Most of us think of the mind as the home and source of our emotions, even though we commonly experience them in the body as well. We get choked up with emotion in the throat and go with gut feelings; fear gnaws at the pit of the stomach; we sense love and heartache in the chest. The fact is that our dynamic emotions pervade the unitary body/mind, mediated by an elaborate network of nerves, neurotransmitters, and hormones. If you want to increase your emotional resilience or move your emotional set point toward more positive moods or simply want to be more open to the possibility of spontaneous happiness, you can use methods directed at the body, as described in the previous chapter, or methods directed at the mind, or, better, both.
Who has not tried to cheer up a depressed friend or family member by offering reassurance, love, or just a sympathetic ear? Some of us need only to talk out our troubles to stop ruminating on them and feel better; innumerable varieties of talk therapy are available to serve this need. Many of the mental health professionals who offer it identify depressive rumination as a root cause of unhappiness. This is the tendency to brood over a few characteristic negative thought patterns and lose control over the thinking process, so that depressive ideas keep intruding and crowding out others. As I told you at the end of chapter 2, evolutionary psychologists propose that so many of us tend to engage in depressive rumination because evolution has selected it as a useful trait. They argue that depression makes sense as a problem-solving mode that spurs us to withdraw and deeply contemplate some thorny issue or situation. Ideally, it is self-limited. Either the brooding leads to discovery of a solution, or, if there is no solution, it should abate when at some deep level we sense that the situation can’t be helped and decide to move on.
Unfortunately, the process often goes awry and plunges people into lasting misery. When you are stuck in depressive rumination, you can’t stop chewing on your problems, which may be as vague and insoluble as “I am a loser.” There is no end point. No one seems to know why this happens; the usual mix of genetic, lifestyle, and social factors is probably responsible. The practical challenge is how to get unstuck.
I’ve told you that when I’m depressed, I can’t fall asleep, because I can’t turn my thinking mind off. This is also the case when I’m worried, and I’d like to share with you some insights I have about worrying as one variety of ruminative thought that does us no good. Both rumination and worry have root meanings associated with the mouth, the former with chewing the cud, the latter with obsessive biting, as a dog worries a bone. Worry comes from an Old English verb meaning “to strangle or kill” in the way a predator seizes its prey by the throat, shakes it back and forth relentlessly, and does not let go. That is an arresting image, one that gives the word a deep meaning.
Anyone who has raised a puppy knows the chewing phase that can be so trying. My first Rhodesian ridgeback entered it one day, as if some circuit were suddenly activated in her developing brain. She would go into chewing frenzies focused on any convenient object, including me. Once, when I was trying to deflect her attention from my hand to a stick, we locked eyes, and I saw in hers a look that conveyed total helplessness in the face of an overpowering neurological drive. It was as if she were saying, “I don’t want to be doing this anymore. It’s wearing me out, but I can’t stop. Help!” I could empathize with her distress at being unable to turn off her chewing and biting, to stop worrying every object she mouthed, because I could relate her helplessness to my own experience of inability to stop ruminating over thoughts that make me anxious or sad.
Mark Twain advised to “drag your thoughts away from your troubles… by the ears, by the heels, or any other way you can manage it,” but managing thoughts might be one of the most difficult challenges for human beings. Our minds produce thoughts in continuous streams, as if from an engine whose controls are not accessible to us. Of course, some of these streams are very useful. They help us navigate the world and can make us feel more comfortable with ourselves and more content with our lives. I am certain, however, that a great deal of the fear, anxiety, and despair that people suffer arises from negative thoughts.
Until recently, Western psychology tried to alleviate this kind of emotional pain by making people aware of how they came to develop such thoughts—for instance, by remembering incidents of abuse or failure in early life that might have started the patterns. Sigmund Freud identified the unconscious mind as the repository of repressed painful memories that spawn neurotic patterns of thought and behavior. Psychoanalysis, the classic method he developed to integrate the mind, is extremely time- and cost-inefficient; the most succinct and trenchant criticism of it I have heard is this: “When you’ve got a poisoned arrow in you, you don’t need to know how it got there; you want to know how to get it out.” Freudian psychoanalysis is today very much out of fashion, but most of the styles of therapy that have evolved from it have also focused on bringing to light the why of negative thinking without giving people practical tools to change it.
Almost a century after Freud, radically new forms of psychotherapy have become popular in the Western world. Practitioners of positive psychology and cognitive psychology teach people how to modify the process of thinking and replace negative thoughts with positive ones. I am most enthusiastic about these new methods.
Though it is rooted in the humanistic psychology of the 1950s, an independent branch of the field known as positive psychology is quite recent. Its chief proponent is Martin Seligman, PhD, of the University of Pennsylvania, who convened the first positive psychology summit in 1999.
Seligman launched the movement because he was dismayed that traditional psychology aimed only to make “dysfunctional people functional.” Accessing the higher, happier realms of human emotion—contentment, engagement, gratitude, joy—was generally deemed trivial, impossible, or otherwise too far outside the realm of therapy even to attempt. Seligman felt this attitude was foolish: why exclude the better half of human experience from the world of psychology? Why be content to make dysfunctional people functional if you could make people happy?
Seligman observed that those who tend to get depressed following setbacks in life differ from others in how they explain such events to themselves. They take them as confirmation of lack of self-worth, instead of seeing them merely as temporary reversals of fortune. This difference in explanatory styles turns out to be the key difference between optimists and pessimists. Furthermore, Seligman’s research showed that people can learn to be more optimistic by consciously reworking their styles of interpreting what happens to them. His discovery echoes philosophical teachings of the ancient world. For example, the Greek philosopher Epictetus (55–135 CE), who taught mostly in Rome and based his work on that of the earlier Stoics, advocated transformation of the self to attain a state of happiness or flourishing (eudaimonia) by making proper use of impressions. What he meant by making proper use of impressions was reinterpreting sensory experience so as not to have automatic negative emotional reactions. He taught: “Remember that foul words or blows in themselves are no outrage, but your judgment that they are so. So when anyone makes you angry, know that it is your own thought that has angered you. Wherefore make it your endeavor not to let your impressions carry you away.”
This teaching is a cornerstone of positive psychology. We cannot always control what happens to us, but we can learn to control our interpretation of what happens to us and in so doing learn to be more optimistic and feel better about ourselves. I find this to be a process requiring attention and practice. Like most authors I know, I consider articles and books that I write to be extensions of myself and tend to take criticism of them personally. During the years when I was prone to dysthymia, I made my living as a writer, often doing commissioned pieces for magazines. To have an article rejected by an editor was devastating. I took it as a rejection of me and would let it plunge me into a long period of despair in which I would ruminate over my failings not only as a writer but as a person. Epictetus would have said that I let my impressions carry me away and, as a consequence, prevented myself from experiencing happiness and being my best. With practice, I have learned to reinterpret rejections and criticism of my creative work as annoyances that have no impact on my self-esteem. I also try to consider them dispassionately to see what I can learn from them. This change—still in process—has spared me a great deal of emotional grief.
