0:00

I'm Joe Graydon. And I'm Terry

0:02

Graydon Welcome to this podcast of

0:04

the People's Pharmacy. You can

0:06

find previous podcast and more

0:09

information on a range of

0:11

health topics at People's pharmacy.com.

0:15

Loneliness is linked to an increased

0:17

risk of heart disease, stroke, diabetes,

0:19

and dementia. What can we do

0:21

about it? This is the people's

0:24

pharmacy with Terry and Joe. Great.

0:34

Social. Isolation has become an

0:36

increasingly serious problem. In the

0:38

Surgeon General's recent report, the

0:40

authors write that loneliness is

0:43

as dangerous as smoking. It

0:45

used to be the people connected

0:48

a work around the water cooler

0:50

or the break room. Now with

0:52

so many people working remotely, work

0:54

relationships have suffered. Doctor Robert

0:57

Wilding are as the director of

0:59

the longest running Study Unhappiness. He'll

1:01

share his insights on why connecting

1:03

is crucial. Coming up on

1:05

the people's pharmacy white, overcoming

1:07

loneliness is important for your

1:09

health. In

1:15

the People's Pharmacy Health headlines.

1:18

Many. Americans are starting the new year

1:20

in bed with a nasty respiratory. Infection.

1:24

The Cdc Flu View report

1:26

shows influenza cases and hospitalizations

1:28

up from the previous week,

1:30

so we're well into flu

1:32

season now. Most of the

1:34

test results show Influenza A

1:36

dominating with the H One

1:38

N One strain. Most apparent

1:40

influence is not the only

1:42

germ making people sick, though

1:44

Hospitalizations for Kovac nineteen went

1:46

up by ten percent in

1:48

mid December and still appear.

1:50

To be rising. people who

1:52

test positive whether or not they

1:54

have symptoms should stay away from

1:56

others for at least five days

1:58

health officials advice The

2:01

most common symptoms of the

2:03

leading variant JN1 are

2:05

sore throat, fever, runny nose and

2:08

congestion, headache, cough, trouble

2:10

breathing, and brain fog. People

2:13

uncertain whether they have influenza or

2:15

COVID-19 might consider using the

2:17

Lucera home test. Respiratory

2:20

syncytial virus is also surging.

2:23

In most people, this infection causes

2:25

cough, sneezes, fever, and wheezing. But

2:28

for babies and elderly people,

2:30

RSV can be deadly. Doctors

2:33

also report that they're seeing more strep

2:35

infections. This bacterial infection is

2:38

best known for causing sore throats

2:40

rather than coughs or congestion. However,

2:42

if left untreated, it could

2:44

lead to complications. The

2:47

start of a new year is

2:49

an excuse for drug companies to

2:51

raise prices. An early report has

2:53

tallied up more than 500 prescription

2:56

medicines that are expected to

2:58

cost more in coming weeks.

3:01

Some companies have announced lower

3:03

prices, especially on insulin. That's

3:05

because the American Rescue Plan Act

3:07

went into effect on January 1.

3:11

It requires pharmaceutical manufacturers to

3:13

reimburse Medicaid on certain drugs

3:16

if the prices outpace

3:18

inflation. While companies

3:20

are trying to avoid penalties by keeping price

3:22

increases under 10% for older drugs,

3:25

list prices for new medicines

3:28

have been soaring. In

3:30

2022, newly launched medications cost $220,000 annually on average.

3:38

Efforts to control drug prices

3:41

through the Inflation Reduction Act

3:43

sometimes have unexpected consequences.

3:46

That appears to be the

3:48

case with a very popular

3:50

asthma inhaler called Flovent, known

3:52

generically as Fluticosone. The

3:54

manufacturer, GlaxoSmithKline, just announced that

3:57

it's taking Flovent off the

3:59

market. Instead, it

4:01

will offer an authorized generic

4:03

fluticasone HFA inhaler that will

4:05

cost 35% less

4:07

than the brand name product it sold for

4:10

more than 20 years. Because

4:12

it will continue to be made on the same

4:15

production line, consumers should pay

4:17

less for the identical medicine.

4:20

This may seem like a good outcome

4:22

for patients and insurance companies, but pharmacy

4:24

benefit managers have thrown a monkey wrench

4:27

into the works. Many

4:29

PBMs are refusing to cover the

4:31

new authorized generic. That's

4:33

because it will probably cost more

4:35

than other generic fluticasone inhalers. Some

4:38

pediatricians worry that children could find

4:41

other inhalers harder to use. GSK

4:43

will be keeping the exact same

4:45

inhaler technology for its authorized

4:48

generic. Before

4:50

a surgeon does an operation, there's

4:52

a legal requirement to obtain informed

4:54

consent from the patient. How

4:57

well do consent forms work to let

4:59

patients know the risks of any given

5:01

procedure? Researchers

5:03

analyzed more than 100 procedure

5:05

consent forms from high-volume hospitals.

5:08

They found that most were written with

5:10

complex language that might be hard for

5:13

some patients to understand. There

5:15

was considerable variation in the

5:17

risks that were disclosed as well as

5:19

the likelihood of success. People

5:22

serving vulnerable populations were less

5:24

likely to include the risk

5:26

of foregoing the intervention and

5:29

also less likely to give patients the

5:31

opportunity to bow out of the surgery.

5:34

Could doctors benefit from learning how to teach?

5:37

A program at Boston University, the

5:39

Educational Fellows Program, has tested

5:42

this idea. Medical

5:44

students act as teaching assistants in

5:46

the physician associate curriculum. This

5:48

near-peer practice offers them a

5:50

framework for best practices in

5:53

both teaching and learning. The

5:55

directors of the program believe these individuals then

5:57

do a better job explaining diagnosis.

6:00

and proposed treatments to patients.

6:04

And that's health news from the

6:06

People's Pharmacy this week. Welcome

6:14

to the People's Pharmacy. I'm Joe Graydon.

