Happy is what you realize you are a fraction of a second before it’s too late.
—Ali Smith, Hotel World
We all look for happiness, but without knowing where to find it: like drunkards who look for their house, knowing dimly that they have one.
—Voltaire, Notebooks
Until her life changed radically and forever at the age of forty-one, Shirley Parsons was a successful solicitor in Exeter, southwest England. Her husband ran a nearby farm. Beef and sheep. They are still married, though these days she doesn’t see him all that often.
I chatted with Shirley on email for a number of months, and during our conversations, I was struck by her thoughtfulness, and by her extraordinary reserves of strength and resilience, though when I put that to her she said, “Most people would use the words stubborn and awkward!” What also struck me was her approach to life. “I’ve come to the conclusion that my brain’s default setting is happiness,” she said on one occasion.
This opened the door to a discussion on the nature of happiness. I asked her if she could define it. There was a long time before a reply came. “To my mind there are different types of happiness,” she said eventually. “A general happiness with life, happiness due to anticipation of a specific event, such as a wedding or party, and happiness created by a particular moment such as passing an exam.” Her conclusion: “I can’t give a single definition for happiness.”
Well, she’s not alone. Thomas Jefferson didn’t define it in the US Declaration of Independence, instead only guaranteeing the right to pursue it. Happiness is at least as slippery a concept as intelligence, and the supposed routes to achieving it are labyrinthine, as we’ll see.
At this point Shirley and I had only ever been in touch by email and we both agreed it would be good to put a face to a name. So we arrange a visit. Now fifty-five, she lives in Devon, and I drive down to see her. Her house is in a village on the edge of Dartmoor, a large, granite-studded national park, which I usually think of as rugged, if not bleak, but today it is incredibly green. It is beautiful and skimmed by swallows and swifts. As I’m driving, a crow chases a buzzard right in front of my car, and I see the raptor turn its head in midair, irritated, and yell at the aggressor. The countryside is roasting. It’s the hottest day of the year so far, and I arrive at Shirley’s place in the middle of the day. There is a freshly mowed lawn leading up to the house, and rows of plant pots with flowers. The doors are open; I have phoned ahead and am expected, so I go in through the front room. I catch sight of Shirley’s two university graduation certificates on the wall; on the mantelpiece is her wedding photo. I go into the bedroom, which is dark, curtains drawn. The bed is elevated, with scissor legs; it is a medical bed. There’s a pouch for an intravenous drip hanging on a stand.
Shirley sits watching tennis. She doesn’t turn around to say hello, because she can’t move. Nor does she speak, because she can’t speak. She has been paralyzed from the neck down for fourteen years and five months. She has locked-in syndrome: her mind is intact, and indeed thriving, but her body has long since closed down.
It started on a Sunday morning in 2003. Shirley woke up with a really bad headache and a sensation of vertigo. She decided to stay in bed, but dragged herself up in the afternoon to help with feeding on the farm. “I suddenly felt dizzy so I sat down on the hay,” she recalls, “and the next thing I knew was when I woke up in intensive care two weeks later.”
Face-to-face, she can answer yes or no questions by looking up (yes) or from side to side (no). If I ask a more complicated question, she answers using her computer, which she operates using a cheek switch and specialist software called EZ Keys. This is how she’s been emailing me.
Like Carmen Tarleton, whom we met in the chapter on resilience, Shirley was in a medically induced coma for those first two weeks. Doctors discovered that she had a mutation in the gene for factor V, the stuff that helps blood clot. The single-letter misprint in the code meant that one of her factor V proteins has a glutamine amino acid instead of an arginine. This gives her thrombophilia, the tendency for her blood to clot more than it ought to. The type she has is called factor V Leiden, after the Dutch city where it was discovered. About 5 percent of people of European descent carry this mutation, which increases the risk of developing deep vein thrombosis, and which in rare instances can cause a detached blood clot to travel to the brain. When this happened to Shirley it caused brain stem bleeding, and a massive hemorrhagic stroke. She was in a rehabilitation center in Exeter for more than a year after the illness burst. She was told that she wasn’t expected to live.
In her room, I move into her line of sight. Her eyes move on to me. She is in a wheelchair, wearing lots of layers, and I wonder that she’s not sweltering in this weather. Her hands are on her lap but covered in closed cotton sleeves. Her face is flushed and sheened. Her mouth hangs open, which is the default setting now that she’s paralyzed. It gives her a hospitalized look. It’s the look you see on people in intensive care, on people in comas. On people in vegetative states. I remember it on the face of my grandmother after she’d fallen into a coma. You see people who look like this and you assume that they are paralyzed in their minds, too. Labels such as “vegetative state” don’t help. Clearly I know that’s not the case with Shirley, but it’s still disconcerting, to see her face-to-face, unable to move on the outside but knowing that she’s buzzing on the inside. “I think too much,” she’s said. She’s also said she is happy with her life. I then asked her, apologizing if it was a strange or even offensive question, whether there was a sense that she was happier now than before she became locked-in. She found the question easy to answer. Easier, she said, than when I asked her to define happiness.
