How to unite people through art (with JR) (Transcript)

How to Be a Better Human

Monday, June 27, 2022

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Chris Duffy:
You’re listening to How to Be a Better Human. I’m your host Chris Duffy.

Today on the show, we’re talking to one of the most famous street artists in the world, J.R. He’s got
this iconic look where he always wears dark glasses and a hat so no one knows exactly what he looks
like.

And even if you’ve never heard his name, you’ve almost certainly seen his work, whether it’s a giant
photograph of a baby that appears to be peering over the border wall between Mexico and the United
States or the cover of Time Magazine featuring 100 people in Lyiv, Ukraine holding up JR’s enormous
canvas print of a young girl smiling and playing, an act of artistic resistance that could be seen for miles
by drone and airplane.

In JR’s work, he takes photos of humans who are too often seen as powerless or invisible and he
makes their images monumental and iconic. The sheer scale of his art forces us to consider the stories
of the people in the pictures. We look into their eyes. And we’re pushed to reconsider our own
perspectives.

So today on the podcast, we’re going to be talking about how we can all use art to connect to others,
see the world differently, and take action.

Here’s a clip from JR’s most recent TED Talk, where he discusses his newest art project, which took
place at a supermax prison in California.

[TALK CLIP]:

We arrived there. And of course, you know, it's not that easy to get there. It's like fences, electric
fences walls, and you add more walls and more people that check your IDs. And my god I get all the
way to the yard and it's looked like some army guy with like bullet proof jackets and heavily armed who
say, all right, this is going to be very simple.

There's some people waiting for you in a gymnasium. We get us some inmates. You cannot approach
them. You cannot touch them. You can sit at the chair that we designated for you, and we're going to
surround the area of the gymnasium. That sounds fun. I enter the room and we do this thing in
France. I don't know if you have that, but you shake people's hand, you know, so I started shaking,
people's hand, hello, how are you?

My name is JR. What's your name? And go around the table. And then I sat. And I spoke with them. A
lot of them have been there since they were teenagers. Some of them, even from the age of 13 and I
never seen anything like it. And so. I told them about my art and about the idea. And they asked me a
question, they say, but what is the purpose of your art?
I was like, well, you know, that's a good question. I don't know if I can answer before trying a project.

Chris Duffy: We’ll be back with JR, right after this.

[Ad Break]

Chris Duffy: We’re back with today’s guest, JR.

JR [00:00:00] My name is J.R., and I'm an artist from France. I say that I'm an artist until I find a real
job. But I do paper and glue. I paste giant images on buildings and cities around the world.

Chris Duffy [00:00:12] Can you tell me a little bit about your upbringing and how that helped you to
develop empathy and maybe a willingness to understand different perspectives?

JR [00:00:21] Yeah, I guess, you know, I grew up in the projects outside Paris and I've never knew
anything about art, let's put it this way. There were no artists in my family. Photography was a rich
sport. There was no digital at the time. I’m 39 now. I guess. When I found graffiti, which was a form to
express myself and to leave a mark on society, to say, I'm here, I exist. Then when later, I found a
camera in the subway and I started photographing my friends who were doing graffiti to kind of tell
those incredible stories that we would have, going in subways and turnarounds on rooftops. I just
printed them on black and white photocopies like Xerox photocopies and pasted them in the street. I
didn't realize that this would be called art or street art or however people wanted to call it. I had no
idea what I was jumping into. I really jumped into this in a really naive way, and I'm glad of that. I had
no idea about galleries and museums. I just thought this museum would like for artists who died a long
time ago. So it's really just a just a kid not really realizing what that world was. And then suddenly
digital arrive and low cost flights arrive, and then the world was all open to me. And then that's what I
ended up doing in my whole life.

Chris Duffy: The people you grew up with and started doing graffiti with - There were other artists in
that group, too, like Ladj Ly who is a very successful film director. What do you think it was about your
particular crew of friends that led you to have this artistic success?

JR [00:01:49] I think, you know, none of us were known or anything like that. It's just that we
followed each other for the last two decades, of course, in the group, you know, by pushing each
other, by being an inspiration to each other. You know, a lot of us then ended up in different form of
art succeeding. And so that that's, I think, is the key and the power and the luck that I had that I was
always surrounded by friends and and people that would push me, that would open my perspective so
that I didn't get stuck. And sometimes when you're alone doing your art in your own corner, you don't
you don't have that chance to actually be challenged. And a lot of the artists that I actually admired, I
realized I always had, like this group, this tight group of like pushing in tandem and really trying to get
the best of each other.

Chris Duffy [00:02:36] I always think that that's one of the biggest things that people misunderstand
about art, is they think it's just this one solitary genius working alone and not understanding that it
actually is part of a community of people who push and inspire and challenge and all of the pieces that
that make art social as well as individual.

JR [00:02:54] Oh, yeah, 100%. This was a big part of what would push me and keep me going is to
do it with others. So when I made that, I've developed my practice in a way that I would only have to
engage other people and groups and communities around the world to do it. And I really create my
projects depending on that. I quit project that are so complicated to put together that I could never do
that by myself.

Chris Duffy: in your 2011 TED talk "Use art to turn the world inside out”, you said that '”what we see
changes who we are'". How does that actually inform the work that you do?

JR [00:03:23] I realize I haven't traveled that much when I was a kid and so I wanted to see the
world. So by going in places that I sometimes here in the media, seen in the media, I would just go
and see by myself and not as a journalist, just as a citizen who just want to understand and really ask
naive questions. And I developed a lot of my practice around that, just going to see and talk to people
in a very simple way and asking them to explain me what is the context and telling them that I know
nothing about it except what I've heard on TV.

And that was an amazing way for me and still today to approach a lot of contacts and go around the
world and try to understand and and then we share those images. And then other people would then
write me and say, Wow, I had no idea about this. I was just in Mauritania last week in the furthest
refugee camp in the world. It's like at the end of the desert. So you have to drive 26 hours to the
desert to get there. Most people wrote me and say we had no idea there were like 80,000 refugees
right there. You know, we just don't know. We hear about the one in Ukraine right now, but we forget
that there’s lots of refugees around the world.

Chris Duffy [00:04:31] I want to talk to you more about that, because it seems like when you choose
subjects for your art, you're almost always choosing people who are seen in a very limited way in the
media. And there's actually an irony in that you're creating two dimensional images, but it seems like
what you're trying to do is actually create a more three dimensional image and more nuanced
representations than what most people normally would see.

JR [00:04:52] I never paint famous people. It's always people you've never heard about, and just
people I meet around the world that had incredible story, like all of us, but that never get to be on the
front line of the news and I don't even do a casting is just a randomness of like these incredible people
that I've met around the world and then I enlarge them so big that I have to involve sometimes
hundreds of people to paste that image or sometimes hundreds of people to carry that image, like
physically, like a giant top that you have to be 2 to 300 people to carry through, through the city.
What's interesting is that there's few layers to this. There's the process, which for me is the art, the
process of it, of in studying, enlarging that image is the actual art. And then the more you involve those
people that sometimes come because it's just fun to pay stuff, it's cool to carry that image, then realize
the message that's behind it sometimes. But really, honestly, the people realize it when they're in the
process of the action. Sometimes they just came because it was fun. And then I was on my good idea.
Now that we were raising that issue today, that's amazing. I have no idea. And then you have that
image traveling through social media. So people to museums, galleries who books, you know, in any
way possible. And that creates another change of reaction. So really, it's a work That's always alive, it's
always moving. I never know when the projects end.

Chris Duffy [00:06:14] How do you approach a community or an individual and get permission for
them to make art involving them? I imagine that most of these people, they may not be familiar with
you in your work. So how do you actually get that trust and make it so that they understand what
you're doing?

JR [00:06:35] I'll tell you, the secret is very simple. I just say hello. I just say bonjour. And then we
shake hands. And then, of course, like anyone that you meet in the streets of New York or in the street
of Mauritania, in the sand of Mauritania, or should I say people want to know who you are, what you
do, and that's the same. So it's really always like that. They ask me, What are you doing here? And I
said, I'm from France. And then after that they say, But what are you really doing in? And I say, Well,
I'm an artist, so what do you do? Then I show some images and then I explain what I came here to do
it and in a conversation stop the fact that I come with an idea that might not be the final idea. It's just
that when I come there, that's the idea I have, and then they get involved. They gave some input and
often the idea really changed because of that. And I love that. I love the process of exchanging and
knowing that a bigger part of the unknown in the project is there. So there's always more risk of failure
than success in every one of my project. That's when I create a project. I know it's interesting when it's
just more risk that it fail than it succeed, then I know I'm into something that no one have ever tapped
into. And so I really always keep that in mind and in the way I work.

Chris Duffy [00:07:43] But another part of the process is to not have brands or sponsorship, to not
have logos on your work. Did you talk about that piece of of your values when it comes to work?

JR [00:07:55] Yeah, to me, finance is a big part of it. I think it's it's just that there's so many hidden
message into everything we see every day today in commercial. It's like subliminal. Everyone's trying to
sell something or brand ideas to everything, and I try to keep the art as the most purest form. The
same way you go to the Louvre and you see La Joconde and and you know that, you know, that's it.
He painted an image, maybe with a lot of subliminal image from the time, but there was no like brand.
He's not trying to sell you anything than just really getting your attention in the painting. That's what
I'm trying to do with my work. And so for that, I make sure that the financing of it doesn't interfere
with the message so that it's not powered by any brand. It's not a projects on the people of their to
then try to sell you this or that. It's really just that story and that person and that's it. So that's why I've
never made collaboration with brands in any way. And, and so I self-financing with the sales of my
artwork. So I always set a couple artworks per project then that pays for the next one. And I've always
been into that journey. I had great mentors like Christo, who also did that for years, then Jean Claude,
and then they were financing all their projects so that they, they could say, Well, you know, that you
like or you don't like the projects. We didn't ask the government for money, we didn't ask the people
for money. We actually used our own money for the sales of our works. So this way they were totally
free. And I feel that same freedom today.

Chris Duffy [00:09:19] I wonder is your kind of personal image and the the presentation of your self
part of that? Because you have a very distinctive style, right? The hat and the glasses, people don't see
your eyes. Is that part of the idea of letting it be about the work and not messages about you and
brands, or is that just it's easier to have a distinctive style?

JR [00:09:37] No, it's it started because what I did in the street for all those years and still today in lots
of places, not everywhere, is illegal. So you have to pay fines for it. And then I remember one day I
had to do an interview and some guys from Holland were there with their cameras and they said, Look,
we can't film you for one day with this on your head. And so I went to the supermarket and I just
bought a hat and glasses. I said, Well, now fill me like this one. I'll take them off. No one will know it's
me. And it worked. And I kept on doing it until today. So it gave me that freedom that when I did the
project at the bottom, Mexican US, instead of that giant kid overlooking the world, basically, when I
would cross the border, the Border Patrol would not recognize me because I would take off my glasses.
And then as soon as I put them on, then people recognized me.

Chris Duffy: I have a question about this project, Tehachapi: The Yard, that you did in a supermax
prison in California. How did that come about? And also, how were you able to get the prisoners to be
able to tell their own stories, the people inside of this prison? How did that actually get them outside of
the borders of the prison, which they can't physically leave?

JR [00:10:44] Exactly. The maximum security prison in the middle of the desert, I don't know. One
would come and see these because you come into this prison. I knew also that it's such a rough
climate there that the image would not stay that long. And I needed concrete and concrete you only
find it in the maximum security prison, and then I would have to find a way to capture it so that the
image could travel, but that the story would travel also.

So that's how it came about, how to create an image that involved everybody. So the guards, some
victims by some of those gangs from those prison and also some of the guards. So inmates, victims
and guards into the same image. And that's like about 50 people into the image. And then we can only
see from one point that point being from the sky. So we sent a drone. And so to kind of get that
perspective. To get their story to answer your question, I told them, look, we're going to create that
image a bit. That's going to be visually very impacting, but your story needs to travel through it. As
much of that story at that as that image travels, I need you to embed into the visual your story and
how to do that is not through an interview. A tweet is who you're going into one room and recording
your story and explaining a guy like me who's French, who don't know how you grew up, who don't
know the different neighborhoods in Los Angeles. And and you have to explain me, like if I'm a child
and you're trying to explain me what you went through, because a lot of those guys actually that I
selected were minor or I ended up in a three strike. There was a lot of like things that got them into
those long sentences and not necessarily a murder. And then I told them, you tell your whole story,
and they did. And they recorded the audience sometime for 30, 40 minutes, which they never had a
possibility like that to do before. And then we created an app which is totally free. It's called JR murals,
and you just go on it and you click on any single face and you can hear what they have to say. And
that went a really long way. I'd really like crossed every walls even inside the prison, like the guards
and not the inmates, because they couldn't have access to phone. But like the guards, the wild and
then their family, their kids and stuff got to hear it. And that changed a lot of things within their own
space. And then also people at the other side of the planet would suddenly get to hear about them.

Chris Duffy [00:13:01] In a way, one of the things that you've done is taken this building, which
obscures all of the humanity inside of it. Right? It's this big concrete block. And instead now we're
forced to look and see, Oh, these are human faces inside of here. And those people are inside of here.

JR [00:13:15] Exactly. And that's what my work is always about, is putting faces on walls to kind of
humanize any places. And prison is maybe the hardest place to humanize. But anywhere around the
world, you realize that people have lack of dignity and and photography's such an amazing way to do
it. And yet I'm not a photographer, and photography is just a small part of my process. I spend more
time mixing the glue than actually taking the photo. It's the pasting. The process and that process
within the prison was also fascinating because we pasted all together and that with different gangs,
different race, different ethnicity, the guards started to come to pasting and they don't have normally
the right to get so close from them. And that's where the wall really fall. And those walls are not visible.
You can't touch them. But yet those are the walls the most important work that I actually felt felt doing
that project.

Chris Duffy: Coming up we’ll hear more about how the impact of JR’s art reaches far beyond the
images he creates

[AD BREAK]

Chris Duffy: We are back with the artist JR. In addition to creating large scale art pieces, J.R. has
worked on projects like a free film and arts school, and a social kitchen dedicated to reducing food
waste and serving communities in need. So J.R., I’d like to ask you the same question you posed in
one of your TED talks: Can art change the world? I know it’s something you think deeply about.

JR [00:14:19] It's a huge question, can art change the world. But actually over the years I find a way
to actually deconstruct it. Each one of us living in our own world. So your world is not my world. And
yet we all live in the same world, but yet we all the blending of where we grew up, our frame of
reference. We still live in our own world, in our own bubble. It's really a question of perspective.
Perspective is what And we live it really right now as people don't want to over see any other
perspective. They want to just stay in that perspective and believe that that's the truth.

This is the moment more than ever that we need to remind people that the world is interesting and not
because it's just black and white. That's why I work and I work in all those shades of gray. And I
always make sure in my art that I even confront my own perspective. And and so I constantly push
myself into places where I don't know anything into worlds that I've never heard about. As long as
there is fear into walking into that world, I know that's the right place to go.

Chris Duffy [00:15:30] Are there instances where people have reached out to you and said that your
work has helped change their perspective about something in their lives?

JR [00:15:37] Oh, a thousand times. A thousand times I've been approached. And it goes from a
simple story of of one in May to tells me, look, I could never talk to my daughter. She's 14 years old.
She didn't want to come and visit me in prison. And now she heard my story on the app and she visits
me every week and he say, my problem is I could never had 40 minutes with her to actually explain
her what I went through. So she never heard it and she just said I was a criminal. I was in prison.
That's it. And now that she heard me and she saw the humanity in me, she comes and visited me all
the time.

JR [00:16:09] The warden of the prison, the guards say, I've never saw them as human. I saw them
as animals. And now, because of the art project, I saw their humanity and how they think and and the
love that gave that life sentence because of the project. Three years later, one set of them got freed
because the guards and the warden like sign on the paper for their board meeting that those guys had
really changed and they saw their witness it and they vouched for them. And that will never happen
without the excuse of the art to just reveal that they don't really have change. But it's just that there
was no way in the system that they could prove that.

Chris Duffy: In 2007, you had a project titled "Face 2 Face" which was murals with side-by-side
portraits of Palestinian and Israeli people. Do you see any parallels between the work that you did on
the border wall between Israel and Palestine and the border wall in the southern US-Mexico border and
all these other projects that you've done, including the walls of a prison, is there a through line through
all of those?

JR [00:17:16] Those walls separates people anywhere in the world. And so that's that's the I think the
connection between those walls that happen in very different contexts. But there's still walls to divides
people. It's just the most physical way of like separating people, literally. And so to me, they appear like
the one in Mexico. I've just installed a giant kid at one place and it represented the whole debate there
and the humanity of like just kids who this kid was like one year and a half and studying him on the
wall. And so as a kid, you don't see walls. It's just that he has his house was right behind that wall. He
don't realize the implication of it.

