EP. 65: EVERYDAY WONDER IN MEDICINE AND BEYOND

Jun 12

WITH DACHER KELTNER, PHD

A leading researcher on human emotion shares where we can find awe in everyday life and how this renewed sense of wonder can help us live more fulfilling lives.

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Episode Summary

Awe is a feeling we've all experienced but often struggle to articulate. Whether it's the sheer scale of a skyscraper, the infinite expanse of a starry night sky, or the miracle of childbirth, moments of awe can strike us at unexpected times, leaving us speechless, inspired, and even profoundly transformed. In this episode, we speak with Dacher Keltner, PhD, a psychologist at UC Berkeley, where he is the founding director of the Greater Good Science Center and the host of The Science of Happiness podcast. Keltner is a leading researcher on human emotion whose work focuses on the socio-biological origins and effects of compassion, beauty, power, morality, love, and social class. His most recent book is AWE: The New Science of Everyday Wonder and How It Can Transform Your Life. In this episode, we discuss the eight sources of wonder in life, how we can nurture an openness to experiencing awe, and how this openness can help us navigate grief, uncertainty, loneliness, and mortality, ultimately allowing us to lead more meaningful lives.

Dacher Keltner, PhD is a full professor at the University of California Berkeley, director of the Berkeley Social Interaction Lab, and faculty director of the Greater Good Science Center.
Dacher’s research focuses on the biological and evolutionary origins of compassion, awe, love, beauty, emotional expression, power, social class, and inequality. Dacher is the co-author of two textbooks, as well as the best-selling Born to Be Good: The Science of a Meaningful Life, The Compassionate Instinct, and The Power Paradox: How We Gain and Lose Influence from Penguin Press in 2016. Dacher has published over 190 scientific articles. He has written for the New York Times Magazine, The Wall Street Journal, The London Times, and Utne Reader, and has received numerous national prizes and grants for his research.
In this episode, you will hear about:
• How growing up in a family of artists and humanists led Dr. Keltner to psychology - 2:26
• What the scientific study of emotions looks like - 4:54
• How scientists grapple with the difficulty of defining and studying emotions and feelings - 8:20
• A discussion of Jonathan Haidt’s revolutionary study of morality, The Righteous Mind - 11:57
• How Dr. Keltner defines and studies awe and wonder - 14:39
• The Eight Wonders of Life - 27:31
• Awe, beauty, and the sublime - 36:16
• Reflections on how digital technologies have negatively impacted our ability to experience awe - 38:35
• Advice for how we can practice the experience of awe - 44:26
• How awe can help with human suffering and physician burnout - 46:39
Henry Bair: [00:00:01] Hi, I'm Henry Bair.
Tyler Johnson: [00:00:02] And I'm Tyler Johnson.
Henry Bair: [00:00:04] And you're listening to the Doctor's Art, a podcast that explores meaning in medicine. Throughout our medical training and career, we have pondered what makes medicine meaningful. Can a stronger understanding of this meaning create better doctors? How can we build healthcare institutions that nurture the doctor patient connection? What can we learn about the human condition from accompanying our patients in times of suffering?
Tyler Johnson: [00:00:27] In seeking answers to these questions, we meet with deep thinkers working across healthcare, from doctors and nurses to patients and health care executives; those who have collected a career's worth of hard earned wisdom probing the moral heart that beats at the core of medicine. We will hear stories that are by turns heartbreaking, amusing, inspiring, challenging and enlightening. We welcome anyone curious about why doctors do what they do. Join us as we think out loud about what illness and healing can teach us about some of life's biggest questions.
Henry Bair: [00:01:03] Awe is a feeling we've all experienced but often struggle to articulate. Whether it's the sheer scale of a skyscraper, the infinite expanse of a starry night sky, the beauty of a piece of music, or the miracle of childbirth. Moments of awe can strike us at the most unexpected times, leaving us speechless, inspired, and even profoundly transformed. In this episode, we speak with Dacher Keltner, a psychologist at UC Berkeley, where he is the founding director of the Greater Good Science Center and the host of the Science of Happiness podcast. Dacher is a leading researcher on human emotion whose work focuses on the socio-biological origins and effects of compassion, beauty, power, morality, love, and social class. In his most recent book AWE: The New Science of Everyday Wonder and How It Can Transform Your Life, he explores the science of awe and its power to expand our minds and open our hearts. In this episode, we discuss the eight sources of wonder in life, how we can nurture an openness to experiencing awe, and how this openness can help us navigate grief, uncertainty, loneliness and mortality, ultimately allowing us to lead more meaningful lives. Dacher, welcome to the show and thanks for being here.
