133. Pay Attention! (Your Body Will Thank You)

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I cannot think of an academic whose research findings have more consistently surprised me than my guest today, Harvard psychologist Ellen Langer.

She's a scientist, but her results seriously challenge the beliefs of mainstream science.

So I had literally made myself sick.

And that set me off on a career where if I can literally make myself sick, then maybe I can literally make myself well.

Welcome to People I Mostly Admire with Steve Levitt.

I've got a model in my head of how the world works, a broad framework for making sense of the world around me.

I'm sure you've got one too.

My model is, I think, pretty typical of someone who puts faith in modern science, perhaps with a little added cynicism about human nature.

So when I hear about a new research study, I have a habit of asking myself, given my model of the world, what results would I expect the study to generate?

Usually I'm pretty good at guessing what the researchers actually find.

But with Ellen Langer, over and over and over, she gets results that I would never predict.

So here are my questions for you as you listen to this conversation.

First, Do you find her research results as stunning as I do?

And the second question I'd like you to think about is, when when research findings surprise you, what's the right reaction?

How do you know whether you should believe surprising results?

I've read the work of many scholars and I can honestly say that you win the prize for the body of research that most consistently finds results that are completely the opposite of what I would have predicted.

You and I have completely different models of how the world works.

And the data keeps supporting your model.

But before we get into those models, I just want to let the listeners hear you describe one of your experiments.

So how about you start with your counterclockwise study?

That's a famous study, Steve.

I can call it famous because if you tune in to The Simpsons Go to Havana, they actually describe it.

So if people don't understand what I'm saying, they can go to that episode and get it reviewed.

This was the first test of our mind-body unity theory, which basically just said mind and body should be best seen as one thing, which gives us enormous control over our health and well-being.

So the first test of this, what we did was retrofit a retreat to appear to be 20 years earlier.

We started with the monastery.

We took out the religious objects and just filled it with magazines and posters and whatever of the 20 year earlier time.

And then we had elderly elderly men live there as if they were their younger selves.

So they were going to be talking about past events.

They would be shown movies, television shows of that earlier time.

Everything was to play out as if it were 20 years earlier.

I was on a low budget, so it wasn't quite Hollywood, but it served its purpose.

So 1959 was the particular year that you chose.

Right.

And they weren't even allowed to talk about anything that happened after that.

No, no, no.

You had to literally live like you're 1959.

Yeah, we did several things before the start of the study.

We sent everybody photos of everybody else that was going to be in the retreat, but photos of their younger selves.

So we did as much as we could to help people step back in time.

And the point of it was that if your mind was going to step back in time and mind and body are one, then the presumption would be that your body, in as many ways as possible, would also seem to be from that earlier time.

And they were there for about a week.

And you had a control group of sorts?

The control group was also to spend a week in the same retreat and they would be talking about all the same things that the experimental subjects were speaking about, all the past events.

But they spoke about them as if they were in the past.

The way we would speak about those same events ourselves now.

Before we talk about the results, what outcomes did you measure?

We measured everything we could think to measure.

You know, what I did was to call geriatricians and I said, okay, if I had a 50-year-old man in one room and a 90-year-old man in another room, what measure would I take that would lead you to know which was who?

So we had measures of strength, we had measures of memory, we had all sorts of health and biological measures and so on.

What did you find?

Simply by putting their minds back to an earlier time, their vision improved, their hearing improved, their memory, their strength, and also they looked noticeably younger.

And I've never heard of a person in their late 80s, 90s having their hearing improved.

Even with medical intervention, it's a very rare thing.

It wasn't until after running the study that I realized that even for the comparison group, this was going to be a very very mindful experience.

Here were people who, as elderly men, were over-cared for,

not in any way acting as their younger selves, having given up much of their vitality and so on, all of a sudden were thrown into a whole new environment where they were in charge of their own lives.

They were to make their own meals and so on.

So they went from being very cared for to now being on their own.

And had I thought about that before the study, I would have expected that they too would improve, just not as much as the experimental group.

So imagine we were colleagues

and we were having lunch before you did the study.

You told me you were planning to run this experiment.

Now, let's assume that I liked you and I wanted good things for your career.

I wouldn't be having lunch with you if I didn't assume that.

I would have said, my God, do not waste your time doing this experiment.

It is completely obvious that you will find nothing.

It is preposterous to think that listening to old radio shows and watching old movies could possibly impact anyone's eyesight.

So, save your time and your research budget and go do something worthwhile.

I'm sure plenty of other people must have said that to you too, didn't they?

No, I didn't talk to people about it, so I didn't get to hear their views.

Otherwise, I might have been discouraged.

But you know, Steve, I did research back in the 70s.

Judy Rodin and I did research in nursing homes where we gave people choices, encouraged them to make decisions, and basically to come alive.

In retrospect, it was really teaching people to be more mindful.

And 18 months after the study, more people in the experimental group were still alive than in the group that was just given tender, loving care.

So I have a history of surprising myself and people like you.

I guess it's because I start off with less certainty than most people have.

I mark the edge of the nurture part of the nature-nurture continuum so that my explanation for why this 90-year-old seems to have more energy, let's say, than this 40-year-old would not be because of an assumption of a difference in their genetic makeup.

I start off believing that so much more is possible than most of us realize.