6:17

And I'm Terry Graydon. When

6:19

health professionals think about the factors

6:22

that contribute to chronic diseases like

6:24

heart disease, stroke, diabetes

6:26

or dementia, they usually

6:28

focus on things they can measure

6:30

like cholesterol, blood pressure, body

6:33

mass index or blood glucose. They

6:36

might not take loneliness into

6:38

consideration. But social

6:40

isolation may be one of the

6:43

most important risk factors for overall

6:45

health as well as

6:47

problems like anxiety or depression. Too

6:50

often, it's overlooked. In

6:52

2023, the U.S. Surgeon

6:54

General issued a report titled,

6:57

Our Epidemic of Loneliness and

6:59

Isolation. It runs more than

7:01

70 pages and points

7:03

out that lacking social connection

7:05

is as dangerous as smoking

7:07

up to 15 cigarettes

7:09

a day and worse

7:11

than physical inactivity or obesity.

7:15

The big challenge is what

7:17

can we do to help people

7:19

overcome loneliness? To help

7:21

us understand how to meet the challenge,

7:23

we are talking with Dr. Robert Waldinger.

7:26

He is a professor of

7:28

psychiatry at Harvard Medical School,

7:30

director of the Harvard Study

7:33

of Adult Development at Mass

7:35

General Hospital, and co-founder of

7:37

the Lifespan Research Foundation. Dr.

7:39

Waldinger directs a psychotherapy teaching

7:42

program for Harvard psychiatry residents.

7:44

He's co-author with Dr. Mark

7:46

Schultz of the book, The Good Life,

7:49

lessons from the world's longest

7:52

scientific study on happiness. Welcome

7:56

back to the People's Pharmacy. Dr.

7:59

Robert Waldinger. I'm so glad

8:01

to be back with you. Dr.

8:04

Waldinger, we have talked

8:06

with you in the past about

8:08

the importance of relationships in creating

8:10

a fulfilling life, but many

8:13

people have been feeling

8:16

isolated over the last few years.

8:18

In fact, the Surgeon General

8:21

recently issued a report, quote,

8:23

our epidemic of loneliness and

8:26

isolation. So

8:28

I guess our first question is

8:30

how does loneliness affect our physical

8:32

and our mental health? There's

8:36

a lot of research into this now.

8:39

The best theory that

8:42

we have backed up by data

8:44

is that loneliness

8:47

leaves us without the buffers

8:49

of stress that we

8:51

get from relationships. So

8:54

if you think about it, things happen to

8:56

us that are stressful all day long and

8:59

the body responds as it should

9:01

in fight or flight mode. Our

9:05

blood pressure goes up, our heart rate goes up,

9:07

that's all normal. And then the

9:09

body's meant to calm down again. What

9:13

seems to happen is that relationships

9:16

help us calm down. If something

9:18

upsetting happens to me, I can

9:21

come home and talk to my partner or

9:23

I can call someone on the phone and

9:25

I can literally feel my body calm down.

9:29

What we understand is that people who

9:31

are lonely stay in

9:33

a kind of low

9:35

level fight or flight response all

9:37

the time. So they have higher

9:40

levels of circulating stress hormones, higher

9:42

levels of inflammation, and

9:45

these things gradually break down our

9:47

body systems. It's

9:50

occurring to me that not every relationship

9:52

is going to help you calm down.

9:55

So how do we figure out

9:57

which ones do and which ones don't?

10:00

That's right. Well, it is a

10:03

subjective feeling. I mean, you

10:05

know when someone helps

10:08

you feel calmer, helps

10:11

you stay on and even keel,

10:13

and you know when a relationship

10:15

agitates you. And

10:17

I think that's really the

10:19

discernment that we need to

10:21

make. That what we do

10:23

find, they've actually studied really

10:25

acrimonious relationships, and they

10:27

find that being in a really

10:30

acrimonious relationship is worse for your

10:32

health probably than breaking up for

10:34

that reason. Dr.

10:37

Waldinger, I've told

10:39

this story before. Our listeners are getting

10:41

very tired of it, but it

10:44

seems appropriate. Decades

10:46

ago, we attended

10:49

a conference at Stevens Point,

10:51

Wisconsin, University of Wisconsin, and

10:54

the physician who was giving the

10:56

talk said, you really

10:58

need to hang out with people

11:00

who make your hands warm and

11:03

avoid those people who make

11:06

your hands cold. And

11:08

he said, you know, we're not very

11:10

good as humans at detecting

11:12

our internal milieu. You

11:15

know, how happy

11:17

we are, or how sad we are,

11:19

how nervous we are,

11:21

or how relaxed we are. But

11:24

our hands are a really great

11:26

thermometer, a great measure

11:28

of what's going on internally.

11:30

So buy a mood ring,

11:33

because mood rings from

11:35

the 60s or 70s, they'll

11:38

turn color when your

11:40

hands are warm or when your

11:42

hands are cold. And you'll be

11:44

able to see immediately, this person

11:46

is making my hands cold.

11:50

There's something happening physiologically. And I think

11:52

we all have had the experience of

11:54

feeling anxious maybe before we have to

11:56

give some big talk, and

11:58

our hands get very cold. and clammy. And

12:01

then we have other situations where with friends

12:03

and, oh man, we're having the greatest time

12:06

and we're talking and laughing and having fun

12:08

and our hands are nice and warm. So

12:11

can you give us some sense of

12:13

how we can detect this and pay

12:15

more attention to it? Because a lot

12:17

of times we may be under stress,

12:19

we may be feeling anxious, and

12:22

we're not really recognizing what's

12:24

going on internally. Well,

12:27

I love that story. And actually I'm

12:29

going to use that indicator. Let

12:31

me just say that talking with you and

12:33

Terry makes my hands warm, which is one

12:35

of the reasons why I'm always happy to

12:37

come back. Oh, wonderful. But

12:41

I think you are right and that

12:43

that physician is right, that we're not

12:45

very good at tuning into

12:47

our internal signals. But we can

12:50

learn to get better at that.