Dacher Keltner: [00:02:24] It's good to be with you, Henry.
Henry Bair: [00:02:26] To kick us off, can you tell us about your career path and journey to this work in psychology?
Dacher Keltner: [00:02:33] My personal journey was I was raised by a visual artist, my dad, and then my mom taught literature at a public university, a state university, on romanticism. And so our house was full of the humanities and ideas about passion and love and rage and war and justice. And, you know, and I was raised in a wild time in the late 60s in Laurel Canyon, California, which was wild. So so I had all this human psychology around me, but I showed no gifts for the humanities. I wasn't a very good fiction writer. I was a terrible artist. And I love math and statistics. So and I have to say, just to be absolutely honest, like I also like the scientific method of proving things or disproving things as a way to disprove or to, you know, assess all of my parents wild claims about the powers of pyramids and, you know, whether we can feel other people's, you know, mental states from afar. So, you know, I was raised in this incredible environment of of humanity, but I wasn't very good at writing in art. And so I gravitated to psychology and psychological science then as an undergrad and grad.
Dacher Keltner: [00:03:46] And then I think the other big thing was the study of emotion. And, you know, I came of age intellectually in graduate school at Stanford, and and it was just the heyday of cognitive psychology and cognitive science. Like the mind's a computer. There are these algorithms. That's what meaning is. That's how we make judgments. That's what morality is. And there wasn't a lot that our science could say about human emotion, about anger and awe and embarrassment and shame and anxiety and the like. We just didn't know. It wasn't in the what we studied. And I remember hearing Paul Ekman give a talk in the mid 80s, you know, and he was just starting to become well known for his work on facial expression and universality of emotion. And it blew me away. It truly- I literally had a spiritual epiphany hearing him talk about facial expression because I was like,"Wow, there is a measurement of the face that could capture human emotion like painters do or writers do." And here I could do it in my own way in research. So that got me to emotion.
Henry Bair: [00:04:54] That's all really fascinating. So, you know, as I as I look at your your your faculty profile here, you know, I'm seeing topics like human connection and emotion and happiness and of course, awe, on which you most recently wrote your book. Before we get into, you know, the subject of your book, though, I'm curious because these are such wide ranging topics and they're not, you know, they don't feel particularly scientific. Can you tell us what some of the research questions you're most interested in answering are?
Dacher Keltner: [00:05:23] Yeah. I mean, first I'd watch out with- They are scientific in the sense that the human mind is probably the most complicated living organism in the universe with 85 billion neurons, you know, connected and, you know, complicated ways. So and there's over here in the social sciences, there's a lot of sophisticated measurement and statistics and the like, but they don't feel scientific for really interesting sociological reasons. You know, can there be a science of love or awe? Well, yeah, of course. It's a mental state. We have a lot of tools to study mental states. And I think that to your question, Henry, like the really serious questions underlying my work and one is sort of a meta assumption that we are just a hyper social species and the idea that we're these individuals animated by selfish genes, you know, that drives behavior has, I think, fallen by the wayside. And and the Western mind really struggles with that understanding. And just a lot of the science that I do on cooperation and altruism and awe and compassion and embarrassment and synchronization of emotion and physiology is animated by the idea that, You know, like E.O. Wilson said (the great biologist) our signature strength evolutionarily is our ability to be social and to connect and be part of collectives. And so a lot of the work I do illustrates that.