“Although on the face of it, it seems a ridiculous question, when I thought about it I realized that it wasn’t, because rather bizarrely I think that I am happier,” her emailed reply said. “Before the stroke my life was noisy and hectic, but now most of the time it’s quiet, peaceful, and calm. Over the years I’ve grown accustomed and become content with my life.”
You often hear people saying they want to make their lives simpler. We complain that there are too many distractions in the world, in our busy lives, and we think we’d be happier if we got rid of some of them. Maybe it’s true, maybe we would be happier. Later we’ll meet a man who has gotten rid of all his possessions apart from only seventy items. He has fewer material goods than anyone I know, and seems happy. We’ll meet a professor at one of the world’s top universities who gives away everything he earns above £25,000 (about $32,000): he says he’s far happier than before he took the donation pledge. Perhaps getting rid of stuff really does make us happy. According to a popular search engine, the happiest person in the world is Matthieu Ricard, a French academic-turned-Buddhist monk who is an interpreter for the Dalai Lama. Buddhists don’t have much in the way of material possessions and they tend to be, if not radiantly happy, then at least suffused with well-being.
I’ve come to visit Shirley because she’s gotten rid of almost everything. She didn’t choose to, granted, but she lives a life stripped down to the barest minimum: just a brain, looking out. So I want to gain an idea of what her life is like. Perhaps it’s not so unbelievable that she could be happy. But happier, even, than before?
• • •
“The great snare of the psychologist,” said William James in 1918, “is the confusion of his own standpoint with that of the mental fact about which he is making his report.” What he called the psychologist’s fallacy is, in other words, the assumption that we know what someone else is experiencing. James was the father of psychology, but it seems to be a tendency that we could still usefully bear in mind. Consider the case of someone with locked-in syndrome. To their family and friends, they have lost everything. They are completely dependent on others for all their needs. Many of us simply assume life wouldn’t be worth living. Martin Pistorius, a South African author and web designer, became locked-in as a teenager, and was paralyzed for more than a decade. He recovered, and later described hearing his mother tell him, thinking that unresponsive meant unconscious, “I hope you die.”1 He said his parents had been told that he was a “vegetable” and that they should wait for him to die.
If you were fully conscious but paralyzed, can you even imagine how you would feel, what you would miss? I’d asked Shirley this. One thing, she said, was toast. She missed crunching on a piece of toast. I ask her the same question again when I visit her, and she starts laughing. She laughs a lot. Although paralyzed, she isn’t completely silent. Unlike many people with locked-in syndrome, she has regained some head movement, and can swallow and make noises. It means she can be fed with a spoon rather than a tube, and it means she can laugh. Her laughter is a funny kind, that’s for sure, but I hear it a lot as I sit with her. This particular laugh is hard to evaluate at first: I worry she is crying, or even choking. But I realize it’s definitely amusement. The panting laugh goes on as she spells out her reply on the computer. What does she miss? “Being able to talk.” Most of all she misses chatting. “The carers don’t talk, and with good reason,” the message goes on. “I don’t suffer fools.” Because she would tell them off? She laughs some more, eyes raised to the ceiling: an emphatic yes. The carers do talk to her, of course. But perhaps what Shirley means is she misses banter and discussion; conversation, argument. She was a solicitor, after all.
• • •
I first began thinking about people with locked-in syndrome after meeting Marie-Christine Nizzi in the department of psychology at Harvard University. Nizzi’s office is at the top of William James Hall, a famous and appropriately named high-rise in Cambridge, which has a fantastic view over the city. Sitting up there, she told me the parable of the Chinese farmer and the horse.
There was once a farmer who was offered a lot of money for his beautiful white horse, but he refused. It’s the only thing he has, he says, he doesn’t want to part with it. The offer is rescinded and the villagers in the neighborhood tell him he’s crazy for missing out. A while later, the horse escapes, and now the farmer has lost even the horse. The villagers jeer at him but he shrugs. Who knows what will happen, he says: it could be good, it could be bad (another name for this parable is the equanimous farmer).
A few days later, the horse returns, leading a herd of wild horses. The farmer is now rich, and the villagers urge him to celebrate. But he doesn’t, trotting out his usual line, “It could be good, it could be bad.” A while later his son breaks his leg trying to tame the wild horses, and the villagers (they are a miserable lot) cluck at him that he wishes now he hadn’t been so lucky with the horses. It goes on like this. War breaks out, and all young men are conscripted, apart from the farmer’s son, who is exempted with his broken leg.
