Johann Hari

00:06Johann Hari I got it right you said it right you're literally the first person ever say my Saint to your fair that I once waited for six hours with a broken arm in an emergency room because they were calling for Johanna Harry to come forward so anyone who gets my name better than that is didn't just assume that was you when you hear you heard Joe Fox I would help me so they have to give you a normal mind I would have done what went what went down with your arm I just I fell and I tried to do nothing no glamorous story - I fell down a staircase I wasn't even drunk I wasn't focused on anything I just fell down the stairs it's right game hasn't even a bit of domestic value surrounding narrative that we made that an interesting story sadly so give me your if you had like a one paragraph take on depression sure what is your take on depression so this is why I wrote this book lost connections

00:56uncovering the real causes of depression and anxiety and the real solutions so I wanted to understand why does depression and anxiety depression anxiety seem to be rising so much it's very personal to me when I was a teenager I've gone to my doctor I'd explained that I'd was in this deep sense of pain and all my doctor did was tell me a biological story just said basically your brains broken and all he did was give me drugs right and drugs play a role in treating people but I was still depressed all that time I was taking these drugs right most of the time and after 13 years of it I thought right I need to understand what's really going on here so I ended up going on this big long journey over 40,000 miles interviewing the leading experts in the world and what causes depression and anxiety what solves them and what I discovered is the we we've told a ridiculously simplistic story to

01:41people about what depression is and how to solve it that you know until I was a teenager and I went to my doctor I thought depression was all in my head meaning you know you've just been weak he being a basically and then the next 13 years I thought it was all in my head meaning you know it's a chemical imbalance in your brain what I discovered is the overwhelming evidence from the World Health Organization leading medical body in the world and loads of other places is there are real biological factors that can make you more sensitive to this stuff but that causes a depression anxiety overwhelming in the way we're living there with these nine causes depression and anxiety for which I could find scientific evidence seven of which in the way we're living and some of which are rising which explains this kind of epidemic and that opens up a whole different way of finding solutions

02:23now when you were young and you were experiencing depression how would you categorize it like what how would you describe it if you had to describe it to someone who didn't understand depression yes I try to keep this a lot of fists away from shorts I think I'll move a bit closer to me I think depression depression is despair spreading everyone has moments of hopelessness in their lives right it's that spreading further but I think one of things I learned is a deeper way of thinking about this which is everyone listening to this everyone watching this knows that they have natural physical needs right you need food you need water you need clean air you need warmth if I took those things away from you you would be a real trouble a real fast right there's equally strong evidence that human beings have natural psychological needs right you've got to feel you belong you've got to feel your

03:11life has meaning and purpose you've got to feel that people see you and value you you've got to feel that you've got autonomy you've got to feel that you've got a future that makes sense and our culture is good at lots of things I'm glad to be alive today but our culture has been getting less and less good at meeting these deep underlying psychological needs for lots of people and that is the key reason it's not only one but it's the key reason why we have this rising depression and anxiety but let me like you sound a bit weird in the abstract so I'll give you some specific examples if you want okay sure so I give you one example I noticed that lots of the people I know who are depressed and anxious their depression and anxiety focuses around their work right start to think what's going on here so I start to look for evidence about how people feel about their work best research on this

03:52was done by Gallup that the opinion poll company massive detailed study took a couple of years they found the figures for how people feel about work in the US and and other comparable countries what they found is 13 percent of US 1 3 percent basically like our work most of the time we get energy from it 63 percent of us or what they called sleep working so don't like their work don't hate their work they're just kind of enduring it and 24% of people hate their work right fear it and dread it so I was quite struck by that when I looked it that means 87% of people don't like the thing they're doing at the time that's incredible is it strike it and boom and this thing that we don't like has spread over even more of our lives right average person answers their first email at 7:40 a.m. and leaves work at 7:15 p.m. so this is most of our waking lives we're doing something we don't like I

04:41start to think could there be some connection between that and this epidemic of awful sort of forms of despair anxiety depression addiction so I start to look for scientists had studied this I discovered an amazing Australian social scientists called Professor Michael Marmot who I got to know who discovered the key to what causes depression at work right there's several aspects that I can tell you the story of how he discovered it if you want to think it's an amazing story but the core of it is if you go to work and you are controlled so you feel you have low or no control you are radically more likely to become depressed you're even more likely to have a stress-related heart attack and I think the reason is clearer than a bit further than professor Marmot does and human beings need to feel our lives have meaning right and if you're controlled all the

05:28time you don't feel like your life has meaning you don't feel like you it disrupts your ability to create meaning out of your work and it makes you feel like right mmm that makes sense and one of the things so one thing that was really important to me in everything I was learning in the research for lost connections was there was this it required this kind of shift in my mind because what I was basically told by my doctor is your pain is a malfunction right he said you know we know what causes depression it's just some people naturally have low levels of serotonin in their brains you know you're clearly one of them that's what's going on here and one thing that was very striking speaking to the leading experts in the world is that story is just not true there are real biological factors there are real things that happen in your brain obviously but actually a professor

06:14Andrew scull at Princeton University says it's deeply misleading and unscientific to say depression is just caused by low serotonin right this is just not true and but but one thing that was so important to me looking at these nine real causes of depression and anxiety was realizing actually our pain makes sense right if you're depressed if you're anxious you've been told basically that you're a bit crazy there's something not working but actually you're not a machine with broken parts you're a human being with unmet needs and that requires a very different set of responses so you think about I think well let's think about that problem with work right most people feel they've got no control at work or low control and it's making them feel terrible they're not wrong to feel that right they've got a need as human beings and it's not being met how can we deal with this and

06:59I learned there's a really interesting strategy to deal with this now this is like some people will be able to do as individuals but it's something we can actually change as a society so far more people could do it I went to Baltimore and I interviewed a woman called Meredith Keough young woman Meredith used to go to bed every Sunday night just sick with anxiety right she would she would she had an office job it wasn't the worst office job in the world right she wasn't being bullied she wasn't being harassed but she just she just felt like she just can bear the thought the next 40 years of her life were gonna be this right and one day with her husband Josh she does quite bold thing josh is a working-class guy from Baltimore since he was a teenager he'd he'd worked in bike stores and you know working in a bike store your viewers will know it's insecure work it's controlled you do it boss

07:47tells you you don't even get vacations unless the boss you know it's nice too young and and Josh and his colleagues in the store they didn't hate their boss he wasn't particularly bad boss as far as bosses go they quite liked him as a person but one day they just asked what does that boss actually do right we fix all the bikes and he seems to make all the money what's going on here they decided to do an experiment they they set up a different bike store a rival bike store it's called Baltimore bicycle works and it works on a different principle so most people were listening to this will work in corporations right top-down you do what the boss says it's modeled like an army that is a very recent human invention right Sun comes along in the late 19th century what they did was try a different model they're called Democratic cooperatives so a Baltimore bicycle works they take all

08:32the big decisions together about their work they vote they share out the good tasks and the shitty tasks so no one just gets stuck with all the shitty tasks they share the profits obviously so they control their environment together they're like a little cry but that control their environment instead of an army with one guy at the top control in it and one things that was so fascinating spending time with them which is totally in finding with Professor Michael marmots Reese about what causes depression at work is how many of them talked about having been really depressed and anxious when they were when they were working in this controlled way and their depression and anxiety had largely gotten to have bad days of course but there that kind of nagging depression and anxiety had gone away in this different environment and as Josh said to me there's no reason why

09:13any business should work in this top-down controlled way that makes people depressed it's not even more efficient a study at Cornell University found that Democratic businesses grow four times faster than than you know top-down businesses and I think well this opens up is a different way thinking about depression so what we've done up to now is we've said to depressed and anxious people the job of fixing this is basically on you buddy right maybe if you're lucky your family maybe if you're lucky your doctor but actually once you begin to realize that the reasons why people are depressed and anxious makes sense this is just one of many reasons why people are depressed and anxious it also one of things is fueling the addiction crisis which you can talk about if you want and once you realize it makes sense you suddenly realize what you've got to do is deal

09:56with the problem in the world as well as the problem just in the individual skull do you see what I mean yeah so you're focusing on work environments right and there's there's many reasons as you were saying for for people being depressed have you when you talk about work environments have you researched people who are independent people work for themselves people who you know make things or make furniture or what have you yeah and that was one of the things as well at Baltimore bus courses most people are so removed from the product from their work right from then the outcome of their work to give you an example of a guy I interviewed a lot and guy could Joe he works in Philly and he worked when I met him in a paints a paint store right and Joe's job was to turn up at whatever it was 8:30 in the morning stay there all day until 7:00 p.m. and just take your order for pain

10:43and then when you ask for a specific shade his job was to put it in a machine that shook it right and then just give you the paint that's it that was his whole life week after week year after year and Joe was acutely depressed and Joe was really felt really guilty about telling me how depressed he was right he kept saying look I know how lucky I am I know how lucky I am but he felt like that like and he said I remember him saying me look I know people need paint right it's not I know that I have some function here in the economy don't think you put it quite like that but this is not giving me any sense of meaning but one of the real mysteries to me about Joe and that that had to learn about one of the other causes of depression and anxiety and solutions to that was so Joe a lot of people some of my relatives who do work like that that basically the

11:29margin for them to change their lives is really narrow right like one of my closest relatives is struggling single mom you know she's she works every hour she can should get to Simon today collapses right the idea is saying to her your job now is to democratize your workplace is ridiculous right she can't do that that's why most of lost connections is about how we can change the culture to free people up to make the changes they need to make although there are things individuals can do that I go through in the book but the but but the the a lot of people how to put it they we live in such an individualistic culture that people think what you're saying is you need to do it yourself but Joe was in an unusual position in that Joe loved fishing right he'd fish do I think 20 of the 50 states and he'd recently been to Florida and he said you know when I was in Florida I am I

12:19realized I could just quit this job I could go and live as a fisherman in Florida I'd make less money but I'd be much happier right and there was somehow I knew as I was talking to Joe and I followed up with him over the years that followed I knew he wasn't gonna go to Florida right and I made you know it was just the way he said it it was a wistful longing normal cycle idea not something based on a real past building that's a really good way of putting it but I remember the last time I saw him and he walked off and I felt like a complete dick for doing this but I shouted after because I felt so strongly Joe go to Florida right right and one day's a tree troubled me was why are so so a lot of people are trapped in the way our culture works which is why we got to change the culture and I talked about specific concrete things that have been tried in other countries that have freed

13:04people up and have reduced depressions I'm sure we'll get to that but if you think about an individual like Joe what's going on there and one of the things I learned for this amazing professor tim Kassar in Illinois and Knox College in Illinois is I think one of the things this is one of the hardest causes a depression to learn about because I realized how much it played out in my life as well so just like we all know junk food has taken over our diets and made us physically sick right something similar has happened with our minds the kind of junk values have taken over our minds well I started learning about this so I kept remembering so I ate nothing but junk food for like ten years from my 20s basically and I remember one day it makes it eat this story even sadder that it was Christmas Eve in 2009 at lunchtime I went to my local KFC and I ordered set my order which I won't even

13:49repeat see because it was so disgusting and the guy behind the counter said oh yeah and we're so glad you're here I was like okay and he said wait a minute wait a minute and he went back and he came out and the whole staff had bought a massive Christmas card for me and they'd written in it to our best customer and my heart was like sang because I was look at this like that suddenly realized this wasn't even the fried chicken shop I went to the most right so I was at an extreme end of the junk food spectrum right I'm not anymore that I've relapsed a bit lately but but so we all know how that works right junk food appeals to the part of us that evolved to what nutrients but it tricks that it's not actually a part of you that wants nutrients it actually makes you sick right and what Professor kasih found is the similar things happen in our minds so um weirdly so for thousands of years

14:37philosophers have said if you think life is about you know money and status and showing off you're gonna feel like right but it's not an exact quote from Confucius but that's the gist of what he said right but weirdly no one had actually scientifically investigated this until until professor caso twenty-five years ago so he knew that basically to put it crudely there's two kinds of motives that human beings have right you've got them I've got them Jamie's got them everyone's got them right and the the first set motives imagine imagine if you play the piano right I'm totally unmusical but imagine if you play the piano if you play the piano in the morning because you love it and it gives you joy that's called an intrinsic motive to play the piano right you're not doing it to get anything out there you're just doing it because you love it right the experience is the

15:24point now imagine you play the piano in a dive bar you know to pay the rent and you don't like it right or you play the piano because your parents really want you to be a piano oh I don't know there's a woman who's really into penis so you learned the piano to impress her that would be an extrinsic reason to play the piano right you're not doing it for the thing itself you know you're not you're doing it to get something out of it right and what professor Cass had discovered loads of really important things about this but there's a few we're all a mixture of these things but we move throughout our lives and what you discovered is the more you are driven by extrinsic values the more your life is guided by how you look to the outside by you know what you're trying to get out of life rather than enjoying it the more you will become depressed and anxious by quite a large margin

16:08there's loads of studies that show this and and also he found that we have become much more obsessed with much more driven by these values over the last 30 years but all sorts of reasons partly cos we from the minute we're born we're immersed in a machine that tells us life is about consumption right about externally consuming things more eighteen-month-old children know what the McDonald's M means then know their own last name right so this this machine constantly geared towards getting us to think extras imagine imagine an advert that said to you know Joe you look great today you smell great you're doing fine right you don't need to buy anything today that would bring perspective with the advertising industry be the worst worst advert ever I would make you want to buy anything so this movement towards these kind of junk values and any shows lots of reasons why these junk values

16:57make us feel like one is it just corrodes the quality of your relationships right if your wife if you think your wife loves you not because you're you but because you're rich because you look good or for some other reason then think about the insecurity that enters into that relationship you know oh right if you suddenly got fat or if you suddenly lost all your money it's over it creates that that a sand of insecurity enters all your relationships the more your extrinsically motivated the more insecure your relationships will be in the worst you'll feel or another example would be something that really makes human beings feel good what are called flow states right there moments when you're doing something you love for me it's writing for you I'm sure it's partly broadcasting partly working out as you can see it's not working out for me the the where you

17:43just get into the zone and time seems to collapse and you're in that moment right but what ex thinking extrinsically what being dominated by these junk values does is it jolts you out of the intrinsic value so imagine go back to the piano example if you're playing the piano just cuz you love it and then suddenly you think am I the best piano player in Los Angeles today right how are these people in this room thinking about my piano playing how much I can be paid for this piano playing you can see how that would jot you out of the flow state right people you the more weird room by extrinsic values the less we get into flow States in the worst we feel it's lots of other reasons as well to talk about but well that completely makes sense that relying constantly and other people's approval and recognition and love in order for you to be satisfied and happy isn't is not a good