12:53

And another way I think about it

12:56

is that there are some

12:59

people who make us more

13:01

agitated and there are some people

13:03

who help us feel calmer. There

13:05

are some people who energize us

13:07

positively. And then there are some people

13:10

who make us feel more negative,

13:12

who drain us of energy. Those

13:14

are signals that we can tune into.

13:17

And when we can to spend more

13:19

time with those people who make

13:22

our hands warm, who energize us, who

13:24

help us feel more open to the

13:27

world. Dr.

13:29

Weldinger, you just described that

13:32

chronic stress that

13:34

isn't alleviated by relationships

13:38

is going to have a negative impact

13:40

on our health. And I'm wondering if

13:42

you might perhaps compare

13:44

it to other health risks.

13:48

Famously, the surgeon general

13:52

mentioned smoking in his

13:54

report on the epidemic of loneliness.

13:57

Yes. There's good work. from

14:00

a researcher named Julianne Holm-Lunstad. She

14:02

is at the University of Utah,

14:05

and she helped the Surgeon

14:07

General with that report. And

14:10

she did an analysis

14:12

of many, many studies and was

14:14

able to estimate with some

14:16

rigor that being

14:19

lonely is as hazardous to our

14:21

health as smoking half a pack

14:23

of cigarettes a day as

14:26

having untreated high blood pressure

14:29

as being obese. So these

14:31

risks that we're all so familiar

14:34

with are no worse

14:36

than being lonely. That doesn't mean

14:39

we should ignore smoking and

14:42

weight and all that. It means that we

14:44

really want to pay attention to

14:46

social isolation and loneliness and try to

14:48

do something about it. Well,

14:51

it strikes me that when you go

14:53

into your doctor for

14:55

your annual checkup, if you

14:57

do that, I'm going to do

14:59

it next week. I hope it goes

15:02

really well. You're

15:04

going to be asked if you are smoking.

15:06

You're going to be asked if you drink.

15:08

Your blood pressure will be measured. Your

15:12

weight will be measured. Your body

15:14

mass index will be calculated. Your

15:16

cholesterol will be measured. All these

15:19

things will be measured. I

15:21

don't recall a

15:23

doctor asking me, are you

15:25

lonely? Do our

15:28

physicians check up on that? And

15:30

if they did, what would

15:32

they do about it? It's

15:35

a very timely question because you're

15:37

right. We haven't asked about that

15:39

routinely at all. Even

15:41

psychiatrists don't ask about it as much as

15:43

they need to. But now,

15:46

because of the Surgeon General's

15:48

attention to social isolation and

15:51

the culture's awareness of it, there

15:55

are protocols being introduced into

15:57

primary care visits where they...

16:01

ask each patient, how's

16:04

your social life? Do you see people

16:07

every week? Do you go out?

16:09

That those kinds of simple questions can

16:12

give physicians an indicator that this

16:14

person may be at risk. Dr.

16:18

Waldinger, how does the United

16:21

States compare to other places,

16:23

other countries, other cultures? Is

16:26

the entire world lonely or are

16:28

we an outlier? We're

16:32

not an outlier, sadly.

16:35

We are among those developed

16:37

countries that have

16:39

more social isolation than more

16:42

traditional societies. The

16:44

reason is pretty clear and

16:46

simple that in more traditional

16:48

societies there are prescribed roles

16:51

for everybody in a family,

16:53

in a community, that people rely

16:55

on each other. Parents

16:58

rely on grandparents to take care

17:01

of children. Now

17:04

in societies like China where

17:06

grandparents were essential to taking

17:09

care of grandchildren, people

17:12

are moving away for economic

17:14

opportunity, away from villages into the

17:16

big cities. And so China

17:18

too is having an upsurge of

17:20

loneliness among older people but

17:22

also among parents, among middle-aged

17:25

people with children. India

17:29

is more and more concerned about

17:31

this. So as countries develop, we

17:34

break apart these social fabrics

17:36

that seem to be essential

17:39

for keeping us connected to

17:41

each other. You're

17:43

listening to Dr. Robert Waldinger, professor

17:45

of psychiatry at Harvard Medical School

17:47

and director of the Harvard

17:49

Study of Adult Development at

17:52

Massachusetts General Hospital. He's

17:54

co-founder of the Lifespan Research Foundation

17:56

and co-author with Dr. Mark Schultz

17:59

of the... book, The Good Life.

18:01

Dr. Woldinger directs a psychotherapy

18:04

teaching program for Harvard psychiatry

18:06

residents, and as a

18:08

Zen master, he teaches meditation. After

18:11

the break, we'll reminisce about a fabulous

18:13

reunion. When people live alone, they

18:15

may find it difficult to nurture close

18:18

relationships. Is television an

18:20

anti-social technology? A lot

18:22

of people traditionally found friends and social

18:24

connection at work. Remote working made that

18:26

more difficult. How can we learn social

18:29

and emotional skills that will help us

18:31

form and maintain friendship? You're

18:40

listening to The People's Pharmacy with Joe

18:42

and Terry Graydon. This

18:44

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20:20

Social isolation and loneliness or

20:22

linked to cardiovascular disease, type

20:25

two, diabetes, dementia, and earlier

20:27

death addiction, anxiety and depression

20:29

are more common and silencing

20:32

when people feel cut off

20:34

from friends and family now

20:36

that so many people are

20:39

working remotely, one place people

20:41

used to make close connections

20:43

is no longer available. We're

20:46

talking with Doctor Robert while dinner.

20:49

Professor Psychiatry at Harvard Medical

20:51

School is the current director

20:53

of the Harvard Study of

20:55

Adult Development at Massachusetts. General

20:58

Hospital and cofounder of

21:00

the Lifespan Research. Foundation.