Dacher Keltner: [00:06:47] And then I think the second big idea that has animated a lot of my work on emotion is emotions are functional. You know that you look at the history of thought on the human emotions from Plato on and people tend to think that they're wild and disruptive and irrational, and that can be true. You know, you look at the rage online about political issues today, and it feels irrational. It feels out of touch with factual beliefs. But in point of fact, most of our life, we're guided very sensibly by emotions. You know, one illustrative finding, the single biggest predictor of effective social protests is anger. Once you have this shared anger about racism or anti-Asian sentiment or bias or fair wages or climate crises, once the anger gets going things happen. So we're social. Big idea. Emotions have these functions. And then the third, I do a lot of work on power and inequality and social class. And and that really is is, you know, animated by the idea like Bertrand Russell said, like all of social life takes place in power dynamics. And we in the the West and, you know, the United States in particular, which is very blind to power dynamics and class dynamics, think that they aren't omnipresent, but they're very influential in how we think and feel.
Tyler Johnson: [00:08:20] So can I back up even a little bit further for a minute? You know, I've been struck. You have alluded mostly indirectly a number of times already to what I think in the Western mind is an often mostly unacknowledged, implicit dichotomy between the- we might call it the thinking brain and the feeling heart. Right? Like those are sort of two halves of every person that are most often maybe not in opposition to each other, but sort of operate independently in a lot of life is sort of choosing between them or figuring out how to reconcile them or whatever. Part of that, though, I think, is that, as you mentioned, in many cases we are more comfortable with the thinking mind, I think in part because it's much easier for us to articulate or conceptualize what a thinking mind is or what it does, or we think that that it's much easier, right? Because we, as you mentioned, we can sort of picture algorithms and we can picture rational choices. And it's sort of like life as a multiple choice test, right? But then if you go over to the feeling heart part of things, I think that from a sort of an unarticulated neuropsychological perspective, a lot of people would say, what even is an emotion? Like if a thought is a is a rational way of processing information from the world, like what even is a feeling or what is like what is it in the body and what is it supposed to be doing?
Dacher Keltner: [00:09:52] Yeah, man, you know, William James like what is an emotion, you know, in the late 19th century? And I still feel like our field hasn't, you know, arrived at a clear definition. But you know what I would say and this is sort of a consensual definition of an emotion and this is tough work and there's still a lot of debates is it is a brief state of mind where it has a subjective component to it, where I feel it, I'm self aware of like I'm feeling. Dacher is angry about something in the world that tends to have some bodily sensations. We don't know how specific they are to the emotion, a sense of a core theme being of your life being imbalanced. Right? Wow, I'm in danger here. My safety is imbalanced. And then some pattern of action arises in your mind, like, all right, in this context, I'm going to freeze or I'll run off to the side. So that's how the field approaches this really hard. Question, Tyler of a brief mental state with a feeling component that has some sensations, some tendency towards action in a sense, like as Dick Lazarus at Berkeley used to argue, a core relational theme, like, Oh, I'm feeling ashamed now. My face is hot because my supervisor is critiquing my work. Right? And and here's what I'm going to do. So it has this existential theme to it. But then that begs some other questions you're probably asking like, well, what is feeling? And that's hard, you know? I mean, is it the language we use to describe the state? Probably. It's more than that. Is it the, you know, the holistic pattern of all these processes we've talked about manifesting in some. Place of consciousness that gets closer to it, and that's a tough one. So you're heading into the some of the hard problems of consciousness.
Tyler Johnson: [00:11:57] Let me just ask because I feel like I mean, this was in some ways examining a somewhat different question, but at least for me, I found it helpful. In his book The Righteous Mind, Jonathan Haidt talks about this idea of the writer and the elephant, right? So his sort of explanation for those who haven't read the book is basically that if you try to figure out why someone is doing something, they will almost always articulate for you a reason that has to do with some rational explanation. And they think that that's the reason that they're doing it. But the truth is that what is actually happening is that that's a sort of a post-hoc explanation they come up with to try to explain their initial visceral, emotional reaction and that the emotion is actually almost always driving the impulse. And the rational explanation comes after the fact. Does that seem about right? Yeah.
