Social Connectivity as an HSP: A Cardiologist’s Perspective on Why It’s Essential for Your Health

Todd: for Highly Sensitive People. If you haven’t listened to the other episodes yet, Dr. Rosansky has been a cardiologist and a researcher in mind body medicine for over 40 years.

Um, he has co authored over 300 peer reviewed medical articles and book chapters, many of which are regarded as seminal contributions in the medical field. During his long tenure at Mount Sinai Morningside and Mount Sinai West Hospitals in New York City, he has served as professor of medicine, director of nuclear cardiology, and the leader of, uh, the cardiology fellowship training program.

He also previously served as chief of cardiology. [00:01:00] Dr. Rozanski brings a unique and holistic view of health. In the first episodes, we gave an overview of Dr. Rozanski’s six domains of health, and we dove, uh, in a little deeper into the domains of physical health, mental vitality, and emotional mastery. Today, we will look more closely at the next domain of health, which is social connectivity.

So it’s great to have you back with us today, Dr. Rozanski. Thank you for being here.

Alan: It’s a pleasure to be here. Thank you so much.

Todd: So what is social connectivity?

Alan: It’s a basic psychological need to be connected to other people. a, um, we have physical needs, they’re obvious to us, but we also have psychological needs. And they’re needs in the same sense that they need to be fulfilled. And when they’re fulfilled, we experience more well being, more vitality, we feel happier. And when they’re not fulfilled, it’s kind of [00:02:00] interesting because something doesn’t feel right. We lose vitality, we may have more tension, and over time it may affect our health. it is a basic need, but it’s not loud. not as obvious as physical needs. And one of those most profound needs is our needs to be connected to other people.

We’re just essentially socially wired to be connected to other people.

Todd: Yeah, that makes a lot of sense. Um, it’s a subtle, it’s a subtle point. Uh, and I can see how it could be missed when we’re just focusing on exercise and diet and sort of the main factors you think of when you think of taking care of your health. So tell me a little bit about the, um, like, what is some of the research that supports this idea that social connectivity is an essential part of even maintaining physical health or health in general.

Alan: Sure, that’s a great question. a theme that I mentioned in the first podcast was that can just [00:03:00] use the body to testify as to what’s healthy and unhealthy. And those things which promote longevity, decrease disease risk, and improve our physiology are protected, are healthier, those that do the opposite are not. So the first research that of note In terms of, uh, all of this was a study called the Alameda County Study. This was, uh, published in 1979. Lisa Berkman was the, uh, first author of that study. And they simply looked at the size of people’s social networks at that time in Alameda County. found that the greater the size of the network, the lower the risk of mortality over follow up, both in men and women. So

Todd: Wow.

Alan: a study. catching. And for a few years, this became a big trend to look at the size of people’s social networks. And all the data was reproducible. And then people began to look at the quality of social relationships. For example, people after a heart attack, what was the quality of your relationship with the loved ones around you? [00:04:00] And it turned out that that was also a very powerful predictor of outcome. Now this has been reproduced in so many studies. It’s led to better analysis. which have also been very reproducible and established that the quality of our social relationships very profound, uh, have a very profound effect size, if you will, meaning a very substantial effect on outcomes.

And when you look at the negative side of that loneliness, It turns out to be a very profound risk factor for, you know, uh, earlier mortality for, you know, more chronic disease, uh, and even studies looking now in terms of cognitive function and so forth. one classic meta analysis, they found that being lonely was equivalent to smoking about 15 cigarettes per day. So

Todd: Oh my goodness.

Alan: crucial.

Todd: That puts it in perspective.

Alan: There’s a lot of physiological studies, which look at, you know, what’s the result in people who are less socially connected, they have higher cortisol levels, [00:05:00] poor immune function. And on the flip side, when people are, you know, enjoying social relationships, you have the release of oxytocin, which is a kind of a bonding hormone, makes us feel good. Dopamine, serotonin. And so forth. And then even in animal studies, uh, when there’s classic studies, like you take Sinomogus monkeys, these are a class of monkeys which are socially bonding to each other. And when they put a group of them in cages and compared them to a group that was not in cages, fed them exactly the same diet. Lo and behold, the caged monkeys developed more atherosclerosis, more

Todd: Um, Okay.

Alan: men who were, uh, in Boston, one group was, you know, people in Harvard University, and the other was people in South [00:06:00] Boston who came from low socioeconomic backgrounds, and they have followed these people, lo and behold, for 85 years. Uh, they found them in terms of constantly bringing them back for interviews, how they did in real life and so forth. found, lo and behold, that people’s social connections more powerful than wealth, social class. In predicting happiness and people who are lonely definitely have poor physical and mental health.

So it’s, when you take all of these studies together, we are built to be socially connected to other people.

Todd: Makes a lot of sense. Um, but it’s, it’s really helpful to see so much research over such a long period of time, uh, and such diverse kinds of studies, all pointing to the same idea that Being social is an important part of being a human being and being a healthy human being. So, tell me a little bit about [00:07:00] the differences in needs, like, for different types of individuals or different, different individuals, um, the different needs for social connect, connection.

I assume it’s not all the same, um, and if there’s any insight in that area.

Alan: Sure. Well, in fact, it’s quite varied. Um, we have introverts versus extroverts. Some people thrive by being in a crowd with other people. Other people don’t want to be among many people. Uh, we have people who can feel alone in a crowd. We have people who just need like one good friend. we have different, uh, needs at different times in life. Maybe when we’re stressed, for example, or we’re going through a journey with an illness. Uh, certainly when we are going through the turbulence of life, I think that’s one of the benefits of having friends and being socially connected. also, uh, interestingly, can sublimate your need for social connections [00:08:00] because there are competing needs we have, like a need to pursue in our jobs, you know, pursue different avenues of meaning and so forth. It kind of is a dividend when you get older. That, you know, if you kept your connections as you get older and you have now retired from your job and, you know, you’re looking to do new things to have, you know, created a dividend of, you know, being socially connected to people that you can’t just take off the bookshelf. Um, so it’s, it’s a very good point that it’s, these needs vary, this need for social connections, both in terms of people’s, expression of it and in terms of different times of your life.

Todd: Now that makes a lot of sense, and it’s a really actually important point for highly sensitive people. Um, which we need. Um, we don’t do well with a large group of people. A lot of times, because of our depth of [00:09:00] processing, we can get overwhelmed by the amount of information coming at us in a larger group setting.

It doesn’t mean we can’t handle that at times, but it’s We do best one on one or in smaller groups, and it’s nice to see that it’s not just, um, like the social, the need for social connection can be fulfilled in different ways, according to different people and different personalities like that.

Alan: Absolutely. Yes.

Todd: Okay. So, um, so let’s look at, um, quality or I think this is an important point and how, like, how do you build quality social relationships? Like what, what tips or what have you learned in that area that can, whether it’s, you know, especially since we are focusing on more sensitive people that tend to do.

[00:10:00] Better with quality over quantity. What do you suggest in that area? And what do you have to to point us to?

Alan: Well, you know, it’s, it’s again variable in terms of people’s needs and so forth, but I think there’s basics that are really important. Um, one of them is the time invested that you, you know, you, you can’t, there’s quality time and there’s quantity time. Um, and both are important actually, because when you think about the building blocks of relationship, whether you say it’s trust. or understanding, or feeling comfortable with another person, or you’re feeling that it’s got an enduring quality to it. All of these things are a function of the time you’re willing to put into that relationship. We develop trust by the interaction we’ve had with people. Understanding requires getting to know people under different circumstances, getting to know them well. Feeling that enduring quality of a [00:11:00] relationship is the test of time, right? You know, uh, is that those long gaps, you know, you stay in contact, you know, and

Todd: Yeah.

Alan: you’re comfortable also is a question of time in some respect, because you, you get more comfortable with people as you get to know them. these are, these are, you know, this is one of the building blocks of, you know, good relationships, but there’s so many other factors, um, uh, we could go through with, uh, uh, you know,

Todd: Well,

Alan: sense of empathy. Go ahead. Yeah.

Todd: Yeah, I, I would like to look at some of those other factors, but I just wanna, um, play with this idea of time and, and the value of quantity. And it just makes me think about, um, you know, like time is a very precious qu uh, quantity or entity. Uh, and we’re always trying to fit different things in competing needs, different, uh, interests and even fitting things like exercise in, or [00:12:00] fitting in time for.

Cooking good food or eating more carefully like these things take some time and what I’m kind of thinking about as I’m listening to you is that planning social time sort of as a part of your routine or part of your schedule is, uh, is probably, uh, an important thing to consider when budgeting time.

Alan: Yeah, it is, um, you know, I say we leave, we live in kind of unique times and think we reflect enough about how, what this means in terms of what I think has become an increasing challenge terms of social connectivity. mean, if you look back historically, you know, people, you know, used to be living in a neighborhood. We weren’t so geographically normal all those years. People were getting married young. Um, there was a lot of, um, proximity based interactions, you know. Clubs. [00:13:00] you know, your school, you know, there was just a lot more there, uh, and also the way we’ve changed in terms of leisure. When I was a kid, you know, uh, you’d go outside and you’d see people, you know, we’d play stoop ball, stick ball, you know, all

Todd: Right. Right.

Alan: lot of, you know, entertainment and, and pastime has moved indoors, right? And so people are, less out there. But the impact of, I think two factors. profound. One is the advent of social media. Uh, and social media has been very profound. and what I say is that, you know, it’s a power, you know, it’s like talking about nuclear energy is a power and it’s good and it’s got bad social media.

Todd: Okay. Okay. Okay. [00:14:00] Okay. Okay. Okay. Okay.

Alan: you know, more people at us in different ways. And so it can, it can of dumb down the quality of your social interactions with people. And I think it does. it doesn’t have to. It

Todd: Okay. Silence.

Alan: food today, a lot of ultra processed foods. And so these are all different ways we have to be careful. We don’t

Todd: [00:15:00] Yeah. Yeah.

Alan: two, those things which are not urgent, but important.

Todd: Yeah. Um,

Alan: we might be taking care of older parents who now are living longer than they used to while taking care of younger children. we feel it. We feel that life is faster today. And it’s easy to say, well, manana, I’ll, you know, spend more time with my friends, you

Todd: [00:16:00] Right.

Alan: and it just goes on. So you have to be intentional to make time to be with your friends.

You just do. So it’s

Todd: Yeah,

Alan: a challenge.

Todd: it is. It is. But just having it on the map and thinking about it from a health perspective, I think, is really valuable for for those of us that are. You know, kind of interested in taking care of our health, then this just gives another, um, way of thinking about socialization instead of it being like an extra frivolous thing or something we can, it’s optional.

It’s like, no, no, this actually is a really important part of quality of life and actual physical health. And I also, uh, I resonate with what you’re saying about the, you know, the physical proximity with people. Um, and, and the difference that is, as much as I love connecting virtually, and I do a lot of that, there is something unique and special about being in the same room with somebody, [00:17:00] uh, being, you know, sometimes you bump elbows.

Uh, there’s like the, there’s a physicality to being, uh, directly with somebody. Yeah. In the same place with someone, and, uh, I think that does get overlooked a little bit, um, as, as

Alan: much of it.

Todd: everything goes online.

Alan: So much of communication is non verbal, right?

Todd: Yeah.

Alan: is that bonding that occurs. Our brain is biologically wired to be connected to people. So, I’m not putting down virtual, you know, interactions at all. It’s just that you need the good stuff too, the other good

Todd: Yeah. Yeah. Yeah. And like with entertainment, you know, you can end up sort of vicariously having a social life with the, with the actors on a program, um, instead of having like real interactions with somebody, uh, has its value, but. There’s some trade offs as well.