Now, my first reaction to hearing the findings of your counterclockwise study would have been, well, that result will never be replicated.

It has to be a fluke.

But it actually has been replicated a number of times, right?

Yeah, and in different ways.

I mean, to me, the important thing was the test of the mind-body unity idea.

The next study in that series was a study Ali Crum and I did where we took chambermaids.

And first thing, we just asked them how much exercise they get.

And surprisingly, they don't think they get any exercise because they think exercise is what you're supposed to do after work, and after work, they're just too tired.

So for the study, what we did was very simple.

We just taught half of them that their work was exercise.

Different things that they're doing, making beds, cleaning the windows and what have you, were likened to working in different machines at the gym.

And so at the end of this, we found that this group wasn't working any harder, eating any differently.

Everything was basically the same as the group that wasn't taught this change in mindset.

So there's no intervention other than teaching.

Exactly.

Nothing can possibly happen.

But something happened.

And what happened was by simply changing their mindset, realizing that their work was exercise, they lost weight.

There was a change in waist to hip ratio, body mass index, and their blood pressure came down.

We have such control, making ourselves sick, making ourselves healthy.

And I think people are largely oblivious to this.

But let me tell you one more of these mind-body studies.

The most recent one I did with my graduate student, Peter Ungel.

So we inflict a wound, not a big wound because we're not satisfied.

And even if we were, the powers that be would not let us do it.

So it's a minor wound.

And the people who've got this wound are sitting in front of a clock.

Unbeknownst to them, the clock is rigged.

So the clock is going twice as fast as real time, half as fast as real time, and in real time.

Now you would say, so what?

Who cares about the clock, right?

The wound will heal when it heals.

But it turns out that the wound healed based on perceived time.

Wow.

In the medical world, you ask the doctor, how long is it going to take for me to heal from whatever the surgery, for example.

And typically, they're going to give the longer part of that so you don't feel bad that you didn't heal quickly or maybe the average healing.

Science, whether it's medical science, psychological science, only gives us probabilities.

When you believe something is absolute, your expectations are sealed and it becomes a self-fulfilling prophecy.

It might be better for people to be told the quickest healing time that's known.

And see, some people heal as quickly as because they can't know.

You have one other study I want to talk talk about before we get into broader issues.

Only one?

It's the study you did where you went into a nursing home and you were working on memory loss.

And so you asked the nursing home residents different questions over the course of three weeks to test whether they could remember things better.

Things like how many nurses' names do you know or whatnot.

And there, actually, you found something that I expected, which is that if you challenge people's memory and they know you want them to remember better, they actually started remembering a bunch of things.

Yeah, it's not so much the challenge is that if there's no reason to remember, you're not going to remember.

During the summers, I'm not teaching, you know, let's assume I'm playing tennis at 10 in the morning every day, then Tuesday is the same as Thursday and so on.

And even a simple question, what day is today, I wouldn't quickly know.

And it's not because I'm old, it because it doesn't matter.

And so all we did in the study was to make remembering matter.

And when it mattered, people remembered.

What makes it your study is that you went back two and a half years later and the people who you had intervened with by asking a few questions over the course of three weeks, 7% of them had died two and a half years later.

33 and 27 percent of those comparison groups.

had died.

You had, through this intervention, seemingly radically changed mortality rates to a degree that that I think you would be hard pressed to find any pharmaceutical compound which has had that kind of effect in a controlled study.

There are several studies, starting with the first one in the nursing home, where we gave people control, made people mindful.

People need to understand when I'm talking about mindfulness, it has nothing to do with meditation.

Meditation is a practice that you engage in, presumably to result in post-meditative mindfulness.

Mindfulness, as I study it is more immediate.

It's the very simple process of noticing.

And as you notice, the neurons are firing and the study that you suggested and several others shows that it's literally and figuratively enlivening.

And if you ask somebody how much of the day are you noticing, aware of what's around you, and so on, people would think, virtually all the time.

Sadly, much of the research has shown me that virtually all of us, much of the time, are mindless.

We're not there.

And Steve, when you're not there, you don't know you're not there.

And it's because of those absolutes that I mentioned a moment ago that leads us not to be there.

If you knew what I was going to say next, why would you listen to me?

And we're not paying attention, the system more or less is turning itself off.

And being there is so easy.

You sit up and you pay attention.

And when you do that, you're engaged and it's exciting.

And we have so many findings of the advantages of being mindful.

The neurons are firing.

You end up happier, healthier.

In some sense, you light up.

People find you more appealing, more charismatic, more authentic and trustworthy.

We even find that it leaves its imprint on the things that you're doing.

If you do something mindfully versus mindlessly, people tend to prefer the mindful version of it.

Everything seems to change.

I've been doing this for, gosh, 45 years.

It's just better for us.

We come alive when we're engaged, and becoming engaged follows from our knowing that we don't know and the fun in finding out.

We'll be right back with more of my conversation with psychologist Ellen Langer after this short break.

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I'd love to spend a little time diving into how you define mindfulness, because I've always struggled a little bit at understanding what people mean by that.

How does your version of mindfulness differ from the more spiritual version that comes out of Eastern religion?

To become mindful from the Eastern perspective, you have to meditate.

My work is all about mindfulness without meditation, although I did some very early work in the 80s on meditation.