The moral of the story, said Nizzi, is that we shouldn’t jump to judge the good or bad of an event. “There can be silver linings. A lot of people project how they would feel in those circumstances, be it the lost horse or the loss of money.” She felt this was something that was being missed widely in psychological evaluations, and started working with people with locked-in syndrome. But how do you know if they’re happy or not? “How about we ask them?” she said. The way she said it, so simply, irrefutably, made me realize what an incredibly obvious question it was, but Nizzi reassured me that many people with locked-in syndrome are never asked about the quality of their inner life. We just assume it’s horrendous so we don’t ask. Also: we don’t want to know. So that’s what she did. She asked them about their perspective.
Nizzi calls it going from the armchair to the wheelchair,2 which is also what the Afghan war veteran Dave Henson in Chapter 5 did to gain perspective from the other side. When Nizzi surveyed patients with locked-in syndrome, “What I found was that they have a much more positive quality of life than what we project from the outside.” Their resilience, she says, allows for a satisfactory quality of life. For example, they want to be resuscitated in case of an accident, when nurses, doctors, and even family members sometimes presume that the patients wouldn’t want to live like this. “The patients report being happy, or being satisfied with their lives. The majority are happy.”
Nizzi’s work follows that of Steven Laureys, who runs the Coma Science Group at the University of Liège in Belgium. In 2008, Laureys decided to conduct a quality-of-life survey of people with locked-in syndrome. Sixty-five patients were included in the survey; forty-seven of them professed themselves happy, and the rest responded that they were unhappy.
Things that made them unhappy included anxiety and their lack of mobility, as well as Shirley’s biggest regret: the loss of speech. The longer they’d spent in the locked-in state, the happier they were, but still, 58 percent of the people responding said they did not wish for resuscitation in the event of a heart attack.3 Laureys concluded that perhaps the happy locked-in people had succeeded in recalibrating their lives.
I accept that some locked-in patients are content, even happy. But surely no one locked-in feels better about their lives now? “I asked that exact question,” says Nizzi. “The answer was yes. They knew themselves better, and they found their life’s meaning more strongly now than they had before.” Being locked-in forces you to halt. It forces you to look for a meaning that you may not have sought before. It’s only because I’ve heard this that I dare ask Shirley if she’s happier now than before her stroke.
Tim Harrower is Shirley’s consultant neurologist at the Royal Devon and Exeter Hospital, and saw her when she was in rehab there after her stroke.
“The big breakthrough with locked-in patients happens when you work out a way to communicate,” he says. “It changes everything because they can communicate their needs.” You might have an itch, or you’re in pain, or you just want the damn TV turned off. Then it’s a case of adjusting to what you can and cannot do, and finding something cerebral to do. “Being able to accept your situation and adjust to your limitations is the biggest problem, really,” Harrower says. “That doesn’t happen straightaway, it can be years down the line.”
Shirley had been locked-in for about five years when she decided to begin a degree course. She was missing her job; she was bored, basically. “It was the loss of my job which prompted me to study,” she says. “I was too young to retire and needed something intellectual to fill the void.” She applied to the Open University. First she took a BA in social sciences with politics. She remembers writing an essay about Tony Blair’s style of government. She graduated in 2010. Then she took a postgraduate certificate in the same subject, graduating in 2012. It must have been challenging, I offer. “The main challenge,” she says dryly, “was that it took me ages to type assignments.”
Shirley has always been a dogged woman. She tells me about her response to the disastrous outbreak of foot-and-mouth disease, which hit the UK in 2001. This was before she was locked-in, when she was working as a solicitor. Their animals had not contracted the disease, but those on a neighboring farm had, and it was government policy to cull animals on properties adjoining those infected. Deeply disturbing images were shown on TV of pyres of burning cattle. “After initially being upset I went into fight mode,” Shirley says. “To cut a long story short, I was successful in preventing all the cattle and the vast majority of the sheep from being killed.”
Shirley wears glasses, and the left-hand lens of the glass is a bit steamed up. There is a humidifier pumping out steam on her left side, next to where I’m sitting, and maybe that clouds up that side of her glasses. So really I just have her right eye to look at, and I find it fixes me with an intensity I can’t hold all the time. I have to look away, at her DVDs (Manchester City Champions; Bridget Jones; Orphan Black; 12 Years a Slave . . . 12 Years a Slave!) and at a large collage of photos from work colleagues with the legend “C’mon Shirley! You can do it!!” I sit there, babbling away, aware that soon I’ll drive back to my life, knowing that the majority of the rest of her life will be spent in this bungalow, in this dark little room, and she knows I know that, and here we are talking about how happy she is.