In Israel and Palestine. I've done it on the wall, but actually installed the portraits of Israeli and
Palestinian doing the same job. So two taxi drivers, two teachers, two students, two hairdresser and
and people couldn't recognize who is who. They would only see the two taxi driver, the two
hairdresser. They're like, But why are you painting those two people? I said, I would say, Well, because
one is Israeli and one is Palestinian, and people couldn't recognize they were like, Oh, I wouldn't know
how to recognize my border. That's the Palestinian. I was like, I tell you wrong, that's the Israeli, but I
give you another chance and we did this all over the region.
Chris Duffy [00:18:28] Well, I'm curious. I ask about that because there are sometimes in your work
in real life, there's obviously certain power dynamics where certain person has more control and more
power and is more oppressed versus less oppressed. And sometimes people have objected to the
implied messages of that in your art. The idea that when you put two people side by side and one is in
a lot more power than the other, that it makes it look like the only difference is that we just need to see
that we're all the same, whereas there are actual systems of power and oppression that are in place,
right? So it's not just about seeing each other as people. It's also we need to change some of the the
underlying systems of oppression, I guess I would say.

JR [00:19:06] Oh yeah, no, I in all my work, I've always kept my I'm an artist. So I. I raise question. I
don't really bring answers. I don't think that's my my place. I think activism is a much stronger form to
actually bring answers. I'll say this is how it should be done. All I could be known as is when I put
people side by side in Israel and Palestine. I actually did it so that people, you know, would play with
them. And I thought that they would actually be destroyed the next day in like ten years, 15 years
later, they're still there for most of them, which is kind of crazy. You would think. So you would say bet
that they are destroyed. They are on one side and stuff and they didn't.

JR [00:19:42] And the idea is to raise questions, but not to kind of bring a message that everyone is
the same and equal. It's much more intricate than that. But people were like, Who do you think you
are to that? We wouldn't deserve having art. They were like, Of course, we deserve art. The same way
anyone else in the world deserves it. And I was, you know, of course, very naive and it just proved me
run the world and how people want want to use the island to show that there exists, that there and
that sometimes they misrepresented or or I've opened a project in 2011 at TEDx actually, which is
called Inside Out. Then people can send me their photos and I will print it in a giant size and ship it
back to them wherever they are in the world for free.

Chris Duffy [00:20:26] For people who aren't familiar with Inside Out, can you just give them a quick
overview of what that is?

JR [00:20:31] Yeah, Inside Out now it's [around] 500,000 posters sent around the world in 140
countries, and people pasting hundreds people of their community into walls and to the floors and to
buildings in each of those places, raising a different issue. But really, when you look at all of it, it's just
people. But yet those posters on the wall because it goes be beyond my work, it becomes the people's
project. So you know that I continue that not it's I don't own it anymore. It's really it's really in their
hands. And you would think it would only happen in poor country or in conflict areas. And actually now
everywhere in the world, people wanted to actually express themself and and raise issues and and
show that they exist. Even in a small village in Switzerland, very calm village, the people install their
photos from an elderly house to show that they still exist, but they have been forgotten within their
own village. You know, and I love that it shows you that we all have this need of of existing, of leaving
a mark, of leaving a trace in our own way. But we all are.

Chris Duffy [00:21:33] Thinking about that, that we all have this need of leaving a mark and leaving
a trace and how art can fill that. How can people who are listening right now make art in small but
meaningful ways in their own daily lives?

JR [00:21:51] I think you have to see art as a process. So it's just an excuse to interact with other
people. So let's say if you decided to then make your whole the whole way of the building that
everyone's sharing to a color whatever blue for just five days you find a way that every wall, everything
is going to be blue and then you can remove it. If it's in paper or whatever it is, you would have to ring
at every door. You have to explain that to every single person. Then you realize that that neighbor you
never talk to is actually much more interesting than you thought. Then you realize one will block you,
but then somebody else will have some ideas that a whole journey of just making your whole hallway
blue will become an incredible like journey. And that's what you'll remember of it. Even if the photos
are not that interesting, that's what you actually will stay with.

Chris Duffy [00:22:39] I think I love the idea of thinking about that as art because that feels so much
more accessible. Sometimes people get stuck on the end product of I have to be Picasso. I have to
have this perfect painting that's in a museum at the end. And it seems like so much of your career and
your success has been rejecting that 100%.

JR [00:22:55] Yeah, because I realized that the strongest part in art nowadays to me, I mean, you
know, in the art of creating with communities and stuff, it is that process that just allows and and
create so much interaction between people. And I just make sure that this can happen with or without
me. And that's why I often engage communities at the other side of the planet without being there.
Because you'd have to walk without me. If not, then it would be it would become such a smaller
concept, and it can happen with or without my art also. That's what I'm trying to say here.

Chris Duffy [00:23:27] One thing that I'm really struck by in your work and I think is very powerful to
me, is how you balance practical needs with artistic and expressive ones, right? I'm thinking about the
fact that some of your projects have not only been art and visual, but they've also replaced roofs that
leak on homes or created a restaurant to feed the hungry. How do you balance that, that question of
fixing people's immediate, basic needs with their artistic and expressive ones?

JR [00:23:54] So it's a very important question. I always at first I go and do art and I always I'm
always really honest. I'm like, I don't know if that's going to change anything, but let's see. And so
we're always going on a journey with totally unknown and it doesn't matter if it doesn't work. So I love
that because also it moves out all the pressure. But then after that I, you know, I think there's more to
do in and so in some places, yes, I've created restaurants, I might have been in school. In some areas
I've created awareness around an issue, but that comes in a second time and then it becomes how
how to create more social impact into the place where we've done art. So anything is just creating
more, more way of showing that art actually have an impact. And so we went from can art change the
world to can art change the war and that was in Ukraine. I realized after going there that I could just
stop there. And I created a lot of awareness and it made it the cover of Time magazine. I could actually
continue and because of all the people I've met and all the, the the network I have, I could actually
deliver trucks every week to Ukraine. And that's what I'm doing now since the beginning of the war.

Chris Duffy [00:25:02] For yourself, for me, for everyone who's listening, how can we use art to
become better humans?

JR [00:25:08] Well, I think whether the insane into art or anything else is into the process is into doing
around your community about what's around you before changing the world, change the world around
yourself. So that means in the few people that that lives around you, that's your inner world. And then
this is where you start. And I realized that after traveling the world and someone told me now at the
beginning say, Well, the hardest thing is often the people around you and it's true, but that's where you
can see the actual impact of it and see, Oh, wow, okay, I did that and that actually impacted my
community and so I would start from there.

Chris Duffy [00:25:45] Well, J.R., thank you so much for being on the show. It's been an absolute
pleasure.

JR [00:25:48] Thank you so much.

Chris Duffy: That’s our show for today! Thanks so much for listening. And thanks to our guest, JR.
You can find more from him at JR DASH ART DOT NET

On the TED side, our show is brought to you by audio artists Sammy Case and Anna Phelan.

From Transmitter Media, Gretta Cohn, Farrah Desgranges, and Leyla Doss are all wearing dark glasses
to preserve an air of mystery.

And from PRX, Jocelyn Gonzales + Sandra Lopez- Monsalve have worked on this episode fully Inside
Out and Face to Face.

I’m your host Chris Duffy! We’ll be back with more next week. In the meantime, share this episode
with someone you think would love it. Thanks again for listening.
How to make yourself more human in an automated world (with
Kevin Roose) (Transcript)

How to Be a Better Human

Monday, July 11, 2022

Listen Along

Robot Chris Duffy: You’re listening to How to Be a Better Human. I’m your host Chris Duffy and
today we’re talking about the surprising ways that artificial intelligence and automation will affect both
the future of our jobs, and our own behavior beyond the workplace.

Chris Duffy: Ok hi this is ACTUALLY Chris. That voice before, it’s actually computer generated based
on audio of me from past episodes. And the fact that it’s even remotely possible to create a computer
generated version of my voice is terrifying. I need this job! Don’t replace me with a host machine! Our
guest today, Kevin Roose, is a columnist for The New York Times and the author of a recent book
called Future Proof: 9 Rules for Humans in the Age of Automation Kevin has written a ton about how
technology might impact our jobs and the way we work. Kevin is a guy who really understands my
terror at hearing that computer Chris open the show. Because Kevin has been there himself. Here’s a
clip from his TED talk.

[Talk Clip]:
I was in my mid-twenties when I first realized I could be replaced by a robot. At the time I was working
as a financial reporter covering Wall Street and the stock market, and one day I heard about this new
AI reporting app. Basically, you just feed in some data like a corporate financial report or a database of
real estate listings, and the app would automatically strip out all the important parts, plug it into a news
story, and publish it – with no human input required. Now, these AI reporting apps, they weren’t gonna
win any Pulitzer Prizes, but they were shockingly effective. Major news organizations were already
starting to use them, and one company said its AI reporting app had been used to write 300 million
news stories in a single year. For the past few years, I’ve been researching this coming wave of AI and
automation, and I’ve learned that what happened to me that day is happening to workers in all kinds of
industries, no matter how seemingly prestigious or high paid their jobs are.

Chris Duffy: You might be surprised, after hearing that clip of Kevin, to learn that I always feel
optimistic after I hear his thoughts. That's because Kevin believes that if we exercise some agency over
technology, we can make it something that works FOR us, not the other way around. Today we’ll be
talking about how to make that vision a reality. But first, we’re going to take a quick break. We’ll be
right back.

[00:00:00]Kevin Roose: Hi, I'm Kevin Roose. I'm the author of future-proof and a tech columnist at
the New York times.

[00:00:07] Chris Duffy: So Kevin let's, let's start by talking about future proof. I actually want to talk
about a lot of your writing and your other books as well. Um, but starting with future-proof, what
should regular people be doing to prepare themselves for the future?

[00:00:22] Kevin Roose: Well, a couple of things. One is, I think we really need to figure out, uh,
who is most at risk. So I think people need to look at what's happening in their industry, their
profession, and, um, you know, automation and AI are making huge strides forward in every industry
right now. Um, including some ones that we thought were kind of immune to it, um, like, uh, like art
and music, uh, And caring for elderly people. I mean, robots are being deployed to do all of those
things now. And so I think, um, we all need to really take a close look in the mirror and say like, is what
I do for a living vulnerable is what I do for a living repetitive enough, um, that it could be automated
and maybe automated soon. And if that's the case, it's, it's doesn't mean that should pack up and, you
know, go, uh, you know, plan for your second career. You know, my. Bitcoin on Elon Musk's Mars
colony or whatever, but it does mean that we should figure out how to. Adapt and make ourselves less
replaceable. And so for, uh, for a lot of people, I think the first step is just sort of acceptance that this,
you know, this could happen to me. And this, this was something that I sort of dawned on me about a
decade ago, and I learned that there were AIS being taught to. Basic reporting tasks, um, including
some of the ones that I did as a young journalist. And then the second thing I think we need to do is
to, um, to display our humanity more in our work. Um, in, in my book, there's a, uh, a rule that I call
leave hand prints, and this is about basis. Taking the work that you do. And instead of trying to erase
yourself and the traces of sort of human frailty from it, um, leave those things in, um, make it very
clear to the people who are, you know, consuming your work, whether it's, you know, an audience.

[00:02:16] Chris Duffy: Well, okay. So I, I have a question about that piece. Like you, you said at
the beginning, I, there are lots of jobs that I would have thought are not at all vulnerable to
automation or to AI. And then increasingly I wonder if that's even true if there is, if there are any jobs
at all, because, you know, I would have never thought that writing and comedy, and for example, like
using my own voice to host a podcast, I would've never thought that those were vulnerable, but now
there are tools where people can. Type words into a script and it will make it sound like I'm saying
them or, uh, you know, it's, it's kind of a meta joke, right. But there's like all over the internet is like, I
fed 300 sitcoms into our neural network and look at what it spit out. And it is genuinely funny, mostly
because it's like full of weird nonsequitors, but it just makes it clear that like it's possible for a computer
to be funny, whether it's intentional or not. Are there jobs that are just not. Automateable or is
everyone at risk?

[00:03:14]Kevin Roose: Well, the way I like to think of it is not as occupational categories, because
there are no occupational categories that are safe. So, so some of every job will be automated. Um,
the question. Which parts and how quickly. Um, so for example, there was a sort of interesting little
flap, uh, just a couple of weeks ago when open AI, the studio at this AI company in San Francisco
released this program called Dali. Have you heard of this sort of like Wall-E, but Dolly it's a, it's an. Uh,
it's an AI that basically takes text and turns it into art. So you tell it, I want an illustration of three bears
playing ping pong in business attire on the moon, and it will generate an original piece of artwork
depicting exactly what you have asked it to deploy. Incredible. It's really, really good. And it's the kind
of thing where immediately illustrators and people who, you know, make art for a living saw this thing
going viral on Twitter and thought to themselves like, oh crap. Like I thought I was safe and I am really
not safe because that is essentially what I do. And this program is maybe not as good as me, but it's
maybe 80% as good as me. And it's. It like so much cheaper and faster and you can get something
instantaneously from a machine. And so that's the kind of realization that I think a lot of people,
especially in. Industries and the creative industries have had recently, we sort of had this like
automation for the, but not for me, attitude where we like thought we were immune because we make
things with words and art and music. And that is just not true. There are AI programs being deployed
now to, for example, create new levels in video games or to write music. A lot of the music that used to
be written by studio musicians, like the songs you would hear, you know, over the loudspeaker in a
supermarket. Those are now being written by AI. Um, and so we, we, creatives are not as safe as we
may have thought.

[00:05:17] Chris Duffy: So, I guess then, it raises the kind of reverse question then, which is what is
uniquely human and how can we be more of that? I know something that a lot of people are
concerned about with AI. Is it the ways in which it's built, but also its effects affecting, uh, Unequally
right. That there's been a lot of talk about like racism in the AI programming, um, and in the effects
that, that the results that it spits out, there's this idea. I think a lot of people have that artificial
intelligence is somehow more neutral and unbiased and just, uh, a computer spitting out facts. And it
seems like the results are very clear that that is not the case. Um, I wonder how you think about
combating that piece too, as we think about like how to make things more human, how do we make
maybe AI, less human in that way?

[00:06:06]Kevin Roose: Yeah. Well, AI is a big category and an includes everything from like, you
know, the Roomba that vacuums my, my house, um, to, you know, the super computers that, um, run
YouTube and Tik TOK and Facebook and all of these, um, these. Billion-plus user algorithms. Um, and
so it's, it's hard to generalize, but I would say that in general, AI is very good at using past data to
predict future outcomes. You know, if you have, uh, clicked on, uh, 300 YouTube videos about, um,
about, uh, toilet repair, um, th the algorithm is pretty good at figuring out that you might want more of
those and. And this is not a random example. I did just watch a bunch of videos about toilet repair,

[00:06:52] Chris Duffy: But this is a side note, but just to say that the algorithm is absolutely
convinced that I own a pet lizard, because one time I was doing research about lizards for a joke.And
like for years it has been like, do you want a warming lamp for your pet lizard? I do not own. You're--

[00:07:05]Kevin Roose: --Being radicalized into–

[00:07:07] Chris Duffy: –Into lizard owners! I guess I am at a certain point, like, fine, I'll get the, I'll
get the aquatic you sold.

[00:07:14]Kevin Roose: Right? So this is, this is a thing that. You know, is the AI is very good at,
and that can be good and it can be quite dangerous. Um, there's been a lot of research showing for
example, that these, um, there are these, uh, things called predictive policing systems that police a lot
of police departments now use AI programs to. Uh, to try to guide their officers to quote unquote high
crime areas. So basically use an algorithm to tell me where a crime is likely to occur.

[00:07:41] Chris Duffy: And coincidence. The high crime area is never the corporate office building
where white collar crime is taking place.

[00:07:46]Kevin Roose: Correct? Correct. And, and because these systems are built off of decades,
worth of data that reflect biased policing practices, over-policing. Um, low-income neighborhoods,
minority neighborhoods, um, systematic, you know, uh, sort of over policing of those areas. It is more
likely to tell an officer, Hey, if you go to this corner on this street, at this time, you are very likely to see
a crime in progress. And of course, where do the, the crimes, you know what, like if you put a police
officer on a corner, they're more likely to see a crime happening there, which then feeds back into the
algorithm, which then tells them this is a really high. Block or a corner and it perpetuates this bias
throughout the ages, except now it's, it seems objective, right? Because it's coming from a computer
rather than from the brain of a police officer. So those are the kinds of things that I worry about. Um, I
also, you know, there are many, many examples of algorithmic bias and for example, hiring.
Companies now use AI to screen resumes, um, and that can be disastrous to it if it tends to select for,
you know, you know, only, only white men or people who went to Harvard or some other, um, you
know, flawed criteria.