18:29recipe for getting by in this life smoothly when you were young and you were experiencing depression as you called it what was the root cause of it so in my case it was I mean there are a few things going on and this is quite difficult me to talk about but one of the people I got to know for lost connections is this amazing guy called dr. Vincent felitti in San Diego and if you don't mind I'll tell you his story first not sure I sure what he made me realize about myself and actually why I was very resistant to this says he was very resistant to the system to this insight that he had okay and really did not want to absorb it so he actually made this discovery and Skycycle talk about a whole other subject but trust me it gets to depress him it led to an incredible breakthrough in depression so in the mid-1980s dr. Phil Edie is doing all this research into obesity

19:18basically Kaiser Permanente are not-for-profit medical provider down in San Diego just had a massive problem with obesity right there is just acutely growing problem with obesity and they were trying everything and nothing was worked like giving people nutritional advice that surgery wasn't working right so they basically said to him they gave him quite a big budget and they're like just figure out what the hell is going on here so he went away and he started he started to work we think it was about 350 extremely obese people right people who weighed more than 400 pounds and he starts doing all sorts of different research with them and one day he just had this this kind of almost stupidly simple thought he thought what if they just literally stopped eating and gave them the nutrients they need would they just lose loads away and then come down to a healthy weight so they

20:06obviously would like massive medical supervision they did this right people they just monitor them and they stop eating and they give them loads of vitamins and everything and it worked right they did in fact lose loads of weight but then something happened that no one expected as a woman I'm going to call Susan to protect her medical confidentiality she'd been over 400 pounds she got down to 138 pounds and won and everyone's celebrating they think Vincent's like a miracle worker and then one day she freaks the out starts massively obsessively eating and very quickly she's back to not quite where she was but close right and Vincent sits with Susan and he's like what happened and she's like I don't know and he said well tell me about the day you cracked right turned out something had happened to her that hadn't happened to her in I think ever or sitting in a very long time a man hit

20:52on her right when she'd been heat you know hugely overweight no man had hit on her a man hit on her and that was the trigger right and he's like okay so they talk a lot more it's like when was it you started to put on weight for her it was when she was 11 and so he's like well what happened when you were 11 that didn't happen when you were 10 that didn't happen when you were 12 or 50 and she said oh well that's when my grandfather started raping me and he this really stuck with him and they start talking to the group I discovered 55 percent of the extremely overweight people in the group I fifty percent people in the group had had put on their way after being sexually abused right which was extraordinary far more than the wider populations like wait what's going on here this is really Susan said to him overweight is overlooked and that's what I wanted to be right so this

21:37thing that had looked like a pathology right and it is a pathology in one sense being extremely overweight will kill you suddenly didn't look like a sign of madness it was actually performing a function that we couldn't see right it was it was it was protecting them from sexual attention but you know this is a small group it's a small study so Vincent wanted to get a lot more research on this this is where it led to the breakthrough and depression so he set it up with funding from the CDC the Center for Disease Control kind of gold plated organization in this in the US for this kind of research everyone who came to Kaiser Permanente in the next it was a year for any whether you broke your leg you had a migraines you had schizophrenia anything got given a questionnaire and it asked about it had two parts personally said did any of these ten bad things happen

22:23to you when you were a kid right it could be sexual abuse neglect that kind of thing and then it says have you had any of these problems as an adult obesity injecting drug use and at the last minute they added depression right my luck so when they got the results back the CDC were just like what the is this for every category of childhood trauma you went through you were radically more likely to become depressed if you had six of those categories you were three thousand one hundred percent more likely to have attempted suicide as an adult if you were if you'd had six of them you were four thousand six hundred percent more likely to have become an adult injecting drug user right and there's a debate about why this is and I'm going beyond what Vincent says now but burn what the science says and this comes it brings it back to my experience so I had when I

23:13was a kid I'd expect some very extreme acts of violence from an adult in my family you know my mother had been very ill when I was a kid my dad was mostly in another country and I'd expect his really really extreme and frightening acts of violence and I this sounds stupid but until I went to see Vincent if you had asked me do you think that played a role in your depression I would have said no right and it makes me realize one of the reasons why I clung to this very simplistic chemical imbalance theory of depression for so long because I did not want to give the individual who behave so appallingly towards me that sense of power over me I didn't want to I didn't want to think about that stuff I wanted to cauterize it I wanted to cut it out of my life I would say well okay that's bad thing that happens to you but you know but but the reason why I stayed with this and

24:07the reason why I kept you know just spent this time with Vincent in San Diego and the reason why I kept going with all these different causes of depression and anxiety is because once you understand what's happened you can find solutions who otherwise didn't find there was a second stage of vincent dr filiz research that to me was so powerful it's one of the reasons why I make myself talk about this now so if you'd indicated on the form that you'd experience one of these forms of childhood trauma the next time you went back to your doctor you weren't called back but the next time you went to a doctor your doctor was told to say something to you like hi Joe I see on the form you indicated that you were violently abused when you were a child I'm really sorry that happened to you that should never have happened would you like to talk about it I've quite a lot of people said thank you but

24:54no I don't want to talk about that but a lot of people did one talk about on average the conversations lasted five minutes and then the doctor said I can refer you to a therapist to talk more about this if you want and they were monitored to see what happened the results were kind of incredible there was a enormous falling depression and anxiety just from the five minute meeting right and from the obvious people referred to therapy saw an even bigger fool and it seems to be again this is going to be this bit is going beyond what Vincent said it said he said I asked him I said oh no I think partly what happens is it's related to shame right if you are a kid and you experience some kind of abuse you can basically do one of two things right you could either say look unfucked here right I've unlike a pin ball being smacked around a pinball machine because

25:37I can't stop this happening and I just got to accept it and I'm really vulnerable or you can say this must be my fault at some level right which is what I did and of course it's what you're being told anyway by whoever's treating you badly in almost every case and a weird thing is if you tell yourself it's your fool actually you gain a sort of weird internal power right you're not the pinball being smacked around the machine you're the person controlling the pin wheel you can change your behavior right you can't you can't change other person's paper so you kind of develop this kind of shame and one of the things we know is and there's plenty of evidence from this people like Professor Jim Pennebaker have shown it shame is a catastrophe for human psychology right that we know for example openly gay men died two years later than closeted gay men in the AIDS

26:23crisis even when they got medical care at the same time right shame destroys you it makes you sick and what Vincent found was this model of releasing your shame which led to this significant for a member one of the letters he got was from an old woman think she was in her 80s who just said she had been sexually abused when she was kid and she said thank you for asking I thought I'd die and no one would ever know and you can see how that release of shame would have a transformative effect on people Wow so for you you had this traumatic experience of violence when you were young you were depressed you were trying to figure out what the source of this was whether it was some sort of a chemical imbalance in your brain when when they say chemical imbalances in the brain have are they capable of measuring the level of serotonin in your brain yes so there's a huge debate about this you

27:14couldn't for example do autopsies and there's a big debate about but that's when someone's dead yeah but there's a big debate about so there seems to be most scientists agree not all of them and there are some people who dissent from this but most scientists agree low serotonin correlates with depression right but it's not the same thing in the same way stretch marks correlate with obesity but they're not reports of obesity they're the product of it so there are real brain changes that happen which I write about in lost connection isn't important to say that I don't think they should be described as chemical imbalances but one thing that was really shocking to me was one of the British experts on this doctor David Healy said to me and you can't even say the sir that idea that depression causes serotonin you can't even say that that theory is discredited because it was

27:56never credited there was never a time when half of the scientists in the field believed that right the reason that story got sold to me and most people listening to this in the 90s is because it worked really well for the drug companies right because what it makes it sound like if you've just got a chemical imbalance the solution is just to give you chemicals now it's important to say chemical antidepressants do play a role we can measure that and there's a slightly nuanced point to make about this which is so depression is measured by something called the Hamilton scale right I've always felt sorry for whoever Hamilton was that the only way we remember him is by how miserable we are but anyway so how to scale goes from one where you are you know dancing around in ecstasy or on ecstasy to 51 when you would be acutely suicidal right and to give you a sense of what movement

28:38on the Hamilton scale looks like if you move six points on the Hamilton scale sorry if your sleep patterns get better you'll gain six points on the Hamilton scale and if your sleep patterns deteriorate say you have a baby who's crying all the time you'll generally lose six points on the Hamilton scale right so professor urban Kurt Harvard Medical School did the best research on this and what he found is on average chemical antidepressants move people 1.8 points on the Hamilton scale right about a third of what improving your sleep patterns does it's important to say that's an average so some people do get more than that some people get less and you can see 1.8 points is not nothing right if you're acutely suicidal 1.8 points can take the edge off there's real value in giving people that relief but it's not solving the problem for most people I thought I was you know

29:23weird for being on antidepressants for so long and remaining depressed turns out I was totally typical according to dr. Stephen lardy he's a professor of psychology he's done a lot of work on this between 65 and 80 percent of people taking chemical into depressants become depressed again right so you can see that's not 100% there is some value isn't that that's what abilify is for right is abilify is the idea that your antidepressant is not enough so you take abilify on top of your antidepressant which is supposed to help you even further and it's one of the most prescribed medications in the country and it's an anti-psychotic yeah whether it's terrifying the the doling out I mean one in five Americans will take a psychiatric drug in their lifetime right it's a sign of a a cultural madness that we're doing this right whether now there's not to say that I want to stress

30:11again there's a real value in these drugs there is some value to them there's so value to them but they're most certainly over ascribed and there's most certainly actual methods that you could use to improve your life without any sort of chemical intervention that are readily available to everybody like exercise and diet yeah well but those things aren't stressed when you when you go to a doctor the first thing the doctor doesn't say is listen what we need to do is get you start running and get you start eating really healthy and then let's talk about antidepressants you're totally right there's a ten billion dollar industry and that doctor giving you drugs that's a crazy number yeah and I think billion dollars exactly so this is why although there is a real value for those drugs with the the the why this is the first primary and for most people only option that's above it

30:56and one things that really helped me change think about this differently and it fits exactly what you're saying Joe is I went to interview this South African psychiatrist called Derrick Sommerfeld and Derrick happened to be in Cambodia and camera antidepressants were first introduced right that's where they were in was just there where and they were first not just in Cambodia they thought I would have been one of the last countries in the world they made their way to and the Cambodian doctors didn't know what they were right so they're like what is this and he explained and they said I would need them we've already got antidepressants and he said what do you mean he thought they were going to talk about some kind of like herbal remedy or something instead they told him a story there was a farmer in their community who one day worked in the rice fields

31:37who one day had stood on a landmine and got his leg blown off so they gave him an artificial limb and went back to work in the rice fields but apparently it's super painful to work in water when your legs been you know when you got artificial limb in your legs been blown off and I'm guessing it's pretty traumatic because he's in the fields where he's been blown up he starts to cry all day doesn't want to get out of bed classic depression right they said to Derek we gave him an antidepressant he said what was it they said explained they went and sat with him they listened to him they realized that his pain made sense they realized that actually made partly sense that he felt so bad they figured if they bought him a cow he could become a dairy farmer he wouldn't be in these fields where he was being tamp so they bought him a care within a couple of weeks he stopped

32:17crying they said to Derek so you see doctor that cow was an antidepressant that's what you mean right now if you'd been raised to think about depression the way we have we've been propagandized - that sounds like a bad joke right I went to my doctor for antidepressant he gave me a cow if you understand what all these experts who I met have been an interviewed extensively I've been trying to tell us beyond somewhat the World Health Organization has been trying to tell us those Cambodian doctors knew intuitively what they knew through the science which is our pain makes sense right you're not crazy to feel like you've got unmet needs and what you need is help to get your needs met now some of the things you're talking about are really good examples exercise diet some of them are these bigger interventions so one of the heroes or lost connections is this doctor I got to know called Sam

32:58evring ttan who is based in in East London actually where I near where I lived for a long time very poor part of East London and sadly he was never my doctor but Sam was really uncomfortable he's a general practitioner general doctor loads of people were coming to him with depression and anxiety right and he'd been told in his medical training even though he knew the science was much more complicated than this to just say to people you know you've just got a chemical imbalance in your brain and just drug them right and Sam thought write it like me he's not opposed to the drugs he does give them out to some people but he just thought this is this is not right this isn't dealing with the reason they feel so right so he tried a different approach he noticed that one of the factors that was making them depressed and anxious was how profoundly lonely they were it's a study to ask

33:45that officers in Britain but figures of some of Britain by giving american examples a study that asset Americans how many close friends do you have who you could call on in a crisis when they started doing the study years ago the most common answer was five today the most common answer is none right it's not the average but more people say none than any other options you think about that much of people in America yeah more people in the United States have nobody to turn to when there's a crisis than any other option right so you think about what life must be like when you're alone that is not the species we are the reason why you and I sitting here Joe in LA the reason why we're alive is because our ancestors in Africa were on the savannahs of Africa what unbelievably good at one thing right they weren't bigger than the animals they took down but they were much better

34:28at cooperating than the animals they took down we exist because our ancestors formed into tribes every instinct we have is to live in a tribe right bees need a hive humans need a tribe we are the first humans ever to try to disband our tribes what no one's ever done that before in human history and it's quite rightly well what do you let me stop you there because we're getting deep in the weeds here what do you say to someone who is happy with what they do lives a fulfilled life exercises and is still depressed yes I've thought a lot about this but I want to come back to think about you I know this is this is an issue with a lot of people I know I know people that worship at the altar of science and modern medicine that firmly believe that all depression is because of some sort of chemical imbalance in the brain and anything that debates that or anything that disputes

35:16that notion is pisses them off you know I understand that and I would have been like that for maybe get that yeah of course I was like that many years do you get that I do I get some people responding that way sure of course of course I think the so the World Health Organization is the leading medical body in the world right they did a study of all the best and they explained very clearly that the mental health is a social indicator right it has social causes that need social solutions as well as individual solutions the science is overwhelming you won't get many scientists who say in fact you struggle to find any scientists who say depression is purely a biological phenomenon right pretty much everyone agrees there's some social and psychological component I think when we it's a weird disconnect between what the scientists know and what the public is

36:01told right I don't know anyone who went to their doctor who apart from this wonderful doctor Elise London we can talk about who went with depression as I think was told anything other than a biological story I mean there may be asked you know as some of them are asked about childhood you know what was your childhood like and refer to a therapist but no one was taught about these wider social causes no one's told like do you feel controlled at work well I get sacked that could be making you make you depressed being toast of the people who who who are depressed but don't because it wasn't real mystery to me right I knew people I thought but this guy's got everything and he feels he's still depressed what's going on here I think there's two things to say about that one is I started to for various reasons for research for something else I was reading some like feminist texts from

36:45the early 60s right and a really common thing that happened in the early 60s is women would go to their doctor and they'd say doctor there's something really wrong with my nerves people took talked about in terms of nerves then we don't do that anymore it's so really wrong with my nerves because I've got everything a woman could possibly want I've got a husband who doesn't beat me I've got a car got a washing machine I've got two kids but I feel like right and the doctors were going right and give a valium now if we could travel back in time and speak to those women what we'd say is right you've got everything you could possibly want by the standards of the culture but it's down as the culture is wrong right as a as a woman as a human being you need more than just a washing machine in a car right you need a fulfilling life people speed up meaning and purpose and a very similar thing I