Years and years ago, when I started studying this, I was studying mindlessness.

And I was studying mindlessness because I would walk into a store and walk into a mannequin and apologize.

And I'd say, well, wait a second.

I'd notice things that I was doing that didn't quite make sense to me.

I wish I could remember who this person was, but there was somebody, not such a nice person, maybe it's good that I don't remember who it was, who said to me, you know, you are what you study and i said that's interesting and then i turned it around and i started studying mindfulness one of the things i've heard you say about mindlessness is that people when they're in a mindless state they're typically in error but rarely in doubt yeah no it's that's very important because when you're mindless it's not even that you're saying to yourself that you're certain you just proceed without any doubt And people run away from doubt without recognizing if you don't have doubt, then you don't have choice.

People don't want doubt, but they want choice.

The most important way from a top-down perspective to become mindful is to appreciate uncertainty.

That with everything changing, everything looking different from different perspectives, you can't know.

Now, what happens is individually when we don't know, sometimes we're afraid.

I think I'm supposed to know.

I don't know.

I don't want anyone to know I don't know.

So then I pretend or I avoid.

And I'm here to free everybody to say nobody knows.

I think that the most powerful position one should assume is one of being confident but uncertain.

Was there such a word as mindfulness before you came around?

Did you invent it?

It existed in Buddhist literature, but in this country it was not on people's tongues.

Once I started using the term mindfulness, I started to become aware of Buddhism and so on.

And to me, it was very exciting that things that I had come to from this Western scientific perspective were so in line with that which had been around for a very long time from the more Eastern perspective.

I mean, now, every place you look, a while ago, this was the funniest for me, I had just given a talk on mindfulness in Chicago, and I go outside and around the block, and there's a restaurant, the Mindful Burger.

Somebody once called me, it was somebody doing her PhD, and wanted to know was mindfulness a fad?

And I was a little offended, but I thought about it for a moment.

And I said, okay, let's say you burn your toast every morning.

And then somebody comes along and shows you, all you need to do is turn the dial down a slight bit.

And then the toast is no longer going to burn.

Is it a fad?

I mean, you're not going to go back eventually to burning your toast unless you preferred it that way.

It's not just paying attention because, well, attention is necessary, it's not sufficient.

There has to be the activity of coming to understand something that was novel, something that's new.

When I started to paint, I'm 50 years old.

Prior to that, if you had asked me what color are leaves, I would have said, mindlessly forgetting about the fall when leaves change color, I would have said they're green.

Then I start painting and I start seeing more.

You look at trees and they're hundreds of different color greens that change as the sun changes in the sky, changes in the seasons and so on.

Once you wake up, there's just so much more.

Everything feels new and potentially exciting.

In your studies, you teach people to have a mindful approach.

What's the process of opening people up to that state of being?

There are three things.

The first was for people to respect uncertainty and to make a universal attribution for not knowing rather than a personal attribution.

Nobody knows.

So then everything is there to be found out and that will necessarily make you mindful.

So the respect for uncertainty.

The second is ask yourself, you know, walk out your door and notice three new things.

Notice three new things about the person you may be living with.

three different ways of doing whatever you're doing.

Look for multiple answers to any question that you're asked and so on.

And the third way is when we're learning something, not to learn it the way most of us have sadly learned most of the things we know with absolutes.

The best way to learn is to learn conditionally.

Rather than is, you should learn could be, would be, possibly.

It would seem that, might be.

And when you know that it could be, you're open to possibilities that otherwise won't occur to you.

Right now, we get our A's in school by memorizing facts, but these facts are context-dependent.

The one thing everybody knows is how much is one in one.

So, Steve, how much is one plus one?

Two.

One in one may be two, but if you're using a base two number system, one plus one is written as 10.

If you add one watt of chewing gum plus one watt of chewing gum, one plus one equals one.

So now you have one plus one can be one, can be two, can be ten.

It's a very different world that we create for ourselves.

Imagine a teacher asks young students, how much is one plus one, and little Steve says one.

What's going to happen?

In most classrooms, a teacher is going to try not to look at you like you're stupid.

You're going to feel uncomfortable and possibly set the stage for a lifetime of feeling stupid.

Where if the teacher were mindful, the teacher would say, little Stevie, how did you come to that?

And then you'd say, if you add one pile of sand to one pile of sand, one plus one is one.

And now everybody would have learned something.

So everything we're learning is absolutes, makes us think we know and we don't know.

And when you think you know, you no longer pay any attention.

It makes us evaluative of other people who may see a different world.

I wouldn't have called it mindful when I was.

a young academic doing my PhD, but it was how I lived my life because it was a new adventure.

I was trying to find ways to say new things about the world.

And I looked around with a open-minded curiosity, unsure what was true or untrue, willing to challenge in a friendly sort of way every piece of conventional wisdom.

And any interesting research I ever did was because somebody said something and I thought, that doesn't seem right.

A lot of times, turns out people were right, but sometimes that things people believed didn't turn out to be true in the data.

I just stopped being an interesting academic because as I got older, I became more and more internally focused.

Not necessarily sure I know the answers.

I just found my center was inside of me instead of outside of me, and that wasn't good for making discoveries.

Or good for your health.

Probably.