[00:09:02] Chris Duffy: So I guess.. that leads to, to a question which is, um, in what ways are the
same things that make us human and make us special and unique. Also what make us susceptible to
being shaped or manipulated by tech.

[00:09:16]Kevin Roose: It's really interesting question. I mean, I think that we have always been
shaped by our technologies, right? There's this famous quote that sometimes attributed to Marshall
McLuhan or sometimes attributed to Winston Churchill, who knows, who said it, but it's something like
we shape our tools and after that our tools shape us. So there's this really fascinating study. And that
came out of the university of Minnesota. A few years ago. And basically they were interested in this
question of whether algorithms sort of reflect our preferences or whether they shape our preferences.
And so they took, um, some, some students at this college and date, they basically set them up with
this experiment where they would, uh, they would be. Uh, tested on how they liked a series of, of
songs. Like whether they liked a series of songs that were played for them. And then they sort of
manipulated the star ratings, like, you know, how, you know, Spotify or any of these disabilities give
you sort of ratings based on how, how much they think you will like the song. And they sort of
manipulated these ratings. And so that they didn't really have any real connection to people's actual
preferences. And then they forced people to sort of listen to the whole songs and it turned out that.
The, the sort of star ratings influenced people's judgment of the songs, regardless of whether or not
they actually liked them. They, they trusted that the star ratings more than they trusted their own
subjective taste and experience. Um, and so I think there's this way in which we are kind of
outsourcing our judgment and our preferences to AI, which may or may not actually have. Our best
interests and a good picture of what we're like as people in mind. Um, and so I think that that worries
me almost as much as like the factory automation and stuff. It's like this kind of internal automation
that I think we all feel kind of tugging on us every day.

[00:11:06] Chris Duffy: I wonder how knowing that, and, and also just your reporting on tech in
general, how has it changed your relationship to what you use in your day-to-day life?

[00:11:17]Kevin Roose: Well, I am. Uh, I am not a Luddite. I am not a technophobe. I have plenty
of robots and gadgets in my house. Um, but I do try to exercise real caution with the kinds of things,
the kinds of decisions that. Algorithms and machines make for me. Um, I, I wrote a story a few years
ago, um, uh, where I did a 30 day phone detox and with the help of a professional phone rehab coach,
because I was like, I was like horribly addicted to my phone. Like we all are, this was pre pandemic,
which, you know, I, I should, I need to probably do it again. But it was really instructive and it was
really instructive about which of my cues I was taking from my phone. Um, I think our phones kind of
started out many years ago as like assistance. Like they were there to sort of be helpful with whatever
you wanted to do. But then at some point in the past, like few years they got promoted and became
our bosses. And now they just tell us, like, pay attention to this thing and get mad about this thing. Get
freaked out about this new, you know, story. And I think that they, um, I think. Restoring balance in
our relationship with the devices in our lives is really important. So, you know, right now I'm just had a
kid and I'm very cautious of, of like what kind of media I'm consuming about that. Whether I'm in, you
know, the Facebook group, where all the parents share the craziest scariest things that have happened
to their kids, like whether it was sort of like, I'm very guarded about what I let into my consciousness.
Um, and. That's uh, maybe makes me sound like a paranoid freak, but it's, it's part of how I, how I try
to reduce the influence that machines have on my life. For example, I don't use, um, YouTube autoplay
I turn that off. Um, so that when I'm watching a video, it doesn't just automatically start playing a new
video. Um, cause that's something that I've found I'm very susceptible to. Um, I'm careful. Uh, tick-
tock, I actually I've been meaning to write about this. I have this sort of like a Tik TOK amnesty policy
where like every like few weeks I delete my Tik TOK account and start a new account just to like clear
out the algorithm, like whatever, like junk I've been watching. I don't want like to be fed just more of
that. Like I want like new junk. Um, and, and so, uh, I try to sort of cleanse my, my timeline a little bit
then.

[00:13:46] Chris Duffy: Oh, so, so you wrote a book review with the help of artificial intelligence,
which I think kind of goes to the idea of flipping the script of like the artificial intelligence and phones
and technology used to be something that we're our assistants. And now they're more like our bosses.
Yeah. Tell us, tell me about the process of writing a book review using AI to help.
[00:14:07]Kevin Roose: Yeah, well, I, this was for the New York times book review, um, earlier this
year and I had gotten, assigned to review this book. Um, Eric Smith, the former CEO of Google and
Henry Kissinger, um, had written a book about AI together. Um, and, um, I read, uh, And I was sort of
dreading reviewing it cause it was like kind of boring. And I was like, I'm not really like really, I got to
come up with like a thousand words about this book. And then I had a light bulb went off and I
thought, what if a robot could help me? So I use this app called pseudo, right. Which is basically like a,
it's basically a super powered version of the autocomplete on your iPhone, where like you put in a little
bit of. And it like spits out the next, you know, however many hundred words you want. So I wrote a
little intro and then I fed it into super right. And it spit out like, Seven or eight paragraphs of analysis of
this book that, you know, it had not read and just was sort of guessing at, and it was pretty good. Like
it was not great. Like it was not perfect. Um, and it took me a couple sort of tries to like tune it, to get
the right kind of output. Um, but eventually it was like, you know, as good as anything I would have
written. And so I just slapped an intro on it and disclosed, you know, Review was written by an AI and
then printed it. And it was like perfectly serviceable. Um, and I don't think people objected to it is a little
bit of a stunt, but this is going to be happening more and more there's there's already, um, I think
we're going to reach very soon if we haven't already the point where more texts on the internet is
written by AI than by humans. Um, and that will be, uh, an important inflection point and kind of a
scary one if you're in the, in the words business.

[00:15:53] Chris Duffy: So thinking about the future. You have kind of an interest. I mean, there's a
lot of reasons why you have an interesting perspective on the future, um, that have to do with just
your own brain, but you also are new father. And I think a lot of people, when we think about the
impact of technology, it's not just for our own lives, it's for the next generation. So I wonder when you
think about your son growing up in this world, what are you excited about for him? And what are you
worried about when it comes to sickness?

[00:16:24]Kevin Roose: Well, I'm excited that he will have access to so much more information.Uh,
I'm not one of these people who thinks that, you know, children have, should have no access to
technology and no access to even phones at the right age. Um, it was really important for me as a kid
to have that stuff. And I think it's important to find ways to co-exist with it for, for kids growing up
today, I am scared about the kind of loss of autonomy that I see happening in a lot of. Parts of culture,
but there, there have been some studies that have shown that it matters what you're doing on these
screens and on these devices, you know, playing Minecraft is not the same as like watching a zillion
tech talks, um, um, you know, connecting with your friends. You know, inside Fortnite or, you know,
on a group chat or on Snapchat is different than, um, you know, posting selfies on Instagram for other
people to kind of like, and comment on. And then, uh, so I think, I think just sort of being discerning
about what kids are doing on social media and encouraging them to do things that involve being
creative. There's so much, I mean, it's so possible to be a totally passive person on the internet and
just lurk and scroll. You know, create anything. Um, and for me, what was, you know, what was
important about the internet as a kid for me is just the ability to make stuff, to create stuff. I had a
modestly successful ring of geo cities, uh, fan pages for Buffy the vampire Slayer that I maintained
when I was a kid. Um, I built websites. I, you know, did little flashy animations. I coded a little bit like it
was a really a sort of sandbox for me. And I think there are ways to do that, you know, today a lot
more ways actually, but there's also this kind of other way to experience the internet, which is like as a
totally passive consumer. And that I think is, is really damaging.

[00:18:29] Chris Duffy: You know, I find that for myself and I'm not a parent. And I find that even
just as a, as an adult who likes to think that I kind of am like more fully formed and. As malleable as
maybe a young teenager is I, I still find that when I am using the internet and I'm using it as a way to
put things out and to produce and to connect with.eel good about, right. Like when I'm like, oh, here's
something that I wrote and I want to publish it. Great. I love that. I love that. If I can't find a, uh, you
know, a newspaper or magazine that will publish something, I can just put out my thoughts and people
will still read it and engage with that feels good. And the part that feels bad and feels like it starts to
shape me and maybe make me feel inadequate or feel like I'm not doing enough or constantly
competing with a bar that is ever shifting higher. And impossibly is when I just start. Passively
consuming. So when I'm scrolling through Instagram, I'm scrolling through Tik TOK, or I'm just looking
at other people's accomplishments, then I feel bad. But when I put things out and creatively engaged,
then I feel like, oh, this is an amazing tool where I can be talking to you from hundreds of miles away.
And we can have an actual conversation that, that never makes me feel bad. That part of it.

[00:19:40]Kevin Roose: Totally, totally. And you asked about reasons for optimism and sort of
things I'm thinking about with respect to, to, you know, my, my son growing up with technology and
I'll, I'll add one more, which is that I think, I think this generation of. You know, so gen Z, people who
got their first smartphones and their first social media accounts as teenagers started during this last
wave of tech, I think, I think those were basically the, like, you know, the, the sort of Guinea pigs for
this giant social experiment. And I think we're going to look back on that and see, and like, look back
and see like a bunch of people driving fast cars with no seatbelts. We just like, didn't have the tools to
like, Cope with, um, with what was now possible. So I think, unfortunately there's like a generation of,
of kids who grew up without any real safeguards or knowledge about what they were even doing to
themselves by like living on these platforms. And I think that by the, I hope that by the time my kid is
of age to start using this stuff, like we've built up a little bit more. Sort of knowledge and awareness
and, you know, sort of immunity and resistance to like this, uh, this thing that we all do. Um, I think,
you know, just, just, you know, you never want to be like the first-generation to be like, uh, to be like
building with stuff. It's always nice to like work the bugs out, um, and, and use the second version of
the product.So, yeah. I think with any luck he will be using like the second or third or fourth or 10th
version of this stuff rather than kind of being on the frontier where no one knows anything.

[00:21:13] Chris Duffy: So Kevin, obviously there is, there's no going back to a world where using
technology like smartphones or the internet it's is not essential to participation, right? We're not going
to go back to that world, but if that was possible, is that something that you would even want. No. And
why, why or why not? Would you, why would you,

[00:21:30]Kevin Roose: No, I, I don't want us to go back to a world with no, uh, no internet, no
social media, no smartphones. Um, you know, I think. I think, you know, these things have had
enormous costs. Um, but they've also had a lot of benefits and, um, I am very critical of certain social
media companies. And I don't think, you know, I don't think a world without, for example, Facebook
would be significantly worse. It might be significantly better. Um, but I do think that on the whole. You
know, we just need to figure out how to make this technology work for us rather than us working for it.
Um, and so I think I I'm still, you know, maybe I'm a starry-eyed optimist. Um, but I still believe that
there's a world in which we use all of this stuff for its highest purpose. And it frees us from routine and
repetitive. You know, tasks and it, uh, it leads to a society that is, you know, more abundant and more
fair. There's a great book. Um, came out a few years ago, which I mostly just loved the title of called
fully automated luxury communism, which is about how sort of robots and AI could produce this kind
of utopian society, where we just all sit around and make art and, and, uh, do philosophy all day. And
the robots just take care of everything we need. Um, so I'm, I'm still. I don't think we'll ever get fully
there, but I think we can, I think we can do better than we are now. And that's what keeps me
motivated.

Chris Duffy: We’ll take a quick break and then we’ll be back with more from Kevin Roose right after
this.

[Ad Break]
Chris Duffy: And we’re back, we’ve been talking about the impact of technology on our work. And if
you find yourself increasingly worried about that impact, here's a clip from Kevin’s TED talk that can
help us understand how we might move forward:

[Talk Clip]:
“If you like me sometimes worry about your place in our automated future, you have a few options.
You can try to compete with machines. You can work long hours. You can turn yourself into a sleek,
efficient productivity machine. Or you can focus on your humanity and doing the things that machines
can’t do: bringing all those human skills to bear on whatever your work is.

[00:23:07] Chris Duffy: So I I'd love to talk a little bit about something that I know you've done a
lot of recent work on in explaining and in doing research on, which is, um, crypto and also web three.
And, um, you know, I I've heard you say this, um, that, that basically the. This element of how
everyone made fun of social media when it first started. And we're like, it's a joke. Ha ha look how
dumb this is on my gosh, this. You know, it's pictures and they get to comment on them. And then the
systems became incredibly powerful and all of the issues with them are deeply entrenched and really
hard to fix. And I I've heard you say that you're basically trying to avoid that same thing happening
with web three, where right now people treat it like a joke, but there's also obvious issues. And if we
don't engage with them now, by the time we do it will be so much harder to fix them. Uh, is that first
of all, is that like an accurate, uh, assessment of how you feel about this and why your report.

[00:24:04]Kevin Roose: Yeah, totally. I mean, that is the essence of why I think this stuff is
important. Um, I'm not a crypto fan. I'm not a crypto skeptic. I'm sort of a crypto moderate. And when
it comes to all things, crypto and web three, um, one of my deeply held beliefs though, is that the
people who are involved in the early days of a technological shift, um, get. Outsize input into what that
technology eventually becomes. Um, so in the early days of social media, as you said, when the people
were sort of mocking like, oh, who wants to see pictures of my brunch and like, you know, why would
anyone tweet about what's going on in their neighborhood? Like, it was just, it was just not seen as a
serious thing. And like now obviously, like it's the biggest, uh, forest, you know, one of the biggest
forces in politics and culture and, uh, You know, elections are won and lost on social media and they, it
shapes the fate of, you know, democracies. And, um, and so I think that right now we have this very
nascent crypto industry that, you know, seems in a lot of ways, like something you shouldn't take
seriously. Like it's got a lot of indicators of like, there are a lot of scam artists. There are a lot of, uh,
you know, there's a lot of fraud. There's a lot of just really stupid stuff. And I think the temptation is to
kind of dismiss it all and like, hope that it goes away and that you never have to understand it. And you
can just kind of like, it's one of these tech trends that just like comes and goes. And I think that's a real
mistake because if this does work, if the crypto people are right, if this is technology that sort of
reshapes, finance, and culture and ownership and art and all the things that they think it will do. I want
there to be people on the ground floor of that who are thinking about these risks and these big
questions. And what happens if crypto takes over the world? How do we make sure that it doesn't just
become, you know, six white guys in San Francisco, like getting all the money again? Um, how do we
actually make this the Mo the best version of itself that it can be? So I want people to engage with it,
whether or not they're skeptical and maybe especially if they are skeptical. I think it's good for people
to understand and engage.

[00:26:25] Chris Duffy: So, what do you think that a regular person who's not a tech reporter and
not a living in Silicon valley? What should they do to engage with. Crypto and with these issues right
now?

[00:26:35]Kevin Roose: Well, uh, first things first to self-promote a little bit, I did write a very long,
um, 14,000 word explainer of crypto and web three and defy and NFTs and all the, all the other stuff,
um, that ran in the New York times back in March, you can see it's incredible.
[00:26:52] Chris Duffy: And it's also, I think, at least in my memory, the only time I've ever seen an
entire section of the paper written by one person, truly incredible.

[00:27:01]Kevin Roose: Yeah. It was a, it was wow. I started and I thought it would be a short little
thing and then it just kept going. Cause it turns out it's sort of complicated. So, um, that, that's sort of
my attempt to give people who are a little bit intimidated by this topic. Like just an easy way into
understanding, like the basic contours of what's going on. Um, So I would start there. It's called the
latecomers guide to crypto and it's on New York times website. And then I think just sort of
experimenting with it a little bit. Like I wouldn't, you know, I'm not a financial advisor. I would be the
last person you should ask about what to invest in. Um, but yeah. I found that my own understanding
of crypto really kicked up a couple notches. Um, when I accidentally sold an NFT, um, for a lot of
money, I'm in a charity auction last year. Um, and all of a sudden I had all this crypto that I was not
keeping, but that I was sort of transferring to a charity and it really forced me to learn how the stuff
worked, because all of a sudden I had this like, you know, pot of money that was, you know, The
custodian of that, I had to figure out like how to keep secure and how to transfer. And it really sort of
threw me into the deep end, um, and made me learn about this stuff.

[00:28:12] Chris Duffy: Well, for people who are listening and are sold on these ideas about the
promise, but also the potential perils of a future technology, how can we be. Participants in the future
of tech, uh, is it being better stewards around regulation or, or how do we get involved and how do we
make it so that the future is what we want it to be rather than what we fear.