Alan: Sure, sure, absolutely.

Todd: So keep [00:18:00] talking you were I kind of interrupt you at one point when you’re talking about Um other other things that help build quality of social relationships. Is there anything else you’d like to add?

Alan: Well, you know, I, I was thinking actually you we teach all these subjects in school, you know, uh, STEM, all these, uh, I don’t even know anything they teach anymore, but you know, I don’t think teacher at science anymore, but certainly you take, uh, English, chemistry, whatever. Um. Shouldn’t we be teaching some of the basics about, you know, social intelligence, if you will, if you’ll call it that, you know, there’s a emotional intelligence, social intelligence. So in terms of, you know, um, things about communication and how to be more empathic and the value of giving how to be more Teflon, I’d say, than Velcro, in other words. The ability to, [00:19:00] know, things go as opposed to let things stick with you, you know, which is a master of social trade as well. I mean, there’s just so many different social skills that we learn as we go, we get older and we get better at it, you know, but we get better at it through life experience. and you should learn about it earlier in life, I believe, I think it would be good, you know, and I do have a concern. Uh, in this media time now where there’s so much is virtual and, you know, very often among young people, less interactions in the

Todd: um, uh,

Alan: which

Todd: Right, um, uh,

Alan: been disappearing from our educational system. [00:20:00] So

Todd: Right.

Alan: a physician, I’m looking at it for multiple ways and saying, these are all basics to teach.

Todd: Yeah, you know, we the advantage of specializing like if you’re specializing and just studying chemistry or studying some subject as you can go deep in it and you can give all your time to it and you can and there’s value to that. But I kind of what I’m hearing from you is we need to step back and make sure that all the domains of, of our life are, have some balance in there so that it’s not becoming one sided.

And yes, okay, I’m a genius in this area or I’ve done great things in this area, but my physical health has suffered because I’m not exercising or I’m not, uh, socializing, um, or Having a balance. So, um, yeah, I think this is this is a great idea to teach it in school. And if you were to teach it, what kind of things would you suggest they include in that curriculum?

Alan: Well, I’m not sure. I would have to think about it. You know, I mean, I think it’s just the very things we’re talking about here. Um, [00:21:00] I think there’s different formats to teaching it. It could be in a seminar sort of situation. Um, you know, I just think it’s, there’s many ways to do it. I think that’s the nice thing about it.

Todd: Um, you know, my background is in, um, in facilitating the work of Byron Katie, which is a way to question stressful thoughts. And it is extremely useful and social. Situations. Um, you’re after, it’s kind of postmortem after a social situation that didn’t go well. Um, when you’re, when you’ve been stressed by something, it can help you digest and process that experience and find new ways of, of experiencing it or different things.

Avenues to try the next time something similar comes along and I know there are many tools out there for uh for reframing and processing and Um, and it’s just it would be nice to see more of that on the table Um as something of a value for us to focus on.[00:22:00]

Alan: Sure. Sure. Sure. Yeah.

Todd: Okay, so um How about like like how to build a high quality social network? What would you suggest in that regard?

Alan: Well, that’s a great topic because we talk about the quality relationships, that’s very important. There is a concept of building a social network, and that becomes very important. And I think, know, you could have like a checklist, you know. Do I have, you know, friends? What quality friends? Do I have any confidence in my life? know, do I have a functional network, uh, that works for me and so forth? I think the first place I would start off there is with friends because know, friends, we can have friends of different sorts, but I think it’s important to have one, two very high quality friends in your life. You know, we shouldn’t be traveling life [00:23:00] alone, you know, so friendships require investment. a high quality friendship is one where you have somebody who you feel that this person you can trust, who you can confide in, that they have your back, that they’re supportive of you, that they get you, for example. And also a friend who might push you a little bit sometimes. You know, uh, and give you honest feedback.

So these are all qualities, you know, and different friends can have different things, but these are assets and it makes a friendship special, you know? So, um, thinking, uh, sometimes I come across news of like friends I had in high school, I didn’t maintain those friendships I was thinking, you know, we leave high school. But we shouldn’t leave our friends behind, when I do end up talking, as of once in a while, with one friend that I got in contact, like, with 30 years later, I got his number, I called him up. [00:24:00] And within two minutes, no, within immediately, it was like we had never lost that

Todd: Yeah.

Alan: other words, it

Todd: Yeah. Mm

Alan: life, in early life, we were more vulnerable. We were more willing to be vulnerable. We were more authentic with our friends. We didn’t have the social mask up. We had the time to be with them. And that’s just a, Paradigm for friendships in general, you know, so when you, but you, you know, okay, so maybe you didn’t invest in those friendships, but you can gain new friends. And another thing about friendships, very interesting, is that a lot of the friends we make is because neighbors, they’re close there, you know, so that’s kind of spontaneous. But when you say, wait a second, how important friendship is, maybe I should search out for the right friends for myself.

Todd: hmm.

Alan: think people think about that enough, that you should go

Todd: Mm hmm.

Alan: and, and, uh, and look for [00:25:00] friends.

So

Todd: That’s

Alan: one thing. Yeah.

Todd: very interesting. Yeah. My experience over the years, I moved many times when I was young and every time I moved, it was like, okay, that’s the end of those friends, you know, and it kind of got in the habit of doing that. And friends, uh, in my, my little world of my, my experience, I tend to put friends, make friends wherever I am, mm hmm.

And they’re very situational or they’re very temporary in a way sometimes and that’s been a move that I’ve been trying to change a bit more of trying to have just picking a few friends that I want to say, you know, let’s go a little like long term with this and become closer and it’s not something I even talk about, but it’s just something that I internally I’m thinking, okay, how could I You know, like it’s, it’s something that I’m valuing more.

So I like hearing this being [00:26:00] proactive about it rather than just passive in terms of which friends end up coming into your life and staying.

Alan: Yeah, I think what you’re describing is commonplace, and it happened to me too, right? We moved to a new place, we’re so busy, and we start to let go of the time invested in those old friendships, even though we had good friends. That’s what happens. So, but in terms of building a network, friends are important.

It’s also important to have a confidant, you know, even just one, but preferably even maybe perhaps more than one. The confidant is somebody who you can be open and you can share the most difficult things that you’re going through because we all go through this turbulence in life. And that doesn’t have to be a friend, by the way.

Confident could be somebody who’s not a friend at all, but just like a wise person or a caring person or someone, you just find that that person supports you.

Todd: Yes.

Alan: [00:27:00] is in your network is extremely important. We can also use our network to keep us more objective in life. there’s this concept here of like this tripod of objectivity, you know, having people above your level, at your level, below your level, or someone who’s a wise person or wise people who you can look up to to get advice. someone at your level, you know, peer or friends and so forth you can talk to, but also younger people, you know, when you can, when you’re teaching,

Todd: Mm.

Alan: they’ll keep you honest and you learn a lot by trying to, you know, teach people and so forth. Teaching is, I mean, I’ve been teaching for 50 years, so I mean, it’s like,

Todd: Yeah,

Alan: you know,

Todd: it’s a wonderful social interaction at the same time, it has other values too, but yes, I agree.

Alan: It really is. So that’s

Todd: So somebody, people to look up to, people on your level and people to look, you know, to support in any [00:28:00] particular area of your life, right? On whatever experience level.

Alan: And then it’s important to have a, I’d call a functional network, which is,

Todd: What does that mean?

Alan: I remember when I was growing up, my dad was, you know, it was a different time in those years, but, you know, we had the local pharmacist, uh, that my dad was friendly with, and you’d come in and you would talk to him and so forth, and you could call him up at odd hours.

You’d have the phone number. You know, I tried to do that with our local pharmacy, you know, introduce myself. So it’s always a different pharmacist, you know, and all these

Todd: Oh, yeah, I read

Alan: the friction of life. [00:29:00] life again has this turbulence and when you need these people of need, it’s better if they’re on the bookshelf, you know, and you can just, you know, you just have that there for you, but that takes time to think about, you know, say, okay, you know, have I made a relationship with a physician that I feel know, I can work with and, you know, it was there for me.

So if, you know, something comes up, I don’t have to search. And I’ve got a network for people in, in, uh, in investment and the mechanic and all these things. So you go and you see what you’re doing. You say, wait, I’m creating this, this network. So that’s, that’s important in terms of, uh, of, uh, building a social network. Now I’ve mentioned two other things. One is that. I read a book a number of years back. I’ll tell you, I have to give credit where the idea comes from. So there’s a book, a famous book called Tuesday with Maurice.

Todd: that. Mm hmm.

Alan: Mitch Albom, and this was at a time when he was a sports writer before he became [00:30:00] famous writing novels.

he had time on his hands, and I remember he had this, professor in college, uh, um, you know, Maury. And he was living in Boston, and Mitch Albom was in Detroit. And he started flying there every Tuesday, once a week, to meet with Maury and get, like, what life wisdom. And he wrote a book on it called, you know, Tuesdays with Moore.

It’s a great book. So in the book, he, he quotes Moore saying that everybody needs to develop their own culture, you know, because you need. a culture that works for you. And if you don’t work on it, you’re just a subject to, you know, the, the, uh, the large culture out there with whatever’s going on. And so it may not serve you well. So I was really taken by the idea after that, you know, in terms of, know, what does it mean creating your own culture?

Todd: Yeah.

Alan: it means exactly creating the environment you want to, will support your interests, [00:31:00] goals, values. attitudes. an obvious one for me as a physician, promulgating health is a health culture,

Todd: Mm hmm. I love that.

Alan: were supporting that, having like minded friends, you know, interested in health. So if you want to build an interest in an area you’re having difficulty, you start to think, well, how can I create a supportive culture? to do that. Um, yeah,

Todd: Hmm.

Alan: I’m trying to remember the name that came in my Columbia magazine. I’m not remembering his name now, but he, uh, it was a story about this person who has had a course Columbia University where he teaches people how to write best selling books. [00:32:00] And it’s like a seminar course, and it’s you meet once a week for seven hours. And people share ideas and so forth. And he’s had tremendous success. But what caught my idea of my fancy in that article about him was that he created a Facebook group so that people who had taken his course years earlier and already been successful in writing books were available to these new students who were starting. So he created a ready made culture for these people to support them.

Todd: Yes, yes,

Alan: Another example, I know, uh, there are parents today who are very concerned with their kids being exposed to, uh, social media too early. But then you have a problem. Well, wait a second. If my, my child’s in seventh grade and everybody else had got a cell phone, what do I do

Todd: mm hmm.

Alan: have to advocate for this?

And maybe you have to find like minded parents and you have to find kids that your kids can interact with, who have alternative [00:33:00] social activities to do. So they’re not participating in maybe social media at that age. So it’s, these are all different ways in which you. can create a culture. Uh,

Todd: I like it. Yeah.

Alan: proactive.

Todd: Very interesting idea. It, it kind of, um, makes me think about an another one of your domains that we’ll be getting into in another session of, of purpose. Um, and when, when you have, when you’re, have some clarity about what, what your purpose is, even, there may be different purposes in different parts of life, but then.

This is like bringing people around that or organizing that, uh, making that be an organizing principle for, uh, for social interaction, which has benefit to the purpose, but also has benefit, uh, as we’ve already seen just on the social level.

Alan: Sure, sure. So the other thing that comes to mind in terms of a social network [00:34:00] is using a power of accountability. We have that challenge in life to move forward in different areas, and we’re pushing in terms of goals. So I sometimes say my middle name is accountability because I just realized it’s a real power and I need it in my own life.

You know, I’ve used it different ways where I’ve like, I wanted to get a certain paper done. Sometimes I volunteer to give a lecture or grand rounds on a topic. And boy, did that make me accountable, you know,

Todd: Yes.

