger/9781982166694 Executive Producer and Host: Doctor Mike Varshavski Produced by Dan Owens and Sam Bowers Artwork by Caroline Weigum CONTACT: [e-mail]

Happiness is a momentary thing. It comes and goes. One of my teachers said, it's like happiness is an accident, but we can make ourselves more accident prone. We can build a life that makes it more likely. We'll be happy more of the time. This is Dr. Robert Waldinger. He's going to tell you what you can do to find happiness. What does he know? Well, Dr. Waldinger is the director of the world's longest running study of happiness, the nearly 100-year-long Harvard study of adult development. Dr. Waldinger is bursting with evidence-based happiness tips and world-class expertise with psychotherapy and boundless insight as a Zen priest. Clearly, there's a ton to unpack here, a lot of which can be read in Bob's new book, The Good Life, available now. Join me in welcoming

Dr. Robert Waldinger to the checkup with Dr. Mike. I'm curious what's been your experience in talking about the science that you're so passionate about with the added tool of social media. Have you seen it as a positive, negative, or a neutral effect? I'm so unfamiliar with social media, but I'm learning to be a little more familiar. And basically, my sense is that putting out small messages can be useful if it gets people to take a deeper dive. Sure. So the idea is to, you know, to leave breadcrumbs, yes. Okay. Yeah, I like that approach. I think that's a good way to make use of short form content because now on social media, there's so many different ways. Like podcast is the longest

version of content online. Then you have the 10, 15 minute informational videos. Then you have the really short form 30 second sound bite videos. And that's where it kind of gets tricky because that's where misinformation spreads. And actually you and I were just talking about that off camera, how difficult it is to see people in our own industry to sometimes say things or sell things that are not, I guess evidence-based is a nice way to put it. You said snake oil. That's a term that's been used a lot. How prevalent is that these days in your eyes?

It's very prevalent. I mean, the problem is even I get asked as a researcher about things I don't have any expertise in. And, you know, one of my teachers once said, without data, I'm just another guy with a bunch opinions. And there are a lot of people with a bunch of opinions, right? And especially if you monetize those opinions, that seems to me unfair to people who might assume that you have evidence behind it. What's tricky for me as someone who likes to myth bust some of these snake oil products is that in science, if we're being true scientists, we can say something is lacking

evidence, as you just said, or lacking data. But we also, when someone comes in with a snake old product and says, this cures all your problems, and I say you have no proof to say that, they say you have no proof to say that it doesn't. That's right. That's right. Well, the tobacco companies have for years said there is no absolute concrete proof that smoking causes cancer because they can't quite find the mechanism. Because we don't know the mechanism of many. many, many things, but we know the relationship between A and B. So we've seen, even though that's a correlation with smoking and lung cancer or COPD and smoking, the correlation is so high that it's not useful to investigate the causative

mechanism behind that, right? That's how I think about it. And we can act on it even before we know the causative mechanism. I mean, we have, we didn't use to know the mechanism by which aspirin worked, but we used it for decades. before we knew the mechanism. Well, that's where I think these snake oil individuals really thrive as they say, this is natural. But for me, even the pharmaceutical company products that are made largely started off as natural products,

became evidence-based, and now are part of the pharmaceutical industry. So like alternative medicine, once it gets evidence, becomes medicine. That's right, that's right. And a lot of our best discoveries are by accident. Yes, exactly. And natural, again, it's some kind of seaweed,

weed in the ocean or some kind of animal that makes a product. And even Botox, like the thing that everyone loves these days to inject to prevent or treat wrinkles is a toxin. Yeah, I know. I know. Botox has not been my thing. But I'm just saying how interesting that is that standpoint of things. Well, earlier also, when you walked in, we were talking about how I labeled the work that you do as being in the field of positive psychology. But you corrected me and you said it's actually not. Can you elaborate on that? Yeah. What I do is often called a study of happiness, but it's really a study of adult lifespan development. And that's different. That includes happiness and unhappiness and it includes heart disease and it includes DNA methylation and just so many things, right? It's about

kind of well-being, sort of organismic well-being. We got caused. a study of happiness when I gave a TED talk that went viral because the TED folks know that when you put the word happiness in the title, it kind of sells. So that's been our label. But really what we're talking about is a kind of broader view of human thriving. And when you were, I mean, obviously when the study first came out, this was 75 years ago. 85 years ago. It's quoting from your probably your TED talk now. When the study first came out, Was the intention to focus on the happiness development or was it larger in scope? Well, it was to focus on positive development.

So there's the positive word because most of the research that was done up until 1938 when the study began was about what goes wrong in human life, understandably, because we want to know what goes wrong and then how to help people. So it was kind of radical to actually start with two studies, which we did, a study of Harvard college undergrads and a study of inner city boys from really difficult family situations. But both studies were, how do young people stay on good developmental paths? And what are the predictors of thriving? And so they were radical for the time.

Yeah, because even this is radical for that time. even in my medical education, there was such a limit place to thinking about positive psychology because everything was about pathology. What can go wrong? Here's how you help someone with depression, anxiety, even though we can describe anxiety as a positive symptom because we're putting energy in. But for me, I felt like I was getting really good at getting patients from the negative side to things to a baseline. But then they'd be flat. They would not

have the enjoyment. And essentially, I started thinking about it from a PTSD model where someone is so worried about having an episode where they have a flashback or something very negative happened that they try and mute all of their emotions. But when they mute their negativity, they also mute their positivity. And essentially, you become a very unhappy person in doing that. And I felt like modern medicine was really focused on creating a flatline. Do you see that happening in your education as a psychiatrist and now as someone who studied human development? Well, there's a famous quote from Sigmund Freud where he said, we want to turn neurotic misery into everyday unhappiness.

And many of us, I'm trained as a psychoanalyst, and many of us said, is that all that we can do? Is that the best we got every day on happiness? No. So actually, I mean, a lot of our work has been on what helps people thrive, not just what keeps them at a flat line of okayness. And do you think we need more of that in terms of investments into research? I think so, because it's also not linear from unhappiness to happiness.

