TRANSCRIPT
Welcome again to another episode of the Better Brain Fitness podcast. I am Dr. Josh Turknett, and once again, I’m joined by my compassionate co host, Dr. Tommy Wood. Hello, Tommy. Hello. So, today’s episode, we have a very special guest who will be talking about a topic that is crucially important to health, but also one that’s often overlooked or neglected.
So Tommy, do you want to tell the audience who we have today?
Absolutely. So today we’re very excited to be joined by my good friend and colleague, Dr. Julian Abel. He’s a palliative care [00:01:00] physician in the UK Julian and I recently co edited a special edition of a journal, Lifestyle Medicine Journal, that was focused on compassionate communities.
, this was really sort of spearheaded by Julian, who is an expert in the field and knows all the other experts in the field and managed to. Strong arm them into writing some very nice papers for us. So, today, Josh is gonna take the reins and ask, particularly Julian, but I might chime in as well, some questions about how compassionate communities affect health.
Julian, thanks so much for joining us.
Well, thank you very much and what a pleasure to be here and always good to see you Tommy and nice to meet you Josh Yeah, I’m looking forward
to it. All right. And yeah, I think most papers are the result of strong arming, aren’t they? Some way or another All right. So Julian, why don’t we get started?
You just tell us a little bit about your background and What inspired you to kind of get involved and want to address the particular problems that you have been? Working on. [00:02:00] Okay.
Just tell me, shut up if I’m talking too much. , so I I trained as a palliative care physician and got a job as a palliative care specialist and been doing that a few years.
And you know, like your brain turns over and you think about it. And I’d been to a talk by my friend professor Alan Keller here, who’d been talking about public health, palliative care, and compassionate cities. And. I think it just simulated a train of thought where it was like, Oh my God, what am I doing?
Of course, social, just relationships are the things that really matter. Whereas, you know, as doctors, we tend to focus on the person with the illness naturally enough. In the context of End of Life, it was just going, no, no, no, no, no, no, no. We live in context. There’s a, there’s a great African philosophy of this called Ubuntu, which is I am because we are.
And most parts of the world, you know, people recognize the importance of relationships anyway. So [00:03:00] that kind of really switched my practice and I got really increasingly engaged in the whole thing about compassionate communities and seeing it as, in particular, death, dying, loss and caregiving as being relational rather than medical.
So after a few years of doing this, I was doing some work in the county where I was living and And the people I was talking to said, oh, go and see those people in Froome, you know, Froome’s a small town in Somerset, 28, 000 people, in a county of 500, 000 people. And so I rang them up and we just realized that we were we were really talking about doing the same thing.
They were just doing it in… the whole, across the whole town of Froome in healthcare in general, and I’ve been doing it in end of life. So we decided we would team up. There was a lot of kind of cross fertilization and after a few months of doing it, the lead GP, Helen Kingston was trying to deal with that agony of getting the funding for the next year to keep the project [00:04:00] going.
So she said, Oh, let’s write a paper. So she showed, she got some, pulled some figures off the the data set from the practice and I looked at them and thought, well, I can probably get all the better figures and I did. , and I got all the figures for all the emergency admissions to hospital across the whole of Somerset over the last four years and, you know, stuck it in a pivot table and, and looked at the results and my jaw hit the floor because what I saw was that the emergency admissions in Froome had gone down by 14 percent whilst in the rest of Somerset, they’d gone up by 30%. And and I knew from the previous work that I’d done That there are no interventions which have ever reduced whole population emergency admissions.
So this is like a total unexpected piece of magic. You know, if there was a pill that could drop emergency admissions by 30%, it would [00:05:00] be a medical breakthrough, the likes of which we’ve not seen before. And that led into this whole area of health and compassionate communities. And it’s been a Something of an obsession ever since and and, and as you dig down into it more and more, you know, the mechanisms and the pathways have become increasingly evident and, and the special issue, which we, which Tommy and I co edited was it was, it brought together the kind of leads in the field to talk about their work.
And it’s a kind of journey from, from the very basic information evidence, which shows that social relationships are more effective at reducing our risk of dying than giving up smoking, drinking, diet, exercise, and anything else you care to mention. Down into the biochemistry and the genomics of it and back up through um, the methodology of community development, through how public health needs to take this into account and [00:06:00] looking at, looking at group consultations, and then looking at What exactly happened in prune and it’s just it’s I find it fascinating.
It’s like a whole side of Science that got lost in Newton’s laws emotions
, so speak to that a little bit could because I think that You know, clearly this is an area that’s been so overlooked especially in the healthcare community. We all appreciate on some level that relationships are important and that they affect our life and how we feel. But some reason we haven’t really connected the dots on how that impacts physical health.