Alan: and the paper got done. Um, so, um, I say we can combine that with a great technique that, um, I use to get people exercising, for example, where they ask them to form an implementation intention. An implementation intention is where you say, I want to get X done. If you just say I want to get X done, you, let’s say I want to go to the gym and work out a few times a [00:35:00] week. That’s a goal, but you know, it’s kind of vague and you might do it on certain days and other days you feel like I got too much to do,

Todd: Okay.

Alan: you know, work just finished. And every day when work finishes at five o’clock or six o’clock, I am going to go to the gym. And you say, I’m taking out of my head, that’s the cue. Now that implementation intention has been shown by meta analysis, many studies to work. When people

Todd: Wow.

Alan: an obligation [00:36:00] intention, that when it’s X I will do Y with Z, which is a person, then it becomes much more powerful. I remember years ago I had a, um, podiatrist I was seeing, uh, I, uh, he had, you know, casual clothes. And when I saw him I said, oh, you really must be into exercise. He says, No, I don’t like it at all. I said, Oh, so you don’t exercise. No, I anxious. I go to Central Park every morning and work out, but I said, But you don’t like exercise. So he’s a good friend. And, you know, we We bonded over the years and he likes to exercise and I’ve agreed to meet with him every morning and I’m not going to let him down.

Todd: Wow. Wow. He’s borrowing his friends desire to exercise and

Alan: recognize that’s a tremendous tool

Todd: yes.

Alan: say, when it is X, I will do Y. With somebody else, it becomes an obligation intention. You

Todd: Yeah.

Alan: committed to do something with somebody else that is another [00:37:00] aspect of social networking, which can be very powerful.

Todd: Yeah. I love that. It’s the, I think it comes to the reason why we were, we’re social in the first place because we can do things, we can do more together than we can do individually and we can borrow on the strengths of others and have them carry us along and we can provide strengths that carry others along.

And that’s exciting. Yeah. I love it.

Alan: Exactly, exactly.

Todd: Yeah, I I can give an example of that from my life. I recently I’ve been doing just kind of body weight exercises at home, you know, and I got some dumbbells and do some of that and and I was regular for a good while and then started wavering as things got stressful and that then I started getting I decided to pay someone just to be like once a month check in and you have to be accountable.

They’re going to give you 16 workouts per month and you’re going to have to check in, you know, with, [00:38:00] and, and then I set up a time, you know, 4 30 PM. That’s my workout time four days a week. And suddenly I’m doing it

Alan: Yes,

Todd: like consistently. So I can attest.

Alan: Ha, ha. Ha, ha.

Todd: Very cool. Okay, so let’s just, um, talk, uh, more generally about, uh, the challenges today, uh, of being social, anything we haven’t covered, um, anything else you’d like to add, uh, on this huge topic of, of social connectivity.

Alan: Well, I think, um, there’s so much more we could say, but one thing that definitely comes to mind um, there’s in coming back to Stephen Covey’s book, he has the seven habits of highly effective people. And he says, one of the habits is to keep the end in mind. And he gives a very powerful exercise for people to do, which is to. Imagine their own funeral and imagine, you know, their families, their, their [00:39:00] colleagues are there. And by the way, this has been a tool used by many people because it’s universal. And you try to imagine what it is you would want people to say about you. And if you do the exercise, realize that I was a good father, I was a good husband, a wife, you know, I was, you know, a loving brother or I cared about my community.

In other words, when you look at the end, we want to be known for, you know, being a giver, for, you know, giving. you know, an aspect of social relationships is the opportunity to give. But interestingly, it’s, first of all, some people are more innately givers than others. It’s just, it’s just the way we’re built. Giving isn’t something that necessarily is part of that social need. You know, it’s something that you can aspire to as a goal and become very meaningful. And, and, you know, but you have to think about it because, you know, it is an investment in time. what I say is if you, if you pay [00:40:00] attention, if you pay attention, you’ll find that when you are giving, even in minor ways, you went. Went out a given day and said, I’m going to, you know, thank five people, you know, you know, I’m going to smile at the cashier or give praise to a colleague, you know, call up my child and say some, something that’s, you know, in a giving way, these little interactions, pay attention, you feel good after you’ve done them, know,

Todd: Um,

Alan: but to be a giver, you know, I remember the story, this came to mind, this was years ago, was in a, yeah, I was a place that I was, uh, it was a bunch of people and a person caught my eye who was a wheelchair and this person looked not well at all. And, um, I’m leaving the store, you know, it’s pouring outside, pouring, and [00:41:00] I said to myself, what, what, what’s this person going to do when they get out of, you know, into the street?

Todd: Um,

Alan: So I remember walking down the street saying, you know, should I wait to see, should I not wait to see? And then this person, you know, wheels himself out, and I see he’s heading to Broadway.

This was in New York City, and I realized he’s going up the street and he doesn’t have an umbrella, you know, and I did, and, um, and I said, okay, I got to go for it. So I went and I, I said, can I help you? So it turns out he was like looking to catch the bus. And um, so, you know, I put my umbrella over him. I wheeled him over there.

We waited about 10 minutes for the bus. I didn’t have much in common with him, but I tried to make, you know, a small talk, which I did, and then I helped him get on the bus. So he gets on the bus, afterwards I start crying, really crying. And I think I cried in part because I realized [00:42:00] this is, this was uncharacteristic for me.

It was like you felt like you, you know, and there was a sense of one sense satisfaction, but what was said in afterwards was, wait a second, don’t give yourself too much credit. This was, would you do it again and again and again? So you have to, know, so it was a pleasurable thing of overcoming, but

Todd: Yeah,

Alan: that I became a giver.

That is by doing it over and over again, but you can take small steps.

Todd: yeah, yes.

Alan: know, and that’s a pleasure for us. And as we develop it more, we were more alive. This is what we want to do, you know, was that, you know, so we can get distracted from it.

And interestingly, that comes back all the issue of time, what happens is that, um, when we’re more under time pressure, we’re more focused on our, you know, what we have to do, we become less receptive [00:43:00] to being. you know, out there for other people. So you’ve got to windows of time, you know, be with friends and where you can give to people.

And that’s, and that’s why people like to volunteer, by the way, but usually you see that among older people and you see that those who volunteer actually have better health outcomes. That’s another aspect of socialization, actually,

Todd: That makes sense. Yeah, it’s a kind of, in a way, an easy way to gain some social interaction, um, in a somewhat, somewhat low risk way, um, but gain the value of giving, uh, through that. Um, it, I like that you said you get a, you feel good afterwards. It’s sort of like exercise. You don’t want to exercise, but then when you do it, you feel better afterwards.

And, uh, it’s the same with that. That giving, um,

Alan: yes, yes,

Todd: balancing two different modes. There’s a focus time and there’s a time when you need to close doors and turn people away. [00:44:00] And there’s a time for closing doors to focus and staying, uh, staying out and connecting in, in less, uh, purposeful ways. Um.

Alan: You know, you have to fill the tank sometimes before you can give, right? I mean, it was that old thing on the airplanes, right? They still show it, you know, when you are going on the plane and let’s say, all of a sudden you need oxygen, they caution you, the parent should put on the mask first before the child. you are able to give to the child. always felt that was a paradigm for giving in general. So you have to take care of your health, and eat well, and get enough sleep, and take care of your own social needs, and stress, and all these things make you more able to give. So these things are all interrelated to each other.

Todd: Yes. Yes. You know, sometimes people, um, have the opposite problem where they’re thinking like, I can’t give it to myself because I should [00:45:00] give to others more and they feel guilty of giving to themselves. But I use that same analogy of like, I have to take care of myself because I can only give what I have.

If I’m burnt out, no matter how, no matter how much I try to give on the surface, it’s not going to be it. Felt as deeply or experienced as deeply as if I can come from a place of fullness and then it’s overflowing. And, and that’s when the fun, uh, began. So everybody has a different balance point. Uh, but, but being aware of where that is and what I need and then where, where I can give and just keeping tabs on both sides of it, I think is really important.

Alan: Yes, yes, yes.

Todd: Wonderful. Well, thank you for this discussion on, uh, social, just social connectivity. And I love that you have it as one of the domains of health. And I know it’s not just your personal, uh, interest, but [00:46:00] based on a lot of research as well. So thank you for sharing your, your expertise and, and your, um, experience with us.

Alan: Sure. Thank you for having me today. It’s been a real pleasure.

Todd: Excellent. And we’ll do the last two domains in two more episodes. We’re just, we’re just, we started out, it was going to all be in one episode and that was just going on. And I’m loving that we’re taking our time. Um, the next one will be on purpose. So looking forward to that.

Alan: look forward to it. Thank you.

Okay.[00:47:00][00:48:00]

It’s a pleasure to be here. Thank you so much.

It’s a basic psychological need to be connected to other people. a, um, we have physical needs, they’re obvious to us, but we also have psychological needs. And they’re needs in the same sense that they need to be fulfilled. And when they’re fulfilled, we experience more well being, more vitality, we feel happier.

And when they’re not fulfilled, it’s kind of interesting because something doesn’t feel right. We lose vitality, we may have more tension, and over time it may affect our health. it is a basic need, but it’s not loud. not as obvious as physical needs. And one of those most profound needs is our needs to be connected to other people.

We’re just essentially socially wired to be connected to other people.[00:49:00]

Sure, that’s a great question. a theme that I mentioned in the first podcast was that can just use the body to testify as to what’s healthy and unhealthy. And those things which promote longevity, decrease disease risk, and improve our physiology are protected, are healthier, those that do the opposite are not.

So the first research that of note In terms of, uh, all of this was a study called the Alameda County Study. This was, uh, published in 1979. Lisa Berkman was the, uh, first author of that study. And they simply looked at the size [00:50:00] of people’s social networks at that time in Alameda County. found that the greater the size of the network, the lower the risk of mortality over follow up, both in men and women.

So a study. catching. And for a few years, this became a big trend to look at the size of people’s social networks. And all the data was reproducible. And then people began to look at the quality of social relationships. For example, people after a heart attack, what was the quality of your relationship with the loved ones around you?

And it turned out that that was also a very powerful predictor of outcome. Now this has been reproduced in so many studies. It’s led to better analysis. which have also been very reproducible and established that the quality of our social relationships very profound, uh, have a very profound effect size, if you will, meaning a very substantial effect on outcomes.

And when you look at the negative side of that loneliness, It turns out to be a very profound [00:51:00] risk factor for, you know, uh, earlier mortality for, you know, more chronic disease, uh, and even studies looking now in terms of cognitive function and so forth. one classic meta analysis, they found that being lonely was equivalent to smoking about 15 cigarettes per day.

So crucial.

There’s a lot of physiological studies, which look at, you know, what’s the result in people who are less socially connected, they have higher cortisol levels, poor immune function. And on the flip side, when people are, you know, enjoying social relationships, you have the release of oxytocin, which is a kind of a bonding hormone, makes us feel good.

Dopamine, serotonin. And so forth. And then even in animal studies, uh, when there’s classic studies, like you take Sinomogus monkeys, these are a class of monkeys which are socially bonding to each other. And when they put a group of them in cages and compared them to a group that [00:52:00] was not in cages, fed them exactly the same diet.

Lo and behold, the caged monkeys developed more atherosclerosis, more men who were, uh, in Boston, one group was, you know, people in Harvard University, and the other was people in South Boston who came from low socioeconomic backgrounds, and they have followed these people, lo and behold, for 85 years.

Uh, they found them in terms of constantly bringing them back for interviews, how they did in real life and so forth. found, lo and behold, that people’s social connections more powerful than wealth, social class. In predicting happiness and people who are lonely definitely have [00:53:00] poor physical and mental health.