37:28think is happening today if you suffer than when I speak to people who say I've got everything I could want but I feel like share so tell me tell me about your life very often they're working really hard in prestigious jobs that they don't like they don't enjoy hour by hour to buy things that don't give them pleasure it comes back to this hijacking by junk values that we're talking about that Professor Tim caso discovered so what you've got is because we've been told a totally misleading story about what makes us satisfied and happy as human beings I think comes up again and again in the interviews you do because we've been taught in different ways because we've been told a misleading story about that we live our lives according to the wrong script we feel like and rather than question the script we think there must be something wrong with us biologically now there are

38:10biological contributions it's important to say that but one of these that really blew my mind on this was Angley this woman amazing social scientist called dr. Brett forward in Berkeley she did this research it's kind of simple research it just asked if you consciously decided you were going to spend more hours a day trying to make yourself happier would you actually become happier right and they did this research she didn't do it alone obviously with her colleagues in the United States Japan Russia and Taiwan and what they found was in the US if you try to make yourself happier consciously you do not become happier in the other countries if you try to make yourself happier you do become happier and they will like what's going on so they did more research and what they discovered was in the US and it spent a lot more time here but in Britain as well if you

39:02try to make yourself happier you tried to do something generally for yourself you buy something for yourself your big yourself are up here try to get a promotion in the other countries generally if you try to make yourself happier you do something for someone else right you try to help your friends your family your community in a minute we're what countries just arresting Russia and China it's most of the rest this that if you this is a part of their culture that if you want to be happy you do something for someone else it's it's so implicit in the culture that they live collectively that it's not even just like we wouldn't even if you said do you think happiness is an individualistic thing we'd be like what are you even talking about isn't that sort of an extrinsic idea as well the idea that you're going to be happy by trying to make other people happy but

39:44there's the thing so intrinsic values are not about just internal to yourself they're things that you value so your intrinsic value could be spending time with your kids right that was probably most people's strongest intrinsic value of their parents is being with their kids bonding with their kids loved my peers if your goal is to get happy and the way you've chosen to get half I'm gonna get happy by making other people happy that's that seems very strange and I think so if you think about where humans I shouldn't you just make other people happy because you love them but that is a way loving people in being present with them is where but not as like a specific for with a specific goal of making yourself happy that's eNOS that's not why they did it it's not like when they were told make yourself happy and they had an implicit script in their culture which is like I

40:31write but when I make myself happy I'll spend time with other people I'll do things with other people but if you think about it in terms of human evolution it makes total sense right think about our ancestors mm-hmm where they evolved if you were a group if our ancestors had been individualist who were out too big up themselves as individuals we wouldn't be having this conversation right right so it makes us we evolved as a species with instincts that are knowledge knowledge is no argument there the the motivation of trying to get happy by helping other people is so implicit in the culture for most people in say China that they wouldn't even articulate it that way it's only if you force them to say look try to make yourself happier that they then the script becomes obvious it's implicit but this script that we have this idea that the way you make yourself

41:15happier is as an individual you know just doing something for yourself and how you look let's start because there is not one script in this country of how to make yourself happy that I think that's sort of disingenuous this idea that the only way to make yourself happy is to do that what that's not what people are trying to do what people are trying to do is be successful and I don't think they necessarily equate success with happiness what would they do equate success with is an alleviation of debt and alleviation of problems and alleviation of a lot of the issues that people face certainly and they think of that as if you look at the problems that you have when you're growing up you look at the prospect if you grow up in a poor family one of the the main problems that you face is you're worried about paying your bills so you say someday I'm gonna get to a point where that is no longer

42:02an issue I'm going to make it I'm going to be successful they're not doing it thinking this is going to make me happy I very rarely see that and which is one of the reasons why people even people's parents freaks me the out well tell them to not pursue their dreams but instead to pursue something that's more likely to happen like don't pursue your dream of becoming an actor or a singer or whatever it is instead pursue your dream of being the foreman at the company you work at because that's attainable I think you're totally right now yeah there's a lot of evidence that you're right that the financial anxiety is a massive driver of depression and anxiety obviously that there's a interesting study that found people who have an income from property are ten times less likely to develop an anxiety disorder than people who don't and there was a really interesting

42:53experiment in how we can respond to that it's one the President Obama said lay in his term he thinks would have to happen across the country in the next 20 years for various reasons so in Canada in the 70s the Canadian government chose a town at random seems to genuinely have been random its town called ofan it's erm anyone who knows canada it's about four hours at a Winnipeg and they said to a big group of people in this town we're gonna give you guys for the net for the foreseeable future we're going to give all of you a guaranteed basic income we're going to give you the equivalent of in today's money fifteen thousand US dollars right there's nothing you can do that means we'll take it away from you and there's nothing you have to do in return for it we're just your citizens of our country we want you to have a good life right it was partly because

43:35they had a kind of welfare system but it was a lot of people were falling through the cracks and they wanted to do a little experiment to see with this work better and this was studied very carefully by a woman I interviewed - Evelyn for Jay to see what happened it loads that interesting things happened people spent more time with their kids very few people quit work but a lot of people turned down shitty jobs so actual overall work standards improved because the employers had to attract people with better standards but for me the most interesting thing is there was a huge fall in depression and anxiety right depression and anxiety that was so severe people had to be hospitalized fell by 9% which is remarkable in just three years and then the program ended dr. 4j said to me I thought so much about that that what I'd learned about the cow dr. Voss they said and you know that's

44:23an antidepressant right we should expand our idea of an antidepressant to be anything that reduces depression and I should include pills but also so you're totally right I mean look I grew up my dad my dad's a bus driver my mum works in a shelter my grandmother clean toilets financial anxiety is a massive driver of of the despair this I mean more than half of all Americans have not because of the incredible financial pressure they've been put under got five hundred dollars set aside for if a crisis comes along right so you're talking about that's a huge drop and again that's really important cuz explain to people if that's making you depressed and anxious don't let a doctor tell you you've just got a chemical imbalance in your brain right that's what do doctors still say that all the time my nephew's best friend just literally a couple of weeks ago went to the doctor Amistad yeah you've

45:09got a dopamine imbalance the doctor said is migrated in the 20 years since I went there from a service in England or in England I mean I get contacted constantly by people who were being told they've got chemical it they're told they got chemical imbalances in their brain are they just as likely to prescribe antidepressants in English as they are American I'm a slightly lower but it's still exceptionally high yes still yeah there's that narrative that an antidepressant must be in some sort of a pill form and that Navy even the expression antidepressant and antidepressant it's it's a very confusing thing that we've sort of adopted very quickly in this country and it's a relatively recent you know over the last 60 70 years and the people that have antidepressants in their body that take them all the time and swear by them boy if you try to tell them in any way

45:58that there's a better option they get extremely defensive I have a friend she's very smart and she's she's one of the one of the people that will you know very aggressively debate this idea that it's anything but a chemical depression chemical imbalance you know but she doesn't take care of her body she's not doesn't exercise all the time you know she's slightly overweight she doesn't eat the best foods you know it's it's it's a weird thing and she's living in a society and culture that has all these forces that are rising that yes this will feel terrible right yeah it's a big thing for me is what I'm talking to this because I've had some of that reactions well not too much but I've had some of that reaction as well first thing for me - I always say I want to expand the menu of options I don't want to take anything off the table right it's not about you say that

46:48and I and I think you're probably being pretty honest but you really do want to you want to eliminate much but just by the standard of improvement you do probably want to take most people off of antidepressants don't you want my rather they have a victorian-era choice yeah I would draw an analogy obesity is massively risen in the Western world it hasn't risen because people suddenly became greedy and lazy it's risen because our food system is terrible the way food supply system is terrible and we built cities that people can't walk and bicycle around right and they're really stressed all the time and they get home from work exhausted so they don't have time to exercise a lot of them in that context some people will do what's a good stomach stapling liposuction that kind of thing right now I'm not against that but if we change the society in the way that I would want

47:32to with obesity so that people could walk and cycle and you know they had access to healthy food far fewer people would need stomach stapling or liposuction right drug it's not a perfect analogy but I'd say is if the social changes that I want to happen happen if we follow the places that have succeeded in reducing depression anxiety over time you would see fewer people feeling they needed and chemical antidepressants we thank top you read it with a couple of things first of all I don't think it's access to healthy food I think most people have access to healthy food they choose not to eat it they choose to eat refined carbohydrates high sugar foods fast food those are the things that are getting people fat and I don't I don't think that salad is so outside of the reach of the normal person I just don't agree with that I just think they make unhealthy choices

48:19that's much more light and they get addicted but people make behind rate I understand what you're saying and I think there's some truth in it but I think people make choices in a context right so for example you know one of my relatives who's very overweight you know she's constantly stressed because she's trying to hold together so much and one of the few reliefs and pleasure she has is to eat too much right and to eat pretty shitty food right I'm not critical of her for that uh what I want is to help her change her life and change the society in which we live so she's not got that constant stress didn't only mean I mean I think of this in relation to addiction and you tweeted one smart a TED talk I gave everything you think you know about addiction is wrong which I'm grateful thank you and and which is based on my previous partly taken from my previous

49:05book chasing the screen which is about addiction and I think about what you're saying in relation to that context so we had a lot of addiction in my family and you know one thing that really changed my mind about this and I think it really relates to what you're saying about food is most people think you know addiction it's a drug addiction I say heroin addiction right very close to me where's withing heroin addiction if said what causes heroin addiction they'd say da heroin causes heroin addiction right we've been told this story for a really long time that you know if you took if we've kidnapped someone off the street we injected them or we injected them with heroin every day for twenty days at the end of that they'd have this desperate physical hunger for the chemical hooks in heroin their body would desperately need it and that's that's why they would be addicted right

49:50the first thing that loads him if that's a not right about that is when it's explained to me in Britain if you get hit by truck and you know you break your hip and you're taken to a hospital you'll be given loads of a drug called diamine right for the pain diamorphine is heroin it's much better than street heroin cause is medically pure right if anyone listening to this has a British grandmother who had a hip replacement operation your grandmother's taken a lot heroin right if what we've been told about the chemical hooks is right what should be happening to all these people in hospital loads of them should be becoming addicted it doesn't happen in Britain with with people were given diamorphine so it's like well wait what's going on I only began to understand it when I went to Vancouver and interviewed this incredible professor there called Bruce Alexander

50:29did this experiment it's changed how we think about addiction I think is very relevant to what you're saying about food so this theory the chemical hooks theory of addiction a chemical hooks are real they're just a small part of it the chemical hooks theory of addiction comes from a series of experiments that were done years ago they're really simple you take a wrap you put it in a cage and you give it two water bottles one is just water the other is water laced with either heroin or cocaine if you do that the rat will almost always prefer the drugged water and almost always died quite quickly right we then think is a weak so there you go you might remembers famous advertisements yeah from the eighties so there you go right that's our story but in the 70s professor Alexander came along I said what hang on a minute you put the rat alone in an empty cage

51:10or it's got nothing to do except use these drugs what would happen if we did this differently so he built a cage that he called rat Park which is basically like heaven for rats right they can got loads of friends they can all the time they've got grain they like and colored balls and they've got both the water bottles the normal water and the drugged water but the fascinating thing is in rat Park they don't like the drugged water that much none of them used it cut something that they do use it but none of them used it compulsively and none of them ever overdose so when they're deprived of the things that make life meaningful they turn obsessively to the drug when they've got the things that make life meaningful for rats they don't the opposite of addiction is it's a prior to the opposite of addiction is connection and that you can see a similar principle

51:47playing out with food right of course there's some margin to the individual I don't want to say that were we're not entirely beginning for away from this woman these these people that were on this diamorphine so why are you saying that they don't get addicted to it because they go back to their lives that are meaningful there's a human example that happen at the same time as rat Park why why are their lives particularly meaningful in relationship to like the lives we're talking about here so I think you can see in an example a good example it was happening at the same time as rat Park and experiment the Vietnam War right huge numbers of American troops in Vietnam about 40 percent used heroin right and if you look at the reports from the time they were themselves because they were like my god when the war ends we're gonna have all these heroine addicts on

52:29the streets of the United States they're going to come home and because they believe the chemical Hicks theory it's a really good study in the archives of General Psychiatry by professor Lee Robbins that followed these guys home a select group of them and what it found was 95 percent of them just stopped right didn't go into some catastrophic withdrawal some of them did experience some physical discomfort but they didn't you know they didn't now if you believe the old theory of addiction that you're taken over by the chemical hooks that makes no sense right well but they've been exposed to all the same chemical hooks there's any homeless street straighted addicted person living on the streets but if you understand this different way of thinking it makes perfect sense if you took you and me now and put this in a hellish pestilential jungle where we don't want to be we

53:11could die at any moment we'd be made to kill people you would definitely survive longer than me but we were both find heroin a lot more appealing than we do now right and then when we come back to our lives and we have mean and purpose we would be find heroin a lot less appealing the core of addiction is not wanting to be present in your life because your life is too painful a place to be so when something an intervention happens that reduces the amount of pain in your life you could you can be less addicted there's a very challenging like Marianne Faithfull you know the British Rox I just want to stop you right there because there is a giant issue though with people taking pain pills after operations that weren't on pain pills before and then they get addicted to them so I think that's because the lack of meaning in their life or is it because there is an

53:51absolute real chemical hook like I have a good friend who had his nose broken and they fixed his nose and he got on some I think was oxycontin afterwards they'd prescribed to him and then four months later he's taking it every day all day so this P thing said about that firstly chemical hooks are real but they're a small part of the picture we know how much they are so this experiments that measure this so we lots of people will have taken in fact some people listen to this we'll be taking part in this experiment now when nicotine patches were invented in the late 80s and they become marketed in the early 90s there's this huge wave of optimism right because the chemical hook in cigarettes is nicotine right nicotine patches give yo the chemical hook you're addicted to and so there was this huge rate we're gonna give people the camp because it's the diction it's caused by

54:35chemical hooks we're gonna give them the chemical hook they'll stop wanting these filthy smoke smoking is gonna end right in fact what happened is 17% of people according to the US Surgeon General's report when they take nicotine use nicotine patches and they're motivated stopped smoking right really important to say 17 percent it's not no one big number that has saved hundreds of thousands of people's lives a conservative estimate still leaves 83 percent where something else is going on right but isn't that because of the delivery method the delivery method of cigarettes is incredibly satisfying you take a hit you get it right into your system and boom you get that nicotine there's transdermal it's very slow it's not the same feeling yeah there are there experiments that show there is pleasure that comes from the delivery method but it's also about self soothing

55:19it's about anxiety it's about boredom and and this is very important to relate to the opioid crisis so one in 130 opioid prescriptions result in an addiction right so it's a small number but a catastrophic and devastating number and I've reported from the places that the most of affected like this by this like Keene and New Hampshire one in one one in a hundred and thirty if the users become addicted that's it yeah it's relatively small proportion now so many people in the country doing wrong yeah I can send you the study that's the best studies that they're in that's in the United States or in the UK yeah in the United States we've got that's 130 prescriptions but bear in mind some people get more than one prescription so you know but the but one of the things that's really important to understand about that is the context in which this is happening right in Britain