And I think it’s partly related to this feeling that it’s somewhat abstract. Not in the way that high blood pressure, you know, is, you can easily trace a line between that and some physical problem you know, or a physical trauma [00:07:00] of some kind. Why do you think, for number one, we’ve neglected this, and how do you, how do you help people understand why it matters so much?
Do you
know I think the the way that I found that people seem to really connect with this most of all is thinking about the difference between survival of the fittest and survival of the kindest. When you look back at the history. Of the, the, you know, the theory of natural selection and what Darwin thought about it.
He was actually much more interested in survival of the kindest. His last book was the the expression of emotion in man and animals. I mean, this was a guy who played the bassoon and talked to his plants. You know, he wasn’t, survival of the fittest wasn’t even a phrase that he came up with. It was a phrase that was invented by.
A philosopher called Herbert Spencer, who, it was a kind of nightmare of British [00:08:00] imperialism and and really matched his dog eat dog philosophy of which he’d applied in economic, in economic theory. And this kind of… Survival of the fittest is something that influenced politics, philosophy, economics, everything.
But the reality is that we evolved over a period of you know, two million years as hominids, surviving in small groups of 25 to 50 to 100 people. And the reason we survived is because we’re social. In other words, care, compassion, kindness and support is how we managed to cover the whole globe. It wasn’t this, this idea that the most beautiful, the most powerful the strongest, you know, had a survival advantage is rubbish.
It was a fact that we could do things together. And when you take that approach, what that means is that the emotions [00:09:00] that are pro social in nature, actually a part of our evolution. And what we’re saying at heart is that every single human being has got compassionate potential, the potential to be kind.
And when, when, when I talk about this and people hear this, they kind of breathe out and go, thank goodness for that. It’s what I always thought you know, but and, and then, you know, as it turns out. If you want to live a long, healthy, happy life, then it’s all about connectedness and emotions and survival of the kindest.
And, you know, when you’re, if you’re looking for a mechanism for all of this. I hope you don’t mind the dogs barking, I’ll tell you while we’re there, if you want to know anything about the evolution of dogs, you see that they, that the, when you look at where the bones are found, [00:10:00] they travel the same path as human beings.
So if you don’t like dogs, you’re missing out on a very primal connection going back 150, 000 years, anyway, you said all that, loneliness is a threat to our survival and we have this reflex, which, which has been called the loneliness threat reflex, which motivates us, it, it activates our flight, fright, freeze system to get us going and find our tribe.
In the modern setting. Loneliness in a chronic setting is really bad for us and generates all of these pro inflammatory pathways, which is the major cause of chronic disease in the Western world. And so that the, you know, it. If you take together this fact that we are pro social, kind, compassionate beings at heart, when we have a sense of [00:11:00] belonging that can flourish, when we’re lonely, isolated or scared, the opposite happens and we have this pro inflammatory thing going on.
You take those two things together, With the overwhelming evidence that, you know, long, healthy, happy lives is all about relationships and friends. Then it’s a kind of convincing story, you know, kind of like, yeah, it makes sense to people because it’s, it touches on your lived experience. You know, if you think about what really matters in your life, it’s great to have purpose, but purpose without.
Friendship and love is almost meaningless.
Hey there. So if you like this podcast, then I think you will enjoy the Brain Joe Connection Newsletter. The Brain Joe Connection is a free newsletter sent out twice a month. And it’s all about the science of how to keep our brain fit and healthy, along with products, books, tools, and resources for improving brain health and function [00:12:00] that we use and recommend.
To subscribe, you can go to brainjoe. academy forward slash connection, or click the link in the podcast description. All right, now back to the show.
You know, if you reflect back on the memories that matter the most to you, they always involve other people. And there’s a, there’s a reason that solitary confinement is considered one of the worst forms of punishment. We recognize deeply in some ways how much this matters, but yet it’s our practice of it has, has not factored that in.
And then you speak about the how, you know, evolution has driven us to kind of be wired to Thrive when we are benefiting others, when we are cooperating, and it also drove the evolution of our brain, right? Almost, you know, so much of it is devoted towards social cognition and communication.
And, you know, we talk [00:13:00] about the importance of, challenging the brain over time as, as being important for maintaining cognitive health. And, being social, having relationships is kind of the. whole brain activity. So there’s hardly anything better than that from that standpoint, but it kind of provides both sides of the equation.
It both stimulates it and it also provides the support, you know, the nourishment that it needs to thrive and to adapt to that stimulation. So it’s, you know, in that, from that point of view, also easy to see why it’s so impactful. The one thing that, you know, Um, seems to be the case is that people will tend to become more isolated the older they get.
And there are certain kind of cultural forces that… That sort of reinforce or steer things in that direction. And that’s kind of adding to the problem of cognitive challenge going down in general, as we get older.[00:14:00] Are there particular populations that are more vulnerable to loneliness and social isolation?