There's so many components that make life rich, right? And so we want to figure out how do we find those elements that make life energizing, rich, interesting, even to combine with the things that make us unhappy, because there's always some of both in life, right? And you know what kind of frightens me when I think about some of this research that's done is that these days we always want to break things down to its fundamental level, meaning what was the takeaway from the study?

Give me three lessons and I'll incorporate that. And then what ends up happening is similarly what happened with self-esteem in the 90s, where it was some research was done and they showed that those who were successful had high levels of self-esteem. So he said, let's pour on the self-esteem and admiration on people, even who are not being challenged in our thriving. And we saw the negative drawbacks of that.

Do you think about that when you're developing the study or changing the study? Yes, because one of the things, when you study like thousands of lives over decades, you realize one size never fits all. There is no quick fix for almost anything, right, in life. And so what we are a study in is complexity, is the many different paths that people take, physically, emotionally, socially. And so I think that one of the difficulties of conveying this science is that we can't say,

these are the quick fixes and you do these and you're going to be happy forever. You know, that's not what we are. So how do you communicate your results? well when I gave that TED talk seven years ago I thought my colleagues were going to shun me I mean you know I'm an NIH funded researcher and I prided myself on being serious but I felt like my god we're not telling people what we know we're publishing in journals nobody reads and so the first challenge was really how could we communicate what we've learned in a way

that's accessible and usable for people. So most of the statements in that TED talk are actually findings from journal articles. And I had to figure out how do you translate those into normal language? And so a lot of what we've done in this book, actually, is to do that. And we've also mixed in real-life stories of people

in order to help people sort of get, well, how does this play out in one individual person's life, but a lot of it has been this kind of wonderful, interesting exercise in translation from the highly technical language of my research life to trying to talk to real people. Of course. That's the constant challenge of being on social media trying to take evidence and making it reasonable, relatable, interesting, culturally relevant even, from one of those scenarios where you were taking some bit of evidence or data and you were trying to translate it for the book. What's one of those lessons that you translated? So we had a statistical interaction

between marital satisfaction and daily pain perception in older adults, right, in older couples. And a statistical interaction is kind of a complicated thing you do with fancy statistics. But really what I had to boil it down to was people who were in more pain each day had lower moods. But if they were in better marriages, their moods didn't go down on days when they had more pain. That is the practical description of statistical interaction. Okay? Very good takeaway. And then from that, are you able to extrapolate and say,

based off this, our recommendation would be to seek a happy marriage, or is that going too far in your eyes? No, it's not going too far. I mean, really what we found was that it doesn't have to be marriage, but that the people who were, you know, not just the happiest, but the healthiest, physically were the people who had better connections with others. And so what we are saying is we've seen in thousands of life stories that the people who stay happy and healthy are the people who have these connections, right? So, yes, please go out and make connections

and let us help you figure out how to do that because there is research actually on how connections get made more easily. And so again, we're trying to bring evidence into our discussion of what you might do about this in your own life. And I could see a cynic saying, well yeah we knew that we knew that having good friends and happy marriages makes us happy but at the same

time i'll push back on those cynics and i'll say well we also know a lot of things like that yeah that were not found to be statistically significant in the research right were there some things like that that stood out to you that weren't statistically significant that you thought they may have been yes and by the way when i gave that ted talk i thought people were going to sit there in the audience in this little elementary school auditorium where I gave it and go, well, duh. But the surprise really was that people stayed healthier, physically healthier. But you're asking an interesting question. Were there things that turned out not to be true that we assumed were true? One of them actually was the idea that there are big gender differences between men and women in how

important we feel relationships are and how we are in relationships, that when we actually went back and looked at the state of the art in relationship research, women are somewhat better than men at making connections and valuing them, but the gender differences really aren't that big, that relationships are very important to men too, that men behave somewhat differently in relationships from women. so that's one of them another and this is actually one of the big takeaways from our study is that so we studied a really disadvantaged group people on the opposite end of the privilege spectrum like people who grew up not just impoverished but in homes that were really troubled and then Harvard college undergraduates

we did not find that the Harvard college grads were any happier as they went through their lives on average than the inner city guys. And that seemed useful to know. And certainly it didn't have to do with how much money you made. It didn't have to do with becoming famous. I mean, you know, we had JFK was in our study, Ben Bradley, editor of the Washington Post, and we had some fancy people. And the whole group was no happier than the disadvantaged group. And that seems really important to name. Yeah. How did you, what barometer of data did you use to gauge happiness? We used a lot of them.

First of all, we asked them, how happy you are you? And we asked them over and over again. But we also asked their partners, right? We asked their kids. Did you find synergy in those answers? Sometimes no. Often, yes, but sometimes there were big disconnects. In fact, there's a story in the book,

a life story of a man who, thought he had the greatest marriage and the greatest relationship with his kids and he was so happy. And his wife and kids said, this man is totally shut off. We can't get him to be real with us, to be present

with us. And so he was like clueless about how he was showing up in the world. And we did find that in some of our... But it seems for the majority, if the person judged their satisfaction to be high, the people around them felt the same. Yeah. For the large part. Yes. Okay.

In large part, yes, absolutely. Okay, I would have thought that might have been a lot more sporadic. But okay, sorry, and then you were... Well, we're all, you know, we're all blind in certain ways to ourselves and, you know, but by and large, people kind of know if they're happy, and it does relate to how other people see them. And then you were going to say some other variables you were measuring as a form of happiness? Yeah, so we brought people into our lab.

but we deliberately stressed them out. And then we watched how quickly they were covered from stress. Is this like cold water immersion experiments? Oh, actually, no, but it is. It's the Trier social stress test. And what that involves is, first of all, telling somebody in five minutes, you're going to give a speech to a group of judges.