56:05in the eighty and this totally relates to what I wrote about in lost connections about depression as well as in chasing the scream about addiction in Britain in the 18th century there was this thing that happened called the gin craze right so huge numbers of people are driven out of the countryside into these disgusting urban slums where you know they're living in this awful but they've lost everything that made life meaningful to them right and what happened was an outbreak of mass alcoholism huge outbreak is could the gin craze there's famous paintings of like a woman drinking a bottle of gin while her baby falls out a window that kind of thing right and it really happened and at the time what people said is look at this evil drug gin look at what it's done to people if only we could get rid of these evil people selling this evil drug gin this problem

56:48would go away now when we look back at it we know that can't have been caused a Jim because we could both have gin in these glasses now anyone in Britain can go and buy gin at any point pretty much and if they're an adult and we don't have Pitman is still some alcoholism of course I understand there was a despair and so yeah it's cuz what changed its not the availability of the drug what changes the amount of pain in the society and that is the key factor that's playing out here with opioids right it's not the only factor Chemical hooks are real but you know I remember in some young guy he was absolutely adamant that you know he he become medically addictive it's an accidental chemical hooks had taken him over he'd been a college athlete right and he was in a I think he was about 21 he was in terrible car accident and they get and they gave him loads of opioids and he

57:30became addicted but then I said what tell me about what was got where else was going on turned out he couldn't be a college athlete anymore his whole life had been built around being an athlete and because of his injuries he couldn't become an athlete anymore and I said well do you think it might have been related also to the despair around that it doesn't take long for people I think part of problems because we've got such stigma about anxiety addiction people will latch on to the biological explanation whether it's the chemical imbalance theory the chemical Hookes theory as their path out of stigma was to me you shouldn't be stigmatized in any circumstance whether it's because you're in pain psychological pain physical pain did you see the point I'm making I think one of the reasons why we're so committed to these and it's not even a good way out of stigma I can explain to

58:10you how if you want interesting evidence about that but did you see the point I'm making Joe I do see the point that you're making that people with lives that are unsatisfying or unfulfilled or there's some sort of a major issue in there like the athlete that's no longer going to be able to be an athlete that that's going to make these drugs more enticing I but I know too many people that have had like real issues getting off of them like physical issues no one does facing full withdrawals of course and most people I mean you're talking about the same people that have a hard time not eating shitty food right people that have a hard time getting disciplined enough to go to the gym these are the same kind of people we're talking about they're gonna have a massive problem if you give them pills and those pills create a chemical hook even if it's a chemical hook that you or

58:58I or a discipline person would be able to get like dr. Carhart famously called it he said it's like getting over the flu he goes that's what heroines like everyone wants to pretend that you're gonna die goes no you feel like for a little while and then you're fine because it's not the thing that everybody makes it out to be withdrawals are not the thing that everybody makes it out to be but but if you have the average person and you give them pills and those pills can keep them from getting the flu they're gonna keep taking those bills and if they stop taking those pills they get the flu people are comfort jumpy junkies and I think it's that's too simplistic I think there's some truth in what you're saying but so I think the key thing that happens so I think dr. Hart is - who's a friend of mine is totally right but the the physical withdrawal is you know a flu is not a

59:42nice thing but it's not the most onerous thing in the world but the the thing that's really devastating is the resumption of the pain that you were a niece that psychological pain that you were nice that izing with the drug right right you want to understand why people are taking so many painkillers we've got to understand why they're in so much pain and that comes back to the nine causes a depression and anxiety that are right by in lost connections and then kind of seven solutions to this problem that I offer so again that's about if you're so let's say Joe right Joe in the paint store who I was talking about who's you know he has this job he can't bear has very little of meaning in his life feels his life is just slipping through his fingers he took oxy for quite a long time he actually contacted me because of my book Ambika and my TED talk and he thought he

60:24was telling me a story about addiction right but the truth is when he took oxy he was numbed it made him as numb as the work itself and then when he stopped he was acutely depressed I felt like so I think the challenges if you are coming off of this drug into a society of profoundly lonely and isolated people who I financially insecure you've been told that life is about money and status who you know who think life is about screaming at each other through screens a lot of those people are gonna feel like and it's not because they're individually weak right it's because another maybe individual weaknesses of course we all have flaws every human being has flaws but but I think it's much more because the fact that it's risen so much tells you that it's a response to social changes right just like the fact obesity is risen so much tells us now they're at course

61:11individual agency I don't want to infantilize anyone that are things individuals can do obviously and I talk about them a lot in lost connections but I think the fact that it's a social transformation does tell you something there's a good illustration of this a kind of weird thing that was discovered about depression in the 70s that was so inconvenient that psychiatrists can't try to brush it under the carpet so in the 70s the American Psychiatric Association for the first time wanted to standardize how depression is diagnosed across the u.s. because up to then doctors were just using their own judgment about what it even was right so they drew up a list of 10 symptoms kind of obvious things like feeling worthless crying a lot you know you could guess what they were and they send this out to doctors all over the US and they use it but a couple up within a couple of

61:57months doctors start to come back and go look we've got a real we've got a problem here because if we just use this checklist we should be diagnosing every grieving person as mentally ill because these are the symptoms of grief right everyone when you lose someone could wants to cry a lot fit you know has Stannis's sadness that kind of thing so what do we do so the psychiatrist's regrouped and they were like okay we'll create something it was called the grief exception which basically said use this checklist to diagnose depression unless the person has lost someone they loved in the last year in which case none of this counts so they start using that but over the next few years that followed this this really awkward debate because they're like women it we've been told to tell our patients the depression is just a brain disease that you can just identify from a checklist

62:42unless there's one situation in life where it's perfectly legitimate to react this way but that begs the question what about all the other differences in your life why not if you're made homeless why not if you've stuck in a shitty job yehey why not if you're really lonely the minute you admit all that you have to admit context and that was so inconvenient they just got rid of the grief exception that's just a fascinating fact and that seems to be a huge issue that seems to be one of the primary reasons why people today I mean if you if you stop and ask the average person today who's not feeling well I guarantee you they're gonna be able to come up with at least one or two of those things on the list that are factors totally right and is there it's a job of financial stress relationship stress loneliness friendship issues or death in the family or losing someone they love

63:36but the fact that losing some of their love like will count that that's the one thing that seems very preposterous and the woman who did the most research and they said one of the best people I got to know people lost connections woman called dr. Joanne cassia Torres an amazing person she lost her baby in childbirth as a baby it's called Cheyenne and she became an expert on this and she said you know she talks about the craziness of this it just shows we don't understand pain in this society great she said she put it to me we don't grief isn't a pathology right we don't sheep she's done this research that shows I think the figure is 32% of grieving parents are diagnosed and drugged in the first 48 hours after their child dies and she said this is a sickness right the the grief is not a pathology we grieve because we've loved someone right it's not a malfunction

64:21it's not a sign of madness it's a sign that you loved the person and in a way I'm going to beyond what she says now but you know I think one of the thing the fact that depression and grief have the same symptoms is really significant because I think depression is grief for your own life not going how it should write its grief for your own needs not being met now when someone we love dies all we can do is hold the survivors and love them right but with but with with your own needs not be mad I mean a real Ian example if there's something you've cut brilliantly on the show Joe about psychedelic some of the research around psychedelics which taught me a lot about how we might think about this differently so as you know you know better than anyone until the mid sixties loads of research was done giving LSD to people with depression alcoholism first problems they weren't done to the

65:09standards we want to do scientific experts now but they found really promising results and then Nixon shuts the whole thing down right in the last six years there's been a huge reawakening list I went and interviewed for lost connections the teams that have worked on this in here in LA at UCLA and weiu at Johns Hopkins in Baltimore in London at UCL in Sao Paulo and in Norway and loads of fascinating things and found about this but there's one that I think really relates to our conversation powerfully and while loads of things but well talk about one and so there was a sub finding of one of the studies that I became obsessed with they did this research Johns Hopkins in Baltimore some of the leading scientists in the world and where they gave psilocybin the active component in magic mushrooms to chronic long-term smokers who tried everything to stop smoking had

65:59not succeeded right I've thought about my mother a lot because my mother is a chain smoker there's a photograph of me and her when I'm six months old she's breastfeeding me smoking and resting the ashtray on my stomach oh my god and and so they take people like my mother right I don't what I showed her that picture she said you were difficult baby I needed that cigarette funny I blame you I was a baby she's a good person but so they take these people chronic long-term smokers and they gave them three doses of psilocybin over think it was six months it was six months so two month intervals a thing and what they found was extraordinary eighty percent of them stopped smoking right and it still remained not smoking more than two years later incredible think about we were comparing to 17% with nicotine patches and they were like what's going on so they did all this

66:46research in this and what we've got to be careful with psychedelics is to not talk about it the way we were misleadingly told about antidepressants chemical antidepressants in the 90s which is how it flips a chemical switch in your brain clearly a chemical process happens in the brain but but what they found I think the most important thing and their lesson for people who don't want to use psychedelics as well is sub finding so if you take psyche if you take psilocybin most people will have a kind of spiritual experience right some people will have a super intense spiritual experience some people have a mild one and a minority will have no spiritual experience it turns out the positive effects like a reduction in depression and addiction correlate exactly with the intensity of the spiritual experience so if you have no spiritual experience you don't have but

67:31isn't this dose dependent no this cut across dose they gave them three varying doses with the doses I can't remember but I said that's pretty significant that's a very important factor yeah so across the three say you were given it three times and you were always given three different doses so obviously you would have the more into most people have much more intense experience with the most with the stress those but the key thing I think about that that finding is that it was one of the experts put it to me it's not that it's a chemical process it's a learning experience what it does is it gives you an experience of what it can feel like to be deeply connected to feel deeply connected to the people around you to the natural world incredible strong natural antidepressant that we can talk about if you want have you like a dog experience so when I was a teenager I

68:15bought some and I think they were a drug dealer in Camden Town market I'm holding off because I got to go to the Amazon rainforest later this year and I want to use ayahuasca for the first time in the Amazon ever had because you know I'm getting that from the way you're describing there that's interest our interviews huge numbers of people who had tell me what you're getting that's interesting well this what it is is a dissolving of the ego that's a general factor that almost everybody reports it also releases you from deeply ingrained patterns of behavior and thinking and and highlights them so as much as it is a spiritual experience it's also a dissolving of the self and the the the way we define find ourselves as oftentimes very limiting you have this this is the way I describe it and this is the way I describe very powerful psychedelic experiences it's like do you remember

69:06the old windows thing control-alt-delete that's how you'd reboot it's like control-alt-delete for your brain and your brain reboots with a fresh new desktop there's nothing on it except one folder and that one two folder is titled my old and you have two choices you can either start fresh and try to re-examine the world with fresh eyes or what's more convenient is you slowly slip into the my old folder and start opening it up and repeating patterns and lighting that cigarette up when you really shouldn't having that drink when you probably shouldn't do that either and those things are common because it's comforting it's comforting for people to repeat patterns that they're familiar with I think it's a few things in that you're totally right and the scientific evidence is overwhelming the in fact that ECL at a University College London professor David Nutt did all this

69:53research this shows one of the things that happens in your brain when you take psychedelics is the part of the brain that relates to ego just doesn't function yeah right I member interviewing one of us moving interviews I did was a guy called mark who was on one of the studies in Baltimore who was a very shy reserved shut down guy when he was ten his dad had died and no one had talked to him about his dad's death his mother was just totally devastated and no one had taught him about it and he'd always been very shut down and he takes the psilocybin and he had this really intense experience where he he thinks he's in space and he believed he met his father and his father apologized believing him and then he reached into mark and he pulled out these walls and he said I want to thank these walls they protected my son they've done a good job but you can let them go now

70:43and after that mark really changed how he lived actually went and exactly so he was able to sustain that insight you went and learned a lot of meditation and I think I think you're absolutely right it's about dissolving at the ego and what an experience of egolessness egolessness can do is almost point a direction on a compass right but there's a another but that emerged in that which i think is one of the slight differences between us although I think there's a lot in what you're saying so in the in London they did this research with chronically depressed people and Robin Carhartt Harris he led that study said to me you know there was one woman chronically depressed she takes the psilocybin she gets everything you're saying the dissolution of ego the need for all the things we're talking about and then she goes back to her job in a shitty seaside town well you just can't live compatible

71:32with those insights right yeah she just couldn't and so her depression came back so to me what the size limit where individuals can change their lives obviously they should right and I thought we would totally agree on that and a lot of people do have more margin to change their lives and they think and we're in total agreement on that and I think you would probably agree that there are some people who are you know through no fault of their own like a lot of my relatives stark right and then there is very people have no margin of change but a lot of people have such a small margin of change but that margin will not carry them out of depression or anxiety or addiction and that's why we need the widest is what the World Health Organization says you need social solutions as well as individual solutions when to change the way the society works in all sorts of ways that

72:16reduce the things that are causing this pain in the first place what I mean changing the way society works though is a grand in entangled gigantic undertaking whereas changing your own life is not so I'm changing your own life is difficult it can be very difficult for a lot of people but it's far easier than changing society I mean who you're telling me has the psychedelic experience experiences this dissolving of ego this beautiful spiritual awakening but then goes back to a job that's like opening up the folder of my old it's the same thing she's going back to the same patterns well I would say she's being forced into that folder because she's what she could Adi but well being what she's gonna do is what a lot of people do I mean a lot of people change their lives I mean it's not impossible to do I don't know if this woman had kids I didn't ask I don't know sure but brother Majan

73:07beiieving can't imagine people being stuck it makes it very difficult it makes it very difficult but she's not in jail she's no no I was making but I think actually and this might sound strange in some ways I think changing the is easier than isolated individuals changing the cell so I'll give you an example how is that possible well I'll give example I'm gay right if I think about the incredible transformation I've seen in my life so I tell the story and loss connections about my friend Andrew Sullivan right 1994 andrew was diagnosed with HIV his first thought was I deserve this I had been raised in such a homophobic world he thought you know what I deserve to have this this illness it's going to kill me he was watching his friends die all around him he thought it was about to die this before protease inhibitors and he goes to Provincetown little town

73:54in Cape Cod to do what he thought would be the last thing he would ever do right and he wrote a book about crazy utopian idea that he thought this is never gonna happen I'm never gonna live to see this but maybe generations from now this will happen it was the first book ever arguing for gay marriage right and if I get depressed about this try to imagine going back in time is saying to Andrew okay and I said okay I've got some good news 25 years from now you're gonna be alive but that's not the good news the Supreme Court of the United States is going to quote this book in their ruling making it mandatory for all states in the United States to introduce gay marriage and the next day you'll be invited to the White House which will be lit up in the colors of the rainbow flag to celebrate with the President and by the way that president is going to be black right that wouldn't sound like