21:02

His book is the Good

21:04

Life Lessons from the world's

21:06

longest scientific study on happiness.

21:11

Doctor. Or the you're talking about

21:13

other cultures. When I'm when

21:15

Terry was doing her field

21:17

work and medical anthropology in

21:19

one haka Mexico see got

21:22

an opportunity to hang out

21:24

with families with mom's with

21:26

their kids. Will families tend

21:28

to stay in touch. I'm

21:30

better than some families do

21:33

here for sure. So

21:35

the. The. Grandparents. The

21:37

great grandparents if they're still

21:39

alive, all the cousins and

21:41

the aunts and uncles, and

21:44

all the grand kids. I

21:46

mean, everybody gets together at

21:48

least several times a year,

21:50

and sometimes several times a

21:52

month. Everybody is aware of

21:54

what's going on with other

21:56

people. and we recently had

21:58

an opportunity to go back to Oaxaca.

22:01

And my ayudhanti, my assistant,

22:03

when I was teaching in the medical school

22:05

there, put together a dinner

22:09

for many of my students who

22:12

are now highly regarded physicians

22:14

in the community. Some of

22:16

them are now retired. Yes. Some of them

22:18

have retired. I mean, it was 50 years ago. And

22:22

it was just wonderful to reconnect

22:24

with these people and learn about

22:26

their lives, what was important

22:28

to them, all of their family and

22:30

their connections. These are people

22:33

who really hang out together. They

22:35

visit with one another on a

22:37

regular basis. They have extended

22:40

families where their cousins and their aunts

22:42

and their uncles and their nephews.

22:45

People really do connect.

22:48

And it was such a joy to be

22:50

back in that culture. And I was thinking,

22:52

I miss that. Because that

22:54

was so special. It

22:56

was so, it

22:58

was heartwarming. And

23:00

I think sometimes there are so many people in

23:03

this country who are either living alone or

23:05

even if they have relatives, they don't

23:07

connect with them very often. Why

23:10

is it important to have these

23:12

relationships? These

23:15

relationships make us feel like we

23:17

belong. They make us feel connected

23:19

to the world, to other people.

23:23

And one theory is that we

23:25

evolved to be tribal. That

23:28

there was a reason for this. That

23:31

social connection makes us feel

23:33

safer. Because if

23:35

you think about it, being all alone, especially

23:37

if you were out in the wilderness having

23:39

to survive, as our ancestors might have been

23:42

thousands of years ago, that it's

23:45

far safer to be connected to other

23:47

people. So we know, for example, that

23:50

when people are alone, they don't sleep

23:52

as soundly. And there's

23:54

probably good evolutionary reason for that.

23:57

So The fact that you enjoyed. Being

24:00

reconnected with your was hacker

24:02

friends are makes perfect sense.

24:05

Let. Me if I can. Remind.

24:08

Us About Robert Putnam Work:

24:10

Robert Putnam is the Political

24:13

scientist. At Harvard

24:15

who. Works. On

24:17

what he calls social capital. Essentially.

24:20

How much do we invest

24:22

in our communities in each

24:24

other? And what he found

24:26

was that starting in the

24:28

Nineteen sixties in the United

24:30

States, all those the metrics

24:32

of investing in other people

24:34

started to decline dramatically. It

24:37

seem to have to do with

24:39

the introduction of television into every

24:41

living room. But what it meant

24:43

was that we stopped joining clubs.

24:45

We stopped go into houses of

24:47

worship. We stopped having family dinners

24:50

as offered are inviting people over

24:52

to our houses. All. Of

24:54

this continued through the twentieth

24:56

century and took a dramatic

24:59

drop and guinean in the

25:01

beginning of the twenty first

25:04

century. We think because of

25:06

the digital revolution. They. Didn't

25:08

start with the internet, but

25:10

the digital revolution seems to

25:12

have taken us farther and

25:14

farther away from each other

25:17

in the United States. Sold.

25:19

My suspicion that television is

25:21

essentially an antisocial technology. I

25:24

think he just supported that

25:26

assess as zombies. We because

25:28

we stare at screens we said we

25:30

sit. In fact in my family my

25:32

my parents had to put their foot

25:35

down that we couldn't have the television

25:37

in the. Dining Room when we

25:39

were eating dinner cause my brother and I

25:41

wanted to be able to watch Tv all

25:43

the time. It

25:45

is very seductive and of

25:48

course the internet is even

25:50

more so. and a you

25:52

know I I. I.

25:54

Heard you say that houses of

25:56

worship aren't are no longer. Ah

25:58

the draw that day. Once we're.

26:02

Are there any

26:04

ways that communities,

26:07

congregations, neighborhoods, Can

26:10

counteract this general

26:12

trend towards increasing

26:14

isolation. Well,

26:16

a lot has to do with

26:18

both individual choices we make, so

26:21

increasing our awareness about this may

26:23

mean that we will individually do

26:25

more to be with other people.

26:28

And so I think that's one of

26:31

the reasons why the Surgeon General took

26:33

this on. Has a. Pillar.

26:35

Of his platform. For. His

26:37

tenure in the government. But in

26:39

addition, we can construct spaces differently.

26:42

If you think about the people

26:45

who began to write about how

26:47

neighborhoods are constructed, we know that

26:49

there are recipes for social isolation.

26:51

It with great big high rises

26:53

where people are anonymous and don't

26:56

know their neighbors as opposed to

26:58

walking neighborhoods, mixed use neighborhoods where

27:00

people are more likely to rub

27:02

elbows to bump into each other

27:04

on to make connections. Similarly,

27:08

We can start. Swarming.

27:11

I'm initiatives to get

27:13

people to connect with

27:15

each other. Community initiatives.