For me, I know exactly what it is that is in the way of me being in a mindful state.

And that is that my natural resting state is a very active dialogue inside my head.

And that dialogue takes up, I don't know, 80%

of all of my attention and brain power.

As soon as I pause that dialogue, it is like I flip a switch and suddenly I'm noticing things around me and I'm more playful.

Is there some evolutionary things to anyway?

Or why is it so difficult for me, even when I appreciate mindfulness, to unlock it from this natural state.

So basically, really, the question you're asking is, why are you so stressed?

And we have a culture that says, well, everybody is stressed.

Work has to be stressful.

I don't agree with any of that.

What people need to understand is that events don't cause stress.

What causes stress are the views you take of the event.

If you open it up and take a more mindful view, knowing that things can be understood in multiple ways, you're not likely to choose the one that's driving you crazy.

This is one thing I say frequently now for which I don't have data, but I believe that stress is our biggest killer.

If you took people who are given some dread diagnosis and you let them get used to it after a few weeks and then you start measuring their level of stress, that would predict the course of the disease over and above genetics, nutrition, and dare I say, even treatment.

That's how important I think stress stress is to our well-being.

And again, given that stress is psychological, that suggests that we can control it.

And I think that there are lots of ways that are not very hard for people to do.

Ask yourself the next time you're stressed, is it a tragedy or an inconvenience?

I missed the bus or I burnt the roast or I didn't finish the project.

So what?

You become wiser to these as you get older, but this is the sort of thing I try to teach my students in their early years in college.

Why do we have to wait to learn this?

Another thing we might recognize is that most of the things we're stressed about never occur.

So we should use the rule, no stress before it's time.

We should not accept that things have to be stressful.

And again, an example I've probably overused, but Steve, you and I go out to dinner and the food is great.

Wonderful.

It's a win.

You and I go out to dinner and the food is awful.

Wonderful.

I'll eat less.

That'll be better for my waistline.

For me, I have a very clear understanding that events are neither good nor bad, but that the way I understand them will make them so.

It's just a matter of recognizing that nothing is important in and of itself.

We give it the importance, and sometimes that works to our disadvantage.

One thing that's really helped me in that domain is if I'm very agitated about something angry or upset, I pause and I think, let me just focus on what I'm feeling in my body.

And when I do that, I'm like, wait, is that anger or is that hunger or tired?

And it's funny, you can't even tell the actual feelings in the body, at least someone like me who's not very tuned to my body, they all feel the same.

And once you pause and say, wait a second, without the story, it doesn't feel so bad.

Exactly.

Steve, you mentioned the longevity findings and the counterclockwise study.

And all of these were obviously meaningful to me.

But there's something that I came up with that doesn't sound as big, but that was probably for me the most important thing that I came to in my career.

And that was the very simple understanding that behavior makes sense from the actor's perspective or else the actor wouldn't do it.

So for example, I'm very gullible.

I am.

If you say to me, Ellen, for a woman of your age and your experience, it's pathetic.

And so I'll look back at my behavior and I'll say, you're right.

I'm going to try to not be so gullible.

But I'm always going to fail.

Because from my perspective, I'm not intending to be gullible.

I'm trusting.

And as long as I'm trusting, I'm going to be gullible.

So then I realize that every single negative characteristic we have to describe ourselves or anybody else has an equally strong but oppositely valenced alternative.

For every negative thing, there's a positive version of it.

And that if you want to change people, what you need to do is

speak to them from the perspective from which the action is originating.

You want me to stop being gullible.

You have to get me to stop valuing being trusting.

And my guess is you would probably like the fact that I'm trusting now that you see it that way.

Or try to get me not to value it, in which case I'd be able to change.

But as long as I value being trusting, I'm going to be gullible.

We did this in a study forever ago where we had people, we gave them behavior descriptions and said, circle those things that you keep trying to change about yourself and you fail.

So for me, I'd circle gullible.

I'd circle impetuous, impulsive.

I won't tell you the others.

And then you turn the page over and in a mixed up order of the positive versions of each of these.

And then we say to people, circle those things you really value about yourself.

I value my being trusting and spontaneous well as long as i do i'm going to be vulnerable to the insults from the other side of the page

i suspect that when people addicts say from the external perspective people think well it's horrible to be addict no one would want to be an addict but i suspect what you've just described is a good characterization of many addicts.

There's all sorts of positives that are coming from the addictive behavior that probably, if you can get inside their head, they don't want to let go of.

And of course, it's impossibly difficult to quit something when you don't want to quit it because it's working for you in some way, shape, or form.

Exactly.

In one of my books, maybe in several of my books, I asked the question, let's say you're very anxious and you do X and now you're no longer anxious.

Is it good to do X?

And everybody's going to say, sure.

And then you add, take a drink or, you know, whatever.

If we didn't punish people for the behaviors that make sense and rather point out that it's successfully achieving what they want, they'd be stronger in finding alternative ways to produce that outcome.

You don't say to somebody who's a heavy drinker, you have to stop drinking because it's hurting your liver.

Nobody is drinking to hurt their liver.

Their liver is inconsequential the moment they're taking the drink.

This idea leads to a very different understanding of people, a very different way of relating.

If you were involved with me and I did something and you forgave me, I don't want your forgiveness.