74:36ridiculous science fiction now daddy is saying to gay people 50 years ago you're not going to change the society that's way too hard what you can do is focus on changing yourself actually gay people would be really miserable if that's what they've done right if that's how it was my life would be immeasurably worse if gay people had just said you know what we is so hard to change society let's change ourselves we would have remained trapped in shitty awful institutions and systems that kept us down I actually think if I think about most the people I know who are depressed to be honest their margin for individual change is limited but banding together their margin for change is huge right think about which was about a universal basic income for example right I said look we're getting we're going to another subject here so yes you you keep going on to the next trying to start

75:25with one it's far easier to explain to one person one life why it's wrong to be homophobic than it is to change all the rednecks and all the ignorant people who don't read and all the people have deeply ingrained archaic religious ideas about homosexuality it's far easier to educate and illuminate one person n it also can be done with the aid of psychedelics especially MDMA therapy that's one of the things that Maps is doing right now with MDMA therapy and they're they're involved in a bunch of clinical trials right now so helping people with all sorts of traumatic stress experiences soldiers people that experience physical violence and all these people that are it's helping them alleviate a lot of the problems of their life there is patterns that people are that that they have in their mind that they can release sure you could release and you can be educated and you can

76:19understand you can change and grow as an individual it's far easier to do that with one person for one person and change their life then they change an entire culture I do agree that there have been great strides in this country when it comes to discrimination when it comes to racism when it comes to so many different ideas I think that's connected to the exchange of ideas that we're experiencing now because of the internet I think because of the fact that there's so many different arguments back and forth and there's so many different ways to approach things that people are being forced to change their opinions even more religious people today are more open to homosexuality than they have been in the past I've really believed that is of a factor of all the information that's available and the other the amount of communication amount of gay people that people know it's from

77:05television from news programs from all these different talk shows where they get a different sense of you know you see Ellen every day well gay people can't be evil Ellen so nice you know I mean there's a thing right I think you're totally right but I think that shows that the first thing you said is it's too simplistic so the what you think is that the division between I think the last thing to point you made is totally on the money but why don't you say the division is the idea that is easier to persuade individuals than persuade the society you persuade the society by persuading individuals you just persuade but they do okay I think we're splitting hairs here because I think if obviously if you change every individual you change society but it's far easier to change one they changed 350 million but that's a bit that's obviously true but you changed 350 million by changing one

77:52person or banding together yeah so you also one of the ways that you change those 1 Peter that one person is by banding together in a group right so gay people for example would be a good example but there are many many good examples but what you're saying about individual psychology it's important to say you're you're right about that so there are there's a very broad scientific agreement there are three kinds of cause of depression and anxiety and most mental health in fact all mental problems the other there at the ratio varies so there's biological causes which we talked about your genes for example can make you more sensitive to these things there's psychological causes which are the things you're talking about which are very real and important and their social causes so that you know a lot of the other things we've talked about and I think it away you don't need to play

78:33them off against each other they're all real right and you want to deal with all of them and so it's not I don't think it's we want to get to talking with you it's like you're saying we should deal with the psychological factor and I'm saying we should deal with the social factor you're totally right we should do what I think we should deal with yeah exactly we certainly do you know what I mean yes yeah yeah but I think that the idea that so like think of what you're saying in terms of people living unfulfilled lives living in job or working in jobs that they don't enjoy where they're being controlled by a boss it's far easier for one person to choose to change the path of their life than to try to restructure society where that doesn't exist anymore I Greece CEOs like this is what look this this is intent there's a met I mean obviously that was a huge factor in the 2016 election it

79:25was one of the things that was talked about is wealth inequality well there's no greater version of wealth inequality than the difference between the CEO of a massive company in its lowest worker I mean it literally is like a king and a peasant yeah it's a very strange sort of a structure that very recently has it become yes yes but it's so common I mean it is it's ingrained I mean how many corporations are there that operate like that top-down I mean it's it's gigantic and to change that I think would be far more difficult than to change an individual's path and to tell this one person hey man do you really want to do do you really like making pottery well you should try to make pottery for a living because this working for Dow Chemicals you're not gonna ever feel fulfilled you're always gonna have that same anxiety on Sunday night before you go to bed you

80:13always gonna feel like while you're at work you're always gonna be numb you're gonna be probably listening to the podcast like this while you're working just to try to pass the time I think you're right and totally if you can do it if you've got that margin for change 100% my advice to is I say why wouldn't you be able to do it eventually you might not be able to do it right now but if you plan for it why wouldn't you be able to do it I think about one of my closest relatives right she's she's very depressed she's got two young kids she's working really hard she's in a shitty town she has very controlled work I'm trying to think I've desperately tried to think of the margins of change that I can help her facilitate in her life right mm-hmm and I've really struggled I mean it's an environment where most people are depressed most people are obese England yeah yeah

81:06but I mean it could have just as easily been sure I've spent a lot of time in the u.s. but I think there's more people with this problem in the US you know now I think we're essentially that's a very green anyone who has any margin of change I go through loss connections the seven ways you can change your life that the science the science shows will reduce your depression and anxiety very likely right if you've got that margin do I think the only disagreement wins is I think you're more youth you think more can be done by individual will alone than I do probably and I would say but that's not disempowering in the sense that I would say the most powerful individually empowering thing you can do is band together with other people like you and fight for something better right work together towards improving yourselves exactly that with the people in your community and making

81:54some sort of a bond tightly and one of the most moving things I learned about for the book was this incredible protest movement in Berlin I can tell you about if you want that transformed it really is one of the places where so much of what I what I learned from these scientists really fell into place with me and it was we're very isolated people came together and just said you know what we're not going to take this anymore and fought for something better I can explain this a longer story but if you can't wait to tell me I will but the so I think you're right that so you were saying you know what do you like to do when you said pottery as an example that's a good example but I would all say and maybe that what you like to do but actually because we're a social species this is what most would like to do is get together with the people around you yes and fight for something better and I

82:35think you're totally right about how this played out in the dynamics around the election I remember so it really haunted me I was with some people who were doing some get-out-the-vote work in Cleveland and if you know Cleveland I mean it's like Detroit without the poetry of the ruins right I mean it's shocking and we were on this street in an area called Slovak City don't know why it's not Slavic and okay what do you say that I mean this great part of Cleveland right now I'm in the area that was answer I should it was this area of West Cleveland called Slovak City not kick your ass a t-shirt at one of my shows that I put on my Instagram like Cleveland or death they're serious about Cleveland they have the heavyweight champion of the world ste p.m. yo chick he lives in Cleveland so we're this street is one of those respective of all of a place like that now I'll take you just kid row

83:32right now sure sure we could just go to Beverly Hills your choice you know what I'm saying it's non-standard son but just just about this street that there was this we're going down the street at a third of the houses have been demolished a third were abandoned a third still have people living in them some of them behind literally behind barbed wire right sounds like a children's math problem fifteen people live in this place heroin oxycontin 15 people lived in that place there on antidepressants who's happier so we we knocked on one door and there was a woman who from looking at her I would've guess was 60 right she was actually the same age as me I was 37 at the time and she was very articulate she was she knew it she knew a lot she was really angry she was raging and and she made this verbal slip that's really stay with me I thought about it while you're speaking earlier

84:26she's about the area used to be like her parents and grandparents right and she meant to say when I was young what she actually said is when I was alive I was like that's how she feels right she feels like she has died and it made me think about this this other research was think about as she was saying this or I think relates to the individual versus collective debate that we've kind of been touching on so Native American groups in Canada they call them First Nations groups have really high suicide rates right and this professor I got to interview President Michael Chandler did this really big research on this because what he realized this is a 196 First Nations groups in Canada some of them have really high suicide and some have none right and it's like why is that so he'd spent ten years researching this discovered loads of things but one of the things he discovered was some of

85:15these groups have basically been able to fight to regain control of their community right they've rebuilt their language they've rebuilt their school control of the schools and you know whatever and some have just been so kept down that they haven't been able to do that suicide rate correlates really tightly with the amount of control they were able to regain over their community in the mound of meaning that you'll find in your life I think it's about meaning it's about having a story about who you are it's about having social connections around you so you're not alone you're part of something being inside exactly so I think when you when we were talking I thought about that one when you were saying you know what what do you like to do what should you do if someone's listen to this and they're lonely and isolated you know because we're such a fractured Society and because we find it

85:54so difficult to be present with each other right the the constant distraction and refracting everything through screens which makes us bill I sure can talk about some of that if you want the the the actually that that initial step is quite hard because we're so broken up right it's not just the initial step its you've gone too far in one direction like say look at it this way if we all started this neutral point right and someone like Jamie does what he wants to do and and finds a good path and starts going in that direction and keeps improving his life and then eventually is a happy human being as an adult or you have someone who goes the wrong way they get addicted to food and cigarettes and drugs and antidepressants and they get into bad relationships and then they have children that they have to take care of then they have a job if they hate and then they find themselves at 37 years

86:48old looking like they're 65 trying to figure out how to get back well they've got to find a way to not just move ahead but to get back to that neutral point so they have to go back in time over all this they up and they have a far longer path so it's not an impossible path but it's a far longer path if you all if everyone's going in that direction and that direction is 25 miles away but you go 37 miles backwards you have to go 37 miles forward and then the additional 25 miles that's the problem with people they look at the the the daunting nature of that task and it's very intimidating to them and they don't feel like they can make it they don't feel like they can but there is satisfaction and hope and happiness and moving towards a positive direction and that's what people have to realize it's not about a goal it's about the journey being a positive journey and the feeling

87:47that you get of improving your life incrementally on a daily basis and it's also the mindset that you carry with you on that journey you can't look at yourself and go god why am I not successful yet why am I not rich why am I not this why am I not that you have to say I am better than I was yesterday tomorrow I will be better than I am today and I am on the right path and there is a lot of deep satisfaction and happiness in being on the right path now if you're a person who wants to be an author but instead you're an accountant every day you spend not feeding that idea that you can be an author is gonna chew away at you it's gonna chip away at you and it's gonna move you away from that neutral point many many miles I totally agree with you I totally agree with you and I think that the that thing about when people realize they have agency that's one of the most because

88:40especially it goes back to what we're saying about work if you are spending nine hours a day being controlled one of the things you do to get through that is it a process of internal deadening right the guy in the paint store he would say you I would just get home and initially it was alcohol and then later oxy he would just want to numb himself right right because there's an internal deadening you have to do to get through that which is why I think one of the key aspects that I talked about loss connections is this transformation of work if the thing that most people are doing most of the time is making 87% of us we don't like it at best but you've got to go to the heart of that right and and you know we're talking about margins of change people who set up that bike store in Baltimore they were working-class people you know who had not had fancy education

89:27they set up a democratic cooperative right they they transformed their lives so they were a good example of people who appeared to have a relatively limited margin they were low wage workers in a in a low wage industry who you know have made this transition so I'm certainly not saying that people can't make these transitions right even in difficult circumstances they absolutely can I just think yeah I think think about the the farmer in the field in Cambodia right whose legs been blown off and he's in this field and it's agony he needed to change his life but he also needed someone to buy him a cow right he couldn't abort that count on his own in that situation yes he would be an illustration or Orin or the rats in rat Park right if you're in that isolated cage I mean it's not a great example because you know the rat can't leave the cage where you could oh yeah but you see

90:16the point I make it I do you could repeat it just to individual oh no this is not what you're doing I think some people attribute this just to it's definitely what you're saying but just an individual weakness or individual failing what I think that the individual psychology is a significant component alongside other components I don't think of it that way at all I think the I think of it as poor choices I don't think of it as individual feeling I've made many many poor choices and in my life here's one of the big ones you could tell people because there's a lot of people that are listening in this at various stages of their life if you're young and you have an open future you don't have massive obligations and debt and all that all the different things that become a real hindrance as you get older move towards a direction that is attractive to you do not move towards

91:03the direction that is safe don't do it because if you do do that if you just take that safe job and then there's a lot of people who know a lot of people can't do that that is a stupid way to think and that will you that that way to think will you you can do what you do what you choose to do you can get better at things if what you choose to do you can move forward and try to figure out a way to carve a path through that life and it's not going to be easy but nothing worth doing is easy but this idea that look if you want to just do construction if that's appealing to you you'd like to just be a laborer and there's look there's a need for that in society if it doesn't bother you it's but find out what bothers you and find out what you enjoy if you're a laborer and you really want to be a songwriter well you better chase that songwriting you better do it

91:53because if you don't do it you don't want to be a 60 year old man sitting around just depressed and crying and then maybe you call your friend up who does do that for a living and he's having a great time and he just released his new album and you both started out together in high school and now here you are at different stages of your life and you you haven't pursued your interest you haven't pursued your passion you haven't pursued what you really want to do I would endorse every word you just said I would just add a layer alongside it which is and we should change our society so fewer people get trapped and more people at the moment a lot of people feel we want to be giving people trampolines up Ronnie I think universal basic income is probably a way that that's going to start happening yeah I think that can happen that can help a lot of people where your basic needs

92:37your food is taken care of I think President Obama talked about this too towards the end of his term partly because he said look I don't attribute this to him I come over he said it made this point in this way but he was interviewed Wired magazine and he said he thinks this will have to happen in the next 20 years partly because of the extraordinary disruption that's coming to the economy through you know Robert ization or our nation exactly so Iran must said that recently as well yeah well I think he'll musk is saying it for a slightly different motive and that he knows the pitchforks are gonna come for people like him and Mark Zuckerberg the anger is gonna be directed at Silicon Valley if there isn't a universal basic income I'm sure they have genuine concerns of people as well but I think so you think that's really why he's saying that I don't know my god maybe

93:19I'm just hurting all the because they just make so much man well I can't move who said that someone said you know the path the economy's on there's gonna be seven tech billionaires and everyone else employed to give them massages right and I think there's something going on here which is I think they know at some level if they don't start providing some if the society doesn't start providing some baseline of security look I forget the thing I think three million people in the United States make a living through driving mm-hmm that's not gonna be exist in 10 years from now probably right self-driving cars are likely to just that's going to be gone right right now that's an extraordinary disruption to the economy those are mostly men they're mostly men with low educational achievement attainments for various reasons a lot which are not their fault and and you know that's devastating

94:03right so I think you're right that a universal basic income is one of the important strategies that can that can kind of deal with that but I think this comes much I think you've got you go back to think that there are there's a kind of recurring theme in this conversation which is you know for both my books for chasing The Scream and the lost connections ant addiction and at depression anxiety both of them required me to go all over the world and just look at really different places that do things really differently and there were some things that just recurred for both right give you example with addiction the places that have most reduced addiction have not been the places that have said this is an I'm not tribute to mr. you very clearly you're not saying this but people whose the places that have said this is a problem for the individual and the individual needs to