Rather than focusing on ways to identify and eliminate negative thoughts, Seligman designed therapeutic exercises—termed interventions—to spotlight and enhance a patient’s positive emotions. The interventions of positive psychology seek to boost three basic types of happiness:
From its modest recent beginnings, the field of positive psychology has grown rapidly, with its own professional journal, popular and academic books, and an annual international conference. Together with like-minded colleagues, Seligman has tested many interventions to help people enjoy greater pleasure, flow, and meaning in their lives and has found three to be particularly effective. The Gratitude Visit, in which the participants write down and recite essays of gratitude to persons who have been kind to them, causes an immediate spike in happiness, but the effect tends to dissipate after a month. Two others have more lasting impact. The Three Good Things intervention has the participant write down each day for a week three things that are going well and the reasons why; it can lift happiness for a full six months. The Using Signature Strengths intervention, in which the participant takes a test to identify his or her personal strengths, such as creativity or forgiveness, and uses a “top strength” in a new, different way daily for a week, also yields a six-month mood improvement.
Many who have experienced these and other positive psychology interventions are enthusiastic about the results. Petrina, thirty-seven, an occupational therapist from Hamilton, Ontario, Canada, writes:
I have lived with depression since I was quite young, and over the years I have learned that my ability to reframe my thoughts has a tremendous influence on my mental health. I first encountered positive psychology through the book Authentic Happiness by Martin Seligman, and I found it to be quite helpful. In all the reading I had done on depression, this was the first that took a truly strengths-based approach to happiness. And while I am the first to acknowledge that medication, cognitive-behavior therapy, and other disease-focused therapies are incredibly important for treating conditions like mine, I am so thankful to Dr. Seligman for offering an alternative perspective. I feel that it gave me the opportunity to accept more of the whole story of who I am, and it suggested a means for developing skills, a perspective, and a lifestyle that focused on keeping me well rather than simply addressing what was going wrong with me.
And Brenda, forty-nine, a therapist from Smyrna, Tennessee, has this to say:
I am a master’s level graduate in counseling and have a lifelong history of depressive symptoms, treatment, and personal as well as professional research on depression. Positive psychology has been the most effective tool I’ve found for managing my periods of depression. Arriving at this point was through epiphany-like experiences that thankfully I was open to enough to receive, even through the fog of symptoms. There is so much to it, my experiences with aspects of positive psychology, but the one key helpful part is staying in the present moment and therefore fully experiencing what is happening now, which also leads to creating good feelings by using gratitude and hopefulness. There is joy to be had if we just are open to it.
As you can tell, I’m a great fan of positive psychology. I agree wholeheartedly with Seligman’s assertion that much modern unhappiness springs from the “society of the maximal self,” which encourages an obsessive focus on the individual rather than on the group. Numerous studies show that the happiest people are those who devote their lives to caring for others rather than focusing on themselves. That’s why many of Seligman’s interventions—such as talking with homeless people, doing volunteer work, or spending three hours a week writing fan letters to heroic people—aim to foster selflessness in daily life by creating opportunities to develop empathy and compassion and put the interests of others ahead of your own.
There is profound wisdom embodied in this movement. I urge you to explore it further. While some therapists employ its insights in their work, it is not a formal branch of clinical psychology. The best way to approach it is to read Seligman’s book Authentic Happiness: Using the New Positive Psychology to Realize Your Potential for Lasting Fulfillment, and try the interventions listed there. You can also find resources at www.ppc.sas.upenn.edu, including exercises that may help you move your emotional set point. Some colleges are teaching positive psychology classes to students, and adult education programs offer courses as well.
One of the best things about positive psychology is that you can choose from its “menu” of interventions to find ones that fit your lifestyle, inclinations, and schedule; some can be done in as little as a week.
As a freshman at Harvard College in 1960, I wanted to study what most interested me: consciousness. But shortly after I chose psychology as my major, I realized I had made a mistake. At that time, academic psychology was under the spell of behaviorism and its leading proponent, Harvard’s own B. F. Skinner, who became my advisor. Skinner was a highly entertaining and persuasive lecturer, as well as a creative experimentalist; his laboratory work with rats and pigeons gave us the terms positive reinforcement and negative reinforcement. The goal of behaviorist psychology was to describe, predict, and, ultimately, control behavior (both animal and human) as a function of environmental influences, such as rewards and punishments, without reference to internal mental states that were considered beyond the reach of scientific investigation. In other words, consciousness was excluded from behaviorist psychology and from the psychology department at Harvard, which I found exceedingly frustrating—so much so that I switched my major to botany.
Soon after, although I was unaware of it at the time, the new field of cognitive psychology began to supersede behaviorism. Cognition comes from a Latin verb “to know” and refers to the totality of our mental abilities: perceiving, learning, thinking, remembering, reasoning, and understanding. Scientific study of these functions was facilitated by the rise of computers and development of the fields of computer science and artificial intelligence. Although the human mind and brain differ significantly from computers, computers gave psychologists a model for approaching the internal mental states of human cognition. By drawing analogies from the operations of code within computers, cognitive scientists were able to propose ways that our minds work. Ironically, it was experiments with machines rather than with rats and pigeons that led psychologists to embrace consciousness and start to analyze its contents. The new movement caught on quickly and has had great influence. If I were an undergraduate today, I would be much less frustrated: Consciousness Studies is now a legitimate major in many colleges.
Unlike positive psychology, cognitive psychology produced a robust clinical arm. American psychiatrist Aaron T. Beck (1921–), who developed a cognitive theory of depression in the 1960s, is regarded as the father of cognitive therapy. Beck attributed depression to faulty processing of information in individuals who had negative views (“schemas”) of the world. There may be a genetic predisposition to this, but Beck believed such negative perspectives often result from rejections, losses, and other traumas in early life. However the schemas develop, they warp thinking in ways that continually reinforce negative bias. For example, depressed persons are quick to overgeneralize and to engage in selective perception and all-or-nothing thinking. They habitually interpret their experience through a distorted lens, letting their impressions carry them away to unhappy realms. (In his original treatment manual, Beck wrote, “The philosophical origins of cognitive therapy can be traced back to the Stoic philosophers.” His work inspired that of Martin Seligman.) By making people aware of their cognitive habits and teaching them to substitute alternative ways of thinking and interpreting perceptions, cognitive therapy can relieve depression and restore emotional wellness.
Beck’s cognitive therapy (CT) is now one of a number of therapeutic methods within the larger framework of cognitive-behavioral therapy (CBT). A National Association of Cognitive-Behavioral Therapists (www.nacbt.org), formed in 1995, is a large and active organization with more than ten thousand members that certifies practitioners and provides referrals. Membership includes psychiatrists, clinical psychologists, and licensed social workers and counselors who have completed CBT training. Whatever their particular styles, CBT practitioners work from the assumptions that our thoughts cause our feelings and behavior and that we can change the way we think in order to feel better and act better. The rapid growth of CBT is easy to explain. Not only does it work, but it is much more time- and cost-effective than more traditional forms of psychotherapy.