My inclination would be, it would be, you know, those over 65 and. Maybe teenagers is there data on that?
It’s a funny thing, you know because I think it affects all of us. When we, when we looked at the breakdown of the emergency admissions by age in Froome and compared it to the rest of Somerset, what we saw is that there were a reduction in emergency admissions across all age groups.
And that means that this kind of. Pro this, this social nature is something that’s important to everyone and and, and the figures when you look at the impact. I mean, obviously, if you’ve got other chronic diseases, you know, you’ve had disease process is getting increasingly mainly be going on for maybe decades.
That it the impact of loneliness is absolutely catastrophic. It increases if you’ve got, you know, figures like if you’ve got already got existing heart [00:15:00] disease, your risk of admission to hospital is increased by three quarters. Your risk of premature death is increased by a half, you know, so that the, the, if you have disease on and on top of that, you have loneliness, then the results are catastrophic.
, so, that’s why when we’re thinking about disease management, we want to make sure that, you know, as physicians, we’re using the most effective tool and the most effective tool we have is about social relationships and it can’t be left out, just can’t be left out. There’s a I’ve been working with the.
fantastic people in the US and Colombia. And we’ve been working for a few years now and and, and they’ve got brilliant at the routine assessment of social relationships. And, you know, We’re now got figures coming back and we’re just a really early stages of this of 62, 000 people who’ve had their social relationships checked and have had a some kind [00:16:00] of social connection intervention.
And we’re just, we know that from on a small scale in the U. S. that healthcare costs go down by 20 percent when you do this. I think we’re expecting it to be even more because project in Colombia is even more sophisticated. But I think it’s one of those things which has just kind of passed, our culture by.
And it’s very interesting to consider the role of elders because you can look at something like aboriginal culture, which has been going for, you know, 60, 000 years. And it’s an oral culture. It’s amazing. And it’s really. really sophisticated. They’ve got really, it’s a rich treasure of a culture.
The way that culture gets handed down is by word of mouth. And the elders are responsible for maintaining that culture. And so what happens is that the The elders have a sense of purpose still in life. [00:17:00] And it’s interesting, you know, you look at the Native American word for grandmother. It actually means a person who holds it together.
The person who holds the knowledge, the person who cares. And even the, the, the words that we used, you know, we think we’re in the UK, we talk about old people, like it’s kind of like, yeah, they’re just, they’re, they’re not young. They kind of had it, you know, they’re not worth it anymore. The word elder is actually got a whole host of different connotations around it.
And I think that we, you know, for old people, they feel like they’re being put in the rubbish dump in modern culture, but actually you can connect and make friendships and, you know, all of that, that can go on for forever, you know. That
is yeah, that’s something I actually think a lot about as well as, is how, our relationship to older people in our communities has.
Has evolved over time, [00:18:00] you know, we’ve, I guess part of it is because of technological evolution like you said, they would have been the sources of knowledge, you know, for very long periods of time until we found ways to put that knowledge elsewhere, which has its own benefits, but that role was then lessened, but there’s still plenty of wisdom, in those minds that we don’t we don’t value and we don’t seek out and that’s another, you know, win win kind of problem to solve. is that it both extracts more experience and wisdom that we’re not getting and also provides a role and a cognitive challenge for those who are, in that stage of their life.
You mentioned a group , that’s gotten really good at sort of assessing For relationships, I just, can you talk a little bit more about that? If I’m wanting to assess it myself, or if I’m wanting to assess it in someone else, you know, understanding kind of what their [00:19:00] sort of relationship health looks like what are things to, what are things to think about oo ask about?
So a way of conceptualizing it is what we call circles of care, you know, circles of connection. , you can think that you’ve got obviously, you know, whether you place yourself and around you, you, you’ve got people who you’re intimately connected with and then and, and the, the amount varies from maybe.
Two to 10 or 20 even and then surrounding that are like family and friends and family and friends, you know, who are not your kind of intimate connections. Maybe that can be anything from 10 to 200 then you have community and the community consists of a whole variety of different things because it might be that you participate in community activities like a choir or a sports group or, watching your children play sport with other [00:20:00] parents or the school gate or going to the hairdressers or down the shops, you know, like there’s a regular shop you go to.
Yeah. There are actually hundreds of activities and and even those light positive connections have this profound impact on our physiology and our biochemistry. And so what you can do is what you, what you can just, you know, if you’re thinking about yourself, you can think about, what’s a quality of those relationships.
So quantity is not that important. It’s a quality that counts and you can think, well, if I, if I think about, you know, the, my more intimate relationships and I think about the the, the kind of next circle around it, you know, what, what, what are those relationships like? And if they’re lacking and you don’t have a sense of belonging, which is absolutely critical, the connection, connection and belonging.