What I want is for you to understand why I did what I did.

And then forgiveness becomes irrelevant.

I was asked many years ago to give a sermon in one of the Harvard churches, which was a bizarre thing for me because I hadn't spent any time in a church.

I'm Jewish.

I don't even know a whole lot about Judaism, but I say yes.

And now I'm trying to figure out what am I going to talk about?

Forgiveness sounds sort of religious-y.

So maybe I can build something around forgiveness.

And it was amazing, Steve, because as I started thinking about this, what I came up with was almost sacrilegious.

So if you ask 10 people, is forgiveness good or bad?

What are they going to tell you?

It's good.

It's good, right?

Now, if you ask 10 people, is blame good or bad?

What are they going to tell you?

It's bad.

It's bad, right.

So what that means is our forgivers are our blamers.

Now, do you blame people for good things or bad things?

Bad things.

Bad things.

But things in and of themselves are neither good nor bad.

So what do we have?

We have people who see the world negatively, who blame and then forgive, which to me seemed hardly divine.

If you blame, you certainly should learn how to forgive.

But as I talk about in the mindful body, if you understand, it obviates the necessity for blame.

And if you don't blame, then you don't need to forgive.

So we have lots of things that sound good that have another side to them.

When you say to somebody, try,

you don't try to eat an ice cream cone.

You just eat it.

Now, trying is better than giving up, but there's an even better way of being, which is just to presume everything is going to be fine, presume you can do it and go forward and don't waste your time.

We did a little research on trying versus doing.

And even with the doing of things, people get themselves crazed.

People think they want perfection.

And you can either do things perfectly mindlessly or imperfectly mindfully.

Let's say you're a golfer and oh, wouldn't it be wonderful if you could get a hole in one each time you swung the club?

Well, no.

After the first couple of times, you'd see there's no game there.

What makes the game is the imperfect performance.

If we recognize that it's the challenge that's exciting for us, we'd possibly enjoy the so-called challenges more.

I was literally just now thinking about golf as you brought it up because my approach to golf as an adult was along with my academic career, one of my most mindful periods.

So I played a lot of golf as a kid and I was completely mindless in the way I did it.

I believed what the experts told me and I followed religiously what I was supposed to do.

And I really wasn't very good.

And I went away from golf for maybe 25 years.

And then I came back to it with a different perspective, which is, look, I figured out all sorts of things in academics.

Why shouldn't I be able to figure out golf?

And I throw out all of the rules and I approached it very differently.

And I had an amazingly joyful time.

It was so much fun to be improving and learning.

And I made one really important miscalculation.

The entire time I was playing golf, I had this vision that the better I got at golf, the more fun it would be.

And eventually I got pretty good.

And what was interesting is that the better I got, the less fun golf was because there was less room for error.

There's less room for creativity.

The expectations of how good I could be maybe rose faster than my physical and mental limitations.

I really wanted to be a professional golfer on the senior golf tour.

And what was most interesting and really lucky for me, and I've described it before on the show, is I actually went out and I was playing in a pro-am with Steve Stricker.

And I actually played incredibly well.

And I shot two or three under par on the front nine.

And I was getting all sorts of attention.

I almost had a hole in one underpar four.

And I realized as I was standing there, this is what I had always dreamed of doing.

And I hated it.

I didn't want that dream at all.

That one day changed completely my relationship to golf.

and actually for the better because then i stepped back from this idea of improving and i accepted golf as something which was for me meditative and fun and intensely personal and golf then became more fun again i played golf only a few times when i would get to florida and visit my father we go out to the course and i get a hole in one well this was outrageous because i don't know what i'm doing we spend a lot of time where's the ball

only eventually to see that it's in the cup.

I always look in the hole right away.

I never find it there, but I always look there first.

That may be a gender difference.

I don't know.

But what was interesting is that it spoiled the game for me.

Every time I swung the club, I was expecting a hole in one.

I do something when I'm lecturing in person, look in the audience for a very tall person, and there's almost always some guy who's 6'5 or so.

And I ask him to come to the stage.

There I am at 5'3.

He's 6'5 ⁇ we look silly together and then all I do is raise the question should we do anything physical the same way it seems ridiculous should we hold the golf club the tennis racket anything

and the rule that follows from that from me goes well beyond physical activities which is the more different you are from the person who created the rule the more important it is for you to basically ignore the rule or amend the rule and do it your own way.

We don't realize that in some sense, everything that is was at one point a decision.

Somebody had to decide how it should be.

And if it were a decision, that means initially there was uncertainty.

And then as soon as we make the decision, we forget all the uncertainty and act as if that's the way it should be.

An example I use in the book is, imagine you want to know if a particular drug is going to be covered by your insurance.

Now, how are these decisions made?

Should people be reimbursed for Cialis, okay, Viagra?

And the committee making this decision were a group of lusty 50-year-old men versus a group of nuns.

When you know there's some set of people deciding this who may or may not be like you or have the same values and so on, would make you more likely to fight for what's good for you.

Not accept the status quo, because the status quo is just one of many potential ways things can be.

That's the piece with all of my work that I think is important for people to recognize.

Whatever is is only one way it could be.

And if it doesn't work, then change it.

You're listening to People I Mostly Admire with Steve Levitt and his conversation with Ellen Langer.