A great many clinical trials show CBT to be effective. In a 2011 publication, the British Royal College of Psychiatrists concluded that CBT:
| • | is one of the most effective treatments for conditions where anxiety or depression is the main problem |
| • | is the most effective psychological treatment for moderate and severe depression |
| • | is as effective as antidepressants for many types of depression |
Patients typically require five to twenty sessions of thirty to sixty minutes, spaced a week or two apart. They first learn the model of CBT and begin to master the skills involved. Depressive symptoms often improve in this initial stage, and many patients are no longer depressed after only eight to twelve sessions. A full course of treatment is fourteen to sixteen sessions, with occasional booster sessions during the following year to maintain improvement. CBT can be done individually or in groups, and people can also get started with self-help books and online programs.
To guide patients toward discovery of the kinds of thinking that make them feel bad about themselves and the world, CBT practitioners use a variety of strategies and methods, including Socratic questioning, role playing, visualization (see here), and behavioral experiments. Once patients recognize their negative thoughts, they may be asked to decide whether there is evidence to support them or whether alternative thoughts might better reflect reality. They receive assignments for homework between sessions. Ideally, as cognitive therapy proceeds, the patient will be able to spot distorted thinking when it arises and get in the habit of “reframing” the situation. Although formal therapy hours are few, CBT is not a quick fix. It can make you aware of the faulty thinking responsible for emotional pain and give you the tools to correct it. Then you have to practice the skills you have learned.
A recent innovation is mindfulness-based cognitive therapy, which combines mindfulness training—that is, the practice of bringing all of our awareness to the here and now—with CBT. In a study reported in the December 2010 issue of the Archives of General Psychiatry, researchers from the Centre for Addiction and Mental Health in Toronto showed this combined therapy to be as effective as antidepressant drugs in preventing relapses of depression. They studied 160 patients, ages eighteen to sixty-five, who had been treated for major depressive disorder and had two past episodes of depression. All of the patients were given antidepressants until they were symptom free. Then some remained on medication, some received a placebo, and the rest were assigned to mindfulness-based cognitive therapy. Those in the therapy group attended eight weekly group meetings and did daily homework, which included mindfulness practice. The emotional health of all patients was assessed at regular intervals. After eighteen months, the relapse rate in the mindfulness group was about 30 percent, the same as it was for the patients who continued to take antidepressants. In the placebo group the relapse rate was much higher—70 percent.
I frequently refer patients to CBT and recommend it to you because of the results I have seen. Here is a report from Renée, forty-eight, a social worker in Wichita, Kansas:
I have done cognitive behavioral therapy and highly recommend it. I used to be a card-carrying pessimist, but thanks to CBT, I have learned to transform my negative thinking. While I still get depressed, I remain optimistic. I know that sounds like a contradiction in terms, but it’s really not. I consider the depression to be a physical illness. It runs in my family. But how I choose to react to it is my choice, and I choose to be positive. I usually feel quite depressed physically, but my thought life is very active, positive, and uplifting. I am always learning about my illness and trying to feel better. Learning cognitive reframing and some stress management skills has helped me so much.
Pam, forty-five, a freelance television producer in Los Angeles, has this to say:
I began suffering from depression at age fifteen—the root cause was maternal neglect and criticism. I suffer from atypical symptoms (overeating, oversleeping, rejection sensitivity). I’ve been told that I probably suffer from double depression—dysthymia with major depressive episodes on top of it. My depression was severe. I went on disability from work three separate times and felt as though I wanted to die every day of my life. Medication has kept me alive but did not erase the damage that I needed to repair. I began therapy several years ago and saw several PhD therapists who largely utilized psychodynamic techniques. That mode of therapy was virtually useless in treating my depression, as I already had a good understanding of the underlying conflicts that contributed to it. It wasn’t until I began seeing an MFT [marriage and family therapist] who utilized cognitive behavioral techniques that I began to heal and experienced relief from my depressive symptoms. Some of the helpful aspects were treating negative thinking, catastrophizing, automatic thoughts, and negative self-talk. For the first time in thirty years of suffering from chronic, unremitting, and debilitating depression, I finally am in remission and have been for one year. Had I known to seek a therapist who utilized CBT early on, I might have been able to avoid years of suffering.
CBT may not be for everyone, and it may not be right for you. It seems most suited to those who are comfortable with introspection and are willing to use scientific method to understand the workings of the mind. And of course, you have to accept the basic tenet of cognitive psychology, that thoughts produce our moods and behaviors. I find that theory convincing and useful. If you suffer from depression or anxiety or just want to have more control over your shifting emotions, I urge you to try CBT. It represents a great advance in Western psychology’s ability to improve emotional well-being.
MEANWHILE, EASTERN PSYCHOLOGY has tackled the challenge of managing thoughts in quite different ways. Advanced practitioners of yoga and Buddhist meditation claim to be able to actually stop thought and free their minds to experience the highest states of consciousness.* Most of us will never be able to do that, but what we can do is break the habit of paying constant attention to our thoughts. Both yogic and Buddhist philosophers see this as a true addiction, one that causes much suffering. Objects of addictive behavior appear to have great power over us. Drugs, food, gambling, and sex can seem so fascinating and attractive that some of us cannot free ourselves from their apparent hold and cannot form healthy relationships with them. Either we indulge in them to excess, often harming ourselves as a result, or we try to abstain from them (not an option, of course, in the case of food).
Early in my professional career, I studied drugs and addiction and became known as an expert in addiction medicine. I came to see addiction as a widespread and fundamental human problem, deeply rooted in the mind and very difficult to treat. Because some forms of addictive behavior—to shopping, for example, or to accumulating wealth or to falling in love—are socially acceptable, we do not see them for what they are and so do not see how many people struggle with addiction.
Options for the treatment of addiction are few. One can try to modify addictive behavior in ways that reduce its potential for harm, such as going from shooting heroin to oral methadone maintenance, or switching from compulsive overeating to compulsive exercising, or one can try to solve addiction at its root. The former method is practical, the latter very hard. Solving addiction at its root is hard because it demands restructuring of the mind at its core, where we experience the distinction between conscious awareness and the objects of awareness, between the perceiving self and what is perceived.
When people cannot stop reaching for the next snack chip or the next cigarette, it is as if chips and cigarettes control attention and behavior. In reality, the mind gives its power and control to the objects of addictive behavior. Freedom from addiction comes with awareness of that process and the ability to experience the object as object, without projecting onto it any undue significance. This is the essence of the Buddhist teaching that suffering comes from attachment, and to reduce our suffering, we must work to reduce attachment. Furthermore, Eastern psychology insists that thoughts are best experienced as objects of awareness, just like trees or birds in the world around us. We suffer emotional pain because we cannot stop attending to our thoughts, cannot stop seeing them as part of us and habitually giving them great significance. Yoga masters and Buddhist teachers recommend a variety of methods to break our attachment to thoughts. Some are practices intended to shift the focus of attention to something else—to the breath, for example, or to images in the mind’s eye, or to sounds. Others aim to develop the power of attention and increase voluntary control of it or to promote awareness of the important distinction between the self and thoughts.