If you don’t have that, you know, you have some work to do. And you know that also [00:21:00] if you’re living in an environment where you feel constantly threatened, you don’t feel safe, then again, you’re disconnected from the social world around you, you know, and then it’s like, okay, how can I find these islands of connection in what looks like a hostile environment?
I’ve come to believe that our single most important primal drive is social connection, is belonging. And so we constantly seek, we constantly seek the village in which we want to live. So make it… Make an effort, you know, enhance it, that makes sense.
Absolutely. I 100 percent agree that our primary need is to belong.
And I think that also explains a lot of the, uh, puzzling behavior we, we see in our online discourse and so forth, is that people care more about the groups that they belong to than any, any other factor that [00:22:00] you might think would be more relevant, which isn’t. . So now that we kind of understand how important these things are, relationships and, and belonging can you tell us a little bit about the Compassionate Communities Project, maybe, you know, kind of the, the sorts of interventions that were done and, and Froome and, what it means to try to create a compassionate community?
So, this, this I would say that there are probably two major components of this the way of thinking about it. One is this whole population community based intervention using the practice methods of compassionate communities community development. And this is about when you look in any community, there is all of this kind of social connection going on, but it’s often hidden.
And so there’s a real thing about what can you do to bring what’s hidden to light and connect it together? And what can you do that will help stimulate it? So there’s a whole series of practice methods for doing it and including, you know, you’re thinking about what are all the groups that are going on?
Do the [00:23:00] groups need a little bit of help and support to be a little bit more stable? Are there little bits of funding that you can direct towards the group so that they can, you know, make it a bit easier for them to survive? And then there’s, the role of the connectors in the community are just like, well, if you’ve got all this stuff available, then we just want people to share it by word of mouth.
And the role of, of these connectors is really, really important. So those are the practice methods of community development of, of mapping out your community about what’s there, what’s already great. And about bringing people together and bringing it to lightand using that. So, you know, like hairdressers, taxi drivers librarians, they all got really important roles to play in terms of this kind of community connection.
The other aspect of it is how you change healthcare. And the kind of reorientation of healthcare is about, okay, look. You know, I mean, I commonly, you know, well, if I’m giving a talk, I’ll ask people to put their hand up if they had their blood pressure checked [00:24:00] and most people will put their hand up and then you go, well, how many of you had your social relationships checked?
And, and of course the answer is practically zero. But in terms of effectiveness. It’s much more effective to measure people’s social relationships and have an intervention based around that than it is to give them the treatment for high blood pressure. Well, okay, how do you bring in the routine measurement of social relationships into clinical practice?
And then you go, okay, you’ve measured it, now what’s your plan once somebody has been identified? You might think of it in terms of three levels. You know, one level is to think, okay, well, we need to connect them to community resources, which we know are out there.
And it may be that we have a conversation about their loneliness and we, and they go, yeah, that’d be great. I’m happy to go and try out this group or that group or go walking or go to the talking cafe or whatever it is. The next level is about people who Kind of naturally shy or don’t feel motivated or don’t feel confident.
And then that there’s one to [00:25:00] one work we just kind of go, okay, look, I’m going to help you figure this out. And then if needs be, I’ll go down to the group or whatever it is with you. So that, yeah, you can get over that obstacle of being a strange person in new faces. And the third one is about, okay, well, look, you know, the, the there’s all of this.
stuff about, you know, diet, exercise, all that kind of stuff. And you guys are total experts on all of that, but why not do them in the context of social relationships? So starting groups up and getting groups to figure all this stuff out for themselves and people make friendships along the way. And we’ve been doing that in Columbia for some while now, and that works really, really well.
So you’ve got this kind of three. From from the aspect of how you change clinical practice, you want to have bring social relationships into the forefront of from the moment somebody walks through the door of a, of a practice through to the clinical [00:26:00] consultation through to the multidisciplinary meeting talking about complexity because people get really isolated, you know, and homebound and all kinds of problems.
What can we do in addition to the things that we’re already doing that will connect them into their environment? So basically you’ve got this kind of two major differences. One is the community development, compassionate communities, safe place to live, good place to live. And the other is. Changing the way that healthcare functions,
, I know this is probably a big question, but if, if there’s someone in a community that, you know, where this doesn’t really exist, but they want it to, what resources are out there or , how can people start to move in that direction?
So I think like on a really personal level I think it’s, if you just understand that the quality of your relationships is not just a nice thing to have, it’s really, really important if you want to be healthy and [00:27:00] happy. You might not want to be healthy and happy and then don’t bother, but if you do, and most people do, most people, right, then, then think about Think about the quality of the relationships you already have and seek seek activities that you’re actually interested in doing.