And it's going to be a speech about yourself applying for a job. And then you have to give the speech and to these stony-faced judges. That shoots your heart. rate right up. Then after that, after you're done, we ask you to subtract the number 17 over and over again from the number 2000. And we tell you it's an easy task. And every time you make a mistake, which everybody does quickly, we make you start over again. And people get really flustered in their heart rates shoot up. So what we wanted was some way to reliably stress people. And then because the

experiment was to see how quickly they recover from stress. And so we did measures like heart rate variability, blood pressure, galvanic skin response, to see, and again, that doesn't sound like measuring happiness, but what it measures is how well you manage stress and return to equilibrium, which we think is a really important component of well-being. So it was the physiologic response to stress and the recoverability from it. Yeah. Yeah. That makes a lot of sense.

Were there factors that worked, you mentioned the gender differences. You mentioned the fact that there wasn't a change depending on someone's famousness, their money, their status. Was there anything that worked in an inverse way that you expected to actually go the other way? Like, for example, we frequently think becoming famous will keep you happy. And actually, you saw the other pattern emerge where becoming famous would actually hurt you. Any patterns like that inversely arise?

Well, certainly the fame one was such a pattern because people lost some of their privacy when they became famous. And they lost the ability to just move as freely in the world as people who aren't famous. especially if you're a president yeah yeah and then of course he had a lot of unhappiness in other ways in his life um actually we did a video um on the youtube channel talking about how each president passed the medical science behind it and i remember part of my presentation was that jfk actually had a lot of medical conditions at the same time like outside of everything terrible back pain i think he had addison's disease There was several things.

I wonder how fame played into that. Yeah, I don't know. I don't know. A lot of theorized that. And I know Ben Bradley had a lot of stress in his life. And I can only tell you about those two people because they have been public about it. Okay. Otherwise, I have to keep the identities of all of our participants confidential.

Okay. Because why would anyone tell us private things about their life if we were going to spread it all over yeah so are the participants that are still involved in it happy to be involved in it was this something you know in life when we say we do something challenging we always look back at it with admiration like we've overcome something is this has this become like a bonding moment for the people involved it kind of has become so when we reached out to the second generation to all the kids the brochure we sent them was your parents helped us will you and and 75% of the kids participated with us.

That's an unconscionable rate. That's so high because they knew that this was important in their families. But we asked our original subjects, how has being in this study affected you? And some people said, your questions are annoying and you've been a nuisance, but most people said this has been a really important element of my life because I knew that every couple of years you were going to ask me

to think about where my life is going and that made a big difference to me in how I lived my life and I think that it creates this scientific problem because by the fact of observing people we are changing them were you giving them feedback

in the midst of the study we were not giving them so how is that changing them because they were I ask you if you know that I'm going to ask you let's say every two years. Tell me about what the last two years have been like. You're going to carry that around in your head, right? You're going to think about, well, how is my life doing? Because if you think about it, most of us don't think about our lives that much. And I can tell you, as a

psychiatrist, there are some very unpsychologically minded people wandering around, many, many, right? Non-introspective. Not introspective, not thinking about that. Well, what if we took a whole bunch of people, many of whom weren't particularly introspective, and said, we want you to introspect regularly for us. It makes a difference. And touch points, whether it's health care or mental health care, is going to be a factor as well. Yeah, yeah. That's interesting. I wonder how that impacts. And also, forgetting that, how about culturally, how culture has shifted in those 85 years, that has to have a huge impact, whether there's culturally a depression going on, a war going on, but something as civil rights movement, changes with digital media.

Any patterns emerge with any of these social events? Well, what we did was we asked about the big domains of life that kind of stay constant. So mental health, physical health, work, relationships. But then we would also put in questions about the big social trends that were happening. So we'd ask a question like, And this was my predecessor, what do you think about the Vietnam War while the war was going on?

What do you think about these hippies? Have you ever tried marijuana, right? And so now we're asking, we're collecting data even as we speak from the second generation. Almost all the first generation has passed away. But we're asking now, along with the usual questions about well-being,

we're asking, what were your experiences like in the pandemic? And we're also asking, how do you use social media? And what's your involvement with the digital world? So again, we're kind of trying to take some of the big things that are coming along in our culture and ask about that. And has any, have any patterns from, obviously it's too soon to gather about the pandemic, but from things in the 70s and 80s, anything has been elucidated with, how society impacted levels of happiness? You know, we don't know about that.

The impression that we've gotten from a lot of data is that people were more concerned in the World War II generation about living lives of purpose and meaning. Not that people aren't concerned about that now, but this idea of being famous for being famous, that kind of stuff, that didn't exist. That just wasn't a thing.

people would have thought it was absurd, right? Yeah. So they, you know, because they had had a great depression where they'd seen themselves and all their neighbors struggle. They had been to war. Most of the Harvard men went to war. The inner city men were too young.

You know, so they had seen these huge cataclysmic events. And so for them, it was like, how do I live a life that works? And how do I raise a family that's healthy and those kinds of things? I'm always so torn. between these traumatic episodes, whether on an individual level

or if we zoom out into like the Great Depression or World War II level of calamity. On one hand, they're so traumatic, so many lives lost, terrible, we never want that for society. And at the same time, there's this level of post-traumatic growth, again, on a societal level and individual level that happens where we're like, wow, look at the good

that we haven't even looked at that has come from a situation. like this. How do we wrap our minds around something like that? It's a great question. I mean, I think life is just like that. I mean, I think that we're going to keep being challenged, right? We know that. Yeah. I mean, what's going to happen with climate change? What's going to happen with the singularity when AI is in charge, right? What's going to happen? How are we going to meet that? And so the question is, will we have the wherewithal and the resources to meet these big new challenges that we've never faced before? Or will there be trauma?

So there's post-traumatic growth when you basically have enough resources not to be overwhelmed by a challenge. There's just trauma when you're overwhelmed, right? And so we're all wondering, are we going to be overwhelmed by climate change? Are we going to be overwhelmed by AI taking over our lives? We don't know. On a species level, you mean? Yeah. Well, because if we're overwhelmed, we're extended.