[00:28:35]Kevin Roose: It could be. Yeah. I think the first step is to learn is to really understand
what's happening on the technological frontier so that you feel comfortable weighing in. So that
technology is not just a thing that happens to you. Um, it is a thing that you feel like you have some
agency over. You know, if, if you're signing up for some new service or new social network or new
product, like, like figure out what is happening under the hood a little bit and be a more educated
consumer, the way that like, you know, you want to understand what's in the food that you eat. Um,
you want to understand what's in your information diet and what forces are operating there. this idea
that. In the tech world, I'm sort of known as like friction, which is basically like, how do I, and it's
usually used in the context of tech products that are trying to get rid of friction. So making it as easy as
possible to like watch a video or order something or like, you know, comment on. Birthday, you know,
Facebook page or something where you stored your credit card.

[00:29:46] Chris Duffy: So it's just one click to buy.

[00:29:48]Kevin Roose: Exactly. But I've been sort of trying to systematically introduce a little bit
more friction into my life. Cause I think like things are a little bit too easy and it tends to put me on to
autopilot. Um, and so I've been, you know, Taking the long way to go somewhere and like, not
following the Google maps fastest route every time, like maybe getting something from the hardware
store down the street, instead of ordering something from Amazon. Uh, even if it's a little more
expensive, um, trying to like be a little bit more thoughtful about what I, what I consume, um, And
then I think, yeah, just, just engaging in the democratic process, you know, elect people who
understand this stuff and are thoughtful about it. Um, make your, your feelings known, um, in a way
that's, you know, thoughtful and, and respectful. But I think, I think we're entering into an age where.
The tools in our society are, are more important than they ever have been. And so, um, it's incumbent
on people to understand that and to weigh in and to not just, you know, wake up one day and find
that the world has changed around you. And you had no part in, uh, in deciding how to live in that
world.

[00:31:02] Chris Duffy: The is called how to be a better human. What are you personally trying to
do right now to be a better human in your own life? Okay.
[00:31:10]Kevin Roose: So the, well, right now I'm trying to raise a son. That's a big wish which
feels, uh, sort of cliche, but also like truly, truly terrifying and challenging and, um, and you know, tests
me in all kinds of ways. Yeah. That I sort of feel like it's forcing me to be a better human, um, you
know, to respond with compassion and empathy at 3:00 AM. Uh, when, when there's a meltdown
happening as I did last night, um, that feels like it's stretching me in some new ways. Um, so that's,
that's one of the ways I'm trying to be a better human.

[00:31:48] Chris Duffy: That's a huge one. That's a really, really big one. And then what is
something that has helped you to be a better human? Whether it's a book, a movie, a piece of music
and idea, anything.

[00:32:00]Kevin Roose: Um and obsessive evangelist for, uh, this app called freedom, um, which is
basically the only reason that I have been able to get anything done for the past five years. Freedom.
Freedom is an app it's on your computer, it's on your phone and you basically tell it like, I like do not
let. Go on social media for the next, you know, X hours. Um, do not, let me, um, check my email, do
not, let me, um, you know, uh, surf YouTube, uh, and you can put in sort of custom sites that you
custom lists of sites that you wanted to block, whatever your time-wasters are like. And your sort of
just, I don't know, junk junk food, um, for your brain are you can set it. Cut that off systematically, uh,
for, for any length of time you want. And so it's how I write. It's how I focus. Um, I have no self
control, so I need to outsource that to this app. And luckily this app has, is very good at, at
implementing self control for me. So that is my shortcut to being a better human amazing.

[00:33:11] Chris Duffy: Kevin. Thank you so much for being on the show. Thank you for all the
writing and all the thinking that you've done about this, but also just for talking to us about it. It's really
been a true pleasure here.

[00:33:20]Kevin Roose: It has been a real pleasure. Thank you for having me.

Chris Duffy: That is it for today’s episode. I am your host Chris Duffy and this has been How To Be A
Better Human. Thank you so much to our guest Kevin Roose, his latest book is called Futureproof, you
can also check out his podcast with the New York Times called Rabbit Hole. On the TED side, this show
is brought to you by Sammy Case, and Anna Phelan. And from Transmitter Media, we’re brought to
you by Isabel Carter, Farrah Desgranges and Wilson Sayre. For PRX Productions the show is produced
by Jocelyn Gonzales and Sandra Lopez-Monsalve. And ME Chris Duffy. We’ll be back next week!
What’s normal anxiety and what’s an anxiety disorder?: Transcript

Body Stuff with Dr. Jen Gunter

Wednesday, June 30, 2021

Listen Along

Dr. Jen Gunter:

Just letting you know, this episode discusses mental illness. Take care while listening.

When I was a kid, it felt like my dad was obsessed with getting to the airport on time. It would start a
week ahead of our flight… sometimes even more. On the day of the flight, if the taxi we’d scheduled
for 4am -- already 2 hours earlier than needed -- wasn’t there by 3:59, he’d get really agitated. Then
we’d always get there so early, that nothing would be open yet. And he’d start screaming at people -
the folks who worked there, my mom.

He was clearly in a lot of distress, and when you’d try to talk him down and explain it was ok, he’d
brush you off. He was in the right, and we just couldn’t see it. He did other things that felt similar: he’d
always worry that he’d left the stove on or that he left the iron on. And my brother and I started
checking these things when we were getting ready to go anywhere, in hopes that my dad wouldn’t
worry if we took care of it.

But it never helped.

My dad’s anxiety permeated lots of things, and caused a lot chaos. As a kid this was really hard on me.
I was embarrassed all the time. Other people thought my family was strange - my friends didn’t want
to come over to my house to hang out. It didn’t know anyone else who was like this and it felt like
there was something wrong with my family.

Now, I recognize my dad had a severe anxiety disorder.

He never sought treatment for it. In the 1970s, no one talked about mental health. Especially not
men’s mental health. And even today, the stigma and silence remains As a doctor, I see this all the
time - I regularly have patients who are clearly struggling with anxiety, but don’t know it, or have a
hard time accepting that diagnosis. It’s not surprising - our whole lives, we receive messages about
how mental illnesses aren’t real illness.

“Why can’t you just stop worrying?! … Don’t be such a snowflake… He’s just so unstable… She’s
crazy… What do you need, a trigger warning?… Why can’t she just get it together?”

But I’m here to tell you that anyone with symptoms of mental illness is experiencing something that is
as real as high blood pressure. And if you had high blood pressure, no one would tell you to just ignore
it, because it’ll go away. That could lead to unnecessary suffering… and perhaps, injury to your heart or
your kidneys. With high blood pressure AND with mental health issues, ignoring problems risks making
a lot of things worse.

Today, we’re talking about something we all experience from time to time, but can sometimes escalate
to a medical condition: Anxiety.
I’m Dr. Jen Gunter. From the TED Audio Collective, this is Body Stuff.

Think about a time when you were feeling really anxious. What was making you feel that way? Maybe
a big test, or a serious conversation you had to have with someone important to you, or when you’ve
had to drive at night during a rainstorm. How did that anxiety feel in your body? Did your heart start to
race? Did you start to sweat? Anxiety isn’t just happening in your mind - it’s full-body reaction. So how
does it all work??

I called up Dr. Kali Cyrus. She’s a psychiatrist in Washington DC. I asked her to give me the basics.

Dr. Kali Cyrus:

So anxiety is generally a form of fear or a form of worry. You are afraid that something is going to
happen or you are just increasingly worried, maybe apprehensive. You're not sure if something bad is
going to happen, you are maybe overly focused on the expectation of some kind of outcome, like you
just can't stop thinking about something.

Dr. Jen Gunter:

One thing I sometimes hear from people is, um, is that, Oh, well, you know, you should just, just be
less anxious. So just try to be less anxious. But I mean, you know, that in many ways sounds like trying
to say to someone why don't you just have less high blood pressure or, you know, why don't you have
just less abnormal cells in your uterus?

Dr. Kali Cyrus:

It's exactly the case. It's just that we don't think about feelings and emotions in that way. For some
people it's actually part of your genetic makeup, um, or there was something in your environment
where you were predisposed to so many circumstances where you were alert. And if you can't control
your environment, you certainly can't control your genes. You can't just get rid of your anxiety just like
your cells or your high blood pressure.

Dr. Jen Gunter:

Anxiety is a normal emotion that all humans experience, just like happiness, sadness, and anger. It
turns out all feelings have purposes. Looking at evolution can give us some insight here.

For example, joy and affection tie families together, to create stronger bonds of support. Anxiety exists
to keep us alive. It’s part of our threat response system. And Anxiety and Fear are closely related.
Imagine thousands of years ago, you’re out foraging for roots and berries, and there’s a rustling in the
tall grass. You need a system in place to help you sort out if it’s just the breeze, or a lioness is on the
prowl.

Today, we have fewer lionesses to deal with. But we still have threats, and anxiety helps us predict
them, and respond to them. So what’s going on here? We have two main parts of our brains that are
involved in anxiety: the limbic system and the cortex.

Dr. Kali Cyrus:

We have the limbic system, which has sort of thought of this old emotional system that helps to sort of,
uh, you know, get us ready to fight a tiger

Dr. Jen Gunter:

The limbic system is involved with our emotions and behavior, among other things. Especially when
those emotional or behavioral responses have to occur quickly, without applying reasoning or
judgement, to keep us alive. Like our fight, flight, or freeze response - which is both a mental and
physical reaction to a potential threat.

Dr. Kali Cyrus:

And then we also have the third part, which I'm just going to call our cortex, right? And this, these are
some of the more complicated parts of our brain when we think about how we reason or how we plan,
where our judgment and where our motivation comes from.

Dr. Jen Gunter:

The brain is complex and interconnected … and what’s going on in one part of the brain is absolutely
influencing the other parts.

Dr. Kali Cyrus:

So you're walking down the street and you see somebody walking towards you, maybe it's like a dark
alley and your amygdala is probably the first thing that goes off.

Dr. Jen Gunter:

The amygdala is a little almond shaped region in our limbic systems. It’s the main fear processor in our
brains

Dr. Kali Cyrus:

Um, which is basically being activated when you see this guy walking towards you, So let's say your,
your mind perceives this as fear. So what ends up happening is that your amygdala will start sending
signals to other parts of your brain, including the hypothalamus. And what will end up happening, the
fight flight or freeze system will get triggered, which will help your body basically run or fight or freeze,
or just stand still.

Dr. Jen Gunter:

The amygdala sends out the distress signal, and it’s received by the hypothalamus - another part of
your limbic system. Then the hypothalamus relays that signal to the rest of your body.

Dr. Kali Cyrus:

Your blood vessels will constrict so that in case you get cut or stabbed or something like that, that you
won't bleed out, your digestive system will shut down because it's not time to pee and poop also is like,
it's time to save your glucose so you can fight... your lungs, your bronchials will dilate so that you can
let in as much oxygen as you can to get to your muscles in case you need to run. And also your heart
rate increases so that you can pump more blood to your muscles.

Dr. Jen Gunter:

So your limbic system is responding to that threat immediately, with the fight flight or freeze system. At
the same time your cortex - the part of your brain that applies reason - is also trying to figure out the
situation.

Dr. Kali Cyrus:

And then I think about the cortex thinking, well, have you seen a face like this before? It's at nighttime?
Should we have we ever encountered a situation with someone who's ever hurt us in a position like
that?
Dr. Jen Gunter:
You have two different systems running at the same time. And so much of your experience of anxiety
depends on how those two systems work together.

Dr. Kali Cyrus:

And so there are some ways in which the amygdala can take over and you are afraid if you don't get,
um, processing from the cortex or some of these higher thinking of reasoning to tell you that you don't
need to be afraid.

Dr. Jen Gunter:

So it may not surprise you considering my history that I used to be very anxious about flying. As soon
as I booked a ticket, I’d be nervous.I knew it wasn’t rational. I knew that the chance of my plane falling
out of the sky was astronomically low. But I couldn’t stop worrying about it. My cortex and my limbic
system were at war - but eventually my cortex would rally the troops, and I’d get on that plane. I’d be
nervous, it would not be fun, but the whole thing didn’t disrupt my life. But for some people, anxiety
can be disruptive. They experience persistent, pervasive anxiety that gets in the way of their daily life
or relationships. That’s when it becomes an anxiety disorder.

People who have anxiety disorders find that they will start feeling super anxious out of nowhere, or
their anxiety is completely disproportionate to a situation.

Dr. Kali Cyrus:

So you can see that your body starts to respond as if it's fighting a tiger and activating this entire
neurochemical response when it doesn't necessarily need to. When someone comes to me and is
talking about how maybe the past couple of weeks, they just haven't been able to leave the house.
Every time they leave the house, they have a panic attack.

Um, or someone comes to me and says you know, maybe I got COVID in December and I've been
afraid to interact with anyone. I like to think that if you are experiencing the symptoms of anxiety, most
days of the week for a prolonged time that is interfering with your daily functioning, then that's when it
poses, um, a level of being a disorder to me.

Dr. Jen Gunter:

There are many types of anxiety disorders, but Generalized Anxiety Disorder is one of the most
common. It’s symptoms can be very unpleasant and disruptive.

Dr. Kali Cyrus:

Someone might be feeling restless or keyed up. They might be tired, you have trouble concentrating.
You're also just kind of irritable. Like things bother you. People are moving as fast as they need to. You
just don't know why you're kind of cranky muscle tension. So for whatever reason, um, maybe your
jaws clench, or you find that your, your teeth are clenched. Um, and then you also usually have some
kind of sleep disturbance. So you might have trouble falling asleep or staying asleep

Dr. Jen Gunter:

It can be incapacitating. Researchers have looked at people with anxiety disorders, and found some
specific differences in the structure and function of parts of their brains.

Our brains have billions of interconnected neurons It’s like the motherboard of a computer, and it’s
incredibly complex. Networks of connected neurons are known as pathways, or circuits. And the more
times those pathways fire, the more likely they are to fire again.
Think of these pathways as literal paths in a grassy field. The more often you use one path, the more
tamped down the grass is, and the easier it is to walk. When you use one path all the time, what
happens to the others? They start to overgrow and get harder to use. So our brains are constantly
changing and adapting to the signals we receive. This is known as neuroplasticity.

Dr. Kali Cyrus:

And that's part of like the wonder of the brain, which is that the circuits that get used and used and
used, you know, so the amygdala to the hypothalamus or the amygdala to the prefrontal cortex in
response to something that you're processing is a pathway that gets strengthened over and over and
over again, every time you respond in a certain way.

Dr. Jen Gunter:

So in the brain of a person with Generalized Anxiety Disorder the amygdala becomes hyperresponsive.
It might even issue false alarms. Over time, anxiety can cause changes in the brain, essentially
strengthening the areas involved with anxiety. This can become a feedback loop that can produce a
lasting shift in brain structure and function.

Dr. Kali Cyrus:

And so trying to undo that is just not going to happen that easily. You really have to put in the work to
try to break that cycle.

Dr. Jen Gunter:

The good news is that our brains have an astounding ability to change. You know how I said I used to
be really anxious about flying? A few years ago, I was on a flight to New Jersey, sitting next to a pilot
who was on his way to his next job. We got to talking, and I told him how anxious I was about flying.

Then during the flight, every time there was a bump, I’d turn to him and ask if it was a big deal? Every
bump felt HUGE to me. But the pilot would chuckle and say, oh, that’s nothing. He’d explain exactly
what was happening. By the time the flight was over, I really understood a lot more of what was going
on. And after that, each time I’d start to get anxious about flying, I’d remind myself of that
conversation. I’d remember how it felt sitting next to that pilot, how safe he made me feel.

I remembered that conversation again and again and again… every time I planned a trip, every time I
got on a plane. After a while, I didn’t have to remember that conversation to feel comfortable flying

I’d created new neural pathways.

After the break, we’re going to talk about how coping with anxiety means understanding it, accepting
it, and asking for help. All of that can mean wading through the stigma around mental illness… a
stigma that has roots deep in history.
_

I understand why my dad never got help for his anxiety. His generation’s attitude about mental illness
was 1 - it’s a sign of weakness, and 2 - it’s a woman’s problem. That stigma’s been around for a long
time.

Professor Helen King:

It's one of those ways that men oppress women and have done for a very, very long time.
Professor Helen King is a brilliant classicist in the UK. She studies the history of Western medicine, and
has a particular interest in the ways misogyny is all tied up in it.

I find her work totally fascinating! I might actually be her biggest fan.

Dr. Jen Gunter:

If we were in person, I’d have you autograph my copies of “Diseases of Virgins” and “Hippocrates
Woman.”

Professor Helen King:

Sorry, had a moment of such excitement there that my microphone fell off!

Dr. Jen Gunter:

Professor King says you can trace the stigma about mental illness to outdated ideas of the female
body. Historically, physicians were absolutely obsessed with the womb… or the uterus.

Dr. Jen Gunter:

I'm always fascinated by, you know, reading, you know, older medical textbooks and why a man may
have gout and maybe it wouldn't be what we'd accept today, but it fit with the model of the day. And
for the woman it's your uterus.