27:18

That can can center certainly around

27:20

religion around houses of worship, but

27:23

they can center around community groups

27:25

as well that don't have a

27:27

religious or spiritual function. Doctor

27:30

more than your. I want to talk

27:33

a little bit about work. Because

27:35

it's for decades you know

27:37

people would gather around the

27:39

water cooler. The whole get

27:41

about yoga the of a

27:43

less bad baseball game or

27:45

football game. And this was actually

27:48

one of the way she made sense. He

27:50

made sense of this bill. You worthless? And

27:52

V days, partly because of

27:54

the pandemic, but partly because

27:56

it's been saving so radically

27:58

in the last that cater

28:00

to people are working more

28:02

from home so there there

28:04

instead of gathering with people

28:06

and. Chatting. And

28:08

having coffee together? Or lunch

28:11

together in the cafeteria? They

28:13

basically you're going to the

28:15

fridge at home and they're

28:17

If they're meeting, they're doing

28:19

it on sumer some other

28:21

i'm you know, computerized system

28:23

and that that work. Cooperation

28:25

has really changed rather

28:27

radically, and I'm wondering

28:30

how that impacts people.

28:33

We think it has a big

28:35

impact. So you mention the water

28:37

cooler. the iconic water cooler or

28:40

could be the coffee machine works

28:42

you know in these newer companies

28:44

to snack wall where people bump

28:47

into each other and the strike

28:49

up conversations. Research shows us that

28:51

one of the most reliable ways

28:54

to make new relationships to make

28:56

friendships is. To. Encounter the

28:58

same people over and over again. Particularly.

29:01

Around a shared endeavor. So the

29:03

workplace is classic rights where you're

29:06

all working in the same place

29:08

often doing similar work. You have

29:10

reason to talk. you have ice

29:13

breakers, You have things you can

29:15

bring up to start a conversation

29:17

with a new person. And what

29:19

we know is that when you

29:22

do that frequently, some of those

29:24

conversations will deepen and some of

29:26

those conversations will develop into friendships.

29:29

The other thing I would have

29:31

used to had the Gallup organization

29:34

did a survey of Sistine Million

29:36

workers and the as the question.

29:38

Do. You have a best friend at

29:40

work, meaning is if anybody you

29:43

can talk to about personal matters

29:45

only thirty percent. Had a

29:47

best friend at work, but those thirty

29:50

percent were better at their jobs. They

29:52

were happy year. They were less likely

29:54

to leave their jobs for a different

29:56

opportunity. On, they were more

29:59

engaged in the. workplace and the bottom

30:01

line improved in these companies when

30:03

people had friends at work. So

30:06

what can look like a distraction

30:08

at work turns out to be

30:11

actually an economic benefit not just

30:13

a social benefit. Well

30:15

that's very interesting because companies are

30:17

always interested in improving the bottom

30:20

line but what you're saying is

30:22

they may need to rethink how

30:25

they focus exclusively

30:27

on productivity and

30:29

not have people chained

30:32

to their computers all the time as it

30:34

were. Exactly, exactly.

30:37

You know the other thing that

30:39

started to happen is that companies

30:41

are bringing people back from completely

30:43

remote work. I'll give you an

30:45

example. My son works for a

30:47

tech company in Chicago. It was

30:49

entirely remote and now they've

30:51

said we want everyone back in the office

30:54

two days a week and my son

30:57

grumbled about it but now he's sort of

30:59

saying you know it's actually okay because

31:03

these connections that we're talking about

31:06

happen when you're

31:08

together in person and so even

31:10

though it may be inconvenient it

31:13

may seem annoying many people are

31:15

finding that at least some face-to-face

31:17

contact in the workplace is

31:20

enhancing their well-being. Dr.

31:23

Weltinger let me ask you about

31:25

some groups of people that may

31:27

find it a little more

31:29

difficult to gather. For

31:31

example people with disabilities, people

31:34

who are older perhaps and

31:37

retired or teenagers

31:39

who obviously they have to go to

31:41

school but that

31:44

doesn't always seem to provide them with

31:46

the social support that they might need.

31:49

Well you've hit on the two

31:51

loneliest groups in our society so

31:53

the loneliest group are

31:55

people aged 16 to 24 which

31:58

I was shocked by because I And I thought,

32:00

oh, these are kids living their best

32:03

lives surrounded by people their own age,

32:06

whether in high school or college, they're

32:08

the loneliest. And then

32:10

the second loneliest are older adults.

32:14

And I think what we're understanding is

32:16

that there are ways to ease

32:19

loneliness and to increase social connection.

32:21

As you can imagine, they're different

32:24

for younger people and for older

32:26

people. And paying

32:28

attention to this and

32:31

structuring interactions can

32:34

go a long way. So let's say with

32:36

younger people, when we

32:38

teach younger people social and

32:40

emotional skills, it

32:42

turns out to be hugely impactful

32:44

in decreasing loneliness and increasing their

32:47

happiness. It also makes them

32:49

do better work in their academic subjects,

32:51

believe it or not, because they're happier

32:54

in school. And if you're happier, you

32:56

can listen, you can concentrate. So

32:58

that's one way. And

33:00

there are many excellent programs now

33:02

that teach social and emotional skills

33:05

to young people. On

33:08

the flip side of the

33:10

lifespan in older adult communities,

33:13

there are all kinds of ways

33:15

to structure it so that older

33:17

adults have more interaction, both with

33:19

each other, but also with

33:22

other generations. So you

33:24

may know they have some projects where

33:27

they put nursery schools

33:29

next to retirement communities.

33:31

And they have older

33:34

adults read to preschoolers.

33:37

And everybody is thrilled. The preschoolers

33:39

love it. The older adults love it.

33:42

So by mixing the generations

33:44

in ways where they connect,

33:47

we find that we can ease loneliness

33:49

and also give young children the attention

33:51

that they crave. Dr.

33:54

Weltinger, the idea of teaching

33:56

children, maybe starting

33:58

with those kids in New York, nursery school, the

34:01

social and emotional skills that

34:03

they will need is brilliant.