So it’s, when you take all of these studies together, we are built to be socially connected to other people.

Sure. Well, in fact, it’s quite varied. Um, we have introverts versus extroverts. Some people thrive by being in a crowd with other people. Other people don’t want to be among many people. Uh, we have people who [00:54:00] can feel alone in a crowd. We have people who just need like one good friend. we have different, uh, needs at different times in life.

Maybe when we’re stressed, for example, or we’re going through a journey with an illness. Uh, certainly when we are going through the turbulence of life, I think that’s one of the benefits of having friends and being socially connected. also, uh, interestingly, can sublimate your need for social connections because there are competing needs we have, like a need to pursue in our jobs, you know, pursue different avenues of meaning and so forth.

It kind of is a dividend when you get older. That, you know, if you kept your connections as you get older and you have now retired from your job and, you know, you’re looking to do new things to have, you know, created a dividend of, you know, being socially connected to people that [00:55:00] you can’t just take off the bookshelf.

Um, so it’s, it’s a very good point that it’s, these needs vary, this need for social connections, both in terms of people’s, expression of it and in terms of different times of your life.

Absolutely. [00:56:00] Yes.

Well, you know, it’s, it’s again variable in terms of people’s needs and so forth, but I think there’s basics that are really important. Um, one of them is the time invested that you, you know, you, you can’t, there’s quality time and there’s quantity time. Um, and both are important [00:57:00] actually, because when you think about the building blocks of relationship, whether you say it’s trust.

or understanding, or feeling comfortable with another person, or you’re feeling that it’s got an enduring quality to it. All of these things are a function of the time you’re willing to put into that relationship. We develop trust by the interaction we’ve had with people. Understanding requires getting to know people under different circumstances, getting to know them well.

Feeling that enduring quality of a relationship is the test of time, right? You know, uh, is that those long gaps, you know, you stay in contact, you know, and you’re comfortable also is a question of time in some respect, because you, you get more comfortable with people as you get to know them. these are, these are, you know, this is one of the building blocks of, you know, good relationships, but there’s so many other factors, um, uh, we could go through with, uh, [00:58:00] uh, you know, sense of empathy.

Go ahead. Yeah.

Yeah, it is, um, you know, I say we leave, [00:59:00] we live in kind of unique times and think we reflect enough about how, what this means in terms of what I think has become an increasing challenge terms of social connectivity. mean, if you look back historically, you know, people, you know, used to be living in a neighborhood.

We weren’t so geographically normal all those years. People were getting married young. Um, there was a lot of, um, proximity based interactions, you know. Clubs. you know, your school, you know, there was just a lot more there, uh, and also the way we’ve changed in terms of leisure. When I was a kid, you know, uh, you’d go outside and you’d see people, you know, we’d play stoop ball, stick ball, you know, all lot of, you know, entertainment and, and pastime has moved indoors, right? And so people are less out there. But the impact of, I think two [01:00:00] factors. profound. One is the advent of social media. Uh, and social media has been very profound. and what I say is that, you know, it’s a power, you know, it’s like talking about nuclear energy is a power and it’s good and it’s got bad social media.

you know, more people at us in different ways. And so it can, it can of dumb down the quality of your social interactions with people. And I think it does. [01:01:00] it doesn’t have to. It food today, a lot of ultra processed foods. And so these are all different ways we have to be careful. We don’t two, those things which are not urgent, but important. [01:02:00] we might be taking care of older parents who now are living longer than they used to while taking care of younger children. we feel it. We feel that life is faster today. And it’s easy to say, well, manana, I’ll, you know, spend more time with my friends, you and it just goes on. So you have to be intentional to make time to be with your friends.

You just do. So it’s a challenge.[01:03:00]

much of it. So much of communication is non verbal, right? is that bonding that occurs. Our brain is biologically wired to be connected to people. So, [01:04:00] I’m not putting down virtual, you know, interactions at all. It’s just that you need the good stuff too, the other good Sure, sure, absolutely.

Well, you know, I, I was thinking actually you we teach all these subjects in school, you know, uh, STEM, all these, uh, I don’t even know anything they teach anymore, but you know, I don’t think teacher at science anymore, but certainly [01:05:00] you take, uh, English, chemistry, whatever. Um. Shouldn’t we be teaching some of the basics about, you know, social intelligence, if you will, if you’ll call it that, you know, there’s a emotional intelligence, social intelligence.

So in terms of, you know, um, things about communication and how to be more empathic and the value of giving how to be more Teflon, I’d say, than Velcro, in other words. The ability to, know, things go as opposed to let things stick with you, you know, which is a master of social trade as well. I mean, there’s just so many different social skills that we learn as we go, we get older and we get better at it, you know, but we get better at it through life experience.

and you should learn about it earlier in life, I believe, I think it would be good, you know, and I do have a concern. Uh, in this media time now where there’s [01:06:00] so much is virtual and, you know, very often among young people, less interactions in the which been disappearing from our educational system. So a physician, I’m looking at it for multiple ways and saying, these are all basics to teach.[01:07:00]

Well, I’m not sure. I would have to think about it. You know, I mean, I think it’s just the very things we’re talking about here. Um, I think there’s different formats to teaching it. It could be in a seminar sort of situation. Um, you know, I just think it’s, there’s many ways to do it. I think that’s the nice thing about it.[01:08:00]

Sure. Sure. Sure. Yeah.

Well, that’s a great topic because we talk about the quality relationships, that’s very important. There is a concept of building a social network, [01:09:00] and that becomes very important. And I think, know, you could have like a checklist, you know. Do I have, you know, friends? What quality friends? Do I have any confidence in my life?

know, do I have a functional network, uh, that works for me and so forth? I think the first place I would start off there is with friends because know, friends, we can have friends of different sorts, but I think it’s important to have one, two very high quality friends in your life. You know, we shouldn’t be traveling life alone, you know, so friendships require investment.

a high quality friendship is one where you have somebody who you feel that this person you can trust, who you can confide in, that they have your back, that they’re supportive of you, that they get you, for example. And also a friend who might push you a little bit sometimes. You know, uh, and give you honest feedback.

So these are all qualities, you know, and different friends can have different things, but [01:10:00] these are assets and it makes a friendship special, you know? So, um, thinking, uh, sometimes I come across news of like friends I had in high school, I didn’t maintain those friendships I was thinking, you know, we leave high school.

But we shouldn’t leave our friends behind, when I do end up talking, as of once in a while, with one friend that I got in contact, like, with 30 years later, I got his number, I called him up. And within two minutes, no, within immediately, it was like we had never lost that other words, it life, in early life, we were more vulnerable. We were more willing to be vulnerable. We were more authentic with our friends. We didn’t have the social mask up. We had the time to be with them. And that’s just a, Paradigm for friendships in general, you know, so when [01:11:00] you, but you, you know, okay, so maybe you didn’t invest in those friendships, but you can gain new friends.

And another thing about friendships, very interesting, is that a lot of the friends we make is because neighbors, they’re close there, you know, so that’s kind of spontaneous. But when you say, wait a second, how important friendship is, maybe I should search out for the right friends for myself. think people think about that enough, that you should go and, and, uh, and look for friends.

So one thing. Yeah.[01:12:00]

Yeah, I think what you’re describing is commonplace, and it happened to me too, right? We moved to a new place, we’re so busy, and we start to let go of the time invested in those old friendships, even though we had good friends. That’s what happens. So, but in terms of building a network, friends are important.

It’s also important to have a confidant, [01:13:00] you know, even just one, but preferably even maybe perhaps more than one. The confidant is somebody who you can be open and you can share the most difficult things that you’re going through because we all go through this turbulence in life. And that doesn’t have to be a friend, by the way.

Confident could be somebody who’s not a friend at all, but just like a wise person or a caring person or someone, you just find that that person supports you. is in your network is extremely important. We can also use our network to keep us more objective in life. there’s this concept here of like this tripod of objectivity, you know, having people above your level, at your level, below your level, or someone who’s a wise person or wise people who you can look up to to get advice.

someone at your level, you know, peer or friends and so forth you can talk to, but also younger people, [01:14:00] you know, when you can, when you’re teaching, they’ll keep you honest and you learn a lot by trying to, you know, teach people and so forth. Teaching is, I mean, I’ve been teaching for 50 years, so I mean, it’s like, you know, it really is. So that’s And then it’s important to have a, I’d call a functional network, which is, I remember when I was growing up, my dad was, you know, it was a different time in those years, but, you know, we had the local pharmacist, uh, that my dad was friendly with, and you’d come in and you would talk to him and so forth, and you could call him up at odd hours.

You’d have the phone number. You know, I tried to do that [01:15:00] with our local pharmacy, you know, introduce myself. So it’s always a different pharmacist, you know, and all these the friction of life. life again has this turbulence and when you need these people of need, it’s better if they’re on the bookshelf, you know, and you can just, you know, you just have that there for you, but that takes time to think about, you know, say, okay, you know, have I made a relationship with a physician that I feel know, I can work with and, you know, it was there for me.

So if, you know, something comes up, I don’t have to search. And I’ve got a network for people in, in, uh, in investment and [01:16:00] the mechanic and all these things. So you go and you see what you’re doing. You say, wait, I’m creating this, this network. So that’s, that’s important in terms of, uh, of, uh, building a social network.

Now I’ve mentioned two other things. One is that. I read a book a number of years back. I’ll tell you, I have to give credit where the idea comes from. So there’s a book, a famous book called Tuesday with Maurice. Mitch Albom, and this was at a time when he was a sports writer before he became famous writing novels.

he had time on his hands, and I remember he had this, professor in college, uh, um, you know, Maury. And he was living in Boston, and Mitch Albom was in Detroit. And he started flying there every Tuesday, once a week, to meet with Maury and get, like, what life wisdom. And he wrote a book on it called, you know, Tuesdays with Moore.

It’s a great book. So in the book, he, he quotes Moore saying that everybody needs to [01:17:00] develop their own culture, you know, because you need. a culture that works for you. And if you don’t work on it, you’re just a subject to, you know, the, the, uh, the large culture out there with whatever’s going on. And so it may not serve you well.

So I was really taken by the idea after that, you know, in terms of, know, what does it mean creating your own culture? it means exactly creating the environment you want to, will support your interests, goals, values. attitudes. an obvious one for me as a physician, promulgating health is a health culture, were supporting that, having like minded friends, you know, interested in health. So if you want to [01:18:00] build an interest in an area you’re having difficulty, you start to think, well, how can I create a supportive culture?

to do that. Um, yeah, I’m trying to remember the name that came in my Columbia magazine. I’m not remembering his name now, but he, uh, it was a story about this person who has had a course Columbia University where he teaches people how to write best selling books. And it’s like a seminar course, and it’s you meet once a week for seven hours.

And people share ideas and so forth. And he’s had tremendous success. But what caught my idea of my fancy in that article about him was that he created a Facebook group so that people who had taken his course years earlier and already been successful in writing books were available to these new students who were starting.

So he created a ready made [01:19:00] culture for these people to support them. Another example, I know, uh, there are parents today who are very concerned with their kids being exposed to, uh, social media too early. But then you have a problem. Well, wait a second. If my, my child’s in seventh grade and everybody else had got a cell phone, what do I do have to advocate for this?

And maybe you have to find like minded parents and you have to find kids that your kids can interact with, who have alternative social activities to do. So they’re not participating in maybe social media at that age. So it’s, these are all different ways in which you. can create a culture. Uh, proactive.[01:20:00]

Sure, sure. So the other thing that comes to mind in terms of a social network is using a power of accountability. We have that challenge in life to move forward in different areas, and we’re pushing in terms of goals. So I sometimes say my middle name is accountability because I just realized it’s a real power and I need it in my own life.