Professor Helen King:

Exactly. It's always a uterus.

Dr. Jen Gunter:

The ancient Greeks blamed A LOT of things on something that seems wacky to us now: the wandering
womb.

Professor Helen King:

So men's organs stay roughly in the right place, except, you know, in obvious sexual situations where
they move up and down a bit. Plato actually says that it's not even me being rude here, it's Plato. Um,
women are different because women have wombs and wombs just wander. And sometimes they're
seen almost as animate.

Dr. Jen Gunter:

they're sort of like naughty animals, I guess, kind of wandering the body. Like they're looking for
something like they are a creature… it’s described as an animal inside an animal in one Roman text.

Dr. Jen Gunter:

This was also the time when doctors believed that the key to how your body worked was something
called the four humours.

I’m not talking about something that makes you laugh… it’s the four fluids that physicians once thought
made up the body: yellow bile, black bile, phlegm, and blood. Before anyone knew about germs and
genetics, people blamed everything on the humours. Got a cold? or a pain in your hip? Your humors
are out of whack.

Professor King says blood was the humour associated with women and their wombs… so most female
maladies were blamed on a blood imbalance or her womb wandering around inside her body.
Professor Helen King:
It's all about the blood getting stuck and that can cause disorders anywhere in the body, you know. A
man, with a pain in his shoulder, is what have you been recently doing? Lifting and carrying. A woman
with a pain in her shoulder? Ooh, your womb got stuck in your shoulder, you know, it's that sort of, it's
that sort of level. It's all about the womb and the womb is all about retaining blood, collecting it,
pouring it out at the right time or not.

Dr. Jen Gunter:

For much of the history of Western medicine, there wasn’t any distinction between physical and mental
health. And when the womb was just a naughty little animal that wandered the body... it was seen as
an unstable organ… and the women who had wombs were seen as unstable too.

Professor Helen King:

So because your, because your womb is on the move all the time, you, you know, you just can't really
settle to anything. So you're kind of naturally unstable “Oh, she's crazy.” That's got an extremely long
history.

Dr. Jen Gunter:

The idea of women as unstable, as made up of weaker stuff… was a very effective way to oppress
women. Professor King told me about an example from the 16th century.

A young woman named Anna isn’t well. And her father is concerned - Anna is old enough to get
married, and he’s worried that her malady could affect her marriage prospects.

Professor Helen King:

She's pale. She's got palpitations. She's got great difficulty breathing. She's got problems with her
eating. Now, I mean, we might say, Oh look, you know, let's look at this as possible anorexia, you
know, she's not eating properly. Or we might say, what about these palpitations? Is this some sort of
nervous thing.

Dr. Jen Gunter:

Anna’s dad reaches out to a doctor for help. And they begin a correspondence.

Professor Helen King:

As far as they're concerned, it's to do with blood it's because she's still a Virgin. Her blood has got stuck
in her body and it can't go out because she's not open at the bottom. This disease is what's called the
Virgin's disease. Because she’s a virgin.

Dr. Jen Gunter:

If you look at Anna in context, I see a young girl going through puberty, with a lot of pressure on her
about getting married. Maybe she’s anxious about getting married, or not getting married.

Marriage was not exactly a picnic for young women at that time.

Professor Helen King:

Particularly, if you had the experience of other members of your family, women, who've been married
and then died in childbirth, which obviously it was a lot more common then than it is now. We don't
always factor in when we look at the past, you know, examples from early modern Europe of people,
writing letters before, before they go into childbirth, in case they die because it was a real risk.
Dr. Jen Gunter:
Right.

Professor Helen King:

Being a woman was a very dangerous thing to be. You can sort of see that someone like that of the
age for marriage, it will be enough to make you pretty anxious.

Dr. Jen Gunter:

But Anna’s doctor makes a very typical diagnosis for the day, with a typical treatment:

Professor Helen King:

The cure ideally is to let the blood out. You can do it with marriage or you can do it with bloodletting.
Lots of things that women have wrong with them, the answer is bloodletting, you know, if in doubt,
there's always bloodletting.

Dr. Jen Gunter:

Bloodletting--cutting a person open and draining some of their blood--was prescribed liberally—to both
men and women—for a very long time. But it was closely associated with female maladies

Professor Helen King:

But then the ultimate bloodletting is actually having a baby. So, not only does your blood form the baby
and feed the baby in utero, but then when you give birth, you also lose blood. So that cures you of
anything that's been built up for, for a long time in your body. So how often you find in the ancient
Greek texts, if she gets pregnant, she will be healthy.

Dr. Jen Gunter:

It’s hard for me to ignore the fact that for Anna, the cure is either performing a painful, traumatic, and
potentially dangerous bloodletting, or a possibly equally traumatic marriage and pregnancy.

Professor King has observed in her work that across thousands of years of medical history, over and
over, medicine was used to control women… because the idea was they needed to be controlled.

Professor Helen King:

Women are just, you know, completely wild and they have to be under the control of men, or they'll
just be; go on being completely wild.

Dr. Jen Gunter:

I think it's this it's if, if you want to stay in power, then the greatest way to stay in power is to tell all
your detractors or the people that you want to have power over that they're, you know, they're crazy
or stupid or wrong or less intelligent.

That persistent idea that women were crazy, or unstable, or less intelligent? It helped set the stage for
a complementary idea to emerge... That mental illness was feminine.

The prime example is hysteria, a diagnosis that came into vogue in the 17th century. Hysteria was an
emotional affliction caused by the womb. That’s why it was named after the Greek word for uterus -
hystera. It supposedly caused everything from anxiety to sexual deviance to fluid retention.
At the same time, the idea that the mind and body were distinct had started to take root. Which meant
medicine was talking about mental illness as something separate from physical illness. And physicians
began to think of hysteria as a problem with the brain… rather than just the womb. That opened up
the possibility that men could be hysterical too. For a time, some doctors used “male hysteria” as a
diagnosis in men who had PTSD-like symptoms after experiencing battle.

Professor Helen King:

It's fascinating. The idea was that the sorts of reactions men with shell shock had were very similar to
what they expected a woman with hysteria to have. So they call it male hysteria, but it didn't catch on
as a name because you can't use the word hysteria of a man because you know, it's not manly as it. So
it became shell shock, which sounds like a manly good, hard consonance shock.

Dr. Jen Gunter:

Wow. That's fascinating.

Professor Helen King:

It is extraordinary. Isn't it? It's basically feminizing them. It's saying that some sorts of bodily reactions
are not appropriate to proper men. And if you've been told all the time that you can't possibly have a
mental illness, cause that's a feminine thing, you won't seek treatment.

Dr. Jen Gunter:

I think we still see this kind of stigma today. I definitely saw that with my dad. And I want to
acknowledge that this isn’t just about misogyny, it’s also about homophobia. And it hurts all of us. It
stigmatizes a lot of people who are struggling… and it keeps them from getting help. I think the way
around all of this is a deeper understanding of what mental illness is… And since we’re talking about
anxiety disorders, lets start there.

It’s true that some people are more vulnerable to anxiety disorders than others, but it has nothing to
do with being feminine, or weak. There’s complex biology at play. In the past few decades we’ve come
to understand how what happens when we’re kids can affect our health as adults. Researchers have
identified a set of Adverse Childhood Experiences - or ACES - that correlate with higher levels of mental
illness later in life, and also physical problems like heart disease and diabetes.

Dr. Kali Cyrus:

And so the ACEs, at least that they categorize are things like being physically, sexually or emotionally
abused being emotionally or physically neglected.

Dr. Jen Gunter:

That’s Psychiatrist Dr. Kali Cyrus.

Dr. Kali Cyrus:

Having an addicted parent, having a parent who is depressed or had some other kind of mental health
condition, having a separation of your parents, uh, having someone who was a parent who was
incarcerated.

Dr. Jen Gunter:

ACES can rewire a young person’s brain in the same way that we talked about earlier - the more often
a path is walked, the more defined the path becomes. Neurons that fire together, wire together.

So if you were raised in a household where you were frequently exposed to abuse...
Dr. Kali Cyrus:
Your reaction and exposure to these events shaped your brain circuitry. How often you, your amygdala
witnesses, something that it signals as fear and how often then your hypothalamus and other parts of
your brain activate that fight flight or freeze response, how that over and over and over again for years
then impacts you as an adult, as an adult, when your circumstances may have changed and how you
can have anxiety because this system is going off constantly

Dr. Jen Gunter:

So when the fight, flight, or freeze response is repeatedly activated, it creates a ripple effect in your
body.

Dr. Kali Cyrus:

And so if you think about your heart rate, going up, your bronchioles and your lungs are being
expanded to bring in more air, you know, all of these processes happen in your body over time and
just sit there. Right? So usually if you're going to fight, you're going to use those resources up. You're
going to use that oxygen. You're gonna use that glucose, but imagine if it's just continually gets
activated and you don't actually need to fight, right? What that does to your body.

Dr. Jen Gunter:

Over time, all of this can disrupt the development of brain architecture and other organ systems.

There are other legacies of ACES.

Children may also develop behaviors formed in reaction to those adverse experiences. They might use
less helpful coping strategies, like shutting down or lashing out when there’s conflict, or working
extremely hard to keep people around them calm, in order to avoid any conflict.

Dr. Kali Cyrus:

And you can imagine if you were typically the kind of child who yelled or you shut down, or you tried to
please everyone, and that got you out of trouble as a child over and over and over again until you were
18. And then you're out in the world, that's going to be your knee jerk because it worked.

And so how do you undo. You know, something that's been habituated for years and not just, I think
behaviorally in terms of like, Oh, if my go-to is to respond in this way, but I mean, also neurochemically
those pathways in your brain are solidified, you know, from the moment you started doing that as a
child.

Dr. Jen Gunter:

These experiences have long term impacts over a person’s life. An adult who experienced ACES as a
child is more likely to have asthma, kidney disease, stroke… they could be even more likely to
experience earlier menopause. And these impacts can be magnified over generations. Some things can
help prevent ACES from having a long term impact. For example, having a loving, supportive
relationship with an important adult can be a buffer. The National Institute of Mental Health says that
more than 30 percent of Americans will experience an anxiety disorder at some point in their lives.

So what is the path forward for so many people who live with one? One of the first steps in managing
an anxiety disorder is getting diagnosed.

Dr. Kali Cyrus:

So the first thing I will say is, is it's okay. If you have severe anxiety is just acknowledge it. Um, but I
think that the main treatments are in terms of medications, but also in terms of therapy and typically,
and also the research suggests that doing these things in combination is more effective than doing one
or the other.

Dr. Jen Gunter:

Let’s start with talk therapy. One of the kinds of talk therapy that can be extremely effective for anxiety
is CBT, or Cognitive Behavioral Therapy. CBT helps you learn to tamp down your fight, flight, or freeze
response

Dr. Kali Cyrus:

You are really just talking through what a patient's personal experiences are in these stressful
situations, step by step, and really trying to help them understand how their emotions are connected to
their body response and how all of that is stored in our brain.

So that the next time we experience it, we have the same kind of reaction. So how do you intervene?
How do you take yourself off of that loop in a way that is actually helpful And so it's really powerful
actually that, you know, a talking form of therapy can do all this.

Dr. Jen Gunter:

It can be hard for people to imagine that a problem so overwhelming could be helped by something
that seems as inconsequential as talking. But this is a structured process that’s been scientifically
proven to help establish and strengthen new pathways in the brain. The stronger those pathways
become, the more likely you are to react to triggers in that new, more productive way.

Medications can also be incredibly helpful. Some prescriptions help change the way the neurons in your
brain are firing.

Dr. Kali Cyrus:

The pharmacological medications that we think about are the ones that are triggering the
neurochemicals that are involved in some of these neuro processes that we've been talking about—You
take a medication and it tries to change the, at least the ratios in which they are released will help to
signal to the amygdala to tell the hypothalamus to turn on or turn off, or tell the amygdala to turn on
or turn off.

Dr. Jen Gunter:

Dr. Cyrus says it can take up to a month for medications like this to start working. But there are also
options that help people who need to calm down in a moment of a panic, and they help lots of people.
Medications get a bad rap, there’s a lot of stigma and misinformation. But working with a qualified
mental health professional you trust is a great way to explore your options.

The basic health things work too: good nutrition, plenty of sleep, and exercise.And many people find
meditation helpful as well. Meditation dampens the fight, flight, or freeze system and promotes an
alternate relaxation response, slowing down the heart rate and breathing.

There’s an elephant in the room that I want to acknowledge - it can be incredibly hard to access
mental health care. It can be hard to find someone who is taking patients, and if you do find someone,
it can be prohibitively expensive.

This lack of access, plus the stigma we’ve been talking about… you can understand why people don’t
get the care they need. This has to change. Until it does, people will keep suffering.
When I got to medical school and figured out that my dad had an anxiety disorder, it was a relief. It
was powerful to have a diagnosis … to learn that my family wasn’t uniquely broken. Sometimes I think
about how my life would have been different had my dad gotten a diagnosis earlier, and received help
with his anxiety disorder. I think of all the chaos, of the yelling and screaming … maybe it could have
all been avoided. And most of all, maybe my dad would have suffered less. This is the point-
conversations about mental health are just conversations about health. Period. Next week on Body
Stuff, sometimes your body just needs to be cleaned out with a detox or cleanse….right?

Kaveh Hoda:
No. The only thing these cleanses and detoxes remove from your body is your money.

Jen Gunter:
We take on a myth that’s stuck around for centuries...and introduce you to your most mysterious
organ… the liver.

Body Stuff is a member of the TED Audio Collective. It’s hosted by me, Dr. Jen Gunter, and brought to
you by TED and Transmitter Media. This episode was produced by Lacy Roberts and edited by Sara
Nics. The rest of the team includes Camille Petersen, Alice Wilder, Gretta Cohn, Michelle Quint, Banban
Cheng, and Roxanne Hai Lash. Alex Overington is our sound designer and mix engineer. Krystian
Aparta and Neeraja Aravindan are our fact checkers. And special thanks to that sweet old lady in the
church choir who has since passed away, who knew my parents were really weird, and took me under
her wing.

We’re back next week with more Body Stuff. Make sure you follow Body Stuff in your favorite podcast
app so you get every episode delivered straight to your device. And leave us a review! We love hearing
from our listeners.

See you next week!

Do you really need 8 hours of sleep? (Transcript)

Body Stuff with Dr. Jen Gunter

Wednesday, June 25, 2022

Listen Along

Sara Nics:
I'm looking at my bedside table. And I have 1, 2, I have three eye masks. I have some melatonin. I
have some Zolpidem in case of emergencies. I have a bag full of earplugs. I fear to not be a great
sleeper.

[00:00:10] Dr. Jen Gunter:

This is our editor, Sara.

Sara Nics:
Lately I wake up in the middle of the night, and I lie in my bed and I think, am I sleeping. Am I
sleeping now? Should I be sleeping? I should be sleeping. Am I sleeping?

Dr. Jen Gunter:

The anxiety can absolutely take over and then it's like a rock rolling down a hill. So why did you start
worrying about your sleep?

Sara Nics:
You know what might have started me getting stressed out about sleep a little bit. I had, like many
people, a Fitbit, some number of years ago, and it had a kind of sleep monitoring aspect where it
would tell you like how, how you were sleeping, how you had slept. I do think sometimes I woke up
and felt like I'd slept fine. And it said that I tossed and turned a lot. And then I think I'd started
worrying. Like oh, am I not sleeping well when I think I am? It made me not trust my sleep.

Dr. Jen Gunter:

Why are you worried about how you sleep and not how you sweat?

Sara Nics:
Maybe because I'm not conscious for when it's happening, like maybe because it is a mystery. Yeah,
it's a mystery. Sleep's a mystery.

[00:01:21] Dr. Jen Gunter:

Sleep IS mysterious. It’s also easy to worry about because it’s so important … when we can’t sleep, we
feel awful and are DESPERATE for help…

But lately, it feels like our fascination with sleep has gone too far. Do a quick Internet search, and you’ll
find a slew of articles about how to make your sleep perfect, and productive.

Even worse, you might find claims that if you’re not sleeping right, you won’t live as long! You’ll get all
kinds of diseases! So… stay away from blue light! Don’t drink caffeine in the afternoon! Buy this
supplement. Get that fancy alarm clock. Try this pillow, this mattress….it goes on and on and on.
And if you're already struggling with sleep – it’s hard to get clear guidance on what will really help.
Honestly, I’m a DOCTOR and it’s hard for me to sort through the noise!

I’m Dr. Jen Gunter. And from the TED Audio Collective, this is Body Stuff. In this episode, we’re getting
to the bottom of sleep. From circadian rhythms to Puritan witches to the bat signal in your brain…it’s all
coming up, after this…

[00:02:46] Dr. Jen Gunter:

I'm just going to confess I'm, I'm a bit of a stalker of your research and your writings.