Yeah, yeah, yeah. That's the only gauge I have that makes sense because the amount of lives lost in World War II, one could say we were overwhelmed. Well, but we weren't. I mean, we survived. We survived, and the number of lives was massive, but there were just a huge number of people to carry on. The question is, what's going to happen now? And I don't think we know. I mean, if the planet falls apart, literally collapses,

then maybe this, you know, people are wondering, is this our time to become extinct? I don't know. And in that case, what are you and I doing here? Talking about happiness and growth and development. Really? Do you see any issues with the fact that this research, the adult development study,

started so many years ago that initially it was all men initially it was the two groups of men do you think it's still the principles that we were learning from it are applicable to those living in mongolia those living in africa those living in york city is it still widely useful we've worried about that a lot and we've tried to make sure that what we're putting out there in our science isn't just specific to our sample of white people in 20th and 21st century Boston, right? So we've had to look at other studies, make sure that other studies corroborate

at least our basic findings. So it seems really important. And that said, the amazing thing we find is that the basics of being human don't differ that much. That there's a lot that does differ, but the basics, the essentials, of human life, don't differ. What's your take on the fact that there is

a reciprocation crisis in the field with some social science research that has been done in the past? Oh, replication? Yes. Yeah, it's a problem. We all have it. We have it, you know, in my work, and in fact, now they have these systems

where you register your hypotheses in advance, you say what analyses you're gonna do, If you then do something that's more exploratory, you're very clear about it. I think it's a really good development. And what it means is that we're just clearer that we haven't manipulated the data to find something significant

because journals aren't gonna publish non-significant finding. Yeah. But the replication crisis is a big one. And, you know, I think over time, what certain findings emerge and keep coming back. I mean, one of the things we do, so for example, I do a bunch of data analyses and I find something and I get all excited. And then I tweak it just a little bit

and the finding goes away. And then I go, oh no, this is probably one of those flukes. And so what you want to do, you can do this with your own data as well as looking at other people's findings. You want to see whether a finding is so robust, whether a signal is strong enough that you can analyze it in different ways and the signal keeps coming through and that's what we try to do because otherwise we have so much data we could just throw our data yeah of course you can come up with conclusions you want oh my god and weird ones yeah i can tell you some of the weird statistically significant findings we've had what's the weirdest one that the that the longevity of your maternal grandmother is the strongest predictor of your own longevity.

It turns out not to be true. Sure, but that's something, a correlation. Yeah. Wow. Okay. Yeah, but that goes to show how you can weaponize data as much as you can use it for good. Absolutely. Yeah.

This is a personal statement I'll make. Within the pandemic, early on, I expected the world to treat this as a moment of trauma. and exhibit signs of post-traumatic growth after the fact, much like we're talking about here with these other instances. And yet I feel like that didn't happen. Do you feel that also? I think it's too soon to tell. Oh, really? Okay, so that's what.

And I also think that it's going to be very different for different people. So we know that particularly levels of mental illness have skyrocketed. You know, addiction, depression, anxiety. and that we are in a crisis because there aren't enough mental health professionals, there's not enough care for the people who need it. What happens then? What happens not just to the people who are suffering, but what happens to their families?

What happens to their children? As children get raised in homes where levels of depression and anxiety are higher, where addiction is more common, we just don't know. On the other hand, there's been this acceleration of work in the digital world that's kind of interesting. I mean, I do psychotherapy every day. And if anybody had told me three years ago

that you could do meaningful psychotherapy on Zoom, I'd say you were completely out of your mind. Well, why at that moment would you think that? Was it because you're not in the room, you can't connect, no body language? All that. And sort of emotional communication. Like, what gets filtered out?

when we're on a digital call. We don't know, actually. I mean, we know that some emotion gets communicated, but we don't know which aspects of emotion and other nonverbal behavior does get communicated. We just don't know. I think there's some good research on its way to tell us more about that.

So my thought was being in person is essential. It's part of the core of what heals people in psychotherapy. now I'm not so sure but you know the thing I love about being a researcher is you get to be surprised you get to be wrong which is funny because society as a whole I think has created a higher level of distrust

because at times science has been wrong or has changed and they I guess fairly to some degree call us flip-floppers but we're not we're just letting evidence guidance guidance and thank God we're wrong I mean we've had so many you know there are so many wrong theories that then need to be clarified, disproved, you know, being, we're not flip-floppers, we're doing science. It's not that the reality, you know, the reality is out there to be understood,

is that our ways of understanding change as we change. Speaking of understanding our realities, what are some misconceptions you frequently hear about happiness? Well, one is that if you're not happy all the time, you're not doing it right you know that there's this fantasy that we all have that if i just do the right stuff i can be happy all the time and and i'll be fixed i'll be set i'm all good then and that's just not the truth of anybody's life in some ways again i'm stating the obvious but in some ways it's important to name because especially with social media for example

we get these messages you know if you if you look at the curated lives that we show each other on social media, like, I don't post my photos when I wake up in the morning and feel like I'm totally clueless, right? Or that my life is going nowhere, right? I pick, you know, the pictures with my family, the beautiful beaches, right? And we know that rationally, but at the same time, you look at those feeds and you say, oh my God, everybody else is having a great life and I'm the one who has all these ups and downs and confusion. So I think it's really worth naming this is you know happiness is a momentary thing it comes and goes and that said one of my teachers said it's like happiness is an accident but we can make ourselves more accident prone

we can build a life that makes it more likely we'll be happy more of the time something you mentioned with the social media and how we present ourselves in certain ways can drive people to feel less happy because they're contrasting and comparing A concept you mentioned in the book is lurkers. People who look at social media often, but don't comment, don't engage, don't post themselves. They frequently have higher levels of dissatisfaction. Do you think that's the reason why?