I should mention that talk of stopping thoughts or detaching from them makes some people in our culture uneasy, even terrified. Intellectuals and academics who base their careers and livelihoods on clever and creative thinking may equate these goals of Eastern psychology with losing one’s mind. If you have such concerns, you might do better with Western therapies that train you to modify thought without denying the validity or importance of thinking. Personally, I find both approaches effective. Just as I have found value in integrating Western and Eastern medical philosophies in my work as a physician, I have found it useful to combine Western and Eastern psychological approaches to tackle the challenge of managing thoughts that produce anxiety and despair and prevent us from enjoying spontaneous happiness.
Let me review the Eastern methods that have helped me and that I recommend most often to others.
Mantram (or mantra)* refers to the practice of silently repeating (in the “mind’s ear”) certain syllables or phrases. It is a way to distract the mind from thoughts, putting attention on sounds or words believed to have spiritual significance and positive effects. Most often associated with Hinduism, Buddhism, and other Eastern religions, it is also a Western religious practice, as exemplified by the Roman Catholic Rosary and the Jesus Prayer of the Eastern Orthodox Church.* The most common Hindu mantram is the syllable aum (or om), representing the essence of the universe; the most common Buddhist formula is om mani padme hum, a Sanskrit phrase referring to the “jewel in the lotus [of the heart],” a symbol of enlightenment. Suitable phrases are available from nearly all spiritual traditions, from Native American to Jewish.
Some contemporary psychologists, however, recommend mantram as a purely secular method of diverting attention from troublesome thoughts in order to reduce anxiety, anger, and stress. One spiritual teacher and author of books on meditation, the late Eknath Easwaran (1910–1999), likened repetition of a mantram to the bamboo shaft given to elephants in festival processions in India to keep them from grabbing anything they can as they go through the narrow passages of street markets:
The elephant steps right along with his stick held upright in a steady trunk, not tempted to feast on mangoes or melons because he has something to hold on to. The human mind is rather like the trunk of an elephant. It never rests… it goes here, there, ceaselessly moving through sensations, images, thoughts, hopes, regrets, impulses…. But what should we give it to hold on to? For this purpose I recommend the systematic repetition of the mantram, which can steady the mind at any time and in any place.
Using Easwaran’s The Mantram Handbook, several researchers have documented the efficacy of this method to improve emotional well-being. One study, published in the Journal of Continuing Education in Nursing in 2006, measured outcomes of a five-week program of mantram practice in a population of health care workers (nurses and social workers, primarily female), who were experiencing high stress. Participants were asked to choose a mantram from recommended sayings from the major spiritual traditions and were given wrist-worn counters to tally the daily frequency of repetition. They were asked to practice mantram repetition first during nonstressful times, such as before falling asleep, “to promote an association between the word and a physiological state of calm.” They were also taught concepts of one-pointed attention (“focused concentration on the mantram in the mind or on a selected task or activity of one’s choice, without multitasking”) and of slowing down (“living intentionally without hurry”). Then they were instructed to use the mantram whenever they felt stressed. The investigators found that the program reduced stress and improved the emotional and spiritual well-being of the participants. They concluded that “mantram repetition is an innovative stress-reduction strategy that is portable, convenient, easy to implement, and inexpensive.”
Other researchers have come to similar conclusions after testing mantram repetition in male veterans and HIV-positive individuals. Participants learned to use the practice to interrupt unwanted thoughts and elicit a relaxation response. Most reported that they found it helpful in a variety of stressful situations. This accords with my experience. After reading about mantram in my early thirties, I began repeating om mani padme hum to myself when I was falling asleep, driving long distances, or just sitting quietly. After a time, I found I could use it to break cycles of worrying that made me anxious or kept me awake. It has also helped me get through dental procedures and remain calm in the midst of turmoil. I do not repeat the words on any fixed schedule or keep count of the number of times I do it, but I’ve done it so often that I can now slip into it almost without conscious effort. Because mantram repetition is, indeed, portable, convenient, easy to implement, and inexpensive, I recommend it to you as a method worth trying to take your attention away from thoughts that make you anxious or sad.
Another alternative to thought as an object of attention is mental imagery. Visual imagination is powerful. It is mostly what we focus on when we daydream, and it can totally fascinate us when we engage in sexual fantasy. A significant portion of the brain, the visual cortex, is responsible for processing data coming from the retinas and optic nerves. When it is not occupied with that task, it is free to generate pictures of its own and act as a conduit between the conscious and unconscious mind, giving access to parts of the nervous system that regulate circulation, digestion, and other body functions normally considered involuntary. Meditation on visual images is a religious practice in Hinduism and Buddhism, where geometric designs of spiritual significance are used.* After studying these designs, practitioners learn to recall them in the mind’s eye. Apart from its religious purpose, this sort of meditation is said to calm the mind and body. (C. J. Jung incorporated the use of mandala into his psychoanalytic work with patients; one Jungian analyst, Gerald Schueler, writes that “chaos in our lives can be transformed into order by the psychic process of drawing a mandala, a universal psychic symbol for order.”)
Visual images that we pay frequent attention to can determine the set point of our emotions just as habitual patterns of thought can, possibly more so because they influence physiology so strongly, evoking visceral responses associated with feelings. To get a sense of their power, close your eyes and picture a lemon wedge, freshly cut and glistening with juice. Concentrate on making the image as clear and detailed as you can. Then visualize bringing the lemon to your lips, sucking on it, and biting into it. As you do this, chances are you will experience sensations in your mouth and salivation, just as if you had sucked on an actual slice of lemon. Or consider how rapidly visual fantasy can lead to sexual arousal. Practitioners of visualization therapy and interactive guided imagery teach patients to modify health conditions by taking advantage of this mind/body phenomenon, often with good results. Over the years, I’ve referred many patients to such therapists and have seen improvement in problems ranging from atopic dermatitis (eczema) and autoimmunity to cancer and recovery from surgery.
For the purpose of optimizing emotional well-being, I recommend experimenting with visualization in two ways. The first is to practice shifting attention from negative thoughts to mental images that evoke positive feelings. The second is to select an image that you associate with your most positive moods and focus on it frequently. For example, think of an actual place where you experienced contentment, comfort, and serenity. Re-create that scene in your mind’s eye, and each time you do, concentrate on sharpening the detail, making the colors brighter, even imagining sounds, physical sensations, and scents that might have been part of the experience. Keep that image as a place you can go to in your mind whenever you feel stressed, anxious, or sad. One place I visit in this way is a secluded pool in a small canyon in the Rincon Mountains east of Tucson, Arizona, where I have had many happy hours lying on polished rocks, dipping into the clear water, being soothed by the sound of running water and awed by the scenery of the Sonoran desert. Even if I am in a New York City subway or a traffic jam in Beijing, I can take myself there in a heartbeat just by closing my eyes. Then I can reconnect with the contentment I experienced there.
Putting your attention on your breath is another way to take it off your thoughts. The breath is such a logical and safe object of attention that it is the most commonly used focus of meditation. The more you can train yourself to shift attention away from emotionally upsetting thoughts (or images), the better off you will be, and the breath is a very safe place to shift it—rather like putting your mind’s engine in neutral.
Breath links body and mind, consciousness and unconsciousness. Working with the breath is one of the main components of yoga for three reasons. First, it gives access to the involuntary nervous system and makes it possible to influence cardiovascular, digestive, and other functions ordinarily beyond conscious control. Second, it is a way to calm the restless mind, facilitating one-pointed attention and meditation. Third, it promotes spiritual development and well-being, a subject I will return to in the following chapter.