Dacher Keltner: [00:12:47] Jonathan Haidt really revolutionized the study of morality by saying we've approached morality as like these rational judgments. But there are these fast automatic, what Danny Kahneman calls "system one processes" that give us feelings and intuitions, holistic things, right? Oh, this feels really impure. And he really saw moral judgment, which has a lot of feeling and emotion in it we now know as starting with these more unconscious, holistic feelings that then get interpreted by language and cultural concepts and the like. And to your question, it's very similar with how we respond to esthetic stimuli like paintings and music, where these colors move in and shapes and forms into your visual cortex. It goes to the back of your brain, and then a signal, neural signal, starts processing the meaning of a painting passes through brain stem regions which get feeling going, gets your body into the act, and then it projects forward into your prefrontal cortex where you're like, God, I'm feeling really empowered and alive by looking at this painting of a social protest. And now I'm going to name it with language and concepts and scripts and stories that are really in the prefrontal cortex. And I think, Tyler, you're right. And Haidt was one of the first to apply that thinking of early emotional processes, brain stem in the middle of the brain, creating this holistic sense of the thing right as beautiful or awe inspiring or disgusting or horrifying. And then it moved that neural signal moves into the prefrontal cortex where we start to make very specific cultural meaning about about it.
Henry Bair: [00:14:39] So speaking of the limitations perhaps of languages and capturing our feelings, let's talk about Awe. Yeah, yeah. So, you know, of course, you recently you recently published the book AWE: the New Science of Everyday Wonder and How it can Transform Your life, which we'll, of course, link to in the description to this episode. So in the book you start off by describing the scientific work you did in trying to define what areas in life we experience Awe in. Right? And it sounds like correct me if I'm wrong, but for the purposes of that research you defined awe as this: Awe is the feeling of being in the presence of something vast that transcends your current understanding of the world. I think there's a lot even in that that could be unpacked. Can you expound upon what we mean by vast, what we mean by transcend, and what is our current understanding of the world?
Dacher Keltner: [00:15:33] Yeah
Tyler Johnson: [00:15:34] And the meaning of life and what we should do with the rest of the moments we're going to be alive? Just all that.
Dacher Keltner: [00:15:39] Yeah, exactly. Thanks, Henry, for three unanswerable questions, but they're great questions. And thank you. And I wish I wish I had had more time to expound upon them in the book. So Awe is an emotion. And we've sort of tried to define emotions that arises when we encounter vast things that are mysterious on balance, and there are counter examples which we can get to. But, you know, vastness has many forms, right? We can be awestruck by really big things a redwood tree or Shaquille O'Neal like, Oh my God, that guy is huge. You know, vast can be in terms of time. And sometimes people have awe inspiring experiences where they they're, you know, playing softball and suddenly they have this flashback to playing little league when they're eight years old and they've done this transportation in time and they're like, wow, life's amazing. Time is so vast. Vast can be semantic, right? When I teach people in medicine, when you think about the incredible advances in medicine and the knowledge that is it's mind blowing gene, you know, gene editing and, you know, optogenetics and all this stuff, and you think, Oh my God, like they're altering proteins in the nervous system to help with Alzheimer's. That's a vast idea. That's just to think about the understanding required to do that. So vastness has many components.
Dacher Keltner: [00:17:07] Transcend means- the thinking is if you really want to push it, our current understanding of the world is like we move through with a sense of reality. Some people might call it kind of a Bayesian reality. You have all these prior beliefs that are helping us navigate the world, you know, and I'm looking at you guys and you guys look like human beings and you're in offices and we're drinking and everything follows these laws of reality, and then all arises when something happens that transcends it, right? Like, wow, Henry's hair just turned blue without anything happening. I'm like, That would be awe inspiring. That transcends my sense of reality. And I think, Henry, I sense in your impossible questions you're pushing in the right direction, which is that sometimes what transcends our sense of of our current understanding of the world isn't necessarily vast, right? A lot of people, when they look into a microscope and see a cell, it's incredible. And that's small. So there are some sort of variations to this general definition. But on balance, I think 90% of Awe experiences follow this. It's big in some fashion and it's way beyond your current understanding of the world and you feel awestruck.
Tyler Johnson: [00:18:23] You know, it's so funny hearing you talk about awe because, I mean, I'm a deeply romantic person. Like if I had to place myself in the sort of literary historical perspective, I would be firmly a transcendentalist. But at the same time, actually, the person that I thought the most about when you were just explaining all of that, strangely enough, and I have very mixed feelings about the fact that this is the person who came to my mind, but the person that I thought of was Steve Jobs, because I actually think that much of what made him so effective, not so much. I mean, there's the behind the scenes stuff, which is a different story, But as a public persona, the thing that made him so effective was that he was so good at stirring a sense of awe, right? Like the black turtleneck, the spare stage, and then like coming out with, in effect, what was a magic trick, Right?