After this short break, they'll return to talk about how Langer Hopes mindfulness could change the medical system.

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I'd like to finish our conversation by focusing on what seems to me to be the most radical implication of Ellen Langer's research.

That the mind is so powerful that just through belief, we can dramatically alter our physical state.

As I've read your body of research, one thing that I've struggled with.

You read all of it?

Oh, no, no one can read all of it.

It's almost endless.

No, because I was going to ask you to remind me of some of the earlier stuff.

There's a concept of mindfulness, and we've talked about that.

That can exist completely absent from the second strand of research, which is this mind-body link.

What surprises me in every study is that I'm very open, attuned, in agreement with the idea that mindfulness is valuable and powerful.

What's a bigger reach for me is that I've really been indoctrinated into the current state of medical wisdom, which says that mind and body are very different.

And it's completely implausible that simply by thinking or believing something different, you could make pain go away.

It's interesting that for you, those two are the same thing, but for me, they're completely different.

The mind-body unity idea is based on sometimes mindlessness.

And if we can do it mindlessly, chances are we can do it better, faster, more efficiently, mindfully.

Let me give an example.

So you take a placebo, and what is a placebo?

A sugar pill, something that's inert by definition.

But you have a doctor give you this nothing that you believe is something, and then you heal.

And we have people healing from all sorts of things from the sugar pill.

Well, if it's not the pill that's making you heal, what's making you ill?

You're doing it yourself.

So part of my work is, can we get rid of the whole charade and help ourselves more immediately without taking a nothing pill, without somebody else giving it to us?

If I'm controlling my own health, let me just control it.

Let's look at the medical world.

It was not that many decades ago that the medical world believed that one's psychology was totally irrelevant to health.

I'm sure doctors always want you to be happy, but they did not think that psychological state has anything to do with illness.

The only way you were going to become ill was if there was an antigen present.

Now, most medical people have moved to the point where people talk about a bio-social model where they know that stress and these things matter.

I don't think they realize that it matters quite as much as it does.

When I started writing The Mindful Body, it was first going to be a memoir, so I have a lot of personal stories in there.

And there was one experience that I had that stayed with me all my life.

I was married when I was really, really young.

So I was 19.

And we went to Paris for our honeymoon.

And now you have to appreciate that for me, I was now all grown up.

It was very important that everything I did revealed that I was a mature woman of the world because after all, I was married.

We're in this restaurant.

I order a mixed grill.

And on the mixed grill was pancreas.

I asked my then-husband, which of these things is the pancreas.

He was more sophisticated than I.

He points to something.

I eat everything.

I'm a big eater.

I love food.

I eat with gusto, but moment of decision.

Can I eat the pancreas?

Now, I don't know why.

When I tell this story, it doesn't follow naturally that if I were a woman of the world, I would have to eat pancreas.

But to my mind, as that young person, I believe that, you know, it was a do-or-die moment.

So I start eating the pancreas.

He, in the meantime, starts laughing.

I'm getting sick, literally sick.

He's laughing.

Not nice, right?

And I look at him, I say, why are you laughing?

He said, because that's chicken.

You ate the pancreas a while ago.

So I had literally made myself sick.

And that set me off on a career where if I can literally make myself sick, then maybe I can literally make myself well.

We have some research on what I call the borderline effect.

So if you give people medical tests, there are some people who fall right above the line that would say that they have it, right?

There's always some point where you have it and you don't.

If you liken it to when a donut expires, you can eat it until March 1st.

So now it's February 28th and it's 10 o'clock at night.

You have two more hours to eat the donut.

I mean, it's ridiculous, right?

So the point of that being that the person right above that cutoff point and the person right below are the same in all meaningful ways.

However, one is going to get the diagnosis and one isn't.

And then if you watch them over time, what tends to happen is the person who's given the dread diagnosis becomes ill.

Which is interesting and surprising because you'd expect the opposite because the person who gets the diagnosis has more reason to seek treatment and is part of the system.

I mean, there are two possible explanations.

One is that when you're above that borderline, the body-mind continuum leads you into sickness.

The other is that our health system just makes you sicker.

And once you interact more with it, you become sicker too.

And those aren't mutually exclusive.

I have been approached to build the mindful hospital, which is very exciting for me.

And you just think of a hospital that, in essence, it hasn't been redesigned since it was first invented.

You have machinery that's updated and so on.

But when you go to the hospital, you walk through the doors and now you're stressed.

And again, I told you that I think stress makes you sicker.

In this mindful hospital, almost everything about it would be quite different from the experience experience we have right now.

Who would design a hospital where you get woken up 17 times a night when you're trying to sleep?

But that's the experience I've had with hospitals.

Sometimes you're awakened so that you can be given a sleepy pill.

One of the things that I find most distressing is the whole notion of chronic illnesses.

When you're given a diagnosis that you have a chronic illness, most people see that as something that's uncontrollable.

There's nothing that can be done about it.

And all it really means is that the medical world has not yet figured out a way to handle it.

It certainly doesn't mean there's nothing that you can do for it.

So I started thinking about all of the things we can do when we have an illness where the medical world can't help us.

I don't think people have a notion of body unity.

And what I mean by that is that anything that affects any part of your body is simultaneously affecting every part of your body.

So doing some research now, let's say lifting weights.