For many years, I have taught medical students and doctors the importance of breath and the practical utility of breath control to improve physical and emotional well-being. I have also taught most of my patients and many thousands of others the simple rules of breath work:
| 1. | Put your attention on the breath whenever possible. |
| 2. | Whenever you can, try to make your breathing deeper, slower, quieter, and more regular. |
| 3. | Let your belly expand outward when you inhale. |
| 4. | To deepen breathing, practice exhaling more air at the end of each breath. |
The correlation between breathing and emotions is a dramatic example of mind/body unity. When people are anxious, angry, or upset, their breathing is always rapid, shallow, noisy, and irregular. Slow, deep, quiet, regular breathing simply cannot coexist with emotional turmoil, and it is much easier to learn to regulate the breath than to will negative moods to end. The most effective anti-anxiety measure I know is a quick and simple breathing technique that I call the 4-7-8 breath. Here it is:
This can be done in any position; if seated, keep the back straight. Do this exercise at least twice a day and, in addition, whenever you feel stressed, anxious, or off center. Do not do more than four breaths at one time for the first month of practice but do the exercise as often as you wish. After a month, if you are comfortable with it, increase to eight breaths each time and gradually slow your counts down. The minimum practice is then eight breaths twice a day, every day.
With practice, this will become a powerful means of inducing a state of deep relaxation that gets better over time. It will enable you to stop anxiety in its tracks and will convince you that you have the ability to control your reactions to potentially upsetting events and situations without relying on drugs or other external aids. You need only spend a few minutes a day on this practice, but you must do it at least twice a day without fail. By imposing this rhythm on your breathing with your voluntary nerves and muscles, you will begin to influence your involuntary nervous system toward more balanced functioning, with great benefits to overall health. Making the 4-7-8 breath part of your daily routine will increase your experience of serenity and comfort and give you greater emotional resilience. I have found it enormously helpful in stabilizing and improving my moods, and I cannot recommend it highly enough.
Apart from their value as practical methods of detaching from troublesome thoughts, mantram, visualization, and breath work provide opportunities to learn about attention. Attention is a tool of the mind. Think of it as a roving searchlight that brings to conscious awareness whatever it illuminates. We can direct our attention to objects both internal and external, and sometimes objects seize our attention. Unless we have had appropriate training, however, we often let our attention wander from one thing to another without maintaining its focus on anything for more than a few moments. Like light, attention becomes powerful when it is concentrated. Just as a magnifying lens can concentrate the energy of sunlight to ignite a fire, so can a focused mind concentrate attention to produce extraordinary effects. It is such one-pointed attention that is the secret of mastery of any craft, skill, or performance and of doing anything well, whether driving a car, cooking, or speaking in public. We all know the experience of being so absorbed in a task or activity that we lose track of time and become oblivious to almost everything except what we are doing, but few of us have learned how to develop that sort of attention in a systematic way.
“A Wandering Mind Is an Unhappy Mind” is the title of a report in the November 12, 2010, issue of the journal Science about an experiment conducted by two Harvard psychologists, Matthew A. Killingsworth and Daniel T. Gilbert. They developed an iPhone app that contacted 2,250 volunteers aged eighteen to eighty-eight at random intervals to ask how happy they were, what they were doing, and whether they were thinking about their current activity or something else. On average, the subjects’ minds were wandering 47 percent of the time and never less than 30 percent of the time (except when they were making love). Other findings were that people were happiest when making love, exercising, or engaging in conversation, and least happy when they were resting, working, or using a home computer—namely, situations that favor mind wandering. Describing the study, one of the researchers said, “Mind-wandering is an excellent predictor of people’s happiness. In fact, how often our minds leave the present and where they tend to go is a better predictor of our happiness than the activities in which we are engaged.” Furthermore, time-lag analyses of the subjects’ responses suggested that their mind-wandering was the cause, not a result, of their unhappiness.
Concentration literally means “gathering (something) to a center.” What we gather up when we practice one-pointed attention is conscious awareness. Instead of letting it diffuse aimlessly and drift into the unreality of past memories and future fantasies, we collect it and bring it together in the reality of the present. This is the essence of mindfulness. As I explained in chapter 4, mindfulness training is now widely offered; today, many health care professionals, including mental health practitioners, are using it as part of integrative treatment. There is no downside to learning to be more mindful. Not only can it help you deal with medical and emotional problems, but it can also make you more efficient and skillful in anything you undertake, improve your relationships, and allow you to experience life most fully—all the result of getting better at concentrating and focusing your attention. I encourage the physicians and allied health professionals who train at the Arizona Center for Integrative Medicine to cultivate mindfulness, and I often refer patients to mindfulness-based stress reduction (MBSR) programs. You can find a great deal of information on this form of meditation, derived from Buddhist practice, in self-help books and online, including web-based instruction.
Mantram, visualization, and breath work are all forms of meditation. Meditation is nothing other than directed concentration—holding the focus of attention on some object. Although many Westerners associate it with Eastern religions, there are Jewish, Christian, and Islamic forms of meditation, as well as purely secular ones intended to reduce stress and evoke the relaxation response. In Buddhist psychology, as distinct from religious Buddhism, meditation is emphasized as a powerful way to restructure the mind, which I find very relevant to the subject of this book. More than just a technique of detaching from unwanted thoughts, meditation can allow you to witness the productions of your mind, including thoughts, from a disinterested, nonattached, nonjudgmental perspective.
The modern spiritual teacher Eckhart Tolle puts it succinctly:
If you can recognize, even occasionally, the thoughts that go through your mind as simply thoughts, if you can witness your own mental-emotional reactive patterns as they happen, then that dimension is already emerging in you as the awareness in which thoughts and emotions happen—the timeless inner space in which the content of your life unfolds.
The stream of thinking has enormous momentum that can easily drag you along with it. Every thought pretends that it matters so much. It wants to draw your attention in completely.
Here is a new spiritual practice for you: don’t take your thoughts too seriously.
Meditation is certainly not a quick fix for anything. It is a long-term solution to the core problem of confusing awareness with the objects of awareness (including thoughts) and suffering as a result of attachment. In chapter 4, I told you that after forty years of practice, I still find it hard to meditate and maintain my focus of awareness on the here and now, noting thoughts and sensations as they arise without judging them or reacting to them. I also told you that making meditation a daily habit, shortly after waking in the morning, has been one of the ways I’ve kept my tendency to dysthymia in check. I wrote about the value of meditation in my first book, The Natural Mind, back in 1972, and I have continued to write and teach about it ever since.
Because practicing meditation can contribute greatly to an integrative program for optimum emotional well-being, I recommend that you give it a try. If you find the associations of meditation with religion in general and Eastern religions in particular an obstacle, look for books, audio programs, online instruction, or classes that teach purely secular forms. Simply sitting still and practicing keeping your attention on your breath is a tried-and-true method that anyone can do. Do it even for ten minutes a day, every day, and you will begin the process of restructuring your mind in a way that will bring you greater contentment, serenity, comfort, and emotional resilience.