You know, I’ve used it different ways where I’ve like, I wanted to get a certain paper done. Sometimes I [01:21:00] volunteer to give a lecture or grand rounds on a topic. And boy, did that make me accountable, you know, and the paper got done. Um, so, um, I say we can combine that with a great technique that, um, I use to get people exercising, for example, where they ask them to form an implementation intention.

An implementation intention is where you say, I want to get X done. If you just say I want to get X done, you, let’s say I want to go to the gym and work out a few times a week. That’s a goal, but you know, it’s kind of vague and you might do it on certain days and other days you feel like I got too much to do, [01:22:00] you know, work just finished. And every day when work finishes at five o’clock or six o’clock, I am going to go to the gym.

And you say, I’m taking out of my head, that’s the cue. Now that implementation intention has been shown by meta analysis, many studies to work. When people an obligation intention, that when it’s X I will do Y with Z, which is a person, then it becomes much more powerful.

I remember years ago I had a, um, podiatrist I was seeing, uh, I, uh, he had, you know, casual clothes. And when I saw him I said, oh, you really must be into exercise. He says, No, I don’t like it at all. I said, Oh, so you don’t exercise. No, I anxious. I go to Central Park every morning and work out, but I said, But you don’t like exercise.[01:23:00]

So he’s a good friend. And, you know, we We bonded over the years and he likes to exercise and I’ve agreed to meet with him every morning and I’m not going to let him down.

recognize that’s a tremendous tool say, when it is X, I will do Y. With somebody else, it becomes an obligation intention. You committed to do something with somebody else that is another aspect of social networking, which can be very powerful.

Exactly, exactly.[01:24:00]

Yes, Ha, ha. Ha, ha.[01:25:00]

Well, I think, um, there’s so much more we could say, but one thing that definitely comes to mind um, there’s in coming back to Stephen Covey’s book, he has the seven habits of highly effective people. And he says, one of the habits is to keep the end in mind. And he gives a very powerful exercise for people to do, which is to.

Imagine their own funeral and imagine, you know, their families, their, their colleagues are there. And by the way, this has been a tool used by many people because it’s universal. And you try to imagine what it is you would want people to say about you. And if you do the exercise, realize that I was a good father, I was a good husband, a wife, you know, I was, you know, a loving brother or I cared about my community.

In other words, when you look at the end, we want to be known for, you know, being a [01:26:00] giver, for, you know, giving. you know, an aspect of social relationships is the opportunity to give. But interestingly, it’s, first of all, some people are more innately givers than others. It’s just, it’s just the way we’re built.

Giving isn’t something that necessarily is part of that social need. You know, it’s something that you can aspire to as a goal and become very meaningful. And, and, you know, but you have to think about it because, you know, it is an investment in time. what I say is if you, if you pay attention, if you pay attention, you’ll find that when you are giving, even in minor ways, you went.

Went out a given day and said, I’m going to, you know, thank five people, you know, you know, I’m going to smile at the cashier or give praise to a colleague, you know, call up my child and say some, something that’s, you know, in a giving way, these little interactions, pay attention, you feel good after you’ve done them, know, but to be [01:27:00] a giver, you know, I remember the story, this came to mind, this was years ago, was in a, yeah, I was a place that I was, uh, it was a bunch of people and a person caught my eye who was a wheelchair and this person looked not well at all.

And, um, I’m leaving the store, you know, it’s pouring outside, pouring, and I said to myself, what, what, what’s this person going to do when they get out of, you know, into the street? So I remember walking down the street saying, you know, should I wait to see, should I not wait to see? And then this person, you know, wheels himself out, and I see he’s heading to Broadway.

This was in New York City, and I realized he’s going up the street and he doesn’t have an umbrella, you know, and I did, and, um, and I said, [01:28:00] okay, I got to go for it. So I went and I, I said, can I help you? So it turns out he was like looking to catch the bus. And um, so, you know, I put my umbrella over him. I wheeled him over there.

We waited about 10 minutes for the bus. I didn’t have much in common with him, but I tried to make, you know, a small talk, which I did, and then I helped him get on the bus. So he gets on the bus, afterwards I start crying, really crying. And I think I cried in part because I realized this is, this was uncharacteristic for me.

It was like you felt like you, you know, and there was a sense of one sense satisfaction, but what was said in afterwards was, wait a second, don’t give yourself too much credit. This was, would you do it again and again and again? So you have to, know, so it was a pleasurable thing of overcoming, but that I became a giver.

That is by doing it over and over [01:29:00] again, but you can take small steps. know, and that’s a pleasure for us. And as we develop it more, we were more alive. This is what we want to do, you know, was that, you know, so we can get distracted from it.

And interestingly, that comes back all the issue of time, what happens is that, um, when we’re more under time pressure, we’re more focused on our, you know, what we have to do, we become less receptive to being. you know, out there for other people. So you’ve got to windows of time, you know, be with friends and where you can give to people.

And that’s, and that’s why people like to volunteer, by the way, but usually you see that among older people and you see that those who volunteer actually have better health outcomes. That’s another aspect of socialization, actually, [01:30:00] yes, yes,

You know, you have to fill the tank sometimes before you can give, right? I mean, it was that old thing on the airplanes, right? They still show it, you know, when you are going on the plane and let’s say, all of a sudden you need oxygen, they caution you, the parent should put on the mask [01:31:00] first before the child.

you are able to give to the child. always felt that was a paradigm for giving in general. So you have to take care of your health, and eat well, and get enough sleep, and take care of your own social needs, and stress, and all these things make you more able to give. So these things are all interrelated to each other.[01:32:00]

Yes, yes, yes.

Sure. Thank you for having me today. It’s been a real pleasure.

look forward to [01:33:00] it. Thank you.

Okay.[01:34:00]

It’s a pleasure to be here. Thank you so much.

It’s a basic psychological need to be connected to other people. a, um, we have physical needs, they’re obvious to us, but we also have psychological needs. And they’re needs in the same sense that they need to be fulfilled. And when they’re fulfilled, we experience more well being, more vitality, we feel happier.[01:35:00]

And when they’re not fulfilled, it’s kind of interesting because something doesn’t feel right. We lose vitality, we may have more tension, and over time it may affect our health. it is a basic need, but it’s not loud. not as obvious as physical needs. And one of those most profound needs is our needs to be connected to other people.

We’re just essentially socially wired to be connected to other people.

Sure, that’s a great question. a theme that I mentioned in the [01:36:00] first podcast was that can just use the body to testify as to what’s healthy and unhealthy. And those things which promote longevity, decrease disease risk, and improve our physiology are protected, are healthier, those that do the opposite are not.

So the first research that of note In terms of, uh, all of this was a study called the Alameda County Study. This was, uh, published in 1979. Lisa Berkman was the, uh, first author of that study. And they simply looked at the size of people’s social networks at that time in Alameda County. found that the greater the size of the network, the lower the risk of mortality over follow up, both in men and women.

So a study. catching. And for a few years, this became a big trend to look at the size of people’s social networks. And all the data was reproducible. And then people began to look at the quality of social relationships. For example, people after a heart attack, what was the [01:37:00] quality of your relationship with the loved ones around you?

And it turned out that that was also a very powerful predictor of outcome. Now this has been reproduced in so many studies. It’s led to better analysis. which have also been very reproducible and established that the quality of our social relationships very profound, uh, have a very profound effect size, if you will, meaning a very substantial effect on outcomes.

And when you look at the negative side of that loneliness, It turns out to be a very profound risk factor for, you know, uh, earlier mortality for, you know, more chronic disease, uh, and even studies looking now in terms of cognitive function and so forth. one classic meta analysis, they found that being lonely was equivalent to smoking about 15 cigarettes per day.

So crucial.

There’s a lot of physiological studies, which look at, you know, what’s the result in people who are less socially [01:38:00] connected, they have higher cortisol levels, poor immune function. And on the flip side, when people are, you know, enjoying social relationships, you have the release of oxytocin, which is a kind of a bonding hormone, makes us feel good.

Dopamine, serotonin. And so forth. And then even in animal studies, uh, when there’s classic studies, like you take Sinomogus monkeys, these are a class of monkeys which are socially bonding to each other. And when they put a group of them in cages and compared them to a group that was not in cages, fed them exactly the same diet.

Lo and behold, the caged monkeys developed more atherosclerosis, more men who were, uh, in Boston, one group was, you know, people in Harvard [01:39:00] University, and the other was people in South Boston who came from low socioeconomic backgrounds, and they have followed these people, lo and behold, for 85 years.

Uh, they found them in terms of constantly bringing them back for interviews, how they did in real life and so forth. found, lo and behold, that people’s social connections more powerful than wealth, social class. In predicting happiness and people who are lonely definitely have poor physical and mental health.

So it’s, when you take all of these studies together, we are built to be socially connected to other people.[01:40:00]

Sure. Well, in fact, it’s quite varied. Um, we have introverts versus extroverts. Some people thrive by being in a crowd with other people. Other people don’t want to be among many people. Uh, we have people who can feel alone in a crowd. We have people who just need like one good friend. we have different, uh, needs at different times in life.

Maybe when we’re stressed, for example, or we’re going through a journey with an illness. Uh, certainly when we are going through the turbulence of life, I think that’s one of the benefits of having friends and being socially connected. also, uh, interestingly, can sublimate your [01:41:00] need for social connections because there are competing needs we have, like a need to pursue in our jobs, you know, pursue different avenues of meaning and so forth.

It kind of is a dividend when you get older. That, you know, if you kept your connections as you get older and you have now retired from your job and, you know, you’re looking to do new things to have, you know, created a dividend of, you know, being socially connected to people that you can’t just take off the bookshelf.

Um, so it’s, it’s a very good point that it’s, these needs vary, this need for social connections, both in terms of people’s, expression of it and in terms of different times of your life.[01:42:00]

Absolutely. Yes.[01:43:00]

Well, you know, it’s, it’s again variable in terms of people’s needs and so forth, but I think there’s basics that are really important. Um, one of them is the time invested that you, you know, you, you can’t, there’s quality time and there’s quantity time. Um, and both are important actually, because when you think about the building blocks of relationship, whether you say it’s trust.

or understanding, or feeling comfortable with another person, or you’re feeling that it’s got an enduring quality to it. All of these things are a function of the time you’re willing to put into that relationship. We develop trust by the interaction we’ve had with people. Understanding requires getting to know people under different circumstances, getting to know them well.

Feeling that [01:44:00] enduring quality of a relationship is the test of time, right? You know, uh, is that those long gaps, you know, you stay in contact, you know, and you’re comfortable also is a question of time in some respect, because you, you get more comfortable with people as you get to know them. these are, these are, you know, this is one of the building blocks of, you know, good relationships, but there’s so many other factors, um, uh, we could go through with, uh, uh, you know, sense of empathy.

Go ahead. Yeah.[01:45:00]

Yeah, it is, um, you know, I say we leave, we live in kind of unique times and think we reflect enough about how, what this means in terms of what I think has become an increasing challenge terms of social connectivity. mean, if you look back historically, you know, people, you know, used to be living in a neighborhood.