Dr. Colleen Carney:

I'm a stalker too. That's funny. I feel like I already know you because I feel like you're a Twitter friend.
You're a feisty one too, kindred spirit there.

[00:03:00] Dr. Jen Gunter:

Dr. Colleen Carney is a psychologist, and the director of the sleep and depression lab at Ryerson
University in Toronto. Sleep medicine is a relatively new field, and studying sleep is kind of like peeling
back the layers of an onion…there’s always more to understand. Researchers like Dr. Carney are
grappling with some really big puzzles. Like what is sleep?

[00:03:25] Dr. Colleen Carney:

The nerd answer is that we don't really know what sleep is and you can think of sleep as more of an
idea that changes based on how you measure it. Is it your Fitbit telling you that you are asleep? Is it
your experience? Because people with chronic pain will tell us they're awake when we think they're
asleep. So is it the EEG telling us that they’re asleep, their brainwaves? So the idea of sleep is actually
this incredible mystery in a way.

[00:03:57] Dr. Jen Gunter:

We know that we need sleep, but we’re still figuring out all the amazing things it does for us…

[00:04:03] Dr. Colleen Carney:

We don't have a universally accepted explanation of what sleep really does. We know that it restores
tissue, right. That's where we get most of our
growth hormone released. So, that makes good sense. And it helps us also when we're growing as
kids.

[00:04:20] Dr. Jen Gunter:

Our brains do lots of organizing and maintenance work while we’re sleeping. Sleep helps us learn, and
form new memories.

[00:04:28] Dr. Colleen Carney

But what's really cool is we're also getting some pruning, the unimportant stuff's getting pruned away
and forgotten. So we sleep to remember but we sleep also to forget.

Dr. Jen Gunter:

I like to joke that I’ve learned so much in medicine over the years that one day knowing how to tie my
shoes will fall out of my brain! But sleep is making sure my brain keeps what I need and gets rid of
what I don’t. It’s kind of like your internal Marie Kondo.

While we sleep, we cycle through different stages. Each one has its own patterns of brain activity.
Dr. Colleen Carney:
Stage one sleep is a stage of sleep in which you might tell me you're awake. Cause you, you have a
memory of that time. You have some awareness of what's going around, going on in your
surroundings.

Dr. Jen Gunter:

One time, I was in this half awake-half asleep state and talking to my son! When he asked me a
question, I responded, “Franklin chicken sausage,” which made perfect sense to my half-asleep brain.
So in my house, that’s what we call this sleep stage.

Stage 2 sleep is probably the stage we spend the most time in.

Dr. Colleen Carney:

And you're going to be less aware of your surroundings during this one. But if you hear an alarm or
your name or something meaningful, you can be roused out of it. In fact, we can actually see your
brain responding to things in the environment, even if you don't wake up, which is really kind of cool.

[00:05:56] Dr. Jen Gunter:

Stage 3 is…deep sleep. Sometimes called delta or slow wave sleep.

Dr. Colleen Carney:

The majority of this stage is really this deep non-responsive growth hormone, recovery type sleep. It's
going to be about 20% or less of your entire night, but it's really important when it happens and it
happens closer to the start of your sleep. So in the first half of your sleep period. And then, you’ve got
your wild REM sleep. It used to be called paradoxical sleep because it looks like wake and this is where
most people are going to have an awareness of dreaming and it's because there's all this transition,
sleep interspersed. So you, you, you see some REM activity and then you see stage one and two
sandwiched all, all around it and throughout it. And, and that's actually how, you know, you're
dreaming is that you have these awakenings either right after or throughout.

[00:06:55] Dr. Jen Gunter:

So how does our body know when it’s time to sleep? There are two internal biological mechanisms that
guide us. First, sleep drive: the longer we’re awake, the more our sleep drive increases. Second,
circadian rhythm, which is like a clock ticking inside us.

Dr. Colleen Carney:

I want you to imagine that you're going to have a dinner party and you're going to invite a friend over
who has a toddler and you say, you know, bring, bring little Johnny. Dinner’s at eight. And imagine
what the mom's face would be like. It would be like no, because you would disrupt when they are
going to have their regular meal and their bedtime and little Johnny is going to be a monster and like
ruin your dinner party. Right.

So why? Well it's because we are clocks. So we have rhythms all throughout our body, in our gut, in
our muscles. In our brain, our suprachiasmatic nucleus. It keeps time and it coordinates itself with the
environment, with the sun. So when we travel and we feel jet lag, it's like, we're little Johnny, right?
Because it's like basically there's a mismatch between the timing that's expected in our body and the
timing in the environment.

[00:08:10] Dr. Jen Gunter:

What’s most important to know about these clocks is that they crave regularity. We spend a lot of time
creating routines for kids to keep their clocks happy! Little Johnny goes outside every day to play, eats
his meals at a certain time, and has a regular bedtime and wake time. But adults often don’t know that
they need a schedule too!

[00:08:31] Dr. Colleen Carney:

And then the sleep problems that we experience are actually really related to the fact that our clock is
always trying to catch up to the environment because you're, like throwing 10:00 PM at it certain days,
and then 2:00 AM certain days and then, no meals, so nothing to, to, to regulate it. And I mean,
COVID has been the worst for this because people have been inside. They don't have a regular work
schedule anymore. And just like going out to the gym, going out to a job, having regular meal times,
it's just all out of whack. So some of the fatigue that people are feeling is actually really just circadian
rhythms.

Dr. Jen Gunter:

That is fascinating. So I have a question about people that live in the extreme north. What happens to
your circadian rhythm, where you have these days that become incredibly short and you even have,
you know, a month with very little sunlight. So what's, what's happening to them?

Dr. Colleen Carney:

It’s what we would call a social zeitgeber. So a zeitgeber is a cue giver to the clock and the most
powerful cue giver to the clock is absolutely light, but behaviors like eating, these things can actually
help with free running circadian rhythm. So when you're up north, they have ways of adapting to that
and they maintain a routine despite.

Dr. Jen Gunter:

So we have this biological system, this clock telling us when it’s time to sleep and time to wake up.

One of the biggest worries we have about sleep is that we’re not getting enough…

We’ve all heard about the magical “8 hours” … but there’s a range of how much sleep we need.

[00:10:14] Dr. Colleen Carney:

We would want adults to sleep somewhere between six and nine hours in terms of norms, but there
are a few people who, who we call short sleepers. Who are actually short sleepers. They're not deluded
or not deluding themselves. If in their heart of hearts, they actually do feel good and they don't fall
asleep ever during the day, then they are probably the exception to that health rule.

Dr. Jen Gunter:

Not getting enough sleep is associated with serious health problems like high blood pressure,
cardiovascular disease, diabetes, and depression. But Dr. Dr. Colleen Carney says the aggressive
messaging about getting 8 hours (or it’s certain doom) is not exactly true and can be really
counterproductive.

Dr. Colleen Carney:

One of the things I love to say to people with insomnia is it is true that we have to sleep to live. But we
don't want to live to sleep. We've got people on the other end of the spectrum too. All of the myths
about you have to sleep eight hours, you have to sleep eight hours. We do that because we have to
reach people from a public health perspective who are not prioritizing sleep. Right. But then we're
throwing people under the bus who over prioritize sleep, because they're the ones listening to that
message. And they're the ones getting anxious.
[00:11:32] Dr. Jen Gunter:
Figuring out if you’re getting enough sleep is pretty straightforward:

Do you feel reasonably well-rested? Then, Dr. Dr. Colleen Carney says you’re getting enough. Do you
fall asleep involuntarily during the day? Then you probably need more sleep.

But lately we’ve started worrying about our sleep a lot.

[00:11:53] Dr. Ben Reiss:

It's sort of the weirdo who says, oh no, I sleep like a baby, people look at them like, what is wrong?
You must be shallow or you must be something is something's off there.

Dr. Jen Gunter:

How did we get here? Dr. Ben Reiss is an English professor at Emory University and the author of Wild
Nights: How Taming Sleep Created Our Restless World.

He says we’ve been fascinated by sleep for millennia, but the way we manage it has changed a lot over
time.

For most of human history, sleep was a religious matter, not a medical one.

Dr. Ben Reiss:

We can see that very clearly through ideas about dreaming, you know, dreaming as being prophecy
and so on, but even the idea of being able to, to manage sleep, to stay asleep, to sleep at the right
time was often interpreted, in, in religious terms. You do your prayers at a certain time. And if you
don't do it, the kind of the right way, maybe you're susceptible to the snares of the devil. Puritans were
really focused on this kind of thing and the, witch, you know, the witch trials that was women getting
out of bed at night and going and meeting and when they're supposed to be sleeping.

[00:13:00] Dr. Jen Gunter:

So going out at night to meet with your gal pals was a sign you were a witch because you were up at
night?

[00:13:05] Dr. Ben Reiss:

Oh yeah. I mean, there's no good reason for women to be getting up and doing much of anything
outside of the home. And so that itself became evidence that, you know, the devil was after you. Cause
why would you be up at night if you weren't a witch?

[00:13:20] Dr. Jen Gunter:

In the 1800s, sleep started going through a big shift. It wasn’t about sins and witches and visions
anymore. It became a medical problem. Dr. Reiss looked closely at the story of one woman, Jane
Rider, who experienced this change firsthand…Jane worked for a wealthy family in Massachusetts.

Dr. Ben Reiss:

Strange things were happening and so they started to observe her and saw that she was rising from
her bed and seemed to be in some kind of trance. So there was a local physician who was interested in
kind of curious psychological behaviors who started to interview her and follow her.
Dr. Jen Gunter:
Eventually, poor Jane was sent to a state asylum.

[00:14:04] Dr. Ben Reiss:

They subjected her to a kind of dizzying array of drugs and, you know, leeches and blistering her scalp.
I mean, it's a really extreme case, but about like just the magnitude of the shift from thinking about
sleep as a spiritual phenomenon to thinking about it as a medical phenomenon, you would think that
doing it the latter way would be an improvement. Not always.

Dr. Jen Gunter:

Dr. Reiss says the people who ran asylums, like the one Jane was sent to, were obsessed with their
patients’ sleep…

[00:14:36] Dr. Ben Reiss:

They would write things like saying, you know, there's, there is no form of madness that can be cured
without getting good sleep. And so they had patients in these separate rooms with very thick walls and
put them on a very strict regimen and order, often keeping track of exactly when they went to bed.
And when they got up. And there were sometimes, fairly severe punishments for people who would
try, you know, try to wander out or who would call out in the night.

[00:14:59] Dr. Jen Gunter:

But it wasn’t just these asylum physicians who became fixated with sleep. Through the Industrial
Revolution, industrialists and factory owners wanted to figure out how to control the sleep of workers.
During this era, people worked long shifts, with a small chunk of time leftover for sleep. In 1890, by
some estimates, the average workweek for manufacturing workers was 100 hours! Industrialists used
the strategies of enslavers to make sure no one fell asleep on the job.

[00:15:36] Dr. Ben Reiss:

Enslaved people were deliberately worked to the point of, and beyond the point of exhaustion as a way
to ensure that when they were off labor, they didn't have a lot of energy leftover. And then they were
punished very severely if they overslept in the morning. And so one of the things that was developed
under the system of slavery became a favorite technique of industrialists, which was the kind of
random surveillance, the spot check.

[00:16:03] Dr. Jen Gunter:

A few decades after slavery was abolished, many descendants of people who were enslaved worked in
the railroad industry, often as porters. And they had horrible sleeping conditions too.

[00:16:15] Dr. Ben Reiss:

You could be doing, you know, 10, 12, 14, 20 days in a row where you're only catching a little bit of
sleep at a time because you can be thrown off if the train jolts. And so one of the really powerful union
organizing campaigns from that period was the Pullman car workers who were organized and testified
about the health detriments of being, you know, forced to work and sleep under these kinds of
conditions for extended periods.

[00:16:44] Dr. Jen Gunter:

Sleep even became part of the labor campaign for an eight-hour work day…

[00:16:50] Dr. Ben Reiss:

It was eight hours for work, eight hours for rest, eight hours for what you will. So you know, the model
that we think of as sort of natural and normal, it's really tied to some of these industrial developments
and struggles around them.

[00:17:07] Dr. Jen Gunter:

While sleep used to be treated as mysterious, even divine, when it became part of the industrial world,
it turned into something to be managed, tinkered with, made more productive! And that’s grown into
our current obsession with “optimizing” our sleep. After the break, how to figure out if you actually
have a sleep issue… and if so, what you can do about it.

[AD BREAK]

[00:17:43] Dr. Jen Gunter:

Everyone has trouble sleeping sometimes but if you struggle at least three times a week for at least
three months…and if this leads to difficulty functioning, you have insomnia.

It’s really common. Thirty-three percent of adults in the US suffer from it sometimes. So do twenty to
forty percent of kids and teenagers.

Dr. Dr. Colleen Carney says insomnia builds on itself. It’s a cascade of damage to your sleep.

It could start out with one night of bad sleep… which you might make up for by napping the next day.

But your body actually has its own way of compensating for lost sleep by producing MORE deep,
restorative sleep. Most people don’t know that!

Then, if you have trouble sleeping the next night, maybe you panic... you start canceling activities and
plans… all to create more time during the day for sleep. And that throws your whole system off
balance.

[00:18:41] Dr. Colleen Carney:

Our time in bed tends to go up. Our activity level tends to go down and it moves that sort of
homeostatic system, the set point about how much deep sleep you're going to get. It kind of moves it
down and down and down, down, down unintentionally.

Dr. Jen Gunter:

Over time, this also creates low sleep drive, which means it’s harder and harder to fall asleep at night.

[00:19:03] Dr. Colleen Carney:

The other thing that's happening is they are laying awake in bed frustrated. And so it's kind of like their
bed becomes paired with wakefulness. So the bed used to be, the place where you slept now, the bed
is the place where I don't sleep. So conditioned arousal happens. And you know, if you have this, if
you're sitting downstairs and you're like, kind of nodding off, you feel ready to go, you get into bed and
a switch goes off and you're wide awake, you have conditioned arousal.

Dr. Jen Gunter:

And eventually, some people with insomnia stop going to bed and waking up at their usual times.

Dr. Colleen Carney:

Because, although we normally would get up, we set the alarm at six and get up, when you feel
exhausted, you're not going to do that. Right. So you'll try and hit the alarm a couple of times, you'll
call in sick maybe. So the timing of when you get into bed and out of bed, we often will find like hours
of difference between the earliest and the latest within one week. That's really the equivalent of what
you would feel if you traveled that many time zones, and you would have that much sleep disruption.

Dr. Jen Gunter:

To treat insomnia, doctors like Dr. Dr. Colleen Carney try to break this downward spiral. They try to
address the root causes of insomnia by getting your clock back on track, and re-associating your bed
with sleep. And the best way to do that is Cognitive Behavioral Therapy or CBT.

[00:20:33] Dr. Colleen Carney:

People track their behaviors and their experience for two weeks on a sleep diary, so that we can come
up with a, um, a schedule that is going to be right for their particular body. And then a set of rules
called stimulus control, So essentially we ask people to wait until they are showing the behavioral signs
of sleepiness. Sleepiness for us is not feeling tired. It's when you're literally falling asleep or nodding off,
and that if you get into that bed and that switch goes off and you're wide awake then to say, well, I'm
not, I'm not falling asleep anytime soon right now. So I'm going to go do something enjoyable until
that feeling comes back. While you're out of the bed it's actually you're building drive for deep sleep.
It's going to create some sleep deprivation, almost like what we're doing for Europe when we're trying
to adjust to local time, we're going to use that to our advantage.

Dr. Jen Gunter:

CBT can help people in just two sessions. And it’s very effective.

Dr. Colleen Carney:

To give you an example, I just, I'm, I'm having trouble right now because I wanted to study relapse
after CBT. So I treated 300 people or my students did 300 people and we tracked them over a year
and no one relapsed.

Dr. Jen Gunter:

Oh wow.

Dr. Colleen Carney:

So we were like, well, that is a weird problem to have, because I said that I was going to study what is
the characteristics of those who relapse? And no one did.

[00:21:58] Dr. Jen Gunter:

That’s remarkable! I wish more patients and doctors knew about CBT!

Dr. Colleen Carney says CBT is recommended over sleeping pills because it’s safer… and so long-
lasting. But she says sleeping pills can provide relief and shouldn’t be as villainized as they are. They
certainly have a place in treating insomnia.

There are a few big things we hear about as treatments for insomnia that are NOT effective. First up,
melatonin. Melatonin supplements are touted everywhere, from the wellness industry to physicians.