Dacher Keltner: [00:19:17] Totally.
Tyler Johnson: [00:19:18] That's that's like what he did is like the iPhone was technology made into magic, right? It was like, look, there's no wires, there's no strings. There's like it's you know, it's doing all of these things. And there's a quote that I can't say verbatim, but that in effect, says that any technology pushed to an advanced enough state appears to the uninitiated as magic, right? And that's really what he was doing, was trading in a large. In large part on a sense of awe, so much so that you would have people literally lining up around the block to pay hundreds of dollars to buy his products when they came out. I think really mostly like I think they thought they were doing it because they could say whatever the something something megapixels. And I don't know what. But really I think the reason they were doing it is mostly because they wanted to feel a sense of awe.
Dacher Keltner: [00:20:07] Yeah, that's an incredible analysis. And I wish, you know, I always try to lean on solid social science, you know, because the idea of like these moments in history where somebody can transform the world through awe and you could almost apply some of the Edmund Burke-type principles of visual awe as you're doing that. I write about in the book like, you know, the light and dark contrast of black shirt with the face, the the big appearance of something that's new, the gasping crowd right. And from what I gather in the biographies of Jobs, he wrote about force fields of people. And he had this force field that moved people. He was awe inspiring. And then it's up to us to think about was he right? Was is did he oversell it? Was he a huckster? Donald Trump had the same effect. His first campaign. You know, more liberal minded people were like, this guy is a bozo, you know, and a racist bozo. But he had this persona and magic and awe for stirring the people who voted for him. So I think it's one of the big questions about awe is, is looking at how it's pivotal in these these moments in history. Right. And you've pointed to one, which is cool.
Tyler Johnson: [00:21:22] Let me let me ask you this question, though, and this gets back to something that Henry alluded to at the beginning. But I've had my own moments of awe, and I'm not talking like sorry to all the Apple philes out there, but I'm not talking Steve Jobs. I'm talking like what feel to me, like truly irreducible moments of contact with something bigger than myself. Right? That that feel like genuine awe.
Dacher Keltner: [00:21:44] Can you describe one?
Tyler Johnson: [00:21:46] Um, sure. I mean, I. Yeah. So I remember actually the first time that I, I may have driven through Northern California when I was young, but the first time I came here as a destination was when I interviewed for my to become an internal medicine resident at Stanford. So I was living in Philadelphia at the time. I had never been to Northern California to speak of, and I came here. It was in January. I still remember I had seen on the first day of my cardiology block in medical school, my cardiology professor, I still remember it distinctly showed a slide that was a picture of him and his family on the valley floor of Yosemite with half dome behind them. And I had somehow I love national parks and always did growing up, but I had somehow never seen a picture of Yosemite that I had, at least that I could remember. And as soon as I saw that picture, I thought, I am going there someday. So when I came out here to interview, I borrowed a friend of a friend's car. I had an extra day and I drove out to Yosemite and it was one of these days where it must have snowed like maybe two days before because all of the pine trees were dusted with snow and the valley floor was all covered with snow. There was I don't even think this ever happens anymore, but there was like nobody in the park, like literally coyotes wandering through the parking lots because there was just nobody there. But the sky was bright blue. And those who've been along Highway 152, you go past Groveland and then go through the entrance to the park and then you sort of come down this long winding road that goes sort of down the canyon, and then you come to where you can see the river and then you sort of pull around this bend and then the canyon sort of opens up into this panorama that has half dome in the back, and then the water falls off to the left and right.
Henry Bair: [00:23:25] I think it's literally just called tunnel view, right? It's this long, dark tunnel you drive through to enter the national park. Then you suddenly emerge into the light and see the vast expanse of the whole of Yosemite Valley. I swear that place is engineered for awe-making I mean, they must have known what they were doing when they made it.
Dacher Keltner: [00:23:45] And we did a study that were, by the way.