All right, so you're lifting weights and you expect your triceps, your abs, whatever parts of the body are going to prosper from this.

If you're aware that the whole body is one, my prediction is that your stomach will be stronger and it will be measurable down to your calves, your toes, and so on.

If you don't have that belief, then you're not going to get the benefit from it.

So you're doing that study right now.

Yeah, and when I get the results, I'm going to mail them to you right away so you can say can't be.

But if we go back to chronic illnesses, mindfulness is the best thing for our health.

And so, all the while we have this chronic illness, we increase our mindfulness, our enjoyment, our engagement with the world.

We're going to be affecting our health.

Then, the last thing, and this, I call it attention to symptom variability.

So, when you are diagnosed with a chronic illness, people think that your symptoms are going to stay the same or just get worse.

But it turns out nothing moves in only one direction.

There are always little blips.

Imagine the stock market is increasing.

It doesn't go up in a straight line.

It'll go up.

It'll go down a tiny bit, go up.

So when it's a little better, what's happening?

Why is it?

So all we do is we have people, we call them periodically throughout the day, throughout the week, and we ask them, how is the symptom now?

Is it better or worse than the last time we called?

And why?

The NY is the important question.

Well, this procedure works.

There are four things that happen.

The first,

when many people have chronic illnesses, they feel helpless, which is bad for their health and certainly for their happiness.

So now you're doing something for yourself.

Second, as soon as you notice that there are times where you feel a little better, wow, that's good because I thought I was always in maximum pain.

Third, when you ask the question why and you start paying attention to when it hurts, when it doesn't, what might be different today or this hour from two hours ago and so on, you're being mindful.

I believe that you're more likely to find a solution if you're looking for one than if you're not.

We went ahead and did this with all sorts of disorders.

We have multiple sclerosis, Parkinson's, chronic pain, stroke, and across all of them, we're getting positive findings.

What's nice about this and what I like about all of the so-called medical treatments in a way that we come up with is that there are no negative side effects.

And also that you can be doing this while you're waiting for the results from the doctor.

I'm not suggesting that we don't seek out medical help when needed.

The suggestion I'm making that we partner at the least in our own health care.

I'm skeptical at some level of many of the things that you profess.

Ah, don't say that.

Although sympathetic and hopeful.

But what's interesting is i just reflect the people i know who are in their 80s and their 90s who have influenced me the most

it is my father my grandfather danny kahneman few others they all exhibit the exact features of mindfulness and

aliveness that you're describing And I'm definitely going to add you to that list because in many ways, the most convincing thing to me about this conversation is that you embody the ideas you talk about

you are obviously mindful and as you talk it is exciting to talk to you and that enthusiasm feeds into my own experience i'll walk out of this discussion and for at least a few hours hopefully longer i'm going to be more mindful i think lots of people in today's world are doing all sorts of things to extend their lives and i think that rather than spend time trying to add more years to to our lives, what we should be doing is adding more life to our years.

And by doing that, I think it will have the surprising effect of having us live longer.

I'm curious to hear your answers to the two questions I posed at the beginning of this episode.

Those questions were, first, do Ellen Langer's research findings surprise you as much as they surprise me?

And second, if they do surprise you, what's the right reaction?

How do you know whether to believe surprising results?

I'm still grappling with that second question myself.

I would love to live in the world suggested by Ellen Langer's research.

A world where I could will pain away simply through the power of thinking.

A world where I could control aging gracefully.

But it isn't so easy.

to toss out a life's worth of believing that those things just aren't possible.

So my own reaction to Ellen's research is to be open-minded to the possibility she's right, and I'm actually going to spend some time practicing her approach to mindfulness.

And also going forward, I'm going to be very attentive to any evidence I see in my own life that supports her worldview.

I haven't really looked for that kind of evidence because I didn't believe it was possible.

But let me be honest with you.

I'm a lot more open to Ellen's research because I like the findings.

If she had research that suggested that the world was a much worse place to live in than I currently thought, I suspect I'd be much much more closed off to it.

We'd love to hear your reactions to the episode.

Our email address is pima at freakanomics.com.

That's p-im-m-a at freakanomics.com.

I'd love to hear from listeners who heard what Ellen had to say and made changes in their life based on it.

I would just as much love to hear from you, whether it turns out great or it's a complete failure.

So this is a point in the show where we bring on the show's producer.

Hi, Morgan.

How are things going?

Hi, Steve.

Good.

How about you?

Great.

Today, I thought we'd do an update on some of our past guests.

And first up is our favorite quizzing lady, Victoria Gross.

She's been on quite a roll lately.

The first thing she did was to win the Jeopardy Invitational Tournament back in April.

She actually had been on Jeopardy many, many years ago before she was very good, before she really devoted herself to quizzing.

So she wasn't a Jeopardy superstar the first time around.

She only had won one or two episodes.

But because of her other celebrity in quizzing, she got invited back and she won that invitational tournament, which then got her invited to the Jeopardy Masters tournament.

And I know, Morgan, that you are a Jeopardy watcher, so you can tell us what happened there.

Yeah, Jeopardy Masters is a separate show hosted by another former Pima guest, Ken Jennings.

And it's like a round-robin style tournament of six past Jeopardy champions.

And Victoria Gross won the whole season.