Well, I think it may get back to what you were saying about comparison, that it may be that, and I work with particularly some young adults in therapy and what they will report is being unable to stop themselves from like scrolling through other, people's Instagram feeds and then they can just feel themselves plummet. They can feel their moods lower. And usually what they describe is comparison. And what we do know from research is that the more

frequently we compare ourselves to other people in a given day, the less happy we are. So trying to find, to step out of that comparing mode, hopefully would include stepping away from that passive scrolling through other people's curated lives. Is it a practical tidbit here to be had of how to, is it just log off social media or is it look with engagement or look with intention or something? Yeah. There's some research on this. There's a psychologist named Gene Twenge who has she suggests with some data that when we actively engage on social media with other people, that that's energizing and our well-being can go up and that when we passively consume,

it goes down. So I think what each listener could do is a little probe to test themselves. So spend time doing something you normally do on the Internet. And, you know, spend 10, 15 minutes, and then just check in with yourself. Am I more energized? Am I more hopeful? Do I feel more open to the world? Or am I more closed off?

Am I a little more depressed? Am I a little more exhausted? And if it's the latter, turn away from those activities. It's tricky on social media because specifically with what you're talking about, this kind of introspective, am I feeling good, am I feeling happy? Am I feeling energized mindset? because oftentimes in social media, you're bombarded with a ton of information,

whether it's science-based, technology-based, new iPhone, Shmifone, whatever it is. A lot of times, to make ourselves feel better, we'll consume content that may not be accurate, but agrees with how we feel. Because it's validating. Almost when a friend comes to you and says they're going through a rough time,

you can choose to be compassion and just give an ear or you can be a truth seeker and help them see if they're wrong in this situation and challenge them a bit. And depending on that person, you could pick one of those two strategies. As an individual who's trying to evaluate what they're doing, if we just solely look at happiness, do you think we can actually misguide ourselves into falling prey to misinformation and trickery online? Well, yeah, absolutely. I mean, that's what That's what clickbait is designed for, right? You know, the problem is that all of this is designed to grab our attention and hold it. Because the more they hold our attention, the more money gets made.

And so the potential to be fooled, to be misled down dark paths is really great. But we can also check in with ourselves. I mean, it may be that I sit in a bubble, an echo chamber. I mean, which I do sometimes. I find myself, you know, looking at media that validate my perceptions and make me feel angry at those other people over there doing those bad things. But then I know, I feel worse. So even though I'm being told the things I already believe, I start feeling worse. I start feeling more closed off. I start feeling more gloomy about life. What I've learned is that I need to step away from that, particularly, it doesn't

matter, whose opinion, you know, whether, you know, whether it's Fox News or MSNBC, they both make me feel terrible. Interesting. And yet they have the highest viewership of, absolutely, because they, you know, anger and victimhood sell, you know. Yeah, that's very true. I was going to ask about the general field of positive psychology. I've read books on the subject, flourish, flow, we talked about earlier.

Dan Gilbert, who even wrote a blurb on the back of your book. Is there anything in the field that is happening as a trend that you disagree with? Hmm. I think that what we always do is we oversell the next thing, right? The new thing. And so that's really the problem. I mean, so for example, positive psychology has been a great corrective to a lot of the doom and gloom psychology that I was trained in, right? And that's great.

And then positive psychology got oversold as the best thing since sliced bread and good for everything, right? And that's what we tend to do. We tend to oversell the next shiny thing that we find. How do you feel it was oversawed? Well, because there is real suffering, there's a real pain. there's also turning toward sadness, turning toward, that that is beneficial, that's healthy, right? Because positive psychology, when it's taken to an extreme, can be papering over of and suppressing of negative emotion. And potentially building narcissism.

Well, yeah, yeah, yeah, exactly. So I think that it's not that positive psychology is a problem. It's the oversell that can happen. I mean, there was an oversell of psychotropic medications. Psychopharmacology was going to be the cure-all for everything. Earlier than that, it was psychoanalysis that was going to be the cure-all for everything. We just do this, you know. And so that's really, that's the human behavior that, and I'm, I've been as guilty as anybody, you know.

Is there any takeaway from that, maybe us in industry of how we protect ourselves from doing that and prevent ourselves from doing that? just keep bringing in other voices, which it sounds like you do a lot. Well, I try and do it. And even recently I had Deepak Chopra sitting in the chair where you're sitting. And to be honest, I wanted to have a very direct discussion of some of the things that I think he's discussed in the past that were questionable at best. And I wanted to be critical. And I found it difficult, if not impossible, to do so, given his skill,

of being able to move the conversation along, flooding with information, not being able to narrow down a specific subject. And as you know, in medicine or in health, when we need to discuss something, the second we move the goalpost away to another variable, the discussion is lost. Right, right.

And I've yet to realize how to do this successfully. Well, I know. It's really hard. And especially when you're with, you know, Deepak is a lovely man. And that's the other thing. thing and you're a good guy and you don't want to be mean to a guest. Sure. But you could invite on other voices to say, okay, tell me some other points of view. Just as, you know, you can bring in

other people to say, okay, you know, Waldinger's work is about the importance and centrality of relationships. What are some other counters to that? You know, what are some other points of view? Because they really are and they need to be heard. And I think, so probably you're not going to be able to do that all by yourself as a kind, responsible interviewer. Well, as someone as well versed as yourself in this field, what are some counterpoints of view to your points of view? Sure.

So one of the things we find is that good relationships are associated with staying healthier as well as being happier. But then the problem is when you lose your health, you don't have the energy or the mood to feel like reaching out to other people, which means you become more disconnected. So there's a kind of vicious cycle that can develop in the other direction. And so that's one of the things that's important to name, that it's not just a one-way relationship where you just get those good relationships

and you'll be healthy and happy and you're all set. No. I was going to ask a question about, you mentioned, that there's some data of how to create these relationships, some fundamental guidance. What is that guidance for people who are perhaps lonely, especially coming out of a pandemic? Yeah.