And, and now we’ve got the internet and there are these incredible resource directories that will tell you about what’s going on in your area and, you know, whatever it is, you know, over the sixties football, which is walking or flower arranging or and you’ll find somebody else in your area who will be interested in doing it.
Or if you want to get healthy, you know then do it with a friend, you know, like work it out. So for example I think a great example is food, we think that you know, as doctors, we think, ah, healthy diet, you know, again, I eat this. Don’t eat that. You know, there’s [00:28:00] a really simple rule, which is eat food, don’t eat chemicals.
It’s a really good idea. But if you think about if you add in the social component into food, well, you can sit around with somebody, plan a menu. And then you can go down the shops together and have a coffee and a a nice piece of not very sweet cake or whatever it is and, and sit and chat and have a nice time over it.
And then you go back to the house and then you cook together and you, you prepare, you got a really nice place where you can sit and chat with each other and have a few people around. And you have a great conversation and you clear, and you like, you, you turn off the computer, you chat the phone away, you don’t have the telly on, you know, you don’t have the radio on, you’re just sitting there chatting with each other, having a nice time in this, you know, candlelit environment, which is warm and cozy, you know, and and then you wash up together.
And then at the end of it, you go, okay, that’s so great. Let’s do it again next week. And [00:29:00] then and when somebody else says, yeah, I’ll do it at my house. Like that simple act of celebration and relationship. Where we might think that it’s just like, oh, it’s diet. Oh my God, it’s going to be agony because I’ve got to…
I’ve got to like, I can’t eat this. It’s like, it just becomes torture and then you give it up. It’s really fascinating when you think about what are the metabolic pathways that happen when you’re in this warm, social environment of belonging, but what happens is that all of your kind of sympathetic drive all calms down that you’re, that you start, you, you move away from the stress, stress pathways where you’re looking for that sugar fix to be able to deal with it.
And you move much more into these anti inflammatory pathways of, you know, particularly when you eat food and you’re not exciting your body with, you know, chemicals and loads of sugar and stuff. Then you’re, then you’re [00:30:00] thinking about. How everything got health improves, everything improves, you know, your cognition improves.
And it’s like, well, from sitting down, having a friend with a meal. Yeah, exactly. Laughing.
Yeah. Like you said, everything. Everything flows from reorienting our priorities around relationships kind of trump everything then we see how our behaviors in many times don’t reflect that and how do we, how do we bring it closer to the, so that our behaviors do, it.
Seems critical that we also integrate these ideas and values into schools and workplaces, you know, where we spend so much of our time. And I think about schools, we do such a great job of valuing kindness and compassion in early childhood education. But then it kind of fades away as a central value and almost is replaced by opposite values centered around academic success and dog eat dog, you know, world.
And [00:31:00] it’s more of a much more individualistic and selfish. And I think it’d be great if schools. And businesses had awards for kindness and compassion and, you know, even better if those awards mattered more to us than being valedictorian. , but do you have any any thoughts on, you know, how to , cultivate compassion and kindness in schools and in the workplace and part of may center around demonstrating its value.
In both education and, you know, workplace productivity and well being .
Yeah, so there’s a fair bit to say about that. So from from the schools front when you think about it, you know, in particular when you’re looking at kind of brain physiology that We’ve got this kind of a gateway around hippocampus, which is constantly on the guard for threat.
And when threat levels are high, then our path, our neurological pathways head towards, you know, the keeping safe. But when the threat level is low and you have a [00:32:00] sense of belonging, then what happens is, you know, the, all the prefrontal cortex and all of the kind of great things about being human can flourish.
, you know, imagination, creativity, reasoning, and logic. And so even in the context of if you want so called good educational performance, the basis of that is a sense of belonging. And, my son and I did, he was a school teacher at the time. We did a really interesting project around okay, well, what could we do to bring community into the classroom?
And it was like, okay, well, first of all, children need to know what emotions are and recognize them. So when you’re When you’re shaking and you’ve gone red in the face and you’re kind of like easily excitable, it’s because you’re angry. Oh, that’s anger. Okay. And then the next thing is having being able to recognize emotions is to start asking the other children about how they’re feeling.
You know, what has your day gone? How are you [00:33:00] feeling now? And is there anything we can do to make it better? Like simple questions, but the act of asking and the act of speaking and the act of listening is how you bring compassion into the classroom. And the interesting thing of course, is that you start creating these really friendly environments where children are looking out for each other.
And then of course, the whole thing is transformed and educational achievement goes up massively. And so there are a variety of programs which are around bringing compassion into the classroom. With regard to what, yeah, I really like what you’re saying about, you know, workplaces. There’s a, we have something called the Compassionate City Charter, which is thinking about what, you know, the, this business of care and support and love and friendship.