I HAVE GIVEN you a menu of options for managing thoughts that make you depressed or anxious and get in the way of spontaneous happiness, options from both Western and Eastern psychology. But caring for the mind means more than dealing with your thoughts. In the following pages, I will discuss other mental factors that influence your moods and tell you what you can do to control them.
Sound has a direct and powerful influence on the nervous system and on our emotions. We become alert and often anxious when we hear sirens, people arguing, screeching tires, and wailing babies. A lullaby can soothe us and induce sleep. Chanting can focus attention and facilitate meditation. Most people are unaware of the effects of sound on the body and mind, even in the midst of the noise pollution so characteristic of cities and workplaces. I cannot exclude from this chapter information about protecting yourself from disturbing sounds and exposing yourself to sounds that make you feel good.
The most obvious correlations are with anxiety and insomnia. If you suffer from either, I urge you to pay attention to the sounds in your environment and find out how they might be affecting you. Two simple experiments are to turn off televisions and radios if you are not actively listening to them, and to notice how different kinds of music make you feel.
Music powerfully affects the brain and mind. It can make us calm or excited, can stir us to action or paralyze us with fear. If you are unaware of this power of music, you are likely to be careless about exposing yourself to kinds of music that worsen moods. It is all too easy to listen unconsciously to sounds that drive the nervous system away from calmness and centeredness.
In his compelling recent book, In Pursuit of Silence: Listening for Meaning in a World of Noise, essayist George Prochnik tells a story of going on patrol with a Washington, DC, police officer named John Spencer:
All of a sudden, at about three in the morning, Officer Spencer turned to me and said, “You know, I’ll tell you something. The majority of domestic disputes we get called into these days are actually noise complaints.” What did he mean? I asked. “You go into these houses where the couple, or the roommate, or the whole family is fighting and you’ve got the television blaring so you can’t think, and a radio on top of that, and somebody who got home from work who wants to relax or sleep, and it’s just obvious what they’re actually fighting about. They’re fighting about the noise. They don’t know it, but that’s the problem. They’ve just got everything on at once. And so the first thing I’ll say to them is, ‘You know what, don’t even tell me what you think you’re fighting about! First, turn down the music. Switch off the game station. Turn down the television.’ Then I just let them sit there for a minute, and I say to them, ‘Now, that feels different, doesn’t it? Maybe the real reason you were fighting is how loud it was inside your apartment. Do you still have anything to tell me? Do you?’ Well, you would be amazed how often that’s the end of it.”
If you have ever stayed in Las Vegas—I have attended more than one conference on health there—you know the experience of walking through hotel casinos and being unable to avoid the incessant sounds of slot machines. They take me far away from serenity and comfort, as do many other electronic beeps, pings, and buzzes, not to mention car alarms, leaf blowers, and jackhammers. If you cannot escape disturbing sounds, the new technology of noise cancellation gives you a way to protect yourself from them. Noise-canceling headphones detect environmental noise with built-in microphones and generate signals that neutralize it; they are readily available and affordable. Another possibility, especially useful in the bedroom, is to mask annoying sounds with white noise, which might sound like rushing air or running water. Portable white-noise generators are also readily available and affordable, and there are larger systems that can cover offices and whole houses. Some allow you to select from a range of sounds, from ocean waves to rain.
Apart from neutralizing or masking unwanted sounds, you can, of course, choose to listen to those that have positive effects on your moods. Unlike most electronic sounds, sounds of nature, such as wind blowing through trees and water running over rocks, are complex and may “nourish” the brain in some way. We evolved with the sounds of nature, and the relative lack of them in our artificial environments of today may be yet another cause of emotional malaise. There are many ways to bring healing sound into your living space. I have a set of very large bass wind chimes that make me happy whenever I hear them. The deepest tone has a remarkably long sustain that reminds me of the chanting of Tibetan monks. Whenever I notice it, I tend to close my eyes, focus my attention on my breathing, and let the sound flow through my body. I feel it as well as hear it. It always returns me to my calm center and often brings a smile to my face.
Finally, I recommend cultivating silence as an antidote to the emotionally unsettling effects of sound and noise. I will give you suggestions about that in the next chapter.
Exercising control over the sounds you let in is one aspect of what I call mental nutrition. We know a great deal about nutrition and health in regard to dietary choices and their influence on well-being and risks of disease. Most people, however, do not consider that what we allow into our minds is as important as what we feed our bodies and significantly influences our emotional well-being. It makes sense to be as careful about mental nutrition as about your diet.
If you habitually and unconsciously listen to sad music, read sad stories, and watch sad movies, chances are you will be sadder than if you choose happier input. If you habitually tune in to news programs that make you angry and distraught, chances are you will spend less time in the zone of serenity and contentment. The challenge is to exercise conscious control over what you pay attention to. The world is both wonderful and terrible, beautiful and ugly. At any moment one can choose to focus on the positive or negative aspects of reality. Without denying the negative, it is possible to practice focusing more on the positive, especially if you want to shift your emotional set point in that direction.
I advise you to take particular care with your choices of media. A great deal of the content is designed to induce excitement and tension. Often it exacerbates anxiety and the sense of being overwhelmed and out of control. I made “news fasting” a major component of my 8-Week Program for Optimum Health: start by excluding news in any form for one day a week and work up to total abstinence for an entire week. I’ve had much fun talking about the benefits of this strategy on national television news shows. (Not a few newscasters have told me privately that they wish they could do it.) A great many people who have done it report decreased anxiety and worry and increased happiness as a result of limiting their intake of news. With news actively foisted on us, it takes effort to keep it out of our consciousness. I very much resent being forced to listen to it in hotel elevators and at airport gates. And just as I started to write this, I received an unsolicited e-mail from an acquaintance recommending a website that allows you to click your mouse on any city on a world map and see the day’s headlines in the local newspaper.* “Double click and the page gets larger,” gushes the sender. “You can read the entire paper from some cities if you click on the right place. You can spend forever here.” Just what we all need.*
I will tell you some of the ways I control input to my mind. I pay attention to the effects on my mood of what I read, watch, and listen to for entertainment. I don’t watch television except when I’m on the road, and when I’m in a hotel room and flip around the ever-increasing number of channels, I am dismayed by how few acceptable options there are. I have no interest in shows about police and criminals. I do not care for mindless sitcoms and game shows, and I do not tune in to the news. I will watch documentaries: biography, nature, history, and science programs; and I look at the food channels from time to time. I do not read newspapers or newsmagazines but may scan Internet headlines or listen sporadically to National Public Radio. I never worry about being uninformed. If something important happens, someone always lets me know about it. When I sense that I am vulnerable to a slump in mood, I take extra care to nourish my mind well.
I am not an arbiter of taste, and it is not my place to tell you what to read, listen to, or watch. I just want you to be aware that the decisions you make about all of this affect your moods and emotions for better and worse. I urge you to make them mindfully.