Some of the research is about how do we make new relationships when we don't have them or we want more? And they find that when we show up alongside, the same people repeatedly were more likely to connect. So that's why the water cooler at work or the coffee machine becomes iconic, right? Because you just happen to bump into people, right? The other thing is that if you join a club or you volunteer for a cause and you do this, you show up with people you don't know, but again and again,

what happens is that you have something in common with these people, something you love to do or some cause you're passionate about that gives you a conversation starter when you might not have one so one idea is to try to do things that you love to do or you care about do them alongside other people and see if that's a way to develop new relationships The other thing they find is that being of service to people is really good for us. Like it makes us feel worthwhile, it makes us feel like we matter. You know, and there are many people who are isolated and feel like the world doesn't want them, that they don't count.

And it's really helpful to kind of take stock of, well, what do I have to offer? So, you know, if you have the possibility of reading to a child or two, tutoring a child in arithmetic or writing, you know, hey, you know, you can do that and everybody wins. They have these programs where they pair older adults at retirement homes with preschoolers. And they, and they just, everybody is just totally thrilled. The preschoolers love it. The older folks love it, right? You know, similarly volunteering, you know, to work, you know, at a food pantry, some of these things where you can use your energy to be of service. It makes us feel better about ourselves, and it also brings us into contact with people who

want us. Yeah. I see that happening a lot, especially in my patients who work in the health care setting. Despite high levels of burnout, they feel like they matter and they want to be there for others. Yeah. Something that I talked about with a pretty popular PhD in mathematics of all things, on the podcast has been about monogamy and how dating apps and the availability of choice

creates the paradox of choice or that there's so many fish in the sea that no one ends up settling down and that dating apps can be problematic for monogamy and then we asked each other the hard question of is monogamy the right answer for us anything that the research so far in adult development has elucidated on whether or not monogamy is the correct play for us. We've elucidated absolutely nothing. So we were the, you know, we started with the World War II generation. I mean, they were all about monogamy. Everybody got married. There were no gay people because gay people didn't exist in that generation, right? You know, everybody, unfortunately, had to be closeted. So we don't have anything to say about that. We actually, with our second

generation, they're baby boomers. There's probably less polyamory in that age group. My wife is a couple's therapist. She's a psychologist, and she has seen a bunch of polyamory in younger generations. So bottom line is, I don't know. We haven't seen it. I don't know. Yeah, that's interesting because even when we say polyamory, we mean a relationship between multiple people. Yeah. But I think what we're now is more so the lack of connections being formed. So it's not even polyamorous, it's just kind of open and flexible. And without a foundation of who's your person, like I heard you speak on another podcast where you said, who can you call in the middle of the night?

You might have a lot of dates to go on and have a lot of sexual experiences, but maybe you don't have the person to call anymore because there's so many of those superficial level relationships. Right, right. And what we think is that everybody needs somebody who's their person, right? And one or two people who they feel are their safety net. It doesn't have to be a romantic relationship, but just somebody out there in the world. Yeah, and I think that's something we've done wrong, but not in a bad way wrong, with research in the past, at least the way that I view it, is we would say a family with two parents does well, a father and a mother. We see that when it's a single parent, there's more difficulties, higher levels of trauma,

et cetera, et cetera. And then we've come to realize it's not a mother and father. It's just the fact that there's two parents. So our definition was wrong, but the principle was still kind of correct. And the same way where we would say a good marriage of someone being there for you is really important. Well, as you're saying now, it's not just. about a marriage, it's just about someone being there for you. Our definitions of how we define those people, I feel like, have changed. Right, because it's really about the emotional connection.

In fact, there's a child development researcher Michael Rudder, who, when he was asked, what's like the single most important factor in a child's healthy development? He said, every child needs at least one adult who's crazy about them. And that's what, you know, He's not talking about who that adult is or what gender or what their relationship is. It's just the affective connection. And that drives a lot of human connection in so many ways. My next point that I wanted to talk about is the current field of psychiatry as it stands. What I'm seeing, I'll just tell you from my practice as a family medicine physician,

a lot of patients are being put on medication. that I don't feel like have adequately been assessed and maybe not even to blame individual providers, maybe it's the system that's broken that's putting pressure on providers to help as many people as possible. But I can begin to explain the numbers of adderall prescriptions that are being sent out,

the number of antidepressant medications that are being put out before a discussion has had with the patient of whether or not they would benefit from therapy, whether or not they're truly fitting the category of depression, or are they just struggling because their friend died two weeks ago? And we're creating pathology out of a normal human experience. Do you see that pattern from your specialized side of things? I see it all the time. In fact, so my specialty is psychotherapy. I'm kind of an anomaly. Yeah, as a psychiatrist. Yeah, I've never actually heard that in my world. Yeah, like I'm

I'm almost a dinosaur. And what that means is I use medication in my practice, but I'm much more likely if someone's not in danger, right? If someone comes to me depressed or wildly anxious, I say, let's talk a few times and see what happens. And so many times the symptoms will abate that the mood will lift if they're depressed or the anxiety will abate just by unburdening themselves

and talking. And then, often we don't ever use medication because they don't need it. However, primary care doctors are so stressed. They have so little time. And if someone's coming in and suffering terribly, you don't have the time to talk for 50 minutes, you know, or more and hear about their life. And so it's just too easy to write a prescription. Sometimes that, that works. And then of course sometimes it doesn't. And that's where we are stuck. The medical model and the pressures of the system leave us taking inadequate care of a lot of the people who come to see us. Yeah, I would say there's no one who practices in my world, meaning in my referral network, if you know, and does what you do. Like I've never sent a patient to a psychiatrist

and had them do psychoanalysis or therapy or anything, or CBT, DBT, anything. I know. So that is almost unavailable for people. And in the same way that I'm lucky that I'm able to practice medicine without time constraints in a community health center, because I'm lucky enough to have a media career where finance is not important to me,

I can spend as much time with a patient and help them because that's my goal, that's not reality for most people. Right. So I don't even know how to guide individuals who are already struggling and may not be motivated to seek out an appointment and call five different offices,

see which insurance carrier still being accepted by their physicians. I know, I know. I mean, the ideal would be if you in your primary care clinic could do a warm handoff with a psychologist or a social worker

or even a psychiatrist who could come in and say hello to a patient who you're worried about and really see if there's a way they could strike up a conversation that could lead to some treatment, some needed treatment. That's so difficult to do. There are a few health centers that are structured that way, but most can't be.