It matters everywhere. It matters in our workplaces. It matters in our places of worship. It matters in in for disadvantaged populations, like prison populations, homelessness. It matters for LGBTQ plus [00:34:00] populations. It matters everywhere. So the Compassion City Charter is takes a public health approach to these problems.
And so we need to create the compassionate communities in All of these environments. This is a not just in our neighborhoods. It’s in our civic life as well. It’s everywhere. And it kind of goes back to saying survival of the kindest, compassionate communities is a social movement. It’s something that we need to be in the hearts of minds of everyone.
We need to be saying forget it. The dog eat dog world of this is some kind of craziness that we’ve got lost in. Let’s think about Survivor of the Kindest. In fact, I’m even, I’m writing a book about it with, Jennifer Nadal Nadal, who runs Compassion in Politics in the UK, she runs this group inside parliament to say, we have forgotten about.
Compassion. [00:35:00] We need to bring it back because it’s fundamentally important. Politics is riven by this dog eats dust up so much so that our politicians and our business leaders can’t even make simple decisions about the environment and to change the, you know, the decrease of burning of fossil fuels because of.
all of the kind of survival of the fittest nonsense. And it’s interesting that two party democracies are a disaster, you know, that the, you look at proportional representation, they, they don’t suffer quite so much with the same kind of problems. Yeah.
Certainly the advent of information technology and social media and so forth has Also contributed towards more tribalistic antisocial behavior and sentiment.
Do you have any thoughts about ways to stem that tide? And utilize those resources in in to promote compassion and promote inclusion and belonging.
Yes, is the [00:36:00] answer. And I think we some, it’s about creating this social movement about bringing it to light saying, you know, we need to be talking about it everywhere saying, look, forget survival of the fittest.
It’s all about survival of the kindest. When it’s like that basic education and to say, look, your relationships are really important, not just a nice thing to have, pay attention to them and shift your focus. Wealth, power, it’s not really, doesn’t make you happy and doesn’t make you live a long time, but connection and belonging, that’s, if you, if you know, I mean, I’m a palliative, I’m retired now as a palliative care physician.
I’ve watched, you know, thousands of people die and I never, ever once heard anyone say, I wish I’d spent longer at work, you know, and and it’s like, and people look back, you’re kind of going, what was it that mattered most? And so I think there’s a. bit about this, which is public education, public engagement, public [00:37:00] participation, social movement, and do something about the rhetoric in which we are stuck in and, you know, altering medicine and, but then, you know, you guys I think you guys are part of that already, you know, all the stuff you already do and Tommy has been, you know, I mean, I’ve known Tommy for a few years now and I’ve been talking about this stuff for ages, as well as all the other stuff.
And so that’s all, you know, it’s really interesting, like this whole thing about lifestyle medicine, which is really a way. Taking a more kind of integrated approach to thinking about health that naturally we can, we can do something ourselves, which is deeply profound. You’ve been talking about it already.
It’s already happening. You know, it’s already out there, you know.
I’d be curious to know do you have any particular practices in your own personal life that you kind of try to adhere to make sure you’re bringing compassion into it? That anything that’s deliberate?
So we, we moved from Somerset down to Cornwall, coming on seven years [00:38:00] ago now.
And, it’s kind of comical because we live in a fairly isolated place, but I kind of like… Figuring out about, you know, what are the community based things that would interest me? And we’ve got a little bit of land and I read this really fascinating book on wilding and about this whole thing about rewilding and, you know biodiversity, carbon catcher.
So I gave the book to a few people locally and said, why don’t we, why don’t we start a group up to see what we can do about this? You know, just for like, I live in a fairly confined area of land. It’s a kind of peninsula, it’s quite enclosed. And but then we decided that what we would do is this is, we have kind of three aims and the one aim is increased carbon capture, another aim is increased biodiversity, but the third aim is about community involvement.
It’s about making it, you know, accessible and interesting enough to the whole of the, to [00:39:00] this kind of isolated peninsula. So just like, so, and what’s interesting is that, The whole, it’s just like using, if you like, the kind of methodology that I’ve learned, learned to create connection and belonging and ownership and enthusiasm and making things better.
And, and I think that’s a, that’s the thing really about figuring out what it, what is it? You like to do, what interests you, and find some other people to do it with.
Yeah, taking the lead. TOmmy, anything else you have to add
this has been great just listening to you both.
I guess I wanted to briefly go back to something you mentioned right at the beginning, is like, why have we gotten lost, or why have we lost the importance of social relationships? And Julian and I wrote an editorial that, that goes with. With this special issue, and one of the things we wrote about was how, and it’s something that you and I have talked about on the podcast, Josh, is this sort of overly reductionist [00:40:00] approach to science and medicine that’s dominated the last few decades.