• • •
I’d heard about William MacAskill by reputation. Not only was he one of the youngest professors in the world when he was appointed to the University of Oxford’s department of philosophy, but he made the decision in 2009 to give away most of his income over the course of his life. Everything he earns over £25,000 he gives away. I was amazed and impressed by this, and not simply by the generosity. How does he manage to live in Oxford, I wondered. It’s not cheap; it’s almost as pricey as London. Before I met him I half wondered if he would be like an ascetic monk, barefoot and in sackcloth.
MacAskill is also known as one of the founders of the effective altruism movement, which uses science and evidence to discover the most effective ways to donate money. He started Giving What We Can, an organization that encourages people to pledge at least 10 percent of their income to charity, for life, and to give it where it will do the most good. Giving What We Can launched with twenty-three people and now has nearly three thousand members who have together pledged $1.4 billion. I meet him at the Centre for Effective Altruism in Oxford, where he is director.
To my slight disappointment, he is not monk-like. He is tall, neat, dressed in a clean T-shirt. He even has a smartphone.
His decision to give away so much of his earnings came after meeting Toby Ord, another philosopher here who has made a similar pledge. The decision was made because of an understanding of how money contributes to happiness, and the difference in happiness he can make by donating.
There’s a famous paper by economist Richard Easterlin that is often cited in discussions on happiness.4 In 1974, Easterlin, now at the University of Southern California, published data purporting to show that as a country’s GDP grew—for example in Japan, spectacularly, after 1945, or in the US, during the course of the twentieth century—the happiness reported by citizens in those countries did not increase. This is known as the Easterlin Paradox, because it must be a paradox that more money doesn’t make us happier, right? I’d heard of this concept, and thought it was a true phenomenon. I thought it was evidence that we were trapped in a system of economics that was driving ever more growth without increasing well-being. MacAskill disabuses me of this.
In 2008, Betsey Stevenson and Justin Wolfers at the University of Pennsylvania looked again at the data.5 They found there was no paradox. As income increases, so does happiness. It’s very clear, and the relationship holds for a wide range of countries: the US, China, India, Japan, Germany. What does this mean—that money does buy you happiness after all? Well, sort of. The Stevenson and Wolfers data shows that as you double your income, you double the amount of happiness you report. The relationship stays the same at all points along the graph. That means if I’m in rural China and am earning $1,000 per year, my happiness is boosted by the same amount if I get a pay raise of $1,000, as it would be if I was in the US earning $80,000 and get a raise to $160,000. If I’m earning eighty grand and get a twenty-grand raise—itself pretty unlikely, right?—my happiness doesn’t really improve by much.
This kind of measure of happiness is called lifetime evaluation. Basically you ask people, “On the whole, how are things going for you these days?” On this measure, more money does make you happier, but because of the doubling effect, this only works up to a point. “Above a certain level of income, earning even more makes a negligible impact on your well-being,” says MacAskill.
There is another main way people measure happiness, and that’s called experiential sampling. In this method, you buzz people randomly on their mobiles throughout the day, and ask them, “How happy are you right now, on a scale of 1 to 10?” In this way researchers are able to assess what are the most enjoyable activities. Can you guess what people get the most happiness from? “Sex wins by a huge margin,” says MacAskill. “People must’ve been interrupting it to give a 9 out of 10.”
Experiential sampling is interesting because it gets around what’s known as the focusing illusion. Another philosopher, Michael Plant, told me about this. “You and I imagine how much fun it would be to be Kanye West driving around in his Maserati, but he’s just annoyed about being stuck in traffic. So there’s a gap between how we imagine other people’s lives, or our future lives, and what they’re like when we live them.”
In other words, we look at Kanye’s car and think that’s cool, I’d like that, but we don’t focus on what the person in the car is experiencing. We’re misled by our desires. Incidentally, talking about moments of transient happiness, there’s a sign on the wall of the pub where we meet saying, “This is where Bill Clinton did not inhale when he was a Rhodes scholar at Oxford.”
Back to MacAskill. “On the experiential sampling measure you get no increase in happiness beyond $75,000 per household,” he says. He’s referring to a paper by Daniel Kahneman and Angus Deaton of Princeton University that analyzed 450,000 such experiential responses from 1000 US citizens.6
So let’s recap. If you measure happiness as a whole, using the lifetime evaluation method, you find that happiness increases steadily with income. If you use experiential sampling, the measure of moment-to-moment emotional happiness, you find it never increases after a certain, surprisingly low, level of income.
“In the UK, that’s about £25,000 for a single person,” MacAskill says. This seems to be a good time to bring up the fact that he lives on £25,000 in an expensive city. “I give away everything over £25,000, and that still puts me into the richest 50 percent in the country. And if the 50 percent who are poorer than me can still live, then surely I can as well.”
There’s not much I can say to that without sounding like Scrooge, or more correctly, like the London-based, middle-class journalist I am. But I plow on anyway. How does he afford somewhere to live?