94:45sort themselves out have a massive and growing addiction crisis prom gets worse and worse the places that I went to where they said actually this is a collective problem we need a collective solution we're very different so Portugal for example in the year 2000 have one of the worst drug problems in the world right one percent of the population was addicted to heroin it was incredible every year the problem got worse as they tried the American Way more and more arrested more people in prison more people and one day the Prime Minister and the leader of the Opposition got together and they were like look we can't go on like this right we can't have that ever more people in our country being addicted to heroin where we're going to do so it was quite bold thing they set up a panel led by an amazing man I got to know dr. Huang gu Lao and and they said to this panel you

95:25guys go away figure out what would actually solve this and we've agreed in advance we'll do whatever you recommend right so they'd be like if Trump and Chuck Schumer and then see plays agreed they would everyone would abide by finding on this so they go away they look at all the evidence including rat Park loads of the things we've talked about they came back and said decriminalized all drugs for cannabis to crack everything but and this is the crucial next step take all the money we currently spend on people's lives up on arresting them shaming them stigmatizing them imprison them and spend it instead on turning their lives around and interestingly it wasn't really what we think of it wasn't there was a little bit of residential rehab most of it was a big program of job creation they set up micro loans so people with addiction problems could set up and run small businesses about things

96:09they cared about they set up a big program of subsidized work so you know say you used to be a mechanic they'd go to a garage they say if you employ this guy for a year we'll pay half his wages right the results in Portugal have been incredible accorded the best scientific study position the British Journal of Criminology injecting drug use fell by more than 50% overdose deaths massively fail HIV massively fell one thing that was so striking there was going around speaking to people I mean one of the most moving interviews I did for chasing the Screamers with them a guy called Haifa Guerra who was the top drug cop in Portugal and he led the opposition to the decriminalization when it first happened right he said this is madness we're gonna have a massive explosion in drug use it's gonna be a nightmare and he said to me everything I said would happen didn't happen and everything the

96:54other side said would happen did and he talked about how he felt really ashamed that he'd spent twenty years before the decriminalization people's lives up and he that goes to the debate that we're talking about because that was now that's individuals changing right that's that's very clearly individuals changing making better choices but they're making those better choices in a context of context where the society instead of beating them down is trying to lift them up do you see what I mean that's a very good point that's a very important point in what Portugal has done should be studied by our country which is now falling right back into the old Nancy Reagan just say no days with Jeff Sessions at the helm of catastrophe he's a terrifying person in that regard because he's so ignorant as to what's going on he's so ignorant all America drug he's a fool I mean he really is and

97:36the the the pattern is terrifying because they're trying to call kratom and opiate right now there there's there's all sorts of resistance to what we know of safe alternatives to pharmaceutical medications like CBD that's another one they're demonizing they want to categorize that with heroin and cocaine it's terrifying it's it's it's a very very weird time because there's so much evidence and so much science and so much history when it comes to things like Portugal where it's been successful to decriminalize everything and spend the money on treatment programs but they're ignoring that they're ignoring that because it's convenient you're so right but my concern is it's not Jeff Sessions is you can imagine what I think about Jeff Sessions is disgusting and insane what he's saying but my worry is it's not me I'm worried about Jeff Sessions primarily but my

98:25other worry is it's not just Jeff Sessions I actually think even outside you know when it comes to the the opioid crisis I think I've been talking about this in quite quite the wrong way so it made me realize actually how deep this Nancy Reagan script is in the culture that even liberals my side of politics have basically been saying their story about the pharmaceutical the opioid crisis is basically evil drug dealers came along they gave people these drugs they got accidentally hurt in this case the evil drug dealers are the big pharma they've got them accidentally hooked and that's why we have this crisis right now there's as you can tell from my conversation about antidepressants there's a lot to criticize big farmer about I'm very critical of them but that story is just ridiculously sick but if that were true antidepressant prescriptions have been given across the

99:11United States right if that were true it would not make sense that the opioid prescriptions are also concentrated the opiate addictions are also concentrated in the places where suicide is highest were depression is highest where of course there's some everywhere but there's a reason for that right Angus Dayton The Economist who studied this described the opioid deaths as despair deaths right if you go to the places where as a know you know you turn right around the country when I go to places that have been most affected by the opioid crisis what's going on right they've been deprived of the things that make life meaningful so they want to be anesthetized all the time there's a devastating line Marianne Faithfull who was Mick Jagger it's best known for being Mick Jagger's girlfriend that kind of pisses me off because think she's even better than Mick Jagger but

99:55she what I know and it's controversial better than Mick Jagger it's controversial are there even conversations Oh shut it out Jamie very unfaithful had a heroin addiction in the sixties when she was homeless and she has this very challenging line in her in her memoir which she says something like heroin saved my life because if it wasn't the heroin I would have killed myself right and don't misunderstand what I'm sayin Herman it's not a good solution to despair if we want it clearly for all sorts of very obvious reasons if we want to understand why there's been this huge increases opioid use we have to understand these things that I'm writing about your connections in the World Health Organization is explaining this deep kind of despair and my worry is that gives you about to worry about how eyesight is getting it wrong so we've got Jeff Sessions getting it wrong in

100:36the most obvious insane way right right you know it's just we need to crack down on the Mexicans and that will stop right we the United States have spent a trillion dollars on the war on drugs it's done it for a hundred years it's imprisoned more people than any other country in human history and at the end of all that you guys can't even keep drugs out of your prisons where you pay people to walk around the perimeter the whole time so good luck keeping them out of a country with to 3,000 mile borders that's so ridiculous and so absurd that it's not just that it's why would you think that you could tell a grown adult what they can and can't do with their body of course but it's really simple but I think I'm pretty sure all of your listeners agree with us on just say or pretty much all of them agree those are just sessions what I think more of them will be

101:17tempted by will be the more liberal argument Isis as a liberal so not attacking liberals but the more liberal argument which is this simplistic even Bernie Sanders who I love and what about it for well I think he's got this wrong which is that although I think Bernie Sanders's politics would deal with some of the deeper problems as well clearly but there's this story that it's about the drug companies we've got to look at the one place that solved an opioid crisis we talked about Portugal one other place so Switzerland I'm a Swiss citizen , dad's from there as well as British obviously Switzerland had a massive heroine problem in the 90s right huge almost as you know not quite as bad as what's happening with opioids here but it was massive and Switzerland got this amazing kick-ass female president called Ruth Dreyfus who explained to people look when you hear the word

102:04legalization what you picture is anarchy and chaos right what we have now is anarchy and chaos when you prohibit drugs what you get is unknown criminals selling unknown chemicals to unknown drug users all in the dark filled with violence disease and chaos what she proposed to do is legalize heroin right I said want to understand that what that doesn't mean doesn't mean there's like a heroin aisle in the CVS in Switzerland right so different things can be legalized differently I don't know the rules in LA but I'm pretty sure you could legally if you wanted to own a dog a monkey and a lion but I'm pretty sure the rules are different right yeah I don't think you can own a monkey reliably could you if you really wanted to one and you were rich you know you could get them in Texas right so you want except you can't have part in Texas pretty sure in Texas it's licensed so you could you

102:52know yes they're all legal but they're legal in different ways right right and a similar way what Ruth Dreyfus the Swiss president was proposing is heroin should be legal but not in the way that alcohol is legal so the way it works is if you've got heroin problem in Switzerland you're assigned to a clinic I went to the one in Geneva where the former president now lives across the street which tells you something you go you you have to go early in the morning for reasons I'll explain you're given your heroin there you can't take it out with you you've got to use it there and then you leave and you go to your job because they give you they do two things and it's the exact opposite of what's be proposed in the US or something post in the US is stop prescribing and don't give support right well they didn't mean it's somebody's exact opposite in Switzerland they'll give you the drug

103:33you're addicted to and then they give you loads of support to figure out why you're in such pain in the first place they'll help you get housing they get you subsidised work and they give you loads of therapy I think you are you aware of iboga yeah of course yeah well that's probably one of the very best ways for people to quit drugs so any especially some horrible drug and it's a ruthlessly introspective drug that many many people found great success and kicking heroin cigarettes alcoholism getting over past abuse I mean it is it's a long experience it can last more than 24 hours totally illegal in the United States but a lot of people go to Mexico and do it and I've had very good friends that have had problems with pills that went over there and and kicked them because of iboga that's a you should um okay but produces an intro to dr. Gabbe Marte he's a friend of

104:23Nelson he would be a great guest view is he living no he lives in Vancouver but he comes to LA Fellows Ian you should definitely talk him and I would really recommend people look at his work but the in terms of just to say with the last point about Switzerland because it was something really and I think it relates to a bugger in a way so one of these really surprised me and that spending time in that clinic I remember there's chief psychiatrist there dr. Rita man Jesus is it so they will give you as they will give you any dose you want except one that will kill you and there is never any pressure to cut back which really surprised me so you could go to this clinic and they'll go to you up with heroin they give you the heroin you you have to use it there you can't take it out with you could they want them sell it people selling it on and also that's kind of badass you're monitored by a

105:03nurse but the results are really incredible right right so um the headline most important fact is there have been zero heroin overdose deaths on legal heroine in Switzerland in the 12 years that programs exist it has the nori she o of people using to not using how's it gone a really significant fall in heroin use could the best researchers by professor Ambrose Austin Hagen who's shown there been no deaths in the legal program and an enormous falling deaths in the illegal program and an enormous falling years over all the various reasons I can talk about but the thing that blew my mind was so they give them whatever days they want for as long as they want and I was like but what we're told that comes back to chemical hooks what we're told is they'll just want more and more forever right right actually what happens is almost everyone chooses to cut back over

105:47time and stop right when I went there I think they were like two people who've been on the program at the start and I said to dr. Maggie who runs it I don't understand this how is this happening and she looked at me like I was an idiot and she said well people's lives get better and as their lives get better they don't want to be anesthetized so much which seems almost stupidly obvious right it goes right back to what you were saying about antidepressants and and people's lives like the choice that you make in the past that you take and the people you surround with and the happiness that you feel from your community that's ultimately what leads to a fulfilling life and if you have all that why would you it up with heroin alright I think the more you're totally right that the the whole premise of lost connections is because right so we're saying at the start

106:28human beings have needs right and if your needs are being met you don't want to be a nice the time I think what you said is very important and there's psychological needs that are just as valuable and important as physical needs like we know we have needs for nutrients we know of needs for water we have needs psychological for for all sorts of different things our communities are incredibly important love is incredibly important family is incredibly important you know I know some people that are older men that have been bachelors their whole lives and they're childless and now they're you know they just they don't have a deep connection with anybody and they get to this very weird strange place where they like is this it now I'm 70 years old and I've never really had children and I don't know what to do and this is this is my life now and it's they did they've all their

107:21friends have had families now and their families a lot of times the kids are grown up and it becomes very very strange you know I thought about that a lot in speed this guy and professor John Cacioppo at the University of Chicago who's the leading expert in the world of loneliness and he said this thing to me this so only weirdos really interesting it's very simple point but just said if you think about the circumstances where we evolved right if you got separated from the tribe if you were alone you were depressed and anxious for really good reason you were about to be eaten like you were in terrible danger if you were injured no one would help you you would die right so all the so women as you know when we when we're stressed we release a hormone called cortisol he showed this room to experiment they were at bat in the burgh being acutely lonely it's as stressful

108:12as being punched in the face by a stranger when it comes to cortisol release right that's how deeply we are resistant to loneliness right it's a signal telling you to get back to the tribe that's why we bought it's a really important signal if humans haven't had that signal we wouldn't be here right and I think you're right so when you look at these these men if you haven't isolated there was this woman that so I covered this incredible protest movement happened in Berlin on a big anonymous housing project where no one knew each other and they came together to protest but it was a woman who was about to kill herself because she was about to be evicted and the whole housing project came together to say she should be allowed to stay in her home and they should have a rent freeze and it's an amazing story I tell it in the book but there's something one of the women said

108:55to me that I never forgot it's called Nariman she'd grown up in Turkey and she'd come to Germany I think when she was 17 she said when I grew up in Turkey what I called my home was my village and everyone in it and then I came to live in the Western world and I learned that what you're meant to call home is just your four walls and if you're lucky your family um and then this protest began and we all got to know each other and this whole place became my home and I think if every where here is home now and and she realized that that we are homeless in some sense in the Western world that as humans have a need for a sense of belonging and our sense of home is too small to me our sense of home belong belonging there's a wonderful Bosnian writer called Alexander Heyman who said home is where people notice when you're not there right and a lot of us like these guys

109:48you're talking about all the guys who notices is they're not there right probably no one probably are in a sense homeless yeah right they are spiritually homeless and I said that I'm not religious personal unless you go through saying yeah you know what I mean yes and so I think it's about and this comes back to think about how different that is what everything we're talking about think how different our conversation has been to what my doctor told me when I was a teenager and I go in and I said I'm in real pain and I feel like pain is leaking out of me and I can't control it and he says you've just got a malfunction in your brain right one of the worst things about that there are many things wrong with that firstly what he said to me it's not true I'm sure he believed it I think he was misinformed I think he was deliberately lying to me but what he said was not true but also

110:32to me the biggest problem with just telling this exclusively biological story about depression and anxiety there's some real biological factors of course is it cuts us off from having this conversation right all those people you were talking about who aren't so insistent as I was to their depression is just the result of a chemical imbalance if you think that it disconnects you from the source of your pain it tells you you're just biologically broken and presumably always going to be biologically broken when the conversation we're having which is a different conversation as a difficult conversation it's a nuanced conversation it's not simplistic it's not one problem one lever to solve it is a much deeper and more textured way of thinking that is the conversation we have to have that's what the best scientists in the world are telling us the world health organization and my

111:18worry is we're just being pushed in it like you said that that a brokered metaphor about driving 37 miles in the wrong direction right we're just driving in the wrong direction we're driving away from the source of our pain rather than towards it where it can be understood and solved of course it's always gonna be some pain in human life but the fact that we have this one in five people taking a psychiatric drug you know I think the figure is one in 10 13 year-old boys is taking a stimulant drug to make them focus I think the figure is 30 percent of old people in in retirement homes have been given anti-psychotic drugs to shut them the up because they're rebelling against the way they're being treated in between one in four middle-aged women in the United States is taking a chemical antidepressant at any given time you're wanting one in four one in four are you

112:02talking about that a society that I mean the figures about how many children is much lower but it's so much more extreme the number at number two toddlers who've been given antipsychotics in the United States is just off the scale right what I am I think dr. Sammy Tamimi has written about this there's some extraordinary figure I'm getting finger slightly wrong but it's something like a majority of children in foster care in the United States are being given stimulant drugs basically to shut them up yeah that's that's a disturbing one the ritalin and verily various stimulants that they give to children what's that about what's the cause of that well I think it's related I researched this much less than the other things we've talked about there but from it came up a lot in the conversations that I had there are many things going on here one of them is and a lot of this