And the thing is that you can’t isolate the effect of friendships and put that as part of a randomized controlled trial and like, see who lives longer. The things that have the biggest impact on human health. are pleiotropic, which means they have multiple effects across multiple systems, and probably multiple people if not multiple communities at the same time, and this, it just doesn’t fit into the current paradigm of, of, Quote unquote scientific or medical discovery.
And I think that’s, that’s where it’s, it’s gotten lost. And you know, I’m sure you could do things like you could do cluster trials where you do a compassionate community and you have a paired city where you don’t do it and you follow their strategies over time. Stuff like that can be done and it should be done.
But I think we also just have to step back a little bit from assuming that we can understand everything about the human body from a randomized controlled trial. And then [00:41:00] another thought that I had, and I’d be interested to hear Julian, Julian’s thoughts on this as well, which is the sort of the tension that we have currently in terms of exposing ourselves to things that make us feel uncomfortable when in fact, longer term, they, they would help build.
resilience and compassion and empathy. So I’m thinking about the book, The Coddling of the American Mind, which is one of my favorite books that I’ve read in the last couple of years, where basically in order to try and create safety for children and students, what we’ve done is stop exposing them to things that make them feel uncomfortable and ideas that make them feel uncomfortable and people who are not like them and disagree with them.
But what you do is the exact opposite of what you’re trying to do is you create. These feelings of constant threat, because, you know, all of a sudden somebody says something you don’t like, and that, that becomes a threat in itself, when in reality, we should have been exposing ourselves to these things [00:42:00] such that you can then have compassion and empathy for people who are not like you.
But I’d love to hear Julian’s thoughts about how we can start to build in that, and appreciate, there’s maybe going to be some friction to start with, but, you know, on the other side of that is a much more compassionate world, hopefully.
I, I, I completely agree, Tommy. And, you know, we learn to walk by falling over, you know, we got this terrible fear of failure and and, and that there is this dynamic tension around safety because safety is driven by fear.
And fear means that you isolate yourself. And so the, but we need this edge of exploration. You know, we spread all over the globe is an absolutely natural part of us. And there is this kind of point of. Exploring these areas, which are not quite so safe, but somehow thrilling as well at the same time and that that goes in every single [00:43:00] direction includes our social environment and, I guess, in a way, it’s about.
making sure we’re exposed to things that are different and that are not entirely safe, not stupidly risky either, if we just understand that everyone has this compassionate potential, that we can be a little bit more warm hearted to people and a little bit more forgiving and understand that aggression and violence only breeds more aggression and violence.
When we’re faced with aggression and violence, we react, trying to protect ourselves. Whereas if we can have a sense of. connection, knowing that every human being has got this warmth. In fact, not just every human being, you know, the, you find these same things throughout the animal kingdom.
It’s just 600 million years of animal evolution. Okay. Okay. Right. Our starting point is this generative state. And, [00:44:00] and then you’d like the way that you move through the world is very different and you can kind of encapsulate. Something a bit more and the whole thing about compassion is that it’s got to be more than just a nice idea.
It means that you actually have to reach out beyond your. own personal safety into something a bit different so that you care for the people in the world around you. So I don’t think there’s a neat fix. I wanted to, I love the point you’re making about complexity as well. And and you know, Occam’s razor, where the simplest, most elegant answer is supposed to be the best, you know, this is a kind of scientific thinking.
In fact, for me, Occam’s razor is the most stupid because what you’ve done is you’ve just stripped all the links of interdependence and have turned something that is complex and interactive and interdependent into something simple and isolated. It’s like, no, you, you just done the opposite of what you should then [00:45:00] particularly.
The human body. We have to embrace this complexity.
Just because a, an explanation is complex doesn’t make it wrong, especially if there’s not a simpler explanation that will suffice, right? And it is as Tommy. Talks about tragically ironic that so many of our most powerful interventions like lifestyle because They’re so complex because there are so many mechanisms involved that we can’t reduce them down to one and we can’t conduct Randomized trials on them is the central reason why they are less they’re off so often neglected And that’s that’s something we have to be addressing and reversing There’s a
great, there’s a great book on this actually, which I recommend to everyone.
And it’s this book um, for the, for the listeners, it’s called Research is Ceremony and it’s Indigenous Research Methods. It’s a fantastic book by this guy, Sean Wilson, and he addresses[00:46:00] the, the issue of scientific rationalism in the context of the broader interconnected relationship of everything.
And and when you, when you, when you sit with interdependence and interconnection, then you kind of figure out what you’re doing research for. You figure out that research is relational, that you bring in all of these other different research methodologies rather than the kind of stupidly reductive cause and effect methodology, which is, you know, I, I, I don’t know whether you see you, I’m sure you both see this as, you know, I see, you know, the whole argument about causation and association, you’re kind of going,
sorry, I interrupted you, Josh.