Tyler Johnson: [00:23:46] But but I, I just but I had never been there before. Right. So I'm coming through this, like, canyon dusted with snow. And then I, like, come around this thing and then this bright blue sky panorama opens up with half dome, you know, like, perfectly framed in the middle of it. And I just pulled the car off to the side of the road. It was bitterly cold because it was January up in the Sierras. I pulled out, I pulled out, put on my like parka and got out of the car. There's nobody around. And I just stood there and it felt like every cell in my body was alive to every most beautiful thing in the universe, right? It was half dome and the blue sky and the snow and the, you know, the cold air prickling the back of my neck. And I mean, it was just the whole thing. And I just sat there in awe. But but all of that was going to be to say you can read whatever John Muir or Emerson or, you know, whoever you want to, to try to capture that in words. That's one thing, and that's impossible even for the best poets that we have to capture it. But how in the world does a person study that scientifically? Like it seems like trying to reduce or quantify things that are by definition irreducible and unquantifiable?
Dacher Keltner: [00:24:56] Yeah. And this is to Henry's observation earlier, and it was a central challenge in writing this book. Right? So, you know, we've spent ten years, 15 years capturing all at Yosemite and, you know, at in big views and in near trees and all over the place and in the lab. And what I can tell you is, you know, as a scientist, I'm always a little skeptical about words, although words are incredible. Do they really capture experience? And so we look to other things and what we know is Awe has almost like a checklist. Right. And I hate to reduce the sublime to a checklist, but it's like, do you vocalize? Whoa. Right. That's a human universal of. Or do you open your mouth and widen your eyes? Do you feel quiet? Do you feel small? We did a lot of research, including at Yosemite where Awe makes you feel that voice of the self kind of quiets. Do you feel open to the world like you did Tyler? Like, wow, I am part of this vast canyon. Are you open to other people's strengths and and humble? Awe produces that. Do you feel tears and chills? Certain kinds of chills. And then the vagus nerves activation the warmth in the chest.
Dacher Keltner: [00:26:12] That gets us to like, I think, 70% of the experience. And then in the book and like you guys are suggesting with some emotions, I feel confident in that. But with Awe as you suggested, I was like, that's not the whole phenomenon. There's identity in Awe there's the sense of history and the like. And so we gathered stories of are from 26 different countries, right? Mexico, China, India, Brazil, Poland, Germany, etcetera. And we took two years to transcribe, translate and code the stories and find there are these eight wonders that produce Awe, of music and art and moral beauty, and we could talk about them. But I think those stories and the book has a lot of stories of Awe. And in addition to that, like I had to interview a lot of people who in realms of Awe I don't know a lot about like music and spirituality, you know, and I talked to ministers like, what is it? I mean, how would you just describe the spiritual, mystical feeling of awe? And I think the mixture of good old fashioned measures and the science and then these stories gets us to like 90% of the feeling. And then there's still the mystery of it.
Henry Bair: [00:27:31] We're definitely going to revisit the mystery part of it. But first, can you briefly walk us through the Eight Wonders of Life?
Dacher Keltner: [00:27:40] Yeah. You know, it was so interesting when William James was trying to figure out the feeling associated with spirituality, he he gathered people's stories. Right. And I feel there's some deep wisdom in that, that stories and narratives are fundamental way in which we make sense of the world. And so we gather these 2600 stories, we translate them, we we classify them. And the eight wonders are: the Moral Beauty of other people. So I do a lot of teaching in medicine. You know, Kaiser Permanente, the Permanente medical group, like the courage of a patient who's just gotten a horrible diagnosis is mind blowing. The way medical doctors sacrifice astounds me. You guys work harder than anybody I know. So moral beauty. Nature, kind of an obvious one. Collective Movement - dance, cheering at a sporting event. Rooting for the Warriors right now brings people a lot of awe, right? Then you get to Culture, which is music, visual design, paintings, architecture, ceramics, fabrics and the like. Fashion, if you will. And Spiritual Practice. 81% of Americans believe in some sort of spiritual force. And awe as part of that, like, wow, you know, nature is divine. And then your last two, which are interesting, which is Big Ideas. You know, every now and then when I teach, somebody will raise her hand and it's like I am blown away by big data. Or a lot of people get all misty eyed about evolution. Like, I can't believe we've evolved, you know? And then really remarkably Life and Death, you know, And I know in medicine, you guys face a lot of life and death and it is this mystery fundamental and you know that, wow, life comes into the world and then it leaves. And what do we make of it? So those are the eight wonders and they help a lot. What are your favorites? Where do you guys find awe?