News fasting is one way to control the amount and kind of information that comes into your life. Unfortunately for all of us, it hardly has an impact on a much bigger problem of quite recent origin that has serious implications for mental health and emotional wellness. We are told that we are living in the Information Age, that the revolution in collecting and disseminating information made possible by computers, the Internet, e-mail, mobile phones, and digital media is the defining characteristic of our times and the main force now shaping the evolution of human society. I agree. The problem is that a great deal of that information is irrelevant or suspect, and the sheer amount of it is drowning us. In addition, the media that deliver it to us are changing brain function, not necessarily for the better. In chapter 2 I wrote that of all the ways the modern environment and our genes are mismatched, I would cite the revolution in communication and information delivery as the one contributing most to epidemic depression.
Many scholarly articles are in print about information overload and its physical, psychological, and social consequences. Francis Heylighen, a cyberneticist* at the Free University of Brussels, in a 2002 article titled “Complexity and Information Overload in Society: Why Increasing Efficiency Leads to Decreasing Control,” writes:
We get much more information than we desire, as we are inundated by an ever growing amount of email messages, internal reports, faxes, phone calls, newspapers, magazine articles, webpages, TV broadcasts, and radio programs…. The retrieval, production and distribution of information [are] infinitely easier than in earlier periods, practically eliminating the cost of publication. This has reduced the natural selection processes, which would otherwise have kept all but the most important information from being transmitted…. The result is an explosion in irrelevant, unclear, and simply erroneous data fragments. This overabundance of low quality information has been called data smog…. The same applies to the ever growing amount of information that reaches us via the mass media…. The problem is that people have clear limits in the amount of information they can process.
When the amount of information coming at them exceeds those limits, people suffer. They are likely to ignore or forget information they need, be overconfident on the basis of flawed or incomplete information, and be less in control of their lives as a result. In the long term, information overload increases stress, with all of its predictable consequences for physical and emotional health.
I can easily see how my life and the lives of my friends and family have changed with the coming of the Information Age. When I was growing up, both my parents worked, and worked hard, but when their workday ended, it ended, and we could be at home as a family to prepare and eat dinner together, and after cleaning up, read or watch a favorite show on television. Usually I had homework to do for school, and my mother might sew or finish hats for the millinery shop she and my father owned, but our evenings were largely relaxed. With the advent of fax machines, portable phones, computers, and, most of all, e-mail, I found that my workdays never ended; work-related communication and information began to invade all of my waking hours. Then, as the Internet developed and I became more proficient at using it, I no longer needed to go to libraries or consult reference books. Today I can get almost any kind of data I need or want within minutes, sometimes seconds, on my home computer: historical facts, medical references, song lyrics, recipes—just about anything. I can communicate almost instantly with people around the world and do television interviews without leaving my desk. Much of this is great—I can’t imagine going back to encyclopedias and snail mail. Unfortunately, I also notice changes that I don’t like at all.
For one thing, I experience time passing more quickly. It seems as if the Christmas holidays come around faster and faster, for instance. I know that most people find time speeding up as they age,* but I was quite surprised a few years ago when my daughter, then twelve, told me she and her friends had the same experience. I remember time passing ever so slowly when I was her age; summer vacations seemed very long, and Christmas did not come around before I was ready for it. I think it is information overload that has altered our subjective sense of time by giving us more data to process moment by moment, hour by hour, day by day. There is more happening per unit of time, more to attend to. As convenient and useful as I find the new technologies of communication and information, I also blame them for making me feel as if I never have enough time to catch up. Often I am overwhelmed by all the e-mails and calls and messages I have to return and feel frantic by midafternoon. I find that I don’t have—or take—time to read as much as I did in the past and that I must force myself to stop thinking about communications and data processing when I get into bed at night if I am to get restorative sleep.
Clearly, information overload is inimical to focused attention. As I wrote earlier in this chapter, focused attention is the essence of mindfulness and the key to mastery of any activity, as well as a mental skill worth developing in order to be happier. So much information coming at us on so many channels forces us to try to attend to more than one thing at a time—to multitask. A great deal of psychological research suggests that performance suffers when people try to do even very simple tasks at the same time. With more complicated ones—such as driving while talking on a mobile phone—the risks are obvious. The reality is that the human brain cannot attend to two or more tasks simultaneously; at best it can rapidly switch back and forth from one thing to another. It is possible that people can become proficient at this kind of switching and that kids raised on video games and multimedia develop mental skills that older folks (like me) don’t. Children of the Information Age may even have better brain function for specific tasks, such as the hand-eye coordination required to win at video gaming. Nonetheless, I observe a collective decrease in attention span in our society, and I see it as another detrimental effect of information overload. For example, when I watch television dramas or contemporary movies, I am struck by the shorter duration of scenes relative to those of the past. And I cannot help feeling that the rising incidence of ADHD (attention deficit hyperactivity disorder) in young people is a manifestation of the same problem.
The new technologies may affect brain activity in other ways, with as yet unknown long-range consequences. How I write has changed as I’ve adapted to word-processing on a computer instead of composing on a typewriter. A lot of the work of word crafting and revision that I used to do in my head (to avoid having to correct or redo typed pages) I now do on the computer screen. I can’t imagine going back to the old, cumbersome way of typing out articles and whole books, but I wonder if I have lost some worthwhile mental ability with the change. I resist using GPS navigation systems in cars, because I like relying on my intuition and sense of direction to get where I’m going and don’t want to lose those. A colleague who teaches physics to undergraduates at a large university in a neighboring state tells me he has had to “dumb down” his courses in recent years. He thinks computers and calculators have eroded students’ intellectual skills; none of them know how to use a slide rule to solve problems, and some cannot add columns of figures.
I mentioned above that inability to process excessive information can make people feel less in control of their lives. That feeling and an associated sense of helplessness are strongly correlated with emotional disorders, with both depression and anxiety. If you pay the most attention to the aspects of your environment and the world that are dreadful, and you feel powerless to change them, you are not likely to enjoy emotional serenity, contentment, and comfort, especially if you are also feeling overwhelmed and swept along by an accelerating rush of time.
Finally, I fear the Information Age might just as well be termed the Age of Social Isolation. We are spending more and more time interacting with other people virtually or not interacting with them at all as we surf the web and indulge in the many forms of escapist fantasy available through multimedia. Social isolation undermines emotional well-being and predisposes us to depression. We must be proactive to avoid it.
I have learned that the hard way. Shortly after I got my first home computer, a friend introduced me to a challenging game with elements of mystery, quest, and treasure hunt in a world of fantasy. I got hooked quickly and found myself staying up until the wee hours three nights in a row, glued to the screen. The following morning I deleted the software and resolved never to do anything like that again. Years later, however, I had to work hard to break the habit of surfing the web for hours, one engaging site leading to another and another, adding up to a similar waste of time. Finding my peace with e-mail has been even more of a challenge, as it has become my preferred way of communicating and keeping in touch with friends and associates. I now do e-mail almost exclusively on my desktop computer, almost never on my cell phone or notepad. The computer stays in my office, and when I leave my office for the day, usually in the afternoon, I leave it and e-mail behind until morning. I recommend that you make similar rules for yourself, lest e-mail take over your life.