Well, we have a collaborative team. We have a behavioral social worker and a behavioral psychologist as well in our practice, who we do have access to that. But just when I look at in general what people talk to me about that are not in my network, it's slim pickings what they have to go through, and the hoops they have to jump through. Absolutely. And I worry, especially with the younger generation, they're becoming accustomed to taking a pill to solve everything. And being in media puts me in a unique crossroads to kind of witness these worlds.

And something that I've postulated on my channel is that those who are in the lower sphere of the socioeconomic ladder get bad care because they don't have access, they can't afford medications. Logically, it makes sense. But then on the other side of things, the people who are wealthy, who are in media, who are successful fames, they kind of also get the bad level of health care because they're over-promised things. They're given quick fixes, which are not quick fixes.

They have viral infections that they get antibiotics for because they demand them and it's a consumer model. Do you see that happening as well? Yes. How do you see it? VIP patients get bad care. And actually, it's been interesting for me because, you know, I'm a lot. as I've gotten older and on in my career, I get some VIP patients.

And the first thing we have to establish is that I don't care about their fame. I don't care about their wealth. I don't care. You know, we've got work to do. And some people don't like that and they go away. And other people are relieved. It's like, okay, so you'll treat you like. Yeah, you're not going to sell me anything.

You're not going to sell me anything. And, you know, because we make bad decisions when we are in awe of a patient. that's a problem yeah yeah i see that happen a lot and i worry about the repercussions of even like just focusing on the adderall crisis everyone in media not everyone i can't say everyone it's incredible how many people in media are taking adderall and i don't believe that there's an unequal distribution of ADHD in those who are successful in media like i just don't think that's it One of the things I've seen as I've encountered media more because of this book is that media goes so fast that there's so much pressure and that it's a kind of beast that has to be fed every day, every hour sometimes, that that's what creates that sense of, I've got to be able to focus. I've got to be able to focus all the time.

And I'm sure that's what makes some people grab for, you know, medications that will help them focus, even though that's not what their bodies need. Yeah. Have you seen any alternative medications, treatments, supplements, you know, they have the mushroom formulas, they have peptides that some researchers talk about. Have you seen any evidence for any of these things,

proving to be beneficial, because I'm just a monster skeptic when it comes here. I am a monster skeptic, too. I haven't seen any anything. There was a great nutritionist on NPR once who said that this whole vitamin and supplement industry, this multi-billion dollar industry, basically ends up creating for people really expensive urine. Yeah, that's true. You know?

For the water-soluble vitamins at the very least. Exactly. Because, like, are you familiar with Andrew Huberman? I know of him. Yeah. Stanford, very popular, exploding right now in the YouTube game, podcast game. And some of the concepts he teaches are so valuable. Like, amazing teacher.

I learn from it. My friends learn from it. And these are people who are not interested in medicine at all. And they're learning really good concepts. But then at the end of the day, when we're recommending these supplements on these podcasts and explaining peptide regimens in order to get good sleep and that if you don't take cold showers or you don't do this. I feel like all it is is fueling a commercial entity

and then also an anxiety entity. Yeah. Because it's like almost if you don't do this, shame on you. Right. Right. And it's this search. I mean, people have been selling snake oil since time immemorial, right? Yeah.

You know, because we have this yearning for a fix, right? And there's a lot of life's conditions that we don't have fixes for. That's true. And that that's what, you know, so social media. is just the next place where, you know, it's playing out. It's playing out. And the sales are being, you know, ringed up. It's very true. My TED Talk is not nearly as popular as yours, but it was basically in a TEDx forum where the theme was licensed to know. And the name of my talk was, don't be afraid to say, I don't know as a medical expert. Because too many people are sure

in areas where we don't yet have answers. They promise you miracle things. they sell you things, talked a little bit about the psychology of influence, how they use celebrities and familiar faces. Much like in your study, you use the psychology of influence for good by saying, hey, your family members were involved in this, so you should be too. Yeah, yeah, yeah. And that's, frankly, what I do on my channel. I try and learn from those who are master marketers that are selling BS, see what they do well, and then try and use that to actually use evidence-based medicine and teach evidence-based medicine. And I think that's part of sort of the work that you do at Harvard.

Well, that's the hope. I mean, and we really, so we really struggled in this book to make sure we are, that, that the statements we make have good solid backing, right, with evidence. And so we've had, we even had to keep the publisher from putting on a certain subtitle that was going to claim too much, right? So we're really trying hard to not stretch beyond. what we can legitimately claim. Although, it's tempting.

It is tempting because people want you to. They want you to, and you're excited about it. This is your passion. This is your life's work, so I understand that. Something else you do in your life's work that is not psychoanalysis or psychiatry is there's some kind of priesthood that I've read about.

Tell me about that because I'm so interested in learning about that. So I'm a Zen practitioner and I have been for almost 20 years. Okay. And meditation has been a wonderful addition to my life. And I started studying with a teacher and eventually decided I wanted to ordain as a Zen priest. And then at the same time I've, well, over time I've become a Zen teacher.

So now I'm officially a Zen master. And all that means is I teach Zen and I meditate. And as a priest. That's a vow of service, so, you know, my vow is to help people where I can, and it runs the gamut from working with Zen students to working with my therapy patients to conducting weddings and funerals, and I just do all that stuff. Wow. What is Zen?