Tyler Johnson: [00:29:39] You first, Henry.
Henry Bair: [00:29:41] Well, I definitely find or in in all of them, I mean, some of them, I think, resonate with me more because I experienced them maybe on a more regular basis. I think moral beauty is a really interesting one.
Dacher Keltner: [00:29:53] I agree. That was the most surprising to me.
Henry Bair: [00:29:55] Yeah, because it it's there. If you open your eyes, you kind of can see everyday kindness, but we kind of just move through life without, you know, without really paying attention. But also what's really fascinating is that the cultural context that I live in wants me to believe that there is no objective truth to what morality means. Like we shouldn't even try to identify what's moral and what's not. And I'm not trying to say that that is definitely the case or that's not the case, But the fact that this is something that kind of unites, that resonates in all of us, that we kind of intuitively can resonate with courage and kindness and love. Like when we see it, we know it. I think that's really remarkable to me.
Dacher Keltner: [00:30:39] Thank you, Henry. And we'll get to you, Tyler, in a second. But I just want to pause and reflect on what you just said, which is really important, which is I was surprised by moral beauty to kindness, courage, sacrifice, overcoming obstacles, virtuosity, watching Usain Bolt run the 100m. You're like, What? What? That's off the charts. But, you know, there are all these debates about morality and like, can it unite people or does it really divide as we sense today? But wow, I suspect, as you suggest, our reactions to other people's sacrifices and courage are pretty universal. Right? If you can understand what you're seeing, you have this feeling of like, I am inspired by that human being so worth thinking about. Tyler, what's your favorite?
Tyler Johnson: [00:31:26] Oh, I'm with Henry. I mean, I. I like many of those things. I think the- I guess I'll say the one that I feel like has been the most reliably the two, I guess that I most reliably go back to are probably music and spirituality in the sense that I feel like those are sort of accessible, right? So I don't tend to care much about stuff. I'm just not wired to care much about stuff. But one of the few stuff things that I really have is they're not even that expensive, but a couple of nice speakers because I love to be able to experience beautiful music, especially sacred choral music is sort of my my special thing, right? Like that. I feel like really, really grounds me and my faith practice. Also, that's probably the most sort of consistent daily, like I have daily sort of spiritual practice that I do that that I feel like really grounds me. But I also, you know, kind of to the point that you were making about that, there's always going to be the 5 to 10% of mystery. The thing that I most think about when I think about that list of eight things is that it feels like to me that all eight of them share a common taproot. That is, that 5 to 10% that is difficult to get your arms around or articulate or describe. But there's some like in some ways, the most hopeful thing to me is the idea that all of them connect in some way that we would have a hard time expressing.
Dacher Keltner: [00:33:01] If I can just reflect on that. Thank you for your examples and the word when you write a book. Sometimes it turns personal, like this book did, and I had to write about my brother who passed away and the awe that helped me in that bereavement process. And then there are also like words that keep coming at you that weren't there in the science, you know, and early and mystery was the key for me. I just kept coming to it. And I was thinking, you know what's interesting? Here's a finding which is interesting, which is the more you practice awe, all the richer it gets, right? The more you do certain pleasures, the less interesting they become, you know? I got my new shoes. I love them. They're amazing. And pretty soon you're like, They're just shoes. This is ridiculous, you know? But awe is the opposite. It's like the more you do it, it just gets richer and deeper. And I think it's because the mystery that it always has this grain of mystery in it, that the minute you think you know something, then you're like, Oh my God, but I don't know this, and I have to wonder about that. So and Darwin was a great example where he just was always awestruck by his observations of the natural world. And it just let him, you know, just keep generating new ideas to to fill out his theory of evolution. So mystery was key to writing the book.
Tyler Johnson: [00:34:19] It's two things that I just want to reflect on quickly. One is that so Henry is preparing to give a Ted talk that is sort of a what we have, like what he has learned from doing this podcast.
Dacher Keltner: [00:34:31] Excellent.