112:51so a lot of that not all of them a lot of the causes of depression and anxiety that I wrote about I couldn't help but notice reading all the research into being the scientists also can lead to decrease in focus and attention so for example if you are dead and at work and you feel controlled all the time you have to deaden yourself to get through it it's harder attention to muscle right it's harder to bring your brain back to focus like Joe wanted to just go and collapse and watch you know watch whatever was on The Bachelor or what I would watch the maturation leave whatever on the telly on the TV and in his full state of depression the bathroom it was prepared to take oxy but not to go to that level of self-harm right but the or think about loneliness right there's really first Cassiopeia shown this if you are lonely that triggers what's called hyper-vigilance

113:42right again for a very good reason if you're on your own in the savannahs of Africa right if you want to be hyper vigilant of course so you find it one of these was most challenging to me is this evidence that the people with the lowest levels of attention problems and depression and anxiety in the United States are the Amish right and I am a atheist gay liberal so the idea of going in like learning slang from the Amish was initially transmitted I've gotta admit I felt really humbled by going to spending time there I went to this village called Elkhart Lagrange's just outside Fort Wayne in Indiana and you know and there's still a lot I disagree with about the Amish don't get me wrong not least because I just re-watched witness but the but but you know they I could see that they've got so it's very something about the Amish as you know when you turn 16 if you're an amish

114:31you've got to leave and go and live in what they call the English world our world right and then you decide whether to come back about 80 percent decide to come back 20 percent down it's one of the reasons why the Amish has never counted as a cult because no cult would do that right no cults gonna tell you to leave for two years and then decide whether to come back in fact the exact opposite so they have lived in our world they know our world really well and I were having this very challenging conversation with what's his name Lauren beachy his name is an Amish guy there who said to a so revered cause back to the wait conversation we had he said that there's loads of things I miss he talked about missing that 70s show he said I used to love driving in trucks because they've gotta drive that he's all tricity off-the-grid and he said but you know if I kept those

115:13things I wouldn't spend time with my family I wouldn't spend time with my children I wouldn't I wouldn't know who my neighbors were and he said this very tragic thing he said you know Weight Watchers and I said yeah and he said well the idea Weight Watchers is you could only lose weight together as a group right it helps or not only but helps you to lose weight together as a group that you would find it harder on your own this is like that and I said what sir are you saying about the Amish is like wait what for the problems of Western civilization and he's like yeah that's what I'm saying and to me that was so challenging the idea that you've got to give because we comes back to itself at John values in our culture we're told the solution is always to get more and the idea that the solution is to have less and be present more is really challenging right

115:53I don't I don't even think it's about having less it's about what they're doing is looking about what the Amish are doing first of all massive sense of community right they're very connected they're not using cell phones they're not using email so the community is also based on one-to-one interaction real social cues real social interaction which is critical it's a big part of being a human being and it's one of the more apps and things in modern society to physical labor they're involved in a lot of physical labor because they don't use electricity they don't use power tools there's so many things that they don't do so because of their culture they're making their own homes all right so they have a vested interest in helping each other working together as a community and they have a deep sense of satisfaction of constructing each other's homes you construct my home with

116:39me I help you build your home they take care of their animals they take care of their crops they take theirs there's a real connection with where they get their food from a real connection with where their they live their community the sense of just that the whole the sense of belonging to something that's bigger than you it's a there's so many factors involved in their happiness that you can kind of see where it yeah there's a lot of wacky with the the cult aspects of being an Amish person but what you get out of it it's almost like if you had a self-help group that subscribe to all the positive benefits of being Amish and they just called it like re grounding or something like that you just go out there and you become a part of nature and I mean that's that seems like a co-op that seems like some sort of a farm based co-op right yeah I build each other's houses stay together

117:32you don't have to wear sexy clothes let's just all wear the same it's some big deal I love how you put that and it you're right to the inequality the richest our mission is as wealthy as the yeah essentially so cuz it's not like they're not holding them back I think that's one of the things that I think about this in relation to attention is so there's this theory that Amish kids don't seem to develop ADHD right and there's been it's been surprisingly understudied maybe none of Amish doctors that's a problem kids bouncing off the wall like he's durable if it was like they don't have electronics so then obviously I think going on there but actually the main thing is when I spoke to them they said yeah we've got some kids who don't want to concentrate and sit in school but so we just let them run around and go fishing and hunting instead right yeah and I said me brothers alright so

118:21there's always going to be maybe factors making it harder for us to concentrate in the environment I think there are but there's always going to be a natural variation and people who want to sit and focus on one thing compared to people who want to you know rather automatically and that's actually you can see how as a species it benefits a star both right right and but what we do is we try to bash every child into one particular mode of being of course actually is designed to prepare them for shitty deadening work the reason our schools are shitty and deadening there's a guy called alfie kohn he says every school has an official curriculum and a hidden curriculum the official curriculum is like history geography whatever and the hidden curriculum is this is what we're training you to put up with in your life right right and if you've got a society where 87 percent of

119:05people don't like their work and you're more twice as likely almost twice as likely to hate your job as love your job part of the job of the school system will be to deaden children so they learn you've got to sit there and shut up and do what you're told right so that's not a malfunction of the system that's an unconscious function of the system right so we've got this system where we're brushing these kids to prepare them for this economic system that's making us feel miserable to me the solution is to change the way we work so we don't have to dead no children right right actually our children can be but but the arm issue you know do what as you say it's not like they're doing and high-end cognitive labourers will be the fancy way of putting it right but the the their kids to them having a kid who goes fishing and running around it's normal is this valuable actually as it may even

119:51be more valuable than the kid who sits there reading right yeah because actually so um and I think that's a real thing about this what that tells us it comes back to one of the themes that's come up all through our conversation Joe these things that we've told our pathologies make sense in their contexts right depression were told it's a pathology actually anxiety which was project actually is largely not entirely but largely a response to things going wrong we're told addiction is a pathology it's a response to things happening we're told that obesity is a pathology in some cases it's a response to things going wrong we're told that kids not wanting to be able to focus is a pathology and adults not be able to focus I think we need to understand that these things have meaning they make sense right doesn't mean they're good most it's clearly not good to be obese

120:33it's clearly not good to be addicted obviously but if you understand that they make sense that opens up a totally different way yes of responding to them ones that actually work right the places that let me talk about the drug war right for chasing the screen my book about addiction in the drug war I went out with a group of women in Arizona in that prison run by that psychopath Joe Arpaio I also interviewed who Trump pardoned how the did he pardon their guy D believe it's funny I can tell you about Joe Arpaio because in a funny sort of way I felt very sorry for him but anyway I went out on this group of with this group of women who made to go out on a chain gang wearing t-shirts saying I was a drug addict while members of the public mocked them and jeer at them right and I remember going back to the prison with them it's called tent city and the women were terrified as

121:30something called the hole which is where you were sent if you up right and I said to the guards we take me to see the hole and I've been in I've done a lot reporting from prisons and dads always don't want to show you the bad things in this one because it's a pantomime of cruelty they want you to see it right so they took me to the hole it was in fact a hole it's a concrete cell bare concrete cell but with nothing in it no TV nothing and I saw this woman in there who was when like she saw my face through that was just so desperate to see a human being who wasn't one of these guards she'd been there for a month and I remember the audio is actually under trace on the screen website and chasing the screen comm and I remember looking in this cell and thinking this is the closest you could get to a literal human reenactment of the cages that guaranteed addiction in rats and

122:18this is what we're doing thinking it'll stop this woman from being addicted all the places which had approaches based on punishment and shame towards these things sometimes people say Oh punishing people with addiction problems doesn't work that's way too soft on it it makes the problem worse right those women go in broken devestated then they're even more broken and devastated they go out even more addicted right so reason why Portugal has massively for Porto and Switzerland have massively falling addiction problems and the United States have massively increasing ones right right so to me again that the evidence is approaches towards this problem that are based on compassion connection love understanding seeing that it makes sense work they're not magic bullets they're still going to be problems in anything we do um approach is based on shame and stigma and rage and just condemning

123:13people they just make the problem worse yeah there's no doubt about that and there's also know about doubt about what you were speaking about when you started that rant about schools yeah about schools with children trying to fit them into these these very convenient categories and trying to get them to get comfortable with doing things that they don't want to do that that's great if we're we've resigned ourselves to turning children into work robots I love that way you just said that's pretty yeah it's not it shouldn't really look I went through that myself I thought it was a fool when I was in high school I was like there's got to be something wrong with me I can't concentrate I can't do it I'm never gonna be good at anything I was like I'm just going to resign myself to be an outcast I'm gonna resign myself to be a loser because I just couldn't sit still in class I couldn't pay

124:02attention I didn't want to do the homework I was bored out of my mind and I didn't even realize there was anything that I could do that I would be intellectually curious about I mean I just I didn't think that that was a part of my life I didn't think I was a curious person it was just merely because I was being forced to do a bunch of that I didn't want to do and it tainted my idea of learning and when I got out of school and then when I started reading books just for my own amusement and interest then I realized oh I'm a very curious person I just I just didn't want to do what they wanted me to do I didn't want to study what they wanted me to study and I didn't want to be stuck in some room with some person who was under motivated and really didn't have any understanding of how to deal with children it was the rare person one out of five one of those

124:49six teachers that would come along that would give you like some spark of happiness and love and you'd go like oh this class is pretty cool that's a good teacher like all she's nice you know he's fun it was rare it was very rare most the time it was a dull grind and I would wake up with nightmares after I'd graduated that I'd up and didn't get the right amount of credits and I had to go back to school I would have crazy nightmares that I would have to repeat the 12th grade and go back to school because I just it was soul sucking and to me it represented the future because the future was going to be more soul sucking because you're gonna be working 40 hours a week plus overtime doing something that you hated and this is what you had to do if you wanted to get by in this life and that is what was presented to me and that's what's presented to a lot of people and

125:35if you take that and keep going with it you eventually become that guy who's in that job and then you say well maybe I'll get some happiness if I get a nice car and so you take out a lease on a nice car and then now you have this debt that you have to pay so now you have to keep working and you keep working so you can keep this car well I'm gonna get a condo and then you get a condo you got more debt then well I'm getting married we're getting married well we got to take out a loan for the marriage because it's real expensive to get married and all she wants a big wedding and then you get a big wedding and a big ring and all this dude now you're deep deep in the hole and now you have children oh and then you know you're like well I really don't want to be selling insurance anymore I wish I could wish I could have been an artist I wish I could have done this I wish I could have

126:13pursued my interest well it's kind of too late you're 150 miles away from the neutral point so you've got to go 150 miles back before you could start at zero I think you put us so well and I'm just thinking about that this is the heart of my but loss connections is saying we don't have to have a human culture that deadens people right now we don't have to have a culture where people are controlled deadened or isolated that's not how most humans have ever lived the Amish live much far more human beings have lived in the way the Amish live have ever lived in the way we lived now I don't wanna go fully back to the Amish obviously but but there are lessons we can learn from all these things that we're talking about about about reconnection to meaning of purpose and part of what you're saying is we live in a landscape that has been constructed not to serve people but to serve

126:57corporations right this very unusual recent human innovation yeah actually I said you know imagine if every corporation was converted into a democratic cooperatives imagine everyone listening to this tomorrow knew they were going in to work in a place where if there is a boss he's elected by them he's accountable to them where you decide the priorities for your workplace with your colleagues by voting maybe once every three months once a year whatever but the boss is accountable to you that's a very different way of living and thinking about the things we do most of the time and that would again require a vote a school system that prepared people to be citizens taking part in a workplace not as you put it brilliantly like robot workers you know just passively receiving orders that requires a big systemic change now lots of people are making that transition you

127:43know that people are talked about but Baltimore bicycle works you've made that transition on their own but these are these are big social changes we can make that and again one of these that's so important is about saying to people like it sounds to me like no one said to you Joe the fact that you hate this school is a sign that you are more likely to be successful not less right the things that will make you a success in your life are the things that this school is trying to beat out of you right not I'm just presumed not literally be out of you but mentally be a right and in a sense that that's what we need to say to a lot of people about a lot of these forms of discomfort it's not a sign of craziness it makes perfect sense you feel this way and you're right to feel this way but I wonder if that's what's causing all these children to be on adderall and on

128:29you know all the various stimulants they put kids on you know Prozac and all the different things that they do it's literally because they're trapped in this thing and they can't do it and they can't do it they can't do it they just can't concentrate so they give him something yeah and they give him this pill and that pill turns them into a worker robot and it's related to a lot of the things we've talked about as well the increase in competition for example so in such an unequal society if you have a society like Norway where if your kid doesn't do well they're gonna have a good life and if your kid does really well they're gonna have a good life you know there's less anxiety about my kids falling behind yeah if your kid falls behind they can have a really terrible life yeah right here too but the counter of that is rich kids don't do well at all like miserable as hell

129:12yeah yeah yeah it's a real problem with kids that don't have to do well I think this this you've got a society that drugs kids at the bottom - shut up these kids in foster care who were traumatized not being looked after they're being drugged - just basically make them docile you've got kids at the top who were drugged to make them compete you know I've got a friend who's a Wall Street banker who put his kid on on a common federal or Ritalin one of the stimulant drugs when he was a young teenager cuz he said but every other kid in the class is on it so if he doesn't go on it he's falling behind right right so you have I mean what a sick culture raising their children a cocaine like drug yeah to make them compete in an unnatural way and the up part is it works yeah well essentially so the research on this is interesting I think this is the thing that's worth putting out am read

130:01about this in my book but the actually there's evidence that kids develop tolerance to it over time right so actually initially it works really really well and then gradually you have to give higher and higher doses until eventually they there's a maximum limit it's just great all day and they're next but then you have this Republic where actually if you then take the kid off it they will experience really severe withdrawal right and what often what that's misinterpreted is oh my god look at what happens to my kid when I take him off that he goes it's like no that's not the baseline of your kid that's your kid in withdrawal from okay hain like remarkable I mean I had a spoke about this before so I think I can say I had a very close relative who had a cocaine addiction and I remember at the height of her cocaine addiction she had a minor one of my a young relative of mine a

130:48suppressor something you ously who she was drugging with ritalin the doctor given it because he didn't want to focus because he was traumatized because his mother was a cocaine addict right and I remember she used to go driving to school in the morning she would snort a line of coke before she went and in the car he'd have to swallow his cocaine like pill and I thought what a crazy culture that her cocaine use is illegal and would end up with her being criminally punished and his cocaine like substances required by the police you know quite not require by the police or required by the school and mandated by the doctor what a crazy sick what a culture that is up about how it thinks about altering itself chemically about children about connection yeah and that my relative was very deprived of a capacity to understand what was happening to this is the cruelest thing

131:37we've done if you just give people these these ridiculously simplistic stories about addiction it's just the chemical hook or this ridiculously simplistic story about depression it's just a chemical imbalance it's like we say you cut them off from understanding the thing that's right in front of them and sometimes I think with with both my books were chasing the scream and lost connections at times I thought but I even need to say this it's so banal right right if you're lonely if you're insecure you're gonna be different but actually he does need to be certain when you say when you say to people it's a very unusual position to be in a position where you're saying something that is both unbelievably obvious and really quite radical right that's a weird I can't think of many common sense but it's not common that really is what it is not a common understanding now I want to get in to