We weren’t so geographically normal all those years. People were getting married young. Um, there was a lot of, um, proximity based [01:46:00] interactions, you know. Clubs. you know, your school, you know, there was just a lot more there, uh, and also the way we’ve changed in terms of leisure. When I was a kid, you know, uh, you’d go outside and you’d see people, you know, we’d play stoop ball, stick ball, you know, all lot of, you know, entertainment and, and pastime has moved indoors, right? And so people are less out there. But the impact of, I think two factors. profound. One is the advent of social media. Uh, and social media has been very profound. and what I say is that, you know, it’s a power, you know, it’s like talking about nuclear energy is a power and it’s good and it’s got bad social media.[01:47:00]

you know, more people at us in different ways. And so it can, it can of dumb down the quality of your social interactions with people. And I think it does. it doesn’t have to. It food today, a lot of ultra processed foods. And so these are all different ways we have to be careful. We don’t [01:48:00] two, those things which are not urgent, but important. we might be taking care of older parents who now are living longer than they used to while taking care of younger children. we feel it. We feel that life is faster today. And it’s easy to say, well, manana, [01:49:00] I’ll, you know, spend more time with my friends, you and it just goes on. So you have to be intentional to make time to be with your friends.

You just do. So it’s a challenge.[01:50:00]

much of it. So much of communication is non verbal, right? is that bonding that occurs. Our brain is biologically wired to be connected to people. So, I’m not putting down virtual, you know, interactions at all. It’s just that you need the good stuff too, the other good Sure, sure, [01:51:00] absolutely.

Well, you know, I, I was thinking actually you we teach all these subjects in school, you know, uh, STEM, all these, uh, I don’t even know anything they teach anymore, but you know, I don’t think teacher at science anymore, but certainly you take, uh, English, chemistry, whatever. Um. Shouldn’t we be teaching some of the basics about, you know, social intelligence, if you will, if you’ll call it that, you know, there’s a emotional intelligence, social intelligence.

So in terms of, you know, um, things about communication and how to be more empathic and the value of giving how to be more Teflon, I’d say, than Velcro, [01:52:00] in other words. The ability to, know, things go as opposed to let things stick with you, you know, which is a master of social trade as well. I mean, there’s just so many different social skills that we learn as we go, we get older and we get better at it, you know, but we get better at it through life experience.

and you should learn about it earlier in life, I believe, I think it would be good, you know, and I do have a concern. Uh, in this media time now where there’s so much is virtual and, you know, very often among young people, less interactions in the which been [01:53:00] disappearing from our educational system. So a physician, I’m looking at it for multiple ways and saying, these are all basics to teach.

Well, I’m not sure. I would have to think about it. You know, I mean, I think it’s just the very [01:54:00] things we’re talking about here. Um, I think there’s different formats to teaching it. It could be in a seminar sort of situation. Um, you know, I just think it’s, there’s many ways to do it. I think that’s the nice thing about it.[01:55:00]

Sure. Sure. Sure. Yeah.

Well, that’s a great topic because we talk about the quality relationships, that’s very important. There is a concept of building a social network, and that becomes very important. And I think, know, you could have like a checklist, you know. Do I have, you know, friends? What quality friends? Do I have any confidence in my life?

know, do I have a functional network, uh, that works for me and so forth? I think the first place I would start off there is with friends because know, friends, we can have friends of different sorts, but I think it’s important to have one, two very high quality friends in your life. You know, [01:56:00] we shouldn’t be traveling life alone, you know, so friendships require investment.

a high quality friendship is one where you have somebody who you feel that this person you can trust, who you can confide in, that they have your back, that they’re supportive of you, that they get you, for example. And also a friend who might push you a little bit sometimes. You know, uh, and give you honest feedback.

So these are all qualities, you know, and different friends can have different things, but these are assets and it makes a friendship special, you know? So, um, thinking, uh, sometimes I come across news of like friends I had in high school, I didn’t maintain those friendships I was thinking, you know, we leave high school.

But we shouldn’t leave our friends behind, when I do end up talking, as of once in a while, with one friend that I got in contact, like, with 30 years later, [01:57:00] I got his number, I called him up. And within two minutes, no, within immediately, it was like we had never lost that other words, it life, in early life, we were more vulnerable. We were more willing to be vulnerable. We were more authentic with our friends. We didn’t have the social mask up. We had the time to be with them. And that’s just a, Paradigm for friendships in general, you know, so when you, but you, you know, okay, so maybe you didn’t invest in those friendships, but you can gain new friends.

And another thing about friendships, very interesting, is that a lot of the friends we make is because neighbors, they’re close there, you know, so that’s kind of spontaneous. But when you say, wait a second, how important friendship is, maybe I should search out for the right friends for myself. think people think about that enough, that you should go [01:58:00] and, and, uh, and look for friends.

So one thing. Yeah.[01:59:00]

Yeah, I think what you’re describing is commonplace, and it happened to me too, right? We moved to a new place, we’re so busy, and we start to let go of the time invested in those old friendships, even though we had good friends. That’s what happens. So, but in terms of building a network, friends are important.

It’s also important to have a confidant, you know, even just one, but preferably even maybe perhaps more than one. The confidant is somebody who you can be open and you can share the most difficult things that you’re going through because we all go through this turbulence in life. And that doesn’t have to be a friend, by the way.

Confident could be somebody who’s not a friend at all, but just like a wise person or a caring person or someone, you just find that that person [02:00:00] supports you. is in your network is extremely important. We can also use our network to keep us more objective in life. there’s this concept here of like this tripod of objectivity, you know, having people above your level, at your level, below your level, or someone who’s a wise person or wise people who you can look up to to get advice.

someone at your level, you know, peer or friends and so forth you can talk to, but also younger people, you know, when you can, when you’re teaching, they’ll keep you honest and you learn a lot by trying to, you know, teach people and so forth. Teaching is, I mean, I’ve been teaching for 50 years, so I mean, it’s like, you know, it really is. So that’s [02:01:00] And then it’s important to have a, I’d call a functional network, which is, I remember when I was growing up, my dad was, you know, it was a different time in those years, but, you know, we had the local pharmacist, uh, that my dad was friendly with, and you’d come in and you would talk to him and so forth, and you could call him up at odd hours.

You’d have the phone number. You know, I tried to do that with our local pharmacy, you know, introduce myself. So it’s always a different pharmacist, you know, and all these [02:02:00] the friction of life. life again has this turbulence and when you need these people of need, it’s better if they’re on the bookshelf, you know, and you can just, you know, you just have that there for you, but that takes time to think about, you know, say, okay, you know, have I made a relationship with a physician that I feel know, I can work with and, you know, it was there for me.

So if, you know, something comes up, I don’t have to search. And I’ve got a network for people in, in, uh, in investment and the mechanic and all these things. So you go and you see what you’re doing. You say, wait, I’m creating this, this network. So that’s, that’s important in terms of, uh, of, uh, building a social network.

Now I’ve mentioned two other things. One is that. I read a book a number of years back. I’ll tell you, I have to give credit where the idea comes from. So there’s a book, a famous book called Tuesday with Maurice. Mitch Albom, and this was at a time when he was [02:03:00] a sports writer before he became famous writing novels.

he had time on his hands, and I remember he had this, professor in college, uh, um, you know, Maury. And he was living in Boston, and Mitch Albom was in Detroit. And he started flying there every Tuesday, once a week, to meet with Maury and get, like, what life wisdom. And he wrote a book on it called, you know, Tuesdays with Moore.

It’s a great book. So in the book, he, he quotes Moore saying that everybody needs to develop their own culture, you know, because you need. a culture that works for you. And if you don’t work on it, you’re just a subject to, you know, the, the, uh, the large culture out there with whatever’s going on. And so it may not serve you well.

So I was really taken by the idea after that, you know, in terms of, know, what does it mean creating your own culture? it means exactly creating the environment you want to, [02:04:00] will support your interests, goals, values. attitudes. an obvious one for me as a physician, promulgating health is a health culture, were supporting that, having like minded friends, you know, interested in health. So if you want to build an interest in an area you’re having difficulty, you start to think, well, how can I create a supportive culture?

to do that. Um, yeah, I’m trying to remember the name that came in my Columbia magazine. I’m not remembering his name now, but he, uh, it was a story about this person who has had a course Columbia University where he teaches [02:05:00] people how to write best selling books. And it’s like a seminar course, and it’s you meet once a week for seven hours.

And people share ideas and so forth. And he’s had tremendous success. But what caught my idea of my fancy in that article about him was that he created a Facebook group so that people who had taken his course years earlier and already been successful in writing books were available to these new students who were starting.

So he created a ready made culture for these people to support them. Another example, I know, uh, there are parents today who are very concerned with their kids being exposed to, uh, social media too early. But then you have a problem. Well, wait a second. If my, my child’s in seventh grade and everybody else had got a cell phone, what do I do have to advocate for this?

And maybe you have to find like minded parents and you have to find kids that your kids can [02:06:00] interact with, who have alternative social activities to do. So they’re not participating in maybe social media at that age. So it’s, these are all different ways in which you. can create a culture. Uh, proactive.

Sure, sure. So the other thing that [02:07:00] comes to mind in terms of a social network is using a power of accountability. We have that challenge in life to move forward in different areas, and we’re pushing in terms of goals. So I sometimes say my middle name is accountability because I just realized it’s a real power and I need it in my own life.

You know, I’ve used it different ways where I’ve like, I wanted to get a certain paper done. Sometimes I volunteer to give a lecture or grand rounds on a topic. And boy, did that make me accountable, you know, and the paper got done. Um, so, um, I say we can combine that with a great technique that, um, I use to get people exercising, for example, where they ask them to form an implementation intention.

An implementation intention is where you say, I want to get X done. If you just say I want to get X done, you, let’s say I want to go to the [02:08:00] gym and work out a few times a week. That’s a goal, but you know, it’s kind of vague and you might do it on certain days and other days you feel like I got too much to do, you know, work just finished. And every day when work finishes at five o’clock or six o’clock, I am going to go to the gym.

And you say, I’m taking out of my head, that’s the cue. Now that implementation intention has been shown by meta analysis, many studies to work. When people [02:09:00] an obligation intention, that when it’s X I will do Y with Z, which is a person, then it becomes much more powerful.

I remember years ago I had a, um, podiatrist I was seeing, uh, I, uh, he had, you know, casual clothes. And when I saw him I said, oh, you really must be into exercise. He says, No, I don’t like it at all. I said, Oh, so you don’t exercise. No, I anxious. I go to Central Park every morning and work out, but I said, But you don’t like exercise.

So he’s a good friend. And, you know, we We bonded over the years and he likes to exercise and I’ve agreed to meet with him every morning and I’m not going to let him down.

recognize that’s a tremendous tool say, when it is X, I will do Y. With somebody else, it becomes an obligation intention. You committed to do something with [02:10:00] somebody else that is another aspect of social networking, which can be very powerful.

Exactly, exactly.[02:11:00]

Yes, Ha, ha. Ha, ha.

Well, I think, um, there’s so much more we could say, but one thing that definitely comes to mind um, there’s in coming back to Stephen Covey’s book, he has the seven habits of highly effective people. And he says, one of the habits is to keep the end in mind. And he gives a very powerful exercise for people to do, which is to.

Imagine their own funeral and [02:12:00] imagine, you know, their families, their, their colleagues are there. And by the way, this has been a tool used by many people because it’s universal. And you try to imagine what it is you would want people to say about you. And if you do the exercise, realize that I was a good father, I was a good husband, a wife, you know, I was, you know, a loving brother or I cared about my community.

In other words, when you look at the end, we want to be known for, you know, being a giver, for, you know, giving. you know, an aspect of social relationships is the opportunity to give. But interestingly, it’s, first of all, some people are more innately givers than others. It’s just, it’s just the way we’re built.

Giving isn’t something that necessarily is part of that social need. You know, it’s something that you can aspire to as a goal and become very meaningful. And, and, you know, but you have to think about it because, you know, it is an investment in [02:13:00] time. what I say is if you, if you pay attention, if you pay attention, you’ll find that when you are giving, even in minor ways, you went.