Zen is a form of Buddhism. It's if Indian Buddhism, the original kind, and Taoism in China had a love child. It was Zen, okay, right? So it's essentially a kind of taking of Buddhist philosophy, sort of the philosophy of impermanence and the interconnectedness of everything and no fixed permanent self, all of that,

and then combining it with Taoism, which is very much about an existential perspective, about being alive in the world and finding a path of equanimity and a path of purpose and intention in the world. What does that mean for the average person? How would that help them? Well, I'll say I worry less about stupid stuff than I used to. Okay.

Like that might be it, you know? Like I can see quicker when I'm worried that somebody else got invited to do. something and I didn't or something, you know, or, you know, somebody else is having a different kind of life and maybe I should have taken that path or, you know, the comparing, the sense of being less than, that what Zen helps me do is to see that as just the normal arising of the junk in my mind and that everybody's mind does it and that it's okay. And I can kind of watch it arise and pass away and move on. And in order to achieve that or practice that, you do meditation.

Yeah. And what kind of meditation do you practice? Do you recommend? Because I know of many different types and styles. And do you have anything like that? Or is it just do it and it doesn't matter which style? Well, okay. Zen meditation emphasizes simplicity.

So I sit and focus on my. breath just watch my breath going in and out and sometimes I don't just watch the breath but I open up my awareness and pay attention to everything the sounds in the room the feel of the air on my skin just the whole whatever reaches my awareness essentially it's about being present to what's here right now and that includes thoughts so in Zen we teach you know thoughts are not the enemy you don't banish thoughts you'll never be able to banish thoughts And so it's a very simple form of meditation. There are lots of other forms and lots of schools of Buddhism and also meditation practices that are not Buddhist.

For me, Buddhist philosophy has been one of the most helpful ways of making sense of the world. And so for me, the spiritual part of Buddhism has been every bit as important as the particular technique of meditation. How come you think in our current modern medicine, we talk about mindfulness, but we don't really teach it to med students, to residents, to our patients? Why do you think that is? It's hard to do. So if you sit down and you simply focus on your breathing, your mind is going to start racing. We call it monkey mind. And okay, if you're a medical student, And you're used to getting A's? Oh, I can do this. Well, actually, what you're going to find is that meditation is something you don't feel good at. Your mind starts to race.

You never master it. It's a lifelong practice. And so it takes a kind of reorientation to say, but the whole practice is simply coming back to the present moment when your mind wanders, when your mind's been wandering for 20 minutes. Just when you remember, come back. that's a hard sell to us achievement-oriented people who want to do well on tests, right, and want to master skills. But even, like, not necessarily teaching it to med students, but teaching the premise of Zen, Buddhism, Taoism, to students to bring to their patients, because we tell our patients to make

lifestyle modifications that are not easy. If I'm telling a patient who's sedentary to say, you should do 150 minutes, and it's of modern intensity exercise per week. That's what we recommend. That's not easy either, especially given the fact that they're coming off the couch. This is going to be tricky too.

And yet, I don't think one class has ever taught me that this is something I should be recommending to my patients. Yeah, yeah. Were you taught it in Harvard? No. Are you kidding?

I mostly had to keep my Zen life quiet. Really? Oh, yeah, in the closet. Why? Well, because I'm a scientist. You know, in Harvard Medical School is one of those fairly conservative institutions. Now it's become fashionable, right? So now I, you know, but I needed to really come out and be very upfront about my Zen life for my own good, right?

I never thought I would hear that. Really? You had to hide the fact that you were meditating? I'm not sure I had to hide it. Nobody told me I had to. I felt it. I felt like people would think I wasn't serious. I was a little too woo-woo, you know, you know.

sure uh and so it's taken me a while to feel comfortable enough so that now you know people you know casually on a monday say how was your weekend and i say well i spent the weekend at a retreat oh what was that you know i mean that i would never have said that do you think evidence based medicine needs to catch up with that yes because it is in the realm of prevention right That if we, you know, it's just like the exercise that you recommend for your patients, that prevention is so much more powerful and valuable than the cures that we do after the fact. So, yeah, I mean, I think that we really do want to try to do that. We want to try to do it.

They teach this to preschoolers, to elementary school kids, and they love it. If you learn that this is a resource that you can just sit down. and breathe quietly with your eyes closed kids when kids learn what it is and they can feel themselves calm down they love it and they will ask their teachers if they can do it right you know so this is something we can start really early we don't have to wait until adulthood and the problem start for us to start activating it is final question I give you a Harry Potter esk rod magic wand what have you and you could change one thing about our current health care system, what are you changing?

I would massively support infants and children and the people who take care of them. That's what I would do, because it's the best long-term investment. Like if we did that, you know, supporting their physical health, their education, their emotional development, and that means supporting parents and, you know, and all that. If you do that, the payoff in terms of lower rates of crime

and addiction and difficult social services and social services and social supports for families and young children that's what I would do and there's good there's data about this so there's an economist James Heckman who published a paper in science economists don't usually publish in science he did this analysis of a whole bunch of studies and his question was for every dollar we invest in supporting people of a certain age group, where do we get the biggest payoff when people reach their 20s, right, in terms of self-sufficiency and all that? And what he found was that investing $1 in zero to four years old was way more impactful than investing money in anybody older. That doesn't mean we shouldn't invest in it. But it means that, boy, if we really took care

of young kids, little kids, and the people who care for them, there's so much economic gain, let alone, societal gain. Well, you know why insurance companies don't like paying for preventive care, even though the same principle applies? Yeah. Why? I don't know. Oh, because throughout life in our hybrid model in the United States,

a patient is unlikely to have the same insurance carrier after five years, because they switch jobs, the carriers change. So they never see the benefit of investing into prevention. Whereas if we created some sort of, you stay with one insurance policy, et cetera, et cetera, watch how much family medicine doctors are starting to get value in that society. So that's, unfortunately, I think, one of the big reasons as to why they don't invest. Because there is so much value in it. It's like if men got pregnant, a lot of things would change in health care as well.

Awesome. Well, doctor, thank you so much for your time. you enjoyed the conversation. I really did. This was a lot of fun. Awesome.