132:24this with you what about the criticisms of your work and how have you have you taken that in if you debated anyone about your work cuz I read quite a few things online that were very critical and I didn't agree with them I didn't agree with what they were saying but I wanted to get your take on it sure so there were a few points that have been made and there were a few pieces that were written as soon as the book came out by psychiatrist who admitted that to be fair to the hand read the book ran they were responding to an extract from the book yes and obviously in an extract you can't make every point you want to make right so the book is 100,000 what was the extract of wolves do so what they thought I was saying is even though the piece I think very clearly didn't say this what they thought I was saying is chemical antidepressants are bad for everyone and people should stop taking

133:09them if I had said that it would be totally right to criticize me that's not my position but such an easy way to criticize just exactly a marie-pierre and my position is you know what we said before chemical antidepressants give you one point eight points on the Hamilton scale right that's not nothing it's not much on average but it's not nothing some people like for example one of my relatives the one that we talked about who is trapped she takes chemical antidepressant I think she's right to take them right she's got very limited margin of change she's not experiencing extreme side effects as lots of people do I think she's right to caring for her one point eight points in the Hamilton scale is worth having but it's not solving a problem right it's not solving the problem for the vast majority of people and so I think there's been some criticisms that are he's telling people

133:54to stop that's a dangerous and terrible thing to do so that's the most monster that is read the book because I don't know that in fact I say explicitly you should carry on taking them a few the benefits outweigh the side efface another criticism which i have more sympathy for in that i understand where it's coming for it's not is it's more like an ideological misunderstanding like we're saying we live in such an individualistic culture that if someone comes along so we basically think there's two ways of thinking about this right either you your depression or anxiety or addiction are due to a biological problem in which case you deserve love and support or yeah if you dismantle the biological story what a lot of people hear is oh my god you're saying it's my fault that I'm a I've got to solve this on my own and lastly we're talking something go well I can't go and democratize

134:45my workplace I can't go and you know take a load of ayahuasca and learn what are you Jay they're just saying what are you talking about and I think because I'm talking in this this this third category which is biologies real psychology is real but most of the drivers of this are social that in the way we live because for so long we've been trained to not think in social terms I think a lot of people just literally don't get what I'm saying right but when I was a kid Margaret Thatcher said the the Prime Minster at a time said there's no such thing as society there's only individuals and their families now I never liked Margaret Thatcher but this debate has made me realize how much I internalized that right I was depressed for 13 years I'd studied social sciences right it never even occurred to me there was a societal component how bad I thought right so I was kind of

135:33like a Thatcherite to my own pain and distress do you see what I mean and I think we've so we've so individualized and internally we've so internalized as individualism that I think people understand again they were riffing on their extracts these are not people who read the book in the main but I think it was kind of understandable for them to be like you I can't do that right now I can see why they're saying that I'm not so I wouldn't push back on them so hard because think well there are narrow margins and this is why we need to change and people get that if you talk about car accidents right we individual drivers should drive safely but we don't just leave car safety up to that we have airbags and seatbelts and speed limits driving tests we're dressed people under DUIs right if we just took away all those things and just said to individual drivers hey drivers do it and

136:23pedestrians pedestrians take care drivers take care we would have far more people dying in car accidents than we do now right so we accept that there's individual and individual role but there's a social role right the whole society deals with the problem of car accidents and what I'm saying is the whole society should deal with the problem of depression and anxiety we need social changes like democratizing workplaces is one we've talked about a lot that reduce the reasons why people are so depressed and anxious in the first place but I think in a society that is so devalued the idea of the social it just amazed well be speaking of Swedish for all they could understand if what you see what I mean yes I think they're just neglecting to consider the possibility that some of the factors are because of your life and and the social aspects the physical aspects the exercise the diet all those

137:07various things there's many many people that are certain neglecting to take those even into consideration I also think people work way too much I don't think that's the way to live your life I think we've got a really bad system and I think the system has existed for so long that we assume that this is the only way to live that you have to do a 40-hour workweek I think it's ridiculous I think we should work maybe four days a week and it might be three we might maybe people would be more productive they kicked ass for three days a week and then had a fun time for four you know maybe maybe it's like one on one off one on one off one on one maybe it's like that and just that's the way we live life like have a work day and have a day where you don't work have you choose to live more to work more because you know you're trying to pursue something and you're a

137:53dedicated person you have a job that's one thing but I just think this soul-sucking grind of you know getting out of college 21 and grinding until you're 65 and then you look forward to your golden years you're dying there's no golden years that's all horseshit you you know you're watching on Golden Pond too many times you're not gonna make it watch it for the first time I played recently banker there's another thing going on there's another thing going on about to make sure I don't miss my flight but there's nothing going on which is what we've done is we've told people the path out of stigma is to say that the problem is just biological right right as we said people you should not be criticized with an imbalance exactly or even more than that it's my share than a pancreas disease we just need to give you a medication exactly we've told people you should not be

138:49judged for your depression anxiety addiction because it's a biological problem right I entirely agree obviously people should not be judged for their anxiety depression or addiction but actually is a real interesting experiment they showed that this is just a complete but it's first trick mmm this is that interviewed amazing neuroscientist called Mark Lewis who I was talking about this I said you know I'm worried because you're explaining a lot of the things we've talked about to me so early in my research and I said you know I'm worried about this mark because won't this just reintroduce stigma right if we're saying it's not just biological and he said yeah man did anyone ever doubt but leprosy or AIDS were biological problems right well literally nobody ever doubted that zero you might have noticed there was some stigma against leprosy and AIDS why do

139:29you think saying something is biological removes the stigma around it I thought I again it's a simple point I'd never thought of that but there's actually this experiment by we're gonna interview called professor Sheila meta which looked at this question of stigma shoot so she wanted to figure out which is more distinguishing telling people that think mental health problems are caused by your biology or saying they're caused by your life so what they do is it's a little bit of complex experiment I think it's worth explaining say you're the guy is taking part in the experiment they bring you in and they say before the experiment begins we just want you to sit here and fill in a questionnaire right this is you don't realize but this is actually the experiment so you're sitting next to someone else so you don't realize as an actor and you get chatting and the actor

140:13will sup they'll run it two ways sometimes the actor will say I've got a mental health problem because of my biology and sometimes he'll say I've got a mental health problem because of bad things that have happened to me right then you're told the experiments beginning come through to this room and you're told you Joe have got to teach this other person person you don't realize as an actor a pattern it's like a pattern on a computer is we're testing how well people learn patterns and every once you've taught it to him every time he gets it wrong I want you to push this button and this button will give him a short sharp electric shock right won't kill him or anything it's not gonna him up but it is uncomfortable right and they wanted to see would there be a difference in how many electric shocks and how hard you hit hit the button depending on what you were taught what

140:58they found was you weren't significantly more like you you zapped the person more and harder if you thought their problem was just due to their biology than if it was due to things that happened to them in their lives and I think that's because I think this is the stuff we're talking about is the part that has stigma because what it says if what we're saying is there's just this class of people who are biologically different to us and they have this flaw that you and I don't have you can see why that leads to stigma right but if what you're saying is actually we're all uniquely we're all vulnerable to this stuff and actually the things that are making some people depressed anxious and addicted are making loads of us just less happy than we could be less fulfilled than we could be well that is instead of making dividing us into two tribes it says we're all on a continuum and actually

141:41the fight that will help these people who were depressed and anxious will also improve your life right that's to me a much more powerful message it's certainly a problem being an inexplicable biological malfunction it's a response to things that you can see in your life right well it's interesting that we've always had the term sadness right people have always experienced sadness but if you go back and go through ancient literature you don't see a lot of stories about people suffering from depression it's a relatively new distinction you do get people who talk about melon melon : yeah sure I do you think depression has always been acute and extreme unhappiness there's always been people living unhappy lives but the state of being depressed as being a clinical psychological sort of a diagnosis that's relatively recent well the idea that it's a pathology yeah it's right and you

142:35know it's very common to think about this way you were speaking earlier when we talk about food there's a thing of it is your talents and British when I am first came to the the US I never remember I remember the first time someone ever offered me an indigestion pill which did exist ingestion Phil yeah you know that you can buy them in like oh yeah upsell bhisma and i remember just saying but but wait in digestion is a sign from your body you're eating too fast you don't want to you don't want to get rid of that signal your your you'll eat too much you'll hurt yourself right that that's that's not a malfunction that's that's a function right and I think it's what about that you know that it comes back to so many things were saying the things the feelings that we have of distress are not malfunctions right they're telling us something is missing in the environment in the

143:27psychology in our lives they're not fuck-ups where there's a signal in this industry that they benefit from filling that void like if you've got an issue they got a pill for it and this is you would create that sort of an environment they're gonna constantly be innovating and trying to come up with new pills for new issues and even create ailments make up ailments and come up with solutions for those ailments and a lot of those are actually we've shown this on the podcast many times those were done by advertising agencies they've actually created names of diseases and issues just so they can come up with solutions one of things that was most shocking in the research for Las connections was realizing how much of what I had been told was invented not by scientists but by drug company PRS so I'll give you an example of two examples that I'm gonna have to go and accept no worries and I

144:22could do one other interview like so the that interview the there's this so everyone knows if you think about I don't know taking selfies right take 30 30 selfies you throw away 29 you only use the one that can't do that don't be a take a selfie and go with it it's like DeNiro and the deer hunter one bullet you already have you know you use the one where you look good right turns out in the whole process when and antidepressants were first being marketed to us they basically did that with scientific studies what they did is they they they would Commission a hundred studies 90 of them would say find mixed results or poor results those all got put in the trashcan and only the ones women there's one study I assigned but I think it was they tested the drug on two hundred and forty seven people and it only published the results for twenty seven of them who you will not

145:21find hard to guess with the twenty seven for whom it worked right so the early results were hugely exaggerated you'll remember that you know when antidepressants were first marketed people are told you know it'll make you better than well right no one says that now you know it's that stuff's all gone away right it doesn't happen anymore so there's actually Eliot Spitzer did an amazing job when he was Attorney General in New York state of taking the pharmaceutical companies to court because it's particularly affecting me when I read it because it was the drug that I was given as a teenager it's um called paroxetine or paxil in the u.s. that the company that manufactures it literally had a leaked memo from them in which they say this doesn't work for teenagers but that I think the phrase they use was this would be unacceptable for the commercial profile of paroxetine so they just said

146:04that it did and that's the drug I was given right it's nothing to see the drug that you were given the this company involved saying didn't work for people like you right right and and and you know it had very powerful side effects on me I gained a huge amount of way it has all sorts of side effects the did it help you at all I felt a strong initial boost and I would say it probably did give me one point eight points on the Hamilton scale like what we're talking about probably gave me a very mild boost but it didn't solve my problem and the problem is the story I was told about it that this is B solution because the problem is the chemical imbalance disconnected me from a much wider program of reconnection in my life that did in fact solve my depression when I embarked on it right right the the so so I think the the drug companies it's scandalous what they did it's not that

146:55the drugs have no value they do but when you read through what they actually did and the way these stories were constructed and the the the the we were told you know I mean I'm every to being a clinical psychologist dr. Lucy Johnson and he's a brilliant person and her just saying you know everything you were told is and me just sitting there and going through this is what my doctor told me this is why dr. Toby this is my doctor fact is you know she Russians no legal repercussions against those people for doing that it's just stunning I mean there was nothing about me you think about like insider trading how devastating the penalties are for that this is far worse one of the scandals is the the FDA how much of it is funded by the drug companies itself right forty percent of the budget I mean imagine if you had a ballgame where one side was fun where one of the

147:46teams paid the referees wages right I think you'd find that game that that team would win a lot more often alright so what we think is oh there's this dispassionate judge the only one of those scanners even the way the rules are constructed so to get a drug and I think the rule has been slightly tightened recently but the when entered a presence were first introduced to get a drug to market you only have to demonstrate two studies anywhere that showed any efficacy right so that means you could commission 3,000 studies and if two of them it's not that the FDA would take the balance of the research right if you could show two that it worked that's what they will not present those studies to the FDA they didn't have to show them everything they've done exactly it's gotten a bit better now there's now more publication required which is one of the reasons why

148:29so few and new chemical antidepressants are coming onto the market because the rules have been slightly tightened and as a result where are all the new ones they're not coming on you know that I mean there are some but they're far more limited haven't they shown also that rigorous exercise is actually more effective in treating depression than antidepressants I think that's going a bit too far but there's evidence that well there's very strong if it's doctor is about benkei you you should you would love I should introduce you to her she's a primatologist chili and primatologists basically the best person in the world as far as I could said she's a hardcore chili and she's currently in some jungle somewhere better than Mick Jagger's ex-wife yeah yeah I mean I like Marianne Faithfull but right so he's about to make this my last point but is about so she's

149:08demonstrated she's shown loads of things one of the real interesting things is nature so she's shown that exercise is a massive really powerful antidepressant but interestingly exercise in nature is even more effective and she's shown her theories and I really like this she did a lot of work with bonobos both in zoos and in the wild and she's got really good stories about how bonobos basically bond by lesbian group sex and she she shows how they pioneered but how they managed to create vibrators when they were in the zoo it's an amazing story but the like literally she would like give the buggers and they would find a way to turn it into a vibrator she was right but and then have massive lesbian orgies with their vibrators the British zoo so these like polite British parents nothing darling come over here but the mouse theory is so animals go crazy in

150:01zoos a lot of the time right now let's rip out their feathers horses start obsessively swaying elephants will grind their tusks down to nothing and and she basically argues is be sure about this is simplify garage dimensions there's many things going on here but the humans are being animals deprived of their habitat feel like and we are increasingly - prior to our habitat the habitat we evolved in right there's lots of evidence of people who live in areas with no green space are much more likely to become depressed than people who don't and people who move from one area without green space to an area with green space become much less depressed right loads of research on this there's such an amazing study Michigan State Prison looks out but just by accident no one designed it this way one part of it looks out over just bare concrete and one part of it looks out over like

150:50lovely green space and the people who which was random where you ended up but the people who looked out over the concrete were 23% more likely to develop mental health problems right so this thing about as Isabelle says we are that were designed to move through nature if you are not an animal moving through nature you are not a healthy human being you are not in your habitat you need to be in that habitat at least some of the time right and yeah I mean she's got is about has the best stories ever so you should you should you would love her anyway she I'm sure I was she has both lesbian group sex stories and stories about how you can kill your depression with major exposures so you're on thank you very much in our time the name of your book so the book is called lost connections uncovering the real causes of depression and the unexpected solutions if you go to the

151:38books website WWE actions calm you can find out what loads of people from Hillary Clinton to Tucker Carlson to Alice at Elton John have said about the book you can take a quiz to see how much you know about depression and anxiety and the book has a Facebook page it's facebook.com slash the lost connections and the other book we've talked about is chasing the screen which is about addiction you can find out more about that at WWDC the scream scream as in our like Jan Jamie Lee Curtis and Halloween be calm okay thank you very much