“I pay a little over £500 a month shared rent, I live in a house with ten other people. It’s great; I’m much happier in a shared house than I would be living alone or just me and my partner—because of the sense of community.”
MacAskill is very good-natured about letting me know how woefully middle-class I am. I guess he’s had a lot of practice at it. “Ninety-seven percent of people in the world live on less than that amount of money. So it’s kind of a strange thing when people are like, ‘How could you live on that?’ It’s a very middle-class thing because 97 percent of the world do it. They get along fine.”
On the shelf there’s a vintage black-and-white photo of a stern-looking young man. To divert attention from how selfish and consumer driven I am, I ask who the man is.
He is Vasili Arkhipov, credited with saving the entire world. Arkhipov was a Soviet naval officer who on October 27, 1962, was on board a submarine awaiting orders from Moscow. It was the very pinnacle of the Cuban missile crisis. The submarine’s captain, having not heard from Moscow, made the decision to launch a nuclear strike. Authorization required the three senior officers on board to agree unanimously, and one other did, but Arkhipov refused, and argued the captain down from the launch. Had it gone ahead, the US would have almost certainly responded in kind, and all-out nuclear war would have broken out. An aide to John F. Kennedy later said it was the most dangerous moment in human history.7 Arkhipov’s picture is up here in the Centre for Effective Altruism as inspiration.
MacAskill says his life is much improved since he took the pledge: “I’m much happier than I was before. I think I have a pretty good idea of what my life would’ve been like otherwise.”
The happiness seems to come from doing something he derives huge satisfaction from, something that also has huge moral payback, in that giving money away in the way he does improves the happiness of others far more than it depletes his own. “I don’t have a car, I don’t have many material possessions, I think they would make my life worse. If I had a yacht, I’d be stressed about having this thing I’ve got to worry about.” Quite frankly I’d love a yacht, but I’m not greedy and would be happy with a rowing boat. I’m briefly adrift, considering the question of which I’d prefer, when MacAskill says, “One of our employees only has a hundred possessions.”
I ask him to repeat this.
“He only has a hundred possessions. He’s a minimalist.”
My first response is not to express consternation or admiration, but to ask how many pairs of undergarments this man owns.
“He has two pairs of pants,” says MacAskill.
I have to talk to this guy.
• • •
Pablo Stafforini is a chisel-jawed, tousle-haired Argentinian tango dancer and philosopher living in Oxford. He works as a research analyst here at the Centre for Effective Altruism. “I don’t aim at a particular number,” he says. “Instead, I try to follow the heuristic of getting rid of as much stuff as possible.” His possessions currently number around seventy. He thinks people are “biased” toward resource accumulation—that effectively we are trapped in a consumerist system and an evolutionary state that tilts us toward wanting and accumulating too many things: “This heuristic is an attempt to correct for that bias. The goal is just to live a richer, more fulfilling life.”
As a philosopher, he was familiar with the findings from the psychological studies we’ve just been hearing about: that spending money on experiences often makes people happier, but spending on material goods usually doesn’t. He was also finding that his own possessions—including a piano and a library of some 3,000 books—were becoming a nuisance. It had been a pain, and an expensive one, to ship his library from grad school in Toronto to Oxford. So he committed to getting rid of almost everything, and he announced as much on Facebook. He sold the books and the piano. Now if he wants to buy something, it is subjected to a strict test: “Do I really need this? Will it make me happier?”
He owns some clothes, a pair of boots, shoes and trousers for tango, a decent laptop, and a few bits and bobs. I’ve never met any adult who has so little. He also donates a substantial percentage of his income to charity. Some people think he’s crazy. “These people mostly believe I suffer from a cute or funny type of madness,” he says. “Overall, the reaction I get is very positive.”
He allows that he thinks he is happier now that he’s shed his worldly goods. He is cautious about concluding that he is happier now that he is a minimalist, but that’s heuristic-following philosophers for you, even fun-loving, tango-dancing ones. “It is worth remembering that the psychological literature teaches us that humans are very unreliable at recollecting and aggregating past experience,” he says. In other words, he feels happier but won’t commit to asserting that to be true.
• • •
When Shirley Parsons said her default setting was happiness, what did she mean by that? She seems to be referring to the commonsense view that some people are naturally happier than others. We all know people who are always positive and sunny, and who return to a stable level of happiness after a knock. This has a name in psychology. It is hedonic adaptation, and crucially it works in both directions: it means you return to happiness after you are derailed from it, but that you also drop back down even if your happiness is elevated by, say, winning the lottery.
“People get used to stuff,” says Michael Plant. “Nothing feels very good or bad for very long. Births, deaths, promotions, demotions. Some people have advanced set point theory—whatever happens you come back to a set point.”
Given there is evidence for this set point we’re always going to come back to, you have to ask: Is there anything we can do to increase our happiness over the long term?