I’ve had an easier time with cell phones for the simple reason that when they came into my life, I lived in an area with no reception (at the base of a mountain range southeast of Tucson). Although I’ve recently moved from there, my habit of using my cell phone only when I’m away from home and then sparingly is well developed. My daughter taught me to text a few years ago, but I have no problem saving that for exceptional situations. And I am not tempted by the many apps I could install on my smartphone, which many people find so fascinating and use in ways that remind me of my obsessive web surfing of the past. I have consciously worked to change my relationship with telephones in general. As a result of my training in hospitals, for a long time I found it hard not to pay attention to a ringing phone; I felt compelled to answer, even when I was no longer caring for patients. For years, I would run to the phone whenever it rang—from another room or even from outside, more often than not getting to it just as the caller hung up, and feeling frustrated and angry as a result. When answering machines appeared, I thought they would help, but I grew to dread coming home to a long series of recorded messages. These days I no longer let ringing phones command my attention or draw me away from what I’m doing. I’m comfortable with letting many calls go to voice mail. And I like getting those messages as e-mail attachments. I’d say it’s taken me thirty years to get to a good place with telephones.
Research helps explain why we find it so difficult to ignore the digital devices that are ever more prominent in our lives, why it takes so much effort to resist checking e-mail before you go to bed, for example, or disregard the beep telling you a new text message has arrived on your cell phone. B. F. Skinner’s experiments with rats and pigeons are very relevant here. When caged animals get the reinforcement of a food pellet in response to pressing a bar or button, how hard they will work for the reward is a function of how it is presented: after a fixed or variable interval of time or after a fixed or variable number of presses. Variable ratio schedules of reinforcement—where the food pellet comes after a certain number of presses but that number varies unpredictably from one reward to the next—control behavior most powerfully. Animals will work themselves to exhaustion when bar pressing is reinforced in this way. That’s exactly how slot machines pay off, and humans will work relentlessly to get money from them. I’m afraid the compulsion to check e-mail frequently is comparable. Once in a while you get a reward—maybe news of a business success or a love note or a video that makes you laugh out loud—but rewarding e-mails come in on variable ratio schedules in response to your behavior, which is why it’s so hard to stop checking to see if one has landed in your inbox.
Furthermore, the sounds that our digital devices make may stimulate dopamine release in the brain. Recall that dopamine is central to the brain’s reward system and our experience of pleasure. As annoying as I find the electronic sounds in casinos, people who love gambling (or are addicted to it) find them pleasurably stimulating. It appears that many people now depend on the dopamine-mediated stimulation provided by personal digital assistants, portable phones, video games, and other devices; without it, they are bored.
I’ve made Limiting Information Overload a major component of the program I will present in the last section of this book and will suggest other strategies for you to try. There is no one right way to do it, but in order to protect your emotional well-being from the harmful effects of data smog and the new media, I think you must decide how connected you want to be and how much of the time and stick to reasonable limits.
I’ve told you that when I was engulfed by dysthymia, I shunned social contact. I rationalized this behavior by telling myself I was in no shape to be out and about, that I didn’t want others to see me so off center and didn’t want to expose them to my gloom. In retrospect I see social isolation as both a central symptom of my depressions and a major contributing factor to them. When I closed myself to social contact, I slipped into a default state of depressive rumination: going inward, focusing on my thoughts, and chewing on the same negative ones over and over.
Social interaction supports emotional wellness. People got much more of it when they lived in tribes and real communities; there is much less of it in our modern world. At the beginning of the twentieth century, families were typically larger and more stable, divorce was less common, and relatively few people lived alone. In 1900, only 5 percent of US households were single-person households; by 1995, 10 percent of Americans lived alone, and now that number has increased to 11 percent, or roughly 31 million. Not surprisingly, this trend is linked to an increase in the prevalence of loneliness.
A 2006 study in the American Sociological Review found that Americans on average had only two close friends to confide in, down from an average of three in 1985. The percentage of people reporting having not even one such confidant rose from 10 percent to almost 25 percent. One estimate is that 20 percent of people in the United States—about 60 million—feel lonely. Loneliness is common in large cities. Despite being surrounded by millions of others, many city dwellers experience absence of identifiable community. Of course, those in small towns and villages can feel lonely, too, but the sheer number of people with whom one comes into contact every day in a big city seems to work against meaningful interaction and increase the sense of being cut off and alone.
Social isolation and loneliness are strongly correlated with depression. In his classic work, Suicide, Émile Durkheim (1858–1917), the father of modern sociology, wrote, “Man cannot live without attachment to some object which transcends and survives him…. [If] we have no other object than ourselves, we cannot avoid the thought that all our efforts will finally end in nothingness, since we ourselves disappear.” Of course, existential loneliness is an inescapable part of the human condition, but you have a lot more time to dwell on it if you live in isolation, focused on yourself. Durkheim attributed depression to social isolation and argued that it is one of the common causes of suicide. Recent research on the psychological effects of solitary confinement of prisoners suggests, to put it bluntly, that people lose their minds when they are completely deprived of contact; growing awareness of this truth may one day end the practice of putting prisoners “in the hole” as cruel and unusual punishment.
Researchers have documented an association between Internet use and social isolation as well as depression among adolescents. (It is not clear whether high Internet usage weakens social ties or whether young people with poor social ties gravitate toward Internet activity; I suspect that it works both ways.) Increasingly, lonely people of all ages are flocking to Internet sites to find help or reduce their emotional pain. Put “I am lonely” into a search engine, and you will find many sites that offer virtual interaction with other lonely souls. Maybe this shared electronic space provides some comfort, but I doubt that it offers the emotional protection of the real thing.
For much of my adult life I lived in relatively remote places, often on the borders of wilderness. I enjoyed the rewards of living close to nature, away from noise, traffic, and pollution, but that was at the expense of enjoying much company. Few people wanted to drive so far over rough roads to visit me, and it took a lot of effort to get myself to go into town to spend time with others. I thought I liked it that way, because I’m often on the road teaching, speaking to large audiences, and appearing on television and radio, and when I get back from such trips, I want to hide out. But I’ve come to realize that my preference for living away from people is not good for me. Writing is a lonely occupation to begin with, and being physically isolated has only made it easier for me to ruminate on thoughts that make me unhappy, no matter how beautiful the scenery. Finally, in my late sixties, I have admitted to myself that I need more quality time with people. I can no longer ignore the fact that my moods are greatly influenced for the worse by social isolation and greatly lifted by social interaction.
In 2010, I put my rural property up for sale and moved into a comfortable house in Tucson, the first time I’ve lived in a town in almost fifty years. Pulling up roots and moving were difficult, but within a few weeks I began feeling at home in my new place and very pleased that I no longer had such a long drive if I wanted to meet people for a meal or an outing. It is also much easier to invite friends over.
Many aspects of contemporary life promote social isolation. We live in nuclear families, not tribes. We learn to be suspicious of strangers, to look out for ourselves. We have grown accustomed to the impersonal nature of many of our interactions. We are seduced by virtual reality, multimedia, and forms of communicating that merely simulate real contact. If you want to be in optimum emotional health, realize that social isolation stands between you and it. Reach out to others. Join groups—to drum, meditate, sing, sew, read, whatever. Find communities—to garden, do service work, travel, whatever. We humans are social animals. Spontaneous happiness is incompatible with social isolation. Period.