Went out a given day and said, I’m going to, you know, thank five people, you know, you know, I’m going to smile at the cashier or give praise to a colleague, you know, call up my child and say some, something that’s, you know, in a giving way, these little interactions, pay attention, you feel good after you’ve done them, know, but to be a giver, you know, I remember the story, this came to mind, this was years ago, was in a, yeah, I was a place that I was, uh, it was a bunch of people and a person caught my eye who was a wheelchair and this person looked not well at all.

And, um, I’m leaving the store, you know, it’s pouring outside, [02:14:00] pouring, and I said to myself, what, what, what’s this person going to do when they get out of, you know, into the street? So I remember walking down the street saying, you know, should I wait to see, should I not wait to see? And then this person, you know, wheels himself out, and I see he’s heading to Broadway.

This was in New York City, and I realized he’s going up the street and he doesn’t have an umbrella, you know, and I did, and, um, and I said, okay, I got to go for it. So I went and I, I said, can I help you? So it turns out he was like looking to catch the bus. And um, so, you know, I put my umbrella over him. I wheeled him over there.

We waited about 10 minutes for the bus. I didn’t have much in common with him, but I tried to make, you know, a small talk, which I did, and then I helped him get on the bus. So he gets on the bus, afterwards I start crying, really crying. And [02:15:00] I think I cried in part because I realized this is, this was uncharacteristic for me.

It was like you felt like you, you know, and there was a sense of one sense satisfaction, but what was said in afterwards was, wait a second, don’t give yourself too much credit. This was, would you do it again and again and again? So you have to, know, so it was a pleasurable thing of overcoming, but that I became a giver.

That is by doing it over and over again, but you can take small steps. know, and that’s a pleasure for us. And as we develop it more, we were more alive. This is what we want to do, you know, was that, you know, so we can get distracted from it.

And interestingly, that comes back all the issue of time, what happens is that, um, when we’re more under time pressure, we’re more focused on our, you know, what we have to [02:16:00] do, we become less receptive to being. you know, out there for other people. So you’ve got to windows of time, you know, be with friends and where you can give to people.

And that’s, and that’s why people like to volunteer, by the way, but usually you see that among older people and you see that those who volunteer actually have better health outcomes. That’s another aspect of socialization, actually, yes, yes,[02:17:00]

You know, you have to fill the tank sometimes before you can give, right? I mean, it was that old thing on the airplanes, right? They still show it, you know, when you are going on the plane and let’s say, all of a sudden you need oxygen, they caution you, the parent should put on the mask first before the child.

you are able to give to the child. always felt that was a paradigm for giving in general. So you have to take care of your health, and eat well, and get enough sleep, and take care of your own social needs, and stress, and all these things make you more able to give. So these things are all interrelated to each other.[02:18:00]

Yes, yes, yes.[02:19:00]

Sure. Thank you for having me today. It’s been a real pleasure.

look forward to it. Thank you.

Okay.[02:20:00][02:21:00]

It’s a pleasure to be here. Thank you so much.

It’s a basic psychological need to be connected to other people. a, um, we have physical needs, they’re obvious to us, but we also have psychological needs. And they’re needs in the same sense that they need to be fulfilled. And when they’re fulfilled, we experience more well being, more vitality, we feel happier.

And when they’re not fulfilled, it’s kind of interesting because something doesn’t feel right. We lose vitality, we may have more tension, and over time it may affect our health. it is a basic need, but it’s not loud. not as obvious as physical needs. And one of those most profound needs is our needs to be connected to other people.

We’re just essentially socially wired to be connected to other people.[02:22:00]

Sure, that’s a great question. a theme that I mentioned in the first podcast was that can just use the body to testify as to what’s healthy and unhealthy. And those things which promote longevity, decrease disease risk, and improve our physiology are protected, are healthier, those that do the opposite are not.

So the first research that of note In terms of, uh, all of this was a study called the Alameda County Study. This was, uh, published in 1979. Lisa Berkman was the, uh, first author of that [02:23:00] study. And they simply looked at the size of people’s social networks at that time in Alameda County. found that the greater the size of the network, the lower the risk of mortality over follow up, both in men and women.

So a study. catching. And for a few years, this became a big trend to look at the size of people’s social networks. And all the data was reproducible. And then people began to look at the quality of social relationships. For example, people after a heart attack, what was the quality of your relationship with the loved ones around you?

And it turned out that that was also a very powerful predictor of outcome. Now this has been reproduced in so many studies. It’s led to better analysis. which have also been very reproducible and established that the quality of our social relationships very profound, uh, have a very profound effect size, if you will, meaning a very substantial effect on outcomes.

And when you look at the negative side of that loneliness, [02:24:00] It turns out to be a very profound risk factor for, you know, uh, earlier mortality for, you know, more chronic disease, uh, and even studies looking now in terms of cognitive function and so forth. one classic meta analysis, they found that being lonely was equivalent to smoking about 15 cigarettes per day.

So crucial.

There’s a lot of physiological studies, which look at, you know, what’s the result in people who are less socially connected, they have higher cortisol levels, poor immune function. And on the flip side, when people are, you know, enjoying social relationships, you have the release of oxytocin, which is a kind of a bonding hormone, makes us feel good.

Dopamine, serotonin. And so forth. And then even in animal studies, uh, when there’s classic studies, like you take Sinomogus monkeys, these are a class of monkeys which are socially bonding to each other. And when they put a group of them in [02:25:00] cages and compared them to a group that was not in cages, fed them exactly the same diet.

Lo and behold, the caged monkeys developed more atherosclerosis, more men who were, uh, in Boston, one group was, you know, people in Harvard University, and the other was people in South Boston who came from low socioeconomic backgrounds, and they have followed these people, lo and behold, for 85 years.

Uh, they found them in terms of constantly bringing them back for interviews, how they did in real life and so forth. found, lo and behold, that people’s social connections more powerful than wealth, social class. In predicting [02:26:00] happiness and people who are lonely definitely have poor physical and mental health.

So it’s, when you take all of these studies together, we are built to be socially connected to other people.

Sure. Well, in fact, it’s quite varied. Um, we have introverts versus extroverts. Some people thrive by being in a crowd with other people. Other people don’t want to be among [02:27:00] many people. Uh, we have people who can feel alone in a crowd. We have people who just need like one good friend. we have different, uh, needs at different times in life.

Maybe when we’re stressed, for example, or we’re going through a journey with an illness. Uh, certainly when we are going through the turbulence of life, I think that’s one of the benefits of having friends and being socially connected. also, uh, interestingly, can sublimate your need for social connections because there are competing needs we have, like a need to pursue in our jobs, you know, pursue different avenues of meaning and so forth.

It kind of is a dividend when you get older. That, you know, if you kept your connections as you get older and you have now retired from your job and, you know, you’re looking to do new things to have, you know, created a dividend [02:28:00] of, you know, being socially connected to people that you can’t just take off the bookshelf.

Um, so it’s, it’s a very good point that it’s, these needs vary, this need for social connections, both in terms of people’s, expression of it and in terms of different times of your life.[02:29:00]

Absolutely. Yes.

Well, you know, it’s, it’s again variable in terms of people’s needs and so forth, but I think there’s basics that are really important. Um, one of them is the time invested that you, you know, you, you can’t, there’s quality time and there’s quantity time. Um, [02:30:00] and both are important actually, because when you think about the building blocks of relationship, whether you say it’s trust.

or understanding, or feeling comfortable with another person, or you’re feeling that it’s got an enduring quality to it. All of these things are a function of the time you’re willing to put into that relationship. We develop trust by the interaction we’ve had with people. Understanding requires getting to know people under different circumstances, getting to know them well.

Feeling that enduring quality of a relationship is the test of time, right? You know, uh, is that those long gaps, you know, you stay in contact, you know, and you’re comfortable also is a question of time in some respect, because you, you get more comfortable with people as you get to know them. these are, these are, you know, this is one of the building blocks of, you know, good relationships, but there’s so many other factors, um, [02:31:00] uh, we could go through with, uh, uh, you know, sense of empathy.

Go ahead. Yeah.

Yeah, it is, [02:32:00] um, you know, I say we leave, we live in kind of unique times and think we reflect enough about how, what this means in terms of what I think has become an increasing challenge terms of social connectivity. mean, if you look back historically, you know, people, you know, used to be living in a neighborhood.

We weren’t so geographically normal all those years. People were getting married young. Um, there was a lot of, um, proximity based interactions, you know. Clubs. you know, your school, you know, there was just a lot more there, uh, and also the way we’ve changed in terms of leisure. When I was a kid, you know, uh, you’d go outside and you’d see people, you know, we’d play stoop ball, stick ball, you know, all lot of, you know, entertainment and, and pastime has moved indoors, right? And so people are less out there. But [02:33:00] the impact of, I think two factors. profound. One is the advent of social media. Uh, and social media has been very profound. and what I say is that, you know, it’s a power, you know, it’s like talking about nuclear energy is a power and it’s good and it’s got bad social media.

you know, more people at us in different ways. And so it can, it can of dumb down the quality of your social interactions with [02:34:00] people. And I think it does. it doesn’t have to. It food today, a lot of ultra processed foods. And so these are all different ways we have to be careful. We don’t two, those things which are not urgent, but important. [02:35:00] we might be taking care of older parents who now are living longer than they used to while taking care of younger children. we feel it. We feel that life is faster today. And it’s easy to say, well, manana, I’ll, you know, spend more time with my friends, you and it just goes on. So you have to be intentional to make time to be with your friends.

You just do. So it’s a challenge.[02:36:00]

much of it. So much of communication is non verbal, right? is that bonding that occurs. Our brain is [02:37:00] biologically wired to be connected to people. So, I’m not putting down virtual, you know, interactions at all. It’s just that you need the good stuff too, the other good Sure, sure, absolutely.

Well, you know, I, I was thinking actually you we teach all these subjects in school, you know, uh, STEM, all these, uh, I don’t even know anything they teach anymore, but you know, I don’t [02:38:00] think teacher at science anymore, but certainly you take, uh, English, chemistry, whatever. Um. Shouldn’t we be teaching some of the basics about, you know, social intelligence, if you will, if you’ll call it that, you know, there’s a emotional intelligence, social intelligence.

So in terms of, you know, um, things about communication and how to be more empathic and the value of giving how to be more Teflon, I’d say, than Velcro, in other words. The ability to, know, things go as opposed to let things stick with you, you know, which is a master of social trade as well. I mean, there’s just so many different social skills that we learn as we go, we get older and we get better at it, you know, but we get better at it through life experience.

and you should learn about it earlier in life, I believe, I think it would be good, you know, and I do have a concern. Uh, in [02:39:00] this media time now where there’s so much is virtual and, you know, very often among young people, less interactions in the which been disappearing from our educational system. So a physician, I’m looking at it for multiple ways and saying, these are all basics to teach.[02:40:00]

Well, I’m not sure. I would have to think about it. You know, I mean, I think it’s just the very things we’re talking about here. Um, I think there’s different formats to teaching it. It could be in a seminar sort of situation. Um, you know, I just think it’s, there’s many ways to do it. I think that’s the nice thing about it.[02:41:00]

Sure. Sure. Sure. Yeah.

Well, that’s a great topic because we talk about the quality relationships, that’s very important. There is a [02:42:00] concept of building a social network, and that becomes very important. And I think, know, you could have like a checklist, you know. Do I have, you know, friends? What quality friends? Do I have any confidence in my life?

know, do I have a functional network, uh, that works for me and so forth? I think the first place I would start off there is with friends because know, friends, we can have friends of different sorts, but I think it’s important to have one, two very high quality friends in your life. You know, we shouldn’t be traveling life alone, you know, so friendships require investment.

a high quality friendship is one where you have somebody who you feel that this person you can trust, who you can confide in, that they have your back, that they’re supportive of you, that they get you, for example. And also a friend who might push you a little bit sometimes. You know, uh, and give you honest feedback.