The first thing we need to do is to understand how the baseline is set in the first place. The problem is, this is incredibly complicated. It’s not controversial to suppose there is a genetic contribution to it, since there’s a genetic contribution to most things, as we’ve seen throughout this book. What’s controversial are claims to have found a specific genetic element that supposedly makes people happier (or more prone to depression). You can imagine what’s at stake here if and when such genetic components are found. I can already see the marketing campaign for the happiness pills.
One such claim has sparked huge amounts of research over the last fifteen years.
The variant in question is found in the serotonin-transporter gene on chromosome 17. You’ll have heard of serotonin, a chemical commonly associated with feelings of happiness. When there is more of it in the bloodstream, we tend to feel happier, which is why stopping it from being mopped up, by using a drug such as Prozac, can benefit people suffering from depression. The serotonin-transporter gene’s job is to make a protein that carries serotonin away to be recycled.
As in most genes, there’s a region of the serotonin transporter that controls how much of the gene product is made. It controls expression of the gene, which is like saying it’s the tap regulating water flow into a bath. In 1994, geneticists discovered that this region, 5-HTTLPR, occurs in two forms, a long and a short form. People with the long form make more of the product than those with the short form, and more of the transporter product means less serotonin is left hanging around than in people with the short form. This discovery immediately had the neuroscientists and psychiatrists wondering: What would the behavioral effect of this difference be in people?
In 2003, a bombshell paper in the journal Science suggested an answer.8 A small study of young men and women in Dunedin, New Zealand, found that people with the short form of the gene were more prone to depression, and even suicide, than people with the long form.
Hundreds of research papers have since attempted to delve into the effect of the 5-HTTLPR gene.9 It’s not clear-cut, and with a condition as complex as depression, known to be influenced by multiple factors, you wouldn’t expect the behavior to map simply to a single gene. But the evidence was starting to suggest that people with the short form do show higher rates of depression. One analysis of data from 2,574 teenagers enrolled in the US National Longitudinal Study of Adolescent Health allowed a comparison of genetic status with life satisfaction responses. Jan-Emmanuel De Neve, now based at the Saïd Business School and the University of Oxford, found that people with the long variant of 5-HTTLPR were happier. This, he proposed, could explain differences in baseline levels of happiness.10
But De Neve’s own follow-up provided mixed results.11 What this tells us, as Robert Plomin—the intelligence researcher we met in Chapter 1—warned, is that you need huge data sets to find relationships between gene variants and complex traits. It’s no good to sample the DNA of a few hundred or even a few thousand people for your study. You need DNA samples from hundreds of thousands, preferably millions of people. Those data sets are only just becoming available. In 2016, De Neve was among the authors of one such study, which looked at the genetic influences on subjective well-being in 298,420 people. Among the millions of differences in DNA, the team found three genetic variants (two on chromosome 5, and one on chromosome 20) that were associated with well-being. Together they account for just 0.9 percent of differences in well-being between people. So on the one hand, we have robustly discovered genetic elements that definitively contribute to well-being. On the other, the explanatory power of each variant is minute. Even adding together all the genetic influences, including the thousands of as-yet-unknown variants, De Neve says, the environmental influence on happiness and depression will likely be greater than that caused by genetics.
These larger data sets have also muddied the water when it comes to 5-HTTLPR. In 2017, there was a major reanalysis of all the data on 5-HTTLPR, stress, and depression. The authors, and there are dozens of them, examined thirty-one data sets containing information on 38,802 people. The conclusion convincingly deflates the idea that there is a link between the short 5-HTTLPR genotype and depression.12
What all this means is that the search for a “happiness gene” is over. The search for the thousands of variants that together boost our happiness, however—that continues. The lead author of the 2017 meta-analysis is Robert Culverhouse, a professor at Washington University School of Medicine in St. Louis, Missouri. A consensus has been reached in recent years, he says. For complex traits, such as those examined throughout this book, there are many hundreds of genetic variants that interact to influence the development of the trait: “The impact of any particular genetic variant in isolation is modest.” This means we should not expect easy gene-based therapies, such as gene editing or a drug to target a single gene, and should be skeptical of any claims to the contrary. “What seems to be a more immediate application of genetic findings for complex traits,” Culverhouse says, “is personalized treatment based on a genetic profile.”
Though the effects are modest, it is still very much worth finding the variants associated with different traits. They will lead to insights into the mechanisms by which the traits develop, and could lead to new treatments. Remember, although the confirmed links between genetic variants and well-being only explain a tiny amount of the trait, that doesn’t mean there aren’t a large amount of other, undiscovered genetic links. There are. Genetics plays a major role in depression, and De Neve’s work—using twin studies—shows that it accounts for about a third of the differences between people in well-being.