34:06

But it also occurs to me, it might

34:08

not be too late to learn some

34:10

social and emotional skills, even when you're

34:12

60 or 70. What

34:17

do you think? Yes. Well, you

34:19

know, what they do often is

34:21

they will give these curricula to

34:23

teachers to teach to their

34:26

children, right? And the teachers will often come

34:28

back and say, we need this for us.

34:31

You know, we need this kind of

34:33

learning for us about emotions, about

34:35

dealing with conflict in relationships, about

34:38

the best ways to make connection.

34:41

And so actually we've done

34:43

this, we decided in our

34:45

longitudinal research group that

34:47

we were going to take much of what

34:50

we've learned about adult life

34:52

and put it into a program that

34:54

adults can use to kind of check

34:56

in on their lives and improve their

34:59

relationships and increase well-being. And

35:01

so we actually created a program

35:03

called Roadmap for Life Transitions that

35:06

we are introducing in retirement

35:09

communities, in colleges and

35:11

universities to try to do just

35:13

this. Dr.

35:16

Rolding here, I'm thinking about

35:18

weather. And

35:21

you might say, what does weather have to do with any

35:23

of this? When

35:25

it's cold and cloudy

35:27

and dreary and rainy

35:30

and snowy, people

35:32

tend to hibernate. They tend

35:34

to, you know, stay inside.

35:38

And I'm wondering how

35:40

we can better improve

35:42

relationships when we say,

35:44

oh, I just, I'm not going to go out

35:46

today. It's too awful out there. How

35:49

do we nurture and

35:51

encourage getting together at

35:54

a time of year when, you know,

35:57

normally we probably would be in a

35:59

cave someplace? Right,

36:01

we want a cocoon. It's

36:03

a real issue and

36:06

it's not just whether although I

36:08

think you're absolutely right, I mean

36:10

I'm sitting in Boston where it's

36:12

getting darker and colder, rainier, but

36:15

in addition there is this kind of reluctance

36:17

to connect with people. There's a little bit

36:20

of resistance that many of us have to

36:22

get over. So if you think about it,

36:24

if someone says to you, let's go to

36:26

this party, you might say,

36:28

I just want to stay home and watch Netflix

36:31

and the temptation to do that is

36:33

very great because we

36:36

are bad at remembering that oh you

36:38

know actually when I do go out

36:40

and connect with people I

36:42

usually feel more energized. I usually

36:44

come home feeling glad that

36:46

I went and so some

36:49

of this is reminding ourselves and

36:51

reminding each other that actually

36:53

we feel better when

36:55

we do more of this active connecting

36:58

rather than when we stay home and

37:01

hibernate. How we can

37:03

structure that, how we can nudge people

37:05

to do more of that, if on

37:08

a bigger scale I'm not

37:10

sure but certainly we can nudge each other.

37:13

It's one of the reasons actually why people

37:15

stay healthier when they live with someone because

37:17

the other person will nudge you to get

37:19

out and do things very often that

37:22

you wouldn't do yourself. You're

37:24

listening to Dr. Robert Waldinger. He's

37:26

a professor of psychiatry at Harvard

37:29

Medical School, director of

37:31

the Harvard Study of Adult

37:33

Development at Massachusetts General Hospital

37:35

and co-founder of

37:37

the Lifespan Research Foundation.

37:40

Dr. Waldinger directs a psychotherapy

37:43

teaching program for Harvard

37:45

psychiatry residents. He's

37:47

the co-author with Dr. Mark Schultz

37:49

of the book The Good Life,

37:51

Lessons from the World's Longest

37:54

Scientific Study on Happiness. After

37:56

the break we'll learn a

37:58

little bit more about... meditation. Some

38:00

people are introverts and others are

38:03

extroverts. Can we help the introverts

38:05

connect with others for vital relationships?

38:08

And Terry, you know, sometimes you can't always

38:10

tell who's an introvert and who's

38:12

an extrovert. And you

38:14

know, it may be hard for adults to make

38:16

new friends. Often they have

38:19

less opportunity to meet new people than

38:21

kids do. How can they

38:23

overcome this barrier? Dr. Waldinger

38:25

often invites people in his audience to send

38:27

a text to a friend they have not

38:29

seen in a while. What's the

38:32

response? We'll also get

38:34

Dr. Waldinger's advice for facing

38:36

the coming year with a

38:38

healthy approach. You're

38:47

listening to The People's Pharmacy with Joe

38:49

and Terry Graden. This

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cocoa via dot com. Are

42:09

you an introvert or are

42:11

you maybe an extrovert? Some

42:13

people have a very hard time reaching

42:15

out to make friends. Others

42:18

find it easier but they

42:20

may need more contact to feel connected.

42:22

When's the last time you reached out

42:24

to someone you like but haven't seen

42:27

in ages? You know Terry I

42:29

just received a postcard from a

42:31

childhood friend and it really

42:33

lifted my spirits. I

42:35

rarely see her because she and

42:37

her husband live in Massachusetts but

42:40

just getting that card helped us

42:42

reconnect. We traded text

42:44

messages and just that little

42:46

extra contact was rewarding. We're

42:49

talking with Dr. Robert Waldinger.

42:51

He's a professor of psychiatry at

42:54

Harvard Medical School, director of

42:56

the Harvard Study of Adult

42:58

Development at Massachusetts General Hospital

43:01

and co-founder of the Lifespan

43:03

Research Foundation. Dr. Waldinger

43:05

directs a psychotherapy teaching program

43:07

for Harvard Psychiatry residents.

43:10

He is the co-author with Dr.

43:12

Mark Schultz of the book The

43:14

Good Life, Lessons from

43:17

the World's Longest Scientific Study

43:19

on Happiness. Dr.