Oh, no, I know one other thought that, that came to mind through talking about this is, is the idea of resilience. You know, we talk about health being resilience and we oftentimes [00:47:00] frame it in relation to an individual.
Right. It’s your own capacity to deal with stressors. We would be, you know, much better served by thinking about a person’s , resilience to extend it to their entire support structure and community, and if we were thinking about health as resilience and thinking about resilience in that way it’d be a lot more natural for us to be considering all of those factors, which obviously are, you know, as are more important because with, you know, without others we’re toast, so.
We have to have that, right?
And I guess you know, one of the things about, about healthcare is actually illness care. Mm-Hmm. . What it focuses on is what’s wrong and what it doesn’t focus on is what’s right about, you know, the, as Bessel VanDerKolk talks about, you know. Love and friendship, holding people in our hearts and mind and others holding us in our hearts and mind.
And so what you could say is you can shift your focus from what’s wrong to what’s [00:48:00] right and what’s great and good and meaningful and precious and matters most. And resilience has still got a kind of element. Resilience needs to be there, but it’s still deficit focused, like safety is deficit focused.
Whereas these other qualities Really positive things in life, and that’s a place to start. And like you say, it’s not just us as individuals, but it’s us in the context of community and culture.
One, last thing I thought about was that. Our lives are more interdependent now than ever before, right?
We have a global society far more than, anything in our evolutionary history, we are more dependent on far more people than we’ve ever been, but we don’t feel that in any way, it doesn’t even feel like there are other people behind all of the things that make our lives better.
And, I don’t know the answer, but it would be certainly great if we could , have a felt sense of that in some way, you know, that other humans have touched every little piece of what we now, you know, have in our world.
I [00:49:00] completely agree. And I think some of it is sitting down thinking about it, you know, like everything.
Everything is dependent on interdependence. There isn’t anything at all that isn’t. It’s amazing when you, when you kind of check it out, even like, I, I, like on the, with this wildlife group, we had this guy come and talk about, the ecology of the soil. And then he’s talking about how. The moon affects the water content of the soil.
So, as the moon circulates the earth, you know, it has this incredible effect on the tides. But also… That the water level in the soil is dragged down and pushed up again twice a day and you think, wow, that’s the moon having effect on how our plants grow, you know, which is our food. Everything is dependent on plants.
And it’s like when you sit and think about it. I think [00:50:00] it helps to engender a bit of respect, you know, that everything is connected together and that the, the way that indigenous people talk about it is relational accountability. In other words, if we know that everything is interdependent, then we, we can have a direct input into that in a positive way, or we can just ignore it.
But if we ignore it, it’s, it’s at our cost as we’re seeing.
Yeah. That’s great. Well, any, any final words, anything we didn’t cover or address that you’d like our listeners to know about?
I Think you guys are on it, you know? I, I don’t have anything to add. It’s a pleasure to be here and chat with you both.
And Tommy’s been very quiet but he’s got a really a lot to add and he always, yeah. He should have spoken more. Yeah.
No, this, this was fantastic. And it was great as always to hear your thoughts, Julian. I always, I always really, really enjoy it. So this is kind of self indulgent in a way, but also very helpful.
The only thing that I was going to add [00:51:00] was that I don’t know when this will come out, but obviously it’s the day before Thanksgiving here. So, and, and I think that that relates to a whole number of things, you know, people are coming together and they’re sharing food together and all these, you know, it’s doesn’t happen often, but it, but it does happen, which is fantastic.
I just want to say that I’m incredibly thankful for, for, for both of you. It’s such an honor to, to work with you both. Thank you. Likewise.
Well, likewise. Absolutely. Right. ,
And another thing about Thanksgiving, it’s oftentimes the holiday people say they like the most, you know, and it’s because it’s only about just getting together with other people.
Well, thanks so much Julian, for coming on and Thanks so much just for the, all of the work that you’re doing. I remember when I first heard you interviewed on the nourish, balance, thrive podcast, I just said, I’m so glad this person exists in the world and is doing what you’re doing.
So and it’s inspiring and hopefully this conversation will raise awareness in our listeners about, you know, how important these issues are and prompt [00:52:00] us to reflect on the ways that we can bring more compassion and kindness into our own lives and in the lives of those around us. So thank you so much.
An absolute pleasure. Lovely to talk with you both.
Thank you. All right. Well, that’s it for this episode of the Better Brain Fitness podcast. Again, if you have any questions for us related to this topic or anything else send them our way at brainjo. academy forward slash questions. Thanks so much for listening and we’ll see you next time.
Bye bye. Thanks everybody. Bye.