Interest in 5-HTTLPR won’t go away. Another author of that 2017 paper is Kathryn Lester, a psychologist at the University of Sussex. One of the problems even with meta-analyses of well-being and depression is, she tells me, heterogeneity—unevenness—in the sampling. For example, some studies might measure individual well-being using self-reported assessments, while others use face-to-face interviews, and the two methods have different levels of accuracy. A meta-analysis tries to minimize this unevenness, but is still vulnerable. “So,” says Lester, “I think the controversy regarding the interaction between 5-HTTLPR genotype and stress exposure on depression may very well continue.”
Lester, like Culverhouse, says that while we are quite a long way off gene-based treatments to improve our well-being, even this complex, emerging understanding of the genetics is promising. It will enable researchers to identify biological pathways in the brain and people who may be more or less responsive to existing treatment options. For now, however, it does seem like we can’t move the baseline that is our initial setting.
• • •
Tim Harrower, Shirley Parsons’s neurologist, says physical recovery from locked-in syndrome doesn’t really happen: “That’s the sad part about it. It is generally very, very limited.” Generally, but not always. One neuroscientist I talked to suggested I get in touch with a woman called Kate Allatt. She is living proof that remarkable recovery does sometimes happen.
When Allatt was a schoolgirl in Sheffield, she says, she messed around a fair bit; she was a mischievous kid. But she was indignant when a career counselor at school advised her to aim only for factory work. “That helped me,” she says. “Now, if they say ‘you can’t,’ I say ‘watch me.’ ”
She says she has always been positive and determined. She grew up to become a fell runner, putting in seventy miles per week. She had three kids and a full-time job. But even those challenges were nothing compared to the one she faced on February 7, 2010, when she was thirty-nine.
Allatt was resting in bed with what doctors had thought was a migraine. That evening she managed to totter downstairs to her husband and asked him, “What’s happening to me?”—but what came out was slurred and unintelligible. She collapsed as a massive brain-stem stroke took hold.
When she came around, in Sheffield’s Northern General Hospital, she said it was like waking up in her own coffin. She was in intensive care, completely paralyzed; locked-in, with a machine breathing for her. Her husband was told she’d be better off dead. Allatt, completely conscious, was terrified the doctors would turn the life-support machine off but was unable to communicate her fears.
Eventually, she started communicating with friends and family by using eye blinks. She was desperate to recover, and worked furiously to improve. “My family were told to get on with their lives,” she told me. “They wrote me off; they immediately lowered expectations before we’d even had a chance to try, and that pissed me off. I said you know what, I’m not taking that. I’ve got three kids at home; I’ll try everything. I tried really hard, over and over and over and over again.”
Her entire focus was directed at trying to regain movement. After eight weeks in intensive care, she managed to move her right thumb two millimeters. She went from there. She managed to speak again. And incredibly, against the odds, she managed to walk out of the hospital on her own (the video of this is on YouTube, and it’s very moving). A year later, she did a one-mile run. Now recovered, back with her family, she spends her time giving talks and visiting people who are locked-in, helping them try to improve their situation and encouraging them with her story.
Parashkev Nachev, a neurologist at the Faculty of Brain Sciences, University College London, is familiar with Allatt’s case and how she recovered. I get in touch with him to find out how she did it. The brain, he explains, develops through self-organization, and requires randomness and chance in order to achieve the complexity it needs. In this sense, it develops through trial and error. When it is damaged, it can either reorganize in order to regain lost function, or it can stay damaged. But reorganization takes a lot of flexibility in order to discover and test out new ways of doing things. “This is where Kate comes in,” says Nachev. “Her insane, superhuman drive meant she did a lot more ‘trialling’ than others in her condition, indeed probably any patient I have ever come across, and so the brain was able to self-organize to a far greater extent than an ordinary human being.”
So at the end of the book we’ve finally met someone actually referred to as a superhuman. For her part, Allatt says that the key to improvement is trying: “I’ve been saying that for years and the scientists are finally catching to my way of thinking.”
Allatt, like Will MacAskill, has found that helping others improves her own well-being.13 When I ask her what her experience has told her about happiness, she tells me about a Finnish former model she’s gotten to know. In 1995 Kati van der Hoeven was living her dream. She was twenty years old, an international model, living in Los Angeles. She was visiting her family in Finland when she had a massive stroke and became locked-in. That was twenty-two years ago. She is still paralyzed, but now she is married, she lives in her own home, and she is happy—Allatt says Kati and her husband are the happiest people she’s ever met.
Of course, Kati can’t talk, so I contact her on Facebook and email. Her replies are so fast I think someone must be answering for her, but then she shows me a video of how she uses the computer. She has a little reflective dot on her forehead, and an infrared sensor on her computer picks up where she’s looking. With this she can swiftly guide a cursor around a virtual keyboard.