But these supplements are marketed based on a complete misunderstanding of how melatonin works.
Melatonin is a hormone secreted by the pineal gland in your brain. It’s released when the sun goes
down.
Dr. Colleen Carney:
And it's kind of a signal that many hours later you're going to be ready for sleep. I mean, that's kind of,
that's basically it.

[00:22:58] Dr. Jen Gunter:

Taking more melatonin, when it’s already circulating through your brain, will NOT help you sleep.

Dr. Colleen Carney:

It's kind of like the bat signal, right. You know Commissioner Gordon like flashes up the bat signal for
Batman to come. And, Batman's on his way, and then he flashes it again, it's like, well, it's, he's already
on his way. Like that the signal has already been thrown. He knows to come. It's not that he's gonna
like extra come. Right. And there's no melatonin problem in insomnia either.

[00:23:25] Dr. Jen Gunter:

Some people really feel that melatonin supplements help them. That’s likely a placebo effect. These
supplements can also be contaminated. In one study, researchers tested what was actually in them
and found the neurochemical serotonin in more than a quarter of the samples! That can be dangerous!
So when you take melatonin, you don’t even know what you’re putting in your body. How about
melatonin for jet lag??? Well, here’s a joke for you — a group of sleep researchers flies from North
America to Rome for a conference….what do they pack?

Dr. Colleen Carney:

We all have the same plan and not, not a one is going to take melatonin.

Dr. Jen Gunter:

Oh, okay. I love this. I, this is what is, so all the sleep researchers are traveling internationally and not
one of them is going to take melatonin.

Dr. Colleen Carney:

Of course not. Why would we do that? I mean, the best thing to do to adjust to jet lag is to use sleep
deprivation. So we fly all night, you get off the plane in the morning, and then we spend all day we've,
we've booked all kinds of tours and whatever in the sunlight. So we will build a strong sleep drive by
staying up all night and being awake all day. And we have very clear input into the clock from the
daylight. And then that night when we go to bed, the last time we did it, we were in Spain and we
were only like 90 minutes off the cycle the next day.

Dr. Jen Gunter:

That is fascinating.

Dr. Colleen Carney:

Except we were a little naughty on the plane that the deal is you shouldn't really drink on the plane
because it does, it does it does thwart your attempts to stay awake. There was some, uh, some poor
adherence there that was alcohol-related.

Dr. Jen Gunter:

The study subjects did not adhere strictly to the trial.

Dr. Colleen Carney:

No, no, there was a bit, I mean, it was French wine. It was free.
[00:25:07] Dr. Jen Gunter:
Whether you struggle with insomnia or not, there’s another piece of advice you’ve probably seen all
over the Internet. Maybe you’ve even heard it from your doctor…sleep hygiene. I even badgered my
own son about sleep hygiene when he started struggling with insomnia.

But the American Academy of Sleep Medicine recommends AGAINST using sleep hygiene as a
standalone treatment. Dr. Colleen Carney says she even uses it as a placebo control in studies because
she knows it won’t work… but people BELIEVE that it will.

When researchers like Dr. Dr. Colleen Carney say “sleep hygiene,” they mean focusing on how
substances and the environment affect our sleep… it might include advice like don’t drink alcohol
before bed. Exercise, but not in the evening. Set your room to a particular temperature. Block out blue
light.

[00:26:02] Dr. Colleen Carney:

Not one of those recommendations were ever developed clinically.

[00:26:08] Dr. Jen Gunter:

And Dr. Carney says blue light is actually important for your sleep cycle! Sunlight and light from screens
are both forms of “blue light” — and they keep you alert and awake during the day. By the evening,
melatonin has been released and your body knows it’s time to sleep. So it’s not likely that blue light can
cause insomnia.

That means you can skip all the blue light filters people are selling — AND the other products marketed
to “optimize” your sleep…

[00:26:40] Dr. Colleen Carney:

We have a whole group of people who are biohacking right now with their fitness trackers, and they're
getting stressed out about their sleep because their wrist is telling them that they're moving in a
particular way. That would suggest that they're sleeping poorly or well. Or that they're getting this
stage of sleep or that stage of sleep and they're adjusting their lifestyles around it, they're deciding
whether or not they feel good during the day. Because of it, and in fact, it, it creates a problem we call
ortho insomnia, this sort of preoccupation with the measure itself and somebody telling us what our
sleep is.

[00:27:22] Dr. Jen Gunter:

That’s right — all this tracking and optimizing, like what our editor Sara Nics was doing, can actually
cause insomnia…So can an overinvestment in rituals.

[00:27:32] Dr. Colleen Carney:

I spent all day with a group teaching them how to, how to treat insomnia. And I said, you know, um,
where am I good sleepers on this call? And so they've raised their hand. I said, could you teach eight
hours like I just did on how to sleep well? And they, he kind of laughs. And he said, I don't like I don’t
know I close my eyes. And I was like, yeah, I mean, I said, you know, the thing is, is that if the stage is
set, that's, that's really what we need for sleeping. But when we make it complicated, when we decide
I'm going to have this tea, I'm gonna have this supplement, I'm gonna smoke up. I'm going to get
blackout blinds. I'm gonna have whales singing to each other. I'm gonna, I'm gonna, I'm gonna, I'm
gonna, I'm going to, it is the effort. It's all of the sort of rituals that actually make insomnia worse.
Because then you require all kinds of things in order to sleep poorly. All of these monetized ways of
trying to make sleep more difficult really get people out of touch with how amazing their body is.
[00:28:35] Dr. Jen Gunter:
She says not to buy into messaging about needing a particular product for a good night’s sleep.

[00:28:42] Dr. Colleen Carney:

Don't get me wrong. I love a high thread count on my sheets. Right? Like there's, there's not a, it's not
like you can't create, a beautiful sanctuary in your room to sleep, right. No problem. But I'm not doing
it to sleep better. I'm doing it because it makes me feel better. And I think there's a difference.

Dr. Jen Gunter:

Right. So if you get pleasure from something that's fine, like life is about enjoying it. And I think that,
yeah, I think, you know, like I like wearing jammies. I love jammies. I just love putting my jammies on.
It just makes me happy, you know?

Dr. Colleen Carney:

But if you are wearing a copper lined jammy that reeked of lavender to sleep better, then I suddenly
don't love your jammies anymore.

[00:29:33] Dr. Jen Gunter:

And Dr. Colleen Carney’s biggest advice for all of us is to act like toddlers! Go outside every day, have a
routine. Have a wind down period before bed.

Dr. Colleen Carney:

Like I put away my phone in the hour before bed, and the reason why it's not blue light it's because
I'm going to be tempted. I'll be tempted to answer an email and who I am the hour before bed. I want
to just be Colleen. I don't want to be Dr. Dr. Colleen Carney. And so I'm going to watch trashy TV or
whatever it is I'm going to do. play video games. I'm not afraid of blue light, because, melatonin has
already been released in the hour before bed. So I'm fine. I'm going to unwind and set the stage.

Dr. Jen Gunter:

And we all have different things that make us unwind, right.

Dr. Colleen Carney:

Exactly, exactly.

For my wind down, I put on my favorite jammies – I call it Jammy Time! And I go over the New York
Times spelling bee with my partner to see if we made genius or not. And if together we can get the
queen bee.

Next time, on Body Stuff…should you worry about yeast?

Dr. Paul Nyirjesy:

The vagina is not a sterile environment. And yeast is part of the environment of, of different organisms
that can be in the vagina.

Dr. Jen Gunter:

From hygiene wipes to boric acid to probiotics, we take on the biggest myths about yeast.

Body Stuff is brought to you by the TED Audio Collective. It’s hosted and developed by me, Dr. Dr. Jen
Gunter Gunter. The show is produced by TED with Transmitter Media. Our team includes Mitchell
Johnson, Poncie Rutsch, Gretta Cohn, Michelle Quint, Banban Cheng, Sammy Case and Roxanne Hai
Lash. Phoebe Wang is our sound designer and mix engineer. This episode was written and produced
by Camille Petersen and edited by Sara Nics.
Fact checking by the TED fact checking team.

We’re back next week with more Body Stuff. Make sure you’re following Body Stuff in your favorite
podcast app so you get every episode delivered straight to your device. And leave us a review! We love
hearing from our listeners.

See you next week!

HOW RACISM MAKES US SICK
An article in the Yale Alumni Magazine told the story of Clyde Murphy, a black man who was
a member of the Class of 1970. Clyde was a success story. After Yale and a law degree from
Columbia, Clyde spent the next 30 years as one of America's top civil rights lawyers. He was
also a great husband and father. But despite his success, personally and professionally,
Clyde's story had a sad ending.

00:39

In 2010, at the age of 62, Clyde died from a blood clot in his lung. Clyde's experience was
not unique. Many of his black classmates from Yale also died young. In fact, the magazine
article indicated that 41 years after graduation from Yale, the black members of the Class of
1970 had a death rate that was three times higher than that of the average class member.
It's stunning.

01:21

America has recently awakened to a steady drumbeat of unarmed black men being shot by
the police. What is even a bigger story is that every seven minutes, a black person dies
prematurely in the United States. That is over 200 black people die every single day who
would not die if the health of blacks and whites were equal.

01:58

For the last 25 years, I have been on a mission to understand why does race matter so
profoundly for health. When I started my career, many believed that it was simply about
racial differences in income and education. I discovered that while economic status matters
for health, there is more to the story. So for example, if we look at life expectancy at age
25, at age 25 there's a five-year gap between blacks and whites. And the gap by education
for both whites and blacks is even larger than the racial gap. At the same time, at every
level of education, whites live longer than blacks. So whites who are high school dropouts
live 3.4 years longer than their black counterparts, and the gap is even larger among college
graduates. Most surprising of all, whites who have graduated from high school live longer
than blacks with a college degree or more education.

03:16

So why does race matter so profoundly for health? What else is it beyond education and
income that might matter?

03:28

In the early 1990s, I was asked to review a new book on the health of black America. I was
struck that almost every single one of its 25 chapters said that racism was a factor that was
hurting the health of blacks. All of these researchers were stating that racism was a factor
adversely impacting blacks, but they provided no evidence. For me, that was not good
enough.

04:01

A few months later, I was speaking at a conference in Washington, DC, and I said that one
of the priorities for research was to document the ways in which racism affected health. A
white gentleman stood in the audience and said that while he agreed with me that racism
was important, we could never measure racism. "We measure self-esteem," I said. "There's
no reason why we can't measure racism if we put our minds to it."

04:33

And so I put my mind to it and developed three scales. The first one captured major
experiences of discrimination, like being unfairly fired or being unfairly stopped by the
police. But discrimination also occurs in more minor and subtle experiences, and so my
second scale, called the Everyday Discrimination Scale, captures nine items that captures
experiences like you're treated with less courtesy than others, you receive poorer service
than others in restaurants or stores, or people act as if they're afraid of you. This scale
captures ways in which the dignity and the respect of people who society does not value is
chipped away on a daily basis.

05:21

Research has found that higher levels of discrimination are associated with an elevated risk
of a broad range of diseases from blood pressure to abdominal obesity to breast cancer to
heart disease and even premature mortality. Strikingly, some of the effects are observed at
a very young age. For example, a study of black teens found that those who reported higher
levels of discrimination as teenagers had higher levels of stress hormones, of blood pressure
and of weight at age 20. However, the stress of discrimination is only one aspect.

06:20

Discrimination and racism also matters in other profound ways for health. For example,
there's discrimination in medical care. In 1999, the National Academy of Medicine asked me
to serve on a committee that found, concluded based on the scientific evidence, that blacks
and other minorities receive poorer quality care than whites. This was true for all kinds of
medical treatment, from the most simple to the most technologically sophisticated. One
explanation for this pattern was a phenomenon that's called "implicit bias" or "unconscious
discrimination." Research for decades by social psychologists indicates that if you hold a
negative stereotype about a group in your subconscious mind and you meet someone from
that group, you will discriminate against that person. You will treat them differently. It's an
unconscious process. It's an automatic process.
It is a subtle process, but it's normal and it occurs even among the most well-intentioned
individuals.

07:39

But the deeper that I delved into the health impact of racism, the more insidious the effects
became. There is institutional discrimination, which refers to discrimination that exists in the
processes of social institutions. Residential segregation by race, which has led to blacks and
whites living in very different neighborhood contexts, is a classic example of institutional
racism. One of America's best-kept secrets is how residential segregation is the secret
source that creates racial inequality in the United States. In America, where you live
determines your access to opportunities in education, in employment, in housing and even
in access to medical care. One study of the 171 largest cities in the United States concluded
that there is not even one city where whites live under equal conditions to blacks, and that
the worst urban contexts in which whites reside is considerably better than the average
context of black communities. Another study found that if you could eliminate statistically
residential segregation, you would completely erase black-white differences in income,
education and unemployment, and reduce black-white differences in single motherhood by
two thirds, all of that driven by segregation. I have also learned how the negative
stereotypes and images of blacks in our culture literally create and sustain both institutional
and individual discrimination.

09:40

A group of researchers have put together a database that contains the books, magazines
and articles that an average college-educated American would read over their lifetime. It
allows us to look within this database and see how Americans have seen words paired
together as they grow up in their society. So when the word "black" appears in American
culture, what co-occurs with it? "Poor," "violent," "religious," "lazy," "cheerful," "dangerous."
When "white" occurs, the frequently co-occurring words are "wealthy," "progressive,"
"conventional," "stubborn," "successful," "educated." So when a police officer overreacts
when he sees an unarmed black male and perceives him to be violent and dangerous, we
are not necessarily dealing with an inherently bad cop. We may be simply viewing a normal
American who is reflecting what he has been exposed to as a result of being raised in this
society.

11:04

From my own experience, I believe that your race does not have to be a determinant of
your destiny. I migrated to the United States from the Caribbean island of Saint Lucia in the
late 1970s in pursuit of higher education, and in the last 40 years, I have done well. I have
had a supportive family, I have worked hard, I have done well. But it took more for me to
be successful. I received a minority fellowship from the University of Michigan. Yes. I am an
affirmative action baby. Without affirmative action, I would not be here.
11:57

But in the last 40 years, black America has been less successful than I have. In 1978, black
households in the United States earned 59 cents for every dollar of income whites earned.
In 2015, black families still earn 59 cents for every dollar of income that white families
receive, and the racial gaps in wealth are even more stunning. For every dollar of wealth
that whites have, black families have six pennies and Latinos have seven pennies.

12:38

The fact is, racism is producing a truly rigged system that is systematically disadvantaging
some racial groups in the United States. To paraphrase Plato, there is nothing so unfair as
the equal treatment of unequal people. And that's why I am committed to working to
dismantle racism.

13:09

I deeply appreciate the fact that I am standing on the shoulders of those who have
sacrificed even their lives to open the doors that I have walked through. I want to ensure
that those doors remain open and that everyone can walk through those doors. Robert
Kennedy said, "Each time a man" -- or woman, I would add -- "stands up for an ideal or acts
to improve the lot of others or strikes out against injustice, he sends forth a tiny ripple of
hope, and those ripples can build a current that can sweep down the mightiest walls of
oppression and resistance."

13:58

I am optimistic today because all across America, I have seen ripples of hope. The Boston
Medical Center has added lawyers to the medical team so that physicians can improve the
health of their patients because the lawyers are addressing the nonmedical needs their
patients have. Loma Linda University has built a gateway college in nearby San Bernardino
so that in addition to delivering medical care, they can provide job skills and job training to a
predominantly minority, low-income community members so that they will have the skills
they need to get a decent job. In Chapel Hill, North Carolina, the Abecedarian Project has
figured out how to ensure that they have lowered the risks for heart disease for blacks in
their mid-30s by providing high-quality day care from birth to age five. In after-school
centers across the United States, Wintley Phipps and the US Dream Academy is breaking the
cycle of incarceration by providing high-quality academic enrichment and mentoring to the
children of prisoners and children who have fallen behind in school. In Huntsville, Alabama,
Oakwood University, a historically black institution, is showing how we can improve the
health of black adults by including a health evaluation as a part of freshman orientation and
giving those students the tools they need to make healthy choices and providing them
annually a health transcript so they can monitor their progress. And in Atlanta, Georgia,
Purpose Built Communities has dismantled the negative effects of segregation by
transforming a crime-ridden, drug-infested public housing project into an oasis of mixed-
income housing, of academic performance, of great community wellness and of full
employment. And finally, there is the Devine solution. Professor Patricia Devine of the
University of Wisconsin has shown us how we can attack our hidden biases head on and
effectively reduce them. Each one of us can be a ripple of hope.

16:41

This work will not always be easy, but former Supreme Court Justice Thurgood Marshall has
told us, "We must dissent. We must dissent from the indifference. We must dissent from the
apathy. We must dissent from the hatred and from the mistrust. We must dissent because
America can do better, because America has no choice but to do better."

17:09

Thank you.