So these are all qualities, [02:43:00] you know, and different friends can have different things, but these are assets and it makes a friendship special, you know? So, um, thinking, uh, sometimes I come across news of like friends I had in high school, I didn’t maintain those friendships I was thinking, you know, we leave high school.

But we shouldn’t leave our friends behind, when I do end up talking, as of once in a while, with one friend that I got in contact, like, with 30 years later, I got his number, I called him up. And within two minutes, no, within immediately, it was like we had never lost that other words, it life, in early life, we were more vulnerable. We were more willing to be vulnerable. We were more authentic with our friends. We didn’t have the social mask up. We had the time to be with them. And that’s just a, Paradigm for [02:44:00] friendships in general, you know, so when you, but you, you know, okay, so maybe you didn’t invest in those friendships, but you can gain new friends.

And another thing about friendships, very interesting, is that a lot of the friends we make is because neighbors, they’re close there, you know, so that’s kind of spontaneous. But when you say, wait a second, how important friendship is, maybe I should search out for the right friends for myself. think people think about that enough, that you should go and, and, uh, and look for friends.

So one thing. Yeah.[02:45:00]

Yeah, I think what you’re describing is commonplace, and it happened to me too, right? We moved to a new place, we’re so busy, and we start to let go of the time invested in those old friendships, even though we had good friends. That’s what happens. So, but in terms of building a network, friends are important.

It’s [02:46:00] also important to have a confidant, you know, even just one, but preferably even maybe perhaps more than one. The confidant is somebody who you can be open and you can share the most difficult things that you’re going through because we all go through this turbulence in life. And that doesn’t have to be a friend, by the way.

Confident could be somebody who’s not a friend at all, but just like a wise person or a caring person or someone, you just find that that person supports you. is in your network is extremely important. We can also use our network to keep us more objective in life. there’s this concept here of like this tripod of objectivity, you know, having people above your level, at your level, below your level, or someone who’s a wise person or wise people who you can look up to to get advice.

someone at your level, you know, peer or friends and so forth you can [02:47:00] talk to, but also younger people, you know, when you can, when you’re teaching, they’ll keep you honest and you learn a lot by trying to, you know, teach people and so forth. Teaching is, I mean, I’ve been teaching for 50 years, so I mean, it’s like, you know, it really is. So that’s And then it’s important to have a, I’d call a functional network, which is, I remember when I was growing up, my dad was, you know, it was a different time in those years, but, you know, we had the local pharmacist, uh, that my dad was friendly with, and you’d come in and you would talk to him and so forth, and you could call him up at odd hours.

You’d have the [02:48:00] phone number. You know, I tried to do that with our local pharmacy, you know, introduce myself. So it’s always a different pharmacist, you know, and all these the friction of life. life again has this turbulence and when you need these people of need, it’s better if they’re on the bookshelf, you know, and you can just, you know, you just have that there for you, but that takes time to think about, you know, say, okay, you know, have I made a relationship with a physician that I feel know, I can work with and, you know, it was there for me.

So if, you know, something comes up, I don’t have to search. And I’ve got a network for people in, [02:49:00] in, uh, in investment and the mechanic and all these things. So you go and you see what you’re doing. You say, wait, I’m creating this, this network. So that’s, that’s important in terms of, uh, of, uh, building a social network.

Now I’ve mentioned two other things. One is that. I read a book a number of years back. I’ll tell you, I have to give credit where the idea comes from. So there’s a book, a famous book called Tuesday with Maurice. Mitch Albom, and this was at a time when he was a sports writer before he became famous writing novels.

he had time on his hands, and I remember he had this, professor in college, uh, um, you know, Maury. And he was living in Boston, and Mitch Albom was in Detroit. And he started flying there every Tuesday, once a week, to meet with Maury and get, like, what life wisdom. And he wrote a book on it called, you know, Tuesdays with Moore.

It’s a great book. So in the book, he, he [02:50:00] quotes Moore saying that everybody needs to develop their own culture, you know, because you need. a culture that works for you. And if you don’t work on it, you’re just a subject to, you know, the, the, uh, the large culture out there with whatever’s going on. And so it may not serve you well.

So I was really taken by the idea after that, you know, in terms of, know, what does it mean creating your own culture? it means exactly creating the environment you want to, will support your interests, goals, values. attitudes. an obvious one for me as a physician, promulgating health is a health culture, were supporting that, having like minded friends, you know, interested [02:51:00] in health. So if you want to build an interest in an area you’re having difficulty, you start to think, well, how can I create a supportive culture?

to do that. Um, yeah, I’m trying to remember the name that came in my Columbia magazine. I’m not remembering his name now, but he, uh, it was a story about this person who has had a course Columbia University where he teaches people how to write best selling books. And it’s like a seminar course, and it’s you meet once a week for seven hours.

And people share ideas and so forth. And he’s had tremendous success. But what caught my idea of my fancy in that article about him was that he created a Facebook group so that people who had taken his course years earlier and already been successful in writing books were available to these new students who were starting.

[02:52:00] So he created a ready made culture for these people to support them. Another example, I know, uh, there are parents today who are very concerned with their kids being exposed to, uh, social media too early. But then you have a problem. Well, wait a second. If my, my child’s in seventh grade and everybody else had got a cell phone, what do I do have to advocate for this?

And maybe you have to find like minded parents and you have to find kids that your kids can interact with, who have alternative social activities to do. So they’re not participating in maybe social media at that age. So it’s, these are all different ways in which you. can create a culture. Uh, proactive.[02:53:00]

Sure, sure. So the other thing that comes to mind in terms of a social network is using a power of accountability. We have that challenge in life to move forward in different areas, and we’re pushing in terms of goals. So I sometimes say my middle name is accountability because I just realized it’s a real power and I need it in my own life.

You know, I’ve used it different ways where I’ve like, I wanted to get a [02:54:00] certain paper done. Sometimes I volunteer to give a lecture or grand rounds on a topic. And boy, did that make me accountable, you know, and the paper got done. Um, so, um, I say we can combine that with a great technique that, um, I use to get people exercising, for example, where they ask them to form an implementation intention.

An implementation intention is where you say, I want to get X done. If you just say I want to get X done, you, let’s say I want to go to the gym and work out a few times a week. That’s a goal, but you know, it’s kind of vague and you might do it on certain days and other days you feel like I got too much to do, [02:55:00] you know, work just finished. And every day when work finishes at five o’clock or six o’clock, I am going to go to the gym.

And you say, I’m taking out of my head, that’s the cue. Now that implementation intention has been shown by meta analysis, many studies to work. When people an obligation intention, that when it’s X I will do Y with Z, which is a person, then it becomes much more powerful.

I remember years ago I had a, um, podiatrist I was seeing, uh, I, uh, he had, you know, casual clothes. And when I saw him I said, oh, you really must be into exercise. He says, No, I don’t like it at all. I said, Oh, so you don’t exercise. No, I anxious. I go to Central Park every morning and work out, [02:56:00] but I said, But you don’t like exercise.

So he’s a good friend. And, you know, we We bonded over the years and he likes to exercise and I’ve agreed to meet with him every morning and I’m not going to let him down.

recognize that’s a tremendous tool say, when it is X, I will do Y. With somebody else, it becomes an obligation intention. You committed to do something with somebody else that is another aspect of social networking, which can be very powerful.

[02:57:00] Exactly, exactly.

Yes, Ha, ha. Ha, ha.[02:58:00]

Well, I think, um, there’s so much more we could say, but one thing that definitely comes to mind um, there’s in coming back to Stephen Covey’s book, he has the seven habits of highly effective people. And he says, one of the habits is to keep the end in mind. And he gives a very powerful exercise for people to do, which is to.

Imagine their own funeral and imagine, you know, their families, their, their colleagues are there. And by the way, this has been a tool used by many people because it’s universal. And you try to imagine what it is you would want people to say about you. And if you do the exercise, realize that I was a good father, I was a good husband, a wife, you know, I was, you know, a loving brother or I cared about my community.

In other words, when you look at the end, we want to be known [02:59:00] for, you know, being a giver, for, you know, giving. you know, an aspect of social relationships is the opportunity to give. But interestingly, it’s, first of all, some people are more innately givers than others. It’s just, it’s just the way we’re built.

Giving isn’t something that necessarily is part of that social need. You know, it’s something that you can aspire to as a goal and become very meaningful. And, and, you know, but you have to think about it because, you know, it is an investment in time. what I say is if you, if you pay attention, if you pay attention, you’ll find that when you are giving, even in minor ways, you went.

Went out a given day and said, I’m going to, you know, thank five people, you know, you know, I’m going to smile at the cashier or give praise to a colleague, you know, call up my child and say some, something that’s, you know, in a giving way, these little interactions, pay attention, you feel good after you’ve done them, [03:00:00] know, but to be a giver, you know, I remember the story, this came to mind, this was years ago, was in a, yeah, I was a place that I was, uh, it was a bunch of people and a person caught my eye who was a wheelchair and this person looked not well at all.

And, um, I’m leaving the store, you know, it’s pouring outside, pouring, and I said to myself, what, what, what’s this person going to do when they get out of, you know, into the street? So I remember walking down the street saying, you know, should I wait to see, should I not wait to see? And then this person, you know, wheels himself out, and I see he’s heading to Broadway.

This was in New York City, and I realized he’s going up the street and he doesn’t have an umbrella, you know, and I did, and, [03:01:00] um, and I said, okay, I got to go for it. So I went and I, I said, can I help you? So it turns out he was like looking to catch the bus. And um, so, you know, I put my umbrella over him. I wheeled him over there.

We waited about 10 minutes for the bus. I didn’t have much in common with him, but I tried to make, you know, a small talk, which I did, and then I helped him get on the bus. So he gets on the bus, afterwards I start crying, really crying. And I think I cried in part because I realized this is, this was uncharacteristic for me.

It was like you felt like you, you know, and there was a sense of one sense satisfaction, but what was said in afterwards was, wait a second, don’t give yourself too much credit. This was, would you do it again and again and again? So you have to, know, so it was a pleasurable thing of overcoming, but that I became a giver.

[03:02:00] That is by doing it over and over again, but you can take small steps. know, and that’s a pleasure for us. And as we develop it more, we were more alive. This is what we want to do, you know, was that, you know, so we can get distracted from it.

And interestingly, that comes back all the issue of time, what happens is that, um, when we’re more under time pressure, we’re more focused on our, you know, what we have to do, we become less receptive to being. you know, out there for other people. So you’ve got to windows of time, you know, be with friends and where you can give to people.

And that’s, and that’s why people like to volunteer, by the way, but usually you see that among older people and you see that those who volunteer actually have better health outcomes. That’s another aspect of socialization, actually, [03:03:00] yes, yes,

You know, you have to fill the tank sometimes before you can give, right? I mean, it was that old thing on the airplanes, right? They still show it, you know, when you are going on the plane and let’s say, all of a sudden you need oxygen, they caution you, the [03:04:00] parent should put on the mask first before the child.

you are able to give to the child. always felt that was a paradigm for giving in general. So you have to take care of your health, and eat well, and get enough sleep, and take care of your own social needs, and stress, and all these things make you more able to give. So these things are all interrelated to each other.[03:05:00]

Yes, yes, yes.

Sure. Thank you for having me today. It’s been a real pleasure.[03:06:00]

look forward to it. Thank you.