She misses dancing, and of course she misses talking. But she says she no longer considers what happened to her a tragedy.14 She is happier now than when she was a model. “For me happiness is love, not just receiving it but also being able to give it, to share it,” she says. (Not just with her husband, Henning, but also with her dog, named Happy.) “Secondly,” she says of happiness, “I would say it’s having a purpose in life and making a difference in other people’s lives, as little that it may be.”
The Finns have a word, sisu, which means something like “grit in the face of adversity,” or “courage against terrible odds.” It has a meaning of equanimity, like we saw in the parable of the farmer and the horse, and also of stress management. (Equanimity, the treatment of both good and bad events with the same detached response, is one of the Seven Factors of Enlightenment taught by the Buddha.)15
Many locked-in people get in touch with Kati. They read her blogs or see her on YouTube, or see her give a talk with Henning. The majority of them, she says, have not come to terms with what has happened. “By this, I mean they do not look on the bright side and they don’t get to learn about themselves.” What she wants to do is teach them sisu. Before her stroke, she says, all her actions were guided by societal rules; now they are mostly guided by emotions: love, compassion, kindness. “My actions are not so much influenced by society but more so by what feels right or wrong.”
There are two things I take away from this. One is that the majority of people who contact her haven’t made peace with their condition. For all I’ve been citing the research that shows most locked-in people are happy, it would be crazy to pretend it’s not a crushing blow to come to terms with.
The other thing is that even those with natural sisu and positivity need a purpose. If you’re going to suffer locked-in syndrome, it will help to have a positive outlook on life. “I don’t doubt that my happy disposition and inability to maintain upset or anger has helped me,” Shirley says. “I think that it also helps that I’m very practical and realistic.” Shirley’s case shows to what extent happiness doesn’t require beauty, athleticism, fame, or riches. What you experience from moment to moment, how you feel in yourself, doesn’t come from these things. Nor even is the other main measure of happiness, the lifetime evaluation measure, irrevocably tied to these things we all chase. If you look back on a life and have spent twenty or thirty years of it locked-in, you might think, and you’d surely be justified, that you’ve been dealt a rough hand. You might, if you were Shirley, look back and say, well, shit happened, but I did some good things, I took those degrees, I improved my mind; I understood myself and the meaning of life. Shipwrecked in my own body, I explored myself, and I found hidden treasure.
Nachev wonders what insight these stories about locked-in people gives us into the ordinary notion of happiness: “Someone might profess to be happy in circumstances most of us would find unbearable. But I am not sure it tells us very much what happiness is for the rest of us.”
I think it does. For me, it drives home how the experiential, moment-to-moment measure of happiness is the one that is more tangible, and, I think, more important. It’s the one we think of if someone asks if we’re okay. Let’s not overcomplicate things. Happiness is simple. It’s a bodily feeling, like being hot or cold, and we know it when we have it. When we want to position ourselves more grandly, or take a wide-angle view, we think about the life evaluation measure of happiness. As Plant said to me, “We’re often driven by the story of our lives rather than the moment-by-moment experience.” We know, from poems, songs, and novels, that money doesn’t make us happier. But we race along on a treadmill trying to get more. When Jefferson wrote about the right to “the pursuit of happiness” in the Declaration of Independence, I think he meant the pursuit of greater well-being in society as a whole, but it’s become confused, in an individual-first world, with the personal life-evaluation measure of happiness. We think the pursuit of happiness means making sure we get that pay raise, but we’ve seen in this chapter that after a certain amount, fairly low in the middle-class scheme of things, extra money doesn’t do much for our well-being. We think it means aiming for Kanye’s car, or a celebrity lifestyle we think is cool, or a certain size house, or a particular school for our kids, and we fashion a story about how that will bring life satisfaction, and we are willing to endure commutes and long hours and tedious jobs—maybe even tedious partners—because we think they will help us reach this point of happiness. We may well get there, and that’s great—but our moment-to-moment emotional happiness may not be altered, and we need to understand that and be ready for it or we’ll always be bashing our heads against the wall. Perhaps an evolutionary viewpoint can help. It made good evolutionary sense hundreds of thousands of years ago to place great value on resources, such as shelter and access to food and tools. People who had them acquired higher status. Now, that desire for resources has been co-opted; it has become a runaway need for more and more. It’s analogous to how obesity can be seen as an evolutionary trap—we evolved appetites at times when sweet and fatty food was far rarer than it is today (and when we had far more active lives), and our bodies can’t cope with the vast amounts of cheap energy they have access to today.16 Consumerism is a similar kind of evolutionary trap.
Surely the simplest change we can make in our lives, in our mind-sets, is to remember that the moment-by-moment experience is what we should think of when we think about our happiness. Kanye might not be happy in his Maserati. Set your life up so as much as possible you are doing things that make you happy in the moment.