And I think that comes with a prize of $500,000.

And that's about $500,000 more than you can make doing anything else in quizzing.

So it's really an amazing win for Victoria.

But my hunch is that even more important to her than either of those two is that just last week, she took down the World Quizzing Championship, which is the most important trivia championship in the world.

And it was the first time she's won.

And she was the first North American to ever win it.

Isn't that right?

God, I didn't even know that.

Although that makes sense because when you do look at the names at the top of the list, they're almost all European.

So Victoria, she really is setting the quizzing world on fire these days.

Well, congrats to Victoria.

We also have an update from Sal Khan of Khan Academy Fame, who's been on the show a few times in the past.

He has a new book out.

It's called Brave New Words, How AI Will Revolutionize Education and Why That's a Good Thing.

And I have to say, this is a fantastic book.

It is a book that has dramatically and profoundly shaped my thinking on the topic.

Like so many other people in education, my initial reaction to ChatGPT was, this is really problematic, right?

It makes it so easy for students to cheat by using ChatGPT and it upends a lot of what teachers wanted to do for evaluation in the classroom.

But Sal is a true visionary and he asked the right question, which is how can we harness this technology to actually help us do education better?

And he lays out this vision, which I just found incredibly compelling, suggesting that AI and ChatGPT will really be a positive factor in education.

How soon does Sal think that AI will actually be useful in the classroom?

Well, I would have thought this would be years and years away.

But then I actually sat down with a program.

It's an extension of ChatGPT.

It's called ConMigo that Sal and his team have created.

And I thought, okay, it'll be fine.

It'll be just like ChatGPT, but maybe with some guardrails.

I was shocked.

It acts as a tutor.

And already now, I would say it's better than the average human tutor.

And at the rate in which it's improving, I think it will be as good as the best human tutors in a really short amount of time.

So I've come to believe that the role of things like ConMigo in the future of education are going to be absolutely huge and transformative.

I'm really excited.

Our last guest update is about Rick Doblin, who is the founder and president of the Multidisciplinary Association for Psychedelic Studies, also called MAPS.

Rick was on the show in the fall of 2023 and he talked about attempts to get the drug MDMA, also known as ecstasy, approved by the FDA for treatment of PTSD post-traumatic stress disorder.

At the time, it seemed like the approval of the drug was imminent, but we're now over six months later, and MDMA's approval just hit a major roadblock.

So, according to news from the journal Nature, members of an independent scientific advisory committee voted nine to two that human trials of MDMA did not prove its efficacy.

They also voted 10 to 1 that the risks of MDMA outweigh its benefits.

This is not promising news news for Rick Doblin.

No, I mean, it doesn't completely rule out approval, but it more or less does.

And I can't really comment on the science.

I don't know the details of exactly what they're looking at in the studies.

But I will say, from a researcher perspective, they worked side by side with the FDA to get assurances that if they could find strong results using the methods they used, that the FDA would give approval.

So it must be shocking to the researchers that they did such a collaborative approach and then for the external committee to just smash things to pieces.

And I think Rick was very aware of some of the clinical trials' weaknesses and he talked about them at length with you in that episode, but he was hopeful because they had designed many of the studies with the FDA.

Now, the FDA, as you alluded to, does not have to follow its advisory committee's recommendations, but they often do.

This is a case, it's actually really interesting in light of this conversation with Ellen Langer today, where traditional science is crashing a little bit into this mind-body world.

Because one of the big concerns of the external committee is that the people who were given MDMA knew they were given MDMA because you can feel it when you're on MDMA.

And they were concerned that since they knew they were on MDMA, that that encouraged them to believe that it worked and that gave good results.

But in Ellen Langer's world, that's great.

If you can do treatments that will convince convince people to feel better and there really are no other treatments that are working for PTSD, then I'm sure Ellen would say, well, you should take advantage of every approach you can that makes people feel better.

But that isn't the way traditionally the FDA has worked.

It'll be interesting to see what kind of transitions happen over the next few years.

Listeners, if you have a question for Ellen Langer, send us an email and we can pass it along to her and maybe have her answer it in a future listener question segment.

If you have a question for us, our email email is pima at freakonomics.com.

That's p-im-a at freakonomics.com.

We read every email that's sent, and we look forward to reading yours.

In two weeks, we're back with a brand new episode featuring mathematician and entrepreneur Conrad Wolfram.

He spent the last decade creating a radical new math curriculum, one that's designed for the modern age.

And he's even managed to convince the country of Estonia to adopt it.

I mean, it actually didn't take as much convincing as you might think.

As always, thanks for listening.

We'll see you back soon.

People I mostly admire is part of the Freakonomics Radio Network, which also includes Frekonomics Radio, No Stupid Questions, and The Economics of Everyday Things.

All our shows are produced by Stitcher and Renbud Radio.

This episode was produced by Morgan Levy with help from Lyric Bautich and mixed by Jasmine Klinger.

We had research assistance from Daniel Moritz Rabson.

Our theme music was composed by Luis Guerra.

We can be reached at Pima at Friconomics.com.

That's P-I-M-A at Friconomics.com.

Thanks for listening.

The only way I vary this, by the way, is if I decide we're going out for lunch or dinner.

It's a compliment to you that we're going out to dinner.

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