43:22

Waldinger, we understand that you are

43:24

a Zen master, that

43:27

you meditate and when

43:30

I think about meditation I think

43:32

about solo activity.

43:34

Somebody sitting on a cushion

43:36

in a dark quiet

43:39

room and being

43:42

isolated. Did

43:44

I get that wrong? Well

43:46

you didn't get it wrong.

43:48

There's a paradox there. So

43:50

one of my colleagues once

43:53

called Zen Retreats Parties for

43:55

Introverts where you just

43:57

go and you hang out by yourself on

43:59

a cushion. with a whole lot of other

44:01

people. And certainly I go

44:03

into my meditation room every

44:06

day and I meditate on my own. But

44:09

one of the things that we

44:11

find with meditation practice is that

44:14

it opens us to

44:16

the world in a kind of paradoxical

44:18

way. That when I sit and

44:21

I really pay attention to myself, to

44:23

the workings of my mind and my

44:25

body, first of all, I

44:27

develop a lot more appreciation for the world.

44:31

It makes me pay more attention

44:33

when I'm walking along the sidewalk,

44:36

when I'm looking at a tree,

44:38

when I'm encountering a dog

44:42

walking the other way on the sidewalk and

44:45

the dog's owner. Paradoxically,

44:47

it opens us more to

44:49

experience because meditation

44:51

is an exercise in

44:53

facing toward what's

44:55

here right now in our

44:57

experience. So yes, you're right,

45:00

there's some isolation involved, there's some

45:02

solo activity, but most

45:04

of us become more open to

45:07

the world when we develop a

45:09

meditation practice. Now, you

45:11

mentioned introverts. And

45:14

you know, there are people who

45:16

are what I'll

45:18

call natural extroverts. They

45:21

love to reach out. They're

45:23

outgoing, they're hugging people,

45:27

they're shaking hands, they've

45:31

never met someone who's a stranger. And

45:33

then there are people who are whatever

45:35

we mean when we say introverts. They're

45:38

shy, they have a hard

45:41

time making friends, their

45:44

natural inclination is to withdraw. And

45:47

everything that you've told us over the last

45:49

year or three is that

45:51

relationships and connection really

45:54

matter. That's what makes

45:56

people happy. So how

45:58

do we help people I

50:00

ask a few people if they're willing to share what

50:02

came back to them and they will tell me. People

50:06

will say, great to hear from you,

50:08

glad you reached out. I've heard from

50:11

people that one person

50:13

said, oh, I just had surgery and I'm

50:15

feeling kind of lonely. I'm so glad

50:17

to hear from you. Other people

50:20

immediately make dinner dates. So all kinds

50:22

of things happen from these tiny actions

50:24

that we can take every day. And

50:28

so instead of waiting to go to a

50:30

talk by Dr. Robert Waldinger, we

50:32

should just take out our phones

50:34

and text the people we haven't heard

50:37

from or that we would like to

50:39

see right now. Exactly, exactly.

50:41

And that's, you know, when we studied all

50:43

these lives over time, we found that the

50:45

people who were the best at this were

50:48

the people who did just that,

50:50

who took these small frequent actions

50:52

to stay connected. Well,

50:55

I think that is wonderful.

50:59

Dr. Waldinger, one of the things

51:01

that has happened with our digital

51:06

exposure is there's news all

51:08

the time. And it seems

51:10

like the news is

51:12

always depressing. There

51:15

are disasters.

51:18

There is polarization. There

51:21

is lots and lots of problems.

51:25

How can we cope with these

51:27

horrible headlines and still maintain a healthy

51:29

attitude? Oh,

51:33

that's such an important question. And I

51:35

work on it myself every day. What

51:38

I'm finding is I need to curate

51:40

it. I need to be

51:43

careful about what I put into

51:45

my mind. The Zen teacher,

51:47

Thich Nhat Hanh, used to say that

51:51

we put into

51:53

our minds what will

51:55

create the content of our minds, and we

51:57

need to remember that. So

52:00

I limit my exposure to the

52:02

news. I don't watch news because

52:04

the images are often traumatizing. I

52:07

will read the paper. I will listen

52:09

often to NPR for a limited amount of

52:11

time and then I will turn away from

52:13

it. The

52:16

other thing I do, which

52:18

I used to think was hokey and now I

52:20

realize is not hokey at all,

52:23

is I call to mind the things

52:25

that I'm grateful for and the things

52:27

that are good in the world. So,

52:31

you know, news focuses us

52:33

on what's negative because that sells

52:36

newspapers. It gets our eyeballs

52:39

to click on different links,

52:41

right? And

52:44

if we call to mind what's

52:46

right in the world, it

52:49

counters that bias toward negativity

52:51

that the news pulls us

52:53

toward. And so

52:55

I remember, my gosh, I've got a roof over

52:58

my head. I've got a

53:00

good partner. I've got friends. I've

53:02

got students who still care a

53:04

lot about making the world

53:06

a better place as young psychiatrists,

53:09

right? And so many

53:11

good people out there in the world doing

53:13

good things all day, every day. And

53:16

when I actively

53:18

call those things to mind,

53:20

it just puts into perspective

53:23

the horrors that I read about

53:25

in the news every day and that helps

53:27

me to go on. Well

53:30

our listeners are probably saying,

53:32

well, that's easy for Dr.