17:10

(Applause)
How we can help the "forgotten middle" reach their full potential
00:00

So, I want to talk to you about the forgotten middle. To me, they are the students, coworkers and
plain old regular folks who are often overlooked because they're seen as neither exceptional nor
problematic. They're the kids we think we can ignore because their needs for support don't seem
particularly urgent. They're the coworkers who actually keep the engines of our organizations
running, but who aren't seen as the innovators who drive excellence. In many ways, we overlook the
folks in the middle because they don't keep us up awake at night wondering what crazy thing they're
going to come up with next.

00:48

(Laughter)

00:50

And the truth is that we've come to rely on their complacency and sense of disconnection because it
makes our work easier.

01:02

You see, I know a little bit about the forgotten middle. As a junior high school student, I hung out in
the middle. For a long time, I had been a good student. But seventh grade was a game changer. I
spent my days gossiping, passing notes, generally goofing off with my friends. I spent my homework
time on the phone, reviewing each day's events. And in many ways, although I was a typical 12-year-
old girl, my ambivalence about my education led to pretty average grades.

01:47

Luckily for me, my mother understood something important, and that was that my location was not
my destination. As a former research librarian and an educator, my mother knew that I was capable
of accomplishing a lot more. But she also understood that because I was a young black woman in
America, I might not have opportunities out of the middle if she wasn't intentional about creating
them.

02:24

So she moved me to a different school. She signed me up for leadership activities in my

neighborhood. And she began to talk to me more seriously about college and career options I could
aspire to. My mother's formula for getting me out of the middle was pretty simple. She started with
high expectations. She made it her business to figure out how to set me up for success. She held me
accountable and, along the way, she convinced me that I had the power to create my own story.
That formula didn't just help me get out of my seventh grade slump -- I used it later on in New York
City, when I was working with kids who had a lot of potential, but not a lot of opportunities to go to
and complete college.
03:26

You see, high-performing students tend to have access to additional resources, like summer
enrichment activities, internships and an expansive curriculum that takes them out of the classroom
and into the world in ways that look great on college applications. But we're not providing those kinds
of opportunities for everyone. And the result isn't just that some kids miss out. I think we, as a
society, miss out too.

03:59

You see, I've got a crazy theory about the folks in the middle. I think there are some unclaimed
winning lottery tickets in the middle. I think the cure for cancer and the path to world peace might
very well reside there. Now, as a former middle school teacher, I'm not saying that magically
everyone is suddenly going to become an A student. But I also believe that most folks in the middle
are capable of a lot more. And I think people stay in the middle because that's where we relegated
them to and, sometimes, that's just where they're kind of chilling while they figure things out.

04:42

All of our journeys are made up of a series of rest stops, accelerations, losses and wins. We have a
responsibility to make sure that one's racial, gender, cultural and socioeconomic identity is never the
reason you didn't have access out of the middle.

05:07

So, just as my mother did with me, I began with high expectations with my young people. And I
started with a question. I stopped asking kids, "Hey, do you want to go to college?" I started asking
them, "What college would you like to attend?" You see, the first question --

05:28

(Applause)

05:33

The first question leaves a lot of vague possibilities open. But the second question says something
about what I thought my young people were capable of. On a basic level, it assumes that they're
going to graduate from high school successfully. It also assumed that they would have the kinds of
academic records that could get them college and university admissions. And I'm proud to say that
the high expectations worked. While black and Latinx students nationally tend to graduate from
college in six years or less, at a percent of 38, we were recognized by the College Board for our
ability not to just get kids into college but to get them through college.

06:25

(Applause)
06:31

But I also understand that high expectations are great, but it takes a little bit more than that. You
wouldn't ask a pastry chef to bake a cake without an oven. And we should not be asking the folks in
the middle to make the leap without providing them with the tools, strategies and support they
deserve to make progress in their lives.

06:56

A young woman I had been mentoring for a long time, Nicole, came to my office one day, after her
guidance counselor looked at her pretty strong transcript and expressed utter shock and amazement
that she was even interested in going to college. What the guidance counselor didn't know was that
through her community, Nicole had had access to college prep work, SAT prep and international
travel programs. Not only was college in her future, but I'm proud to say that Nicole went on to earn
two master's degrees after graduating from Purdue University.

07:39

(Applause)

07:45

We also made it our business to hold our young people accountable, but also to instill a sense of
accountability in those young people to themselves, to each other, to their families and their
communities. We doubled down on asset-based youth development. We went on leadership retreats
and did high ropes courses and low ropes courses and tackled life's biggest questions together. The
result was that the kids really bought into the notion that they were accountable for achieving these
college degrees. It was so gratifying to see the kids calling each other and texting each other to say,
"Hey, why are you late for SAT prep?" And, "What are you packing for the college tour tomorrow?"

08:41

We really worked to kind of make college the thing to do. We began to create programs on college
campuses and events that allow young people to really visualize themselves as college students and
college graduates. Me and my staff rocked our own college gear and had lots of fun, healthy
competition about whose school was better than whose. The kids really bought into it, and they
began to see that something more was possible for their lives. Not only that -- they could look around
at that college-going community and see kids who came from the same backgrounds and the same
neighborhoods and who were aspiring to the same things.

09:30

That sense of belonging was really key, and it showed up in a remarkable, beautiful way one day
when we were in the Johannesburg airport, waiting to go through customs on our way to Botswana
for a service learning trip. I saw a group of kids kind of huddled in a circle. Usually, with teens, that
means something's going on.

09:52
(Laughter)

09:54

So I kind of walked up behind the kids to figure out what they were talking about. They were
comparing passport stamps.

10:02

(Laughter)

10:03

And they were dreaming out loud about all the other countries they planned to visit in the future. And
seeing these young people from New York City go on to not just become college students but to
participate in study abroad programs and to then take jobs around the world was incredibly
gratifying.

10:27

When I think of my kids and all the doctors, lawyers, teachers, social workers, journalists and artists
who came from our little nook in New York City, I hate to think of what would have happened if we
hadn't invested in the middle. Just think about all that their communities and the world would have
missed out on.

10:52

This formula for the middle doesn't just work with young people. It can transform our organizations
as well. We can be more bold in coming up and articulating a mission that inspires everyone. We can
authentically invite our colleagues to the table to come up with a strategy to meet the mission. We
can give meaningful feedback to folks along the way, and -- and sometimes most importantly -- make
sure that you're sharing credit for everyone's contributions.

11:33

What happened when my staff aimed high for themselves is that what they were able to do for young
people was pretty transformational. And it's been so wonderful to look back and see all of my former
colleagues who've gone on to get doctorates and assume leadership roles in other organizations.

11:56

We have what it takes to inspire and uplift the folks in the middle. We can extend love to the people
in the middle. We can challenge our own biases about who deserves a hand-up, and how. We can
structure our organizations, communities and institutions in ways that are inclusive and that uphold
principles of equity. Because, in the final analysis, what is often mistaken for a period is really just a
comma.
How technology has changed what it's like to be deaf
00:01

My name is Rebecca, and I'm a cyborg.

00:03

(Laughter)

00:06

Specifically, I have 32 computer chips inside my head, which rebuild my sense of hearing. This is
called a cochlear implant. You remember the Borg from Star Trek, those aliens who conquered and
absorbed everything in sight? Well, that's me.

00:26

(Laughter)

00:27

The good news is I come for your technology and not for your human life-forms.

00:32

(Laughter)

00:35

Actually, I've never seen an episode of Star Trek.

00:37

(Laughter)

00:39

But there's a reason for that: television wasn't closed-captioned when I was a kid. I grew up
profoundly deaf. I went to regular schools, and I had to lip-read. I didn't meet another deaf person
until I was 20. Electronics were mostly audio back then. My alarm clock was my sister Barbara, who
would set her alarm and then throw something at me to wake up.

01:03

(Laughter)
01:06

My hearing aids were industrial-strength, sledgehammer volume, but they helped me more than they
helped most people. With them, I could hear music and the sound of my own voice. I've always liked
the idea that technology can help make the world more human. I used to watch the stereo flash color
when the music shifted, and I knew it was just a matter of time before my watch could show me
sound, too.

01:36

Did you know that hearing occurs in the brain? In your ear is a small organ called the cochlea, and
the cochlea is lined with thousands of receptors called hair cells. When sound enters your ear, those
hair cells, they send electric signals to your brain, and your brain then interprets that as sound. Hair-
cell damage is really common: noise exposure, ordinary aging, illness. My hair cells were damaged
before I was even born. My mother was exposed to German measles when she was pregnant with
me. About five percent of the world has significant hearing loss. By 2050, that's expected to double to
over 900 million people, or one in 10. For seniors, it's already one out of three.

02:30

With a cochlear implant, computer chips do the job for the damaged hair cells. Imagine a box of 16
crayons, and those 16 crayons, in combination, have to make all of the colors in the universe. Same
with the cochlear implant. I have 16 electrodes in each of my cochleas. Those 16 electrodes, in
combination, send signals to my brain, representing all of the sounds in the universe. I have
electronics inside and outside of my head to make that happen, including a small processor, magnets
inside my skull and a rechargeable power source. Radio waves transmit sound through the magnets.
The number one question that I get about the cochlear implant when people hear about the magnets
is whether my head sticks to the refrigerator.

03:28

(Laughter)

03:35

No, it does not.

03:36

(Laughter)

03:38

(Applause)
03:40

Thank you, thank you.

03:42

(Applause)

03:44

I know this, because I tried.

03:45

(Laughter)

03:48

Hearing people assume that the Deaf live in a perpetual state of wanting to hear, because they can't
imagine any other way. But I've never once wished to be hearing. I just wanted to be part of a
community like me. I wanted everyone else to be deaf. I think that sense of belonging is what
ultimately connects our stories, and mine felt incomplete.

04:13

When cochlear implants first got going, back in the '80s, the operation was Frankenstein-monster
scary. By 2001, the procedure had evolved considerably, but it still wiped out any natural hearing that
you had. The success rate then for speech comprehension was low, maybe 50 percent. So if it didn't
work, you couldn't go back. At that time, implants were also controversial in the Deaf culture.
Basically, it was considered the equivalent of changing the color of your skin.

04:52

I held off for a while, but my hearing was going downhill fast, and hearing aids were no longer
helping. So in 2003, I made the tough decision to have the cochlear implant. I just needed to stop
that soul-sucking cycle of loss, regardless of whether the operation worked, and I really didn't think
that it would. I saw it as one last box to check off before I made the transition to being completely
deaf, which a part of me wanted.

05:29

Complete silence is very addictive. Maybe you've spent time in a sensory deprivation tank, and you
know what I mean. Silence has mind-expanding capabilities. In silence, I see sound. When I watch a
music video without sound, I can hear music. In the absence of sound, my brain fills in the gaps
based on the movement I see. My mind is no longer competing with the distraction of sound. It's
freed up to think more creatively.
06:07

There are advantages to having bionic body parts as well. It's undeniably convenient to be able to
hear, and I can turn it off any time I want.

06:16

(Laughter)

06:18

I'm hearing when I need to be, and the rest of the time, I'm not. Bionic hearing doesn't age, although
external parts sometimes need replacement. It would be so cool to just automatically regenerate a
damaged part like a real cyborg, but I get mine FedExed from Advanced Bionics.

06:38

(Laughter)

06:40

Oh, I get updates downloaded into my head.

06:46

(Laughter)

06:47

It's not quite AirDrop -- but close.

06:50

(Laughter)

06:52

With the cochlear implant, I can stream music from my iPod into my head without earbuds. Recently,
I went to a friend's long, tedious concert ...

07:04

(Laughter)

07:06
and unknown to anyone else, I listened to the Beatles for three hours instead.

07:11

(Laughter)

07:12

(Applause)

07:19

Technology has come so far so fast. The biggest obstacle I face as a deaf person is no longer a
physical barrier. It's the way that people respond to my deafness, the outdated way people respond
to my deafness -- pity, patronization, even anger -- because that just cancels out the human
connection that technology achieves.

07:46

I once had a travel roommate who had a complete temper tantrum, because I didn't hear her
knocking on the door when her key didn't work. If I hadn't been there, no problem, she could get
another key, but when she saw that I was there, her anger boiled over. It was no longer about a key.
It was about deafness not being a good enough reason for her inconvenience.

08:12

Or the commercial about the deaf man whose neighborhood surprised him with sign language
messages from people on the street. Everyone who sent me the video told me they cried, so I asked
them, "Well, what if he wasn't deaf? What if his first language was Spanish, and everyone learned
Spanish instead? Would you have cried?" And they all said no. They weren't crying because of the
communication barrier, they were crying because the man was deaf.

08:42

But I see it differently. What if the Borg showed up in that video, and the Borg said, "Deafness is
irrelevant." Because that's what they say, right? Everything's "irrelevant." And then the Borg
assimilated the deaf guy -- not out of pity, not out of anger, but because he had a biological
distinctiveness that the Borg wanted, including unique language capabilities. I would much rather see
that commercial.

09:13

(Laughter)
09:15

Why does thinking about ability make people so uncomfortable? You might know a play, later a
movie, called "Children of a Lesser God," by Mark Medoff. That play, that title, actually comes from a
poem by Alfred Tennyson, and I interpret both the play and title to say that humans who are
perceived as defective were made by a lesser God and live an inferior existence, while those made by
the real God are a superior class, because God doesn't make mistakes.

09:53

In World War II, an estimated 275,000 people with disabilities were murdered in special death
camps, because they didn't fit Hitler's vision of a superior race. Hitler said that he was inspired by the
United States, which had enacted involuntary sterilization laws for "the unfit" in the early 1900s. That
practice continued in more than 30 states until the '70s, with the last law finally repealed in 2003. So
the world is not that far removed from Tennyson's poem.

10:36

That tendency to make assumptions about people based on ability comes out in sentences like
"You're so special," "I couldn't live like that" or "Thank God that's not me."

10:52

Changing how people think is like getting them to break a habit. Before the implant, I had stopped
using the voice telephone and switched to email, but people kept leaving me voice mail. They were
upset that I was unreachable by phone and not returning messages. I continued to tell them my
situation. It took them months to adapt. Fast-forward 10 years, and you know who else hated voice
mail? Millennials.

11:23

(Laughter)

11:26

And you know what they did? They normalized texting for communication instead. Now, when it
comes to ignoring voice mail, it no longer matters whether you're deaf or just self-absorbed.

11:40

(Laughter)

11:43

(Applause)
11:50

Millennials changed how people think about messaging. They reset the default. Can I just tell you
how much I love texting? Oh, and group texts. I have six siblings -- they're all hearing, but I don't
think any less of them.

12:09

(Laughter)

12:10

And we all text. Do you know how thrilling it is to have a visual means of communication that
everyone else actually uses?

12:19

So I am on a mission now. As a consumer of technology, I want visual options whenever there's

audio. It doesn't matter whether I'm deaf or don't want to wake the baby. Both are equally valid.
Smart designers include multiple ways to access technology, but segregating that access under
"accessibility" -- that's just hiding it from mainstream users. In order to change how people think, we
need to be more than accessible, we need to be connected. Apple did this recently. On my iPhone, it
automatically displays a visual transcript of my voice mail, right next to the audio button. I couldn't
turn it off even if I wanted to. Youknow what else? Netflix, Hulu, Amazon Prime no longer say
"Closed-captioned for the hearing impaired." They say "subtitles," "on" or "off," with a list of
languages underneath, including English.

13:26

Technology has come so far. Our mindset just needs to catch up. "Resistance is futile."

13:34

(Laughter)

13:36

You have been assimilated.

13:37

(Laughter)

13:39
Thank you.

13:40

(Applause)

02:18

"About five percent of the world has significant hearing loss."

According to the WHO (here), "over 5% of the world’s population has disabling hearing loss."

06:56

"With the cochlear implant, I can stream music from my iPod into my head without earbuds."

For more on the technology that makes this possible, see here

08:16

"Or the commercial about the deaf man whose neighborhood surprised him with sign language
messages from people on the street."

For more on this advertisement, see here.

09:28

"You might know a play, later a movie, called "Children of a Lesser God," by Mark Medoff. That play,
that title, actually comes from a poem by Alfred Tennyson ..."

This title is derived from a line in the Tennyson poem "Idylls of the King: The Passing of Arthur,"
which can be read here.
09:57

"In World War II, an estimated 275,000 people with disabilities were murdered in special death
camps, because they didn't fit Hitler's vision of a superior race. Hitler said that he was inspired by the
United States, which had enacted involuntary sterilization laws for "the unfit" in the early 1900s. That
practice continued in more than 30 states until the '70s, with the last law finally repealed in 2003."

For more on the history of the eugenics movement in America, see here and here.

For more on the states that participated in this sterilization law before it was repealed in 2003, see
here. The law that repealed this policy can be found here.