53:35

Robert Walz. I mean,

53:37

he is after all a

53:39

psychiatrist. He is

53:41

after all a Zen master. He

53:44

meditates. So he can tune

53:46

out all those horrible

53:48

headlines. But what about me? And

53:52

I ran into a very

53:54

high powered surgeon not

53:56

too long ago and we were

53:59

talking about meditation and she said,

54:01

you know, I took a meditation

54:03

class mindfulness and I enjoyed

54:06

it. It was very relaxing and

54:08

very meaningful for the two months

54:11

that I participated, but of

54:13

course I got back to my regular life and

54:16

I'm always very busy. I put in,

54:18

you know, 12-14 hour days and I'm

54:20

writing research papers all the

54:22

time and I've got colleagues who are

54:24

depending on me. So, you know,

54:27

I just didn't have time and I'm

54:29

maybe not inclined to

54:32

do meditation. Maybe it's just

54:34

not my thing, but

54:37

I kind of miss it a little bit,

54:39

but I just can't work it into my

54:41

daily schedule and I suspect that there are

54:43

lots of people who say, meditation,

54:46

it sounds nice, but I

54:48

just don't have time. I

54:51

have a different approach. I

54:55

cheat. I don't take

54:57

time to sit on a cushion or

55:00

in a chair and meditate,

55:02

but I do set

55:05

aside some time after we're in bed and we've

55:07

turned out the lights. I set aside some time

55:09

to think about the people that I love and

55:13

I do the same thing in the morning when I

55:15

wake up. I

55:17

mean, that is cheating. It's not really meditating,

55:20

but I find it helpful. Well,

55:24

it's not cheating at all. So,

55:27

meditation is not for everyone by

55:29

any means. Most people don't meditate.

55:32

Many people should not meditate. It's not right

55:34

for them. Meditation

55:36

is just one way of

55:38

coming into the present moment,

55:41

right, and calling

55:43

to mind the experience

55:45

of being alive right now.

55:48

So, you know, what you do

55:50

when you think of the people

55:52

you love is you're

55:54

calling to mind those

55:56

people who nourish you. That's

55:59

a very helpful practice. You

56:01

don't need to be sitting on a cushion to

56:03

do any of that. You could

56:05

be sitting at a stoplight in

56:07

traffic and just pay

56:09

attention to your breathing for two

56:11

or three breaths. And

56:13

that alone brings you back

56:16

out of the automatic pilot of our

56:19

thinking mind and back into the present

56:21

moment. So there are all kinds of

56:23

ways of doing this. And

56:26

actually if you think about it, a surgeon has

56:28

to be very focused on the present

56:30

moment when she or

56:32

he is doing an operation.

56:35

That can actually be sustaining

56:37

because it's part of what

56:39

we call this experience of

56:41

flow, where you're just so

56:44

in an experience that time

56:46

just goes by and that you're

56:48

not lost in busy mind and

56:50

what we call monkey mind. So

56:53

there are all kinds of ways of

56:57

refueling, of nourishing ourselves

56:59

that don't have to include meditation. Dr.

57:02

Weltinger, in the minute

57:05

we have left, I wonder if

57:07

you have some advice for our

57:09

listeners that you have

57:11

culled from your studies over

57:13

the years that you have distilled in

57:15

the good life to help

57:17

us all face the

57:20

coming year with a

57:22

healthy approach. I

57:26

would say turn toward

57:29

the people who

57:31

help you feel more hopeful and help

57:34

you feel more open to the world.

57:36

Turn away from those voices that make

57:38

you feel more afraid and more closed

57:41

off when you can. And

57:43

turn toward those activities that

57:47

nourish you, that help you feel

57:49

more energy, that help you feel

57:51

more positive. Turn toward the people

57:53

and the activities that

57:55

are energizing for you. And

57:58

maybe get a mood drink so you know who

58:00

those people are. Exactly.

58:04

You know, or just talk to Joe and Terry.

58:07

I mean, that's the other possibility. Anytime.

58:11

Dr. Robert Waldinger, thank you so much

58:14

for talking with us on the People's

58:16

Pharmacy today and we do hope we'll

58:18

have another chance to talk with you

58:20

in the future. Well, this

58:23

is always a pleasure and my hands are

58:25

very warm today. Thank you very much. You've

58:28

been listening to Dr. Robert Waldinger.

58:30

He's a professor of psychiatry at

58:32

Harvard Medical School, director

58:34

of the Harvard Study of

58:36

Adult Development at Massachusetts General

58:39

Hospital, and co-founder

58:41

of the Lifespan Research

58:43

Foundation. Dr. Waldinger

58:45

is the co-author with Dr. Mark

58:47

Schultz of The Good Life,

58:50

Lessons from the World's Longest

58:53

Scientific Study on Happiness. Lynn

58:55

Siegel produced today's show. Al

58:58

Wadarsky engineered. Dave Graydon edits

59:00

our interviews. BJ Liederman

59:02

composed our theme music. This show

59:05

is a co-production of North

59:07

Carolina Public Radio WUNC with

59:10

the People's Pharmacy. The

59:12

People's Pharmacy is made possible in part

59:15

by Coco Via Dietary Supplements.

59:17

The new year is the perfect

59:20

time to start healthy habits. Can

59:23

you make Coco Via a part of

59:25

your nutrition routine? More

59:27

information at cocovia.com.

59:31

Today's show is number 1368, 1368. You can find

59:33

it online

59:38

at People's pharmacy.com. That's

59:41

where you can share your comments

59:43

about today's interview. You

59:45

can also reach us through email,

59:48

radio at People's pharmacy.com. Is

59:51

there someone you would like to talk

59:53

with again after a long absence? Who

59:56

might that be? What's holding

59:59

you back from... following Dr. Waldinger's

1:00:01

suggestion to text that person

1:00:03

right now or just send

1:00:05

them an email. If

1:00:07

that's inconvenient, why

1:00:10

not send them a postcard? You

1:00:13

know, I have found lately that

1:00:15

writing actual notes on paper is

1:00:18

surprisingly satisfying, and

1:00:20

I do hear back from friends who

1:00:22

love getting a handwritten message. Our

1:00:26

interviews are available through your favorite

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1:00:30

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1:00:33

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1:00:49

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1:00:51

In Durham, North Carolina, I'm Joe

1:00:53

Graydon. And I'm Terri Graydon. Thanks

1:00:55

for listening. Please join us again

1:00:57

next week.

1:01:09

Thank you for listening to the Peoples

1:01:12

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