Tyler Johnson: [00:34:32] And as we've been sort of working together on wordsmithing, the script for the Ted Talk is just so funny because there's this, Henry is smiling, but so he has a coach that's supposed to help him make the Ted talk, I don't know, digestible or something. And the like key word at the kind of the climax of the talk is that, in effect, that the most important thing that we have gleaned from the many hours that we've been talking to people, trying to figure out what makes medicine meaningful, the key word, which the coach wanted to remove, but Henry then fought to have it left in because it's so important, is ineffable.
Dacher Keltner: [00:35:16] I just got goosebumps. I truly did.
Tyler Johnson: [00:35:23] Because precisely this. When you try to reduce what makes medicine meaningful. Like when you sort of excavate and excavate and excavate and excavate and try to get down to what is really at the heart of it, it's the mystery. Right. It's the sanctity, the the ineffable part that that's what it is. And that's the reason that Henry fought to keep the word in, because there is no other word that means what that word means.
Dacher Keltner: [00:36:00] Right on, Henry! And it's so important, you know, I mean, medicine is so humbling how complex it is and that lives are on the line. And, you know, And what what other thing could it be? But ineffable and mysterious. But we have to approach it, you know.
Henry Bair: [00:36:16] So I definitely I want to put a bookmark in how we can because you talked about practicing, which I think is a fascinating idea. So definitely want to come back to that. But quickly to address something that came into my mind earlier even was you had mentioned Edmund Burke's idea of the sublime, right? Which for him it transcends. It's the reason why sublime is different from say, something That's beautiful is that there is an element of terror, like a slight element of terror. Maybe a recognition that something, as you use the word vast, something is so much bigger than you or how small you are. So that made me think is awe always a positive feeling? Is there is there you know, because I think actually in your book you do point to some instances when someone reported that it wasn't necessarily a positive thing, but it was still awe inspiring. Can you talk a little bit more about that?
Dacher Keltner: [00:37:08] Yeah, Thank you. What a terrific question. And everybody should read Edmund Burke amazing book he wrote when he was 27. Did the hard work of separating beauty from awe. Awe about today, And I don't think this is true historically, and it will probably change and it changes across cultures. But in the many cultures we've studied with different methodologies, about three quarters of all experiences are largely positive. They feel good dopamine is involved, elevated vagus nerve activation. You feel expansive and you want to explore, right? And that is approach related, positive emotion. I'm not terribly. Uh, you know, the word positive is a little problematic, but it just feels good. About a quarter of experiences of Awe in most parts of the world are negative. You know, they really, like you said, you know, Henry, they have fear and a terror uncertainty. I'm confused. I'm alienated. And they look different physiologically. They look different in terms of the effects on well-being and thought. But that tells us and it's important the the word Awe derives from eighth and ninth century old Norse and old English or Norse and old English. They have a lot of dread in it, the words and the connotations. But our experience is pretty positive of Awe today. And and again, reminds us words are a little sketchy in really capturing full phenomenology.
Tyler Johnson: [00:38:35] So this is a sort of a two part thing. But because I want to ask the first question to set up the second question. You know, we earlier about probably about this time last year, we had on the program a woman named Anna Lembke, who is one of the world's experts in addiction. And so she articulates this really interesting thesis, which I think links to some of what we're talking about in a really important way. So so she has this idea that the world has never before been the same, that it is now in the following sense. We have set up sort of a prototype of Brave New World where we can get Soma hits whenever we want them. And so what she argues is that because we have become so accustomed to dopamine on demand, whether it's from junk food or social media or online pornography or alcohol or whatever it is, we're just so used to dopamine that what happens is that we essentially have habituated ourselves to always being on a dopamine high so that any time we're not on a dopamine high, we feel anxious and depressed. And so, ironically, by the constant pursuit of pleasure, we have actually left ourselves more anxious and depressed because we're always trying to get pleasure and used to getting it whenever we want it. And so what, when she was on the program and she explained this thesis to us, we said she also said that she has she is here at Stanford, that she has as a psychiatrist, students sometimes who will come to her in this kind of dopamine addicted state.
Tyler Johnson: [00:40:13] In effect, what they say is, I'm addicted to dopamine. Can you please help me to figure out how to not be addicted to dopamine anymore? And so for college students, oftentimes the biggest or most important locus of the problem is their cell phone, because that's social media and likes and retweets or whatever. And so what she will often help them to do, she said, is that she'll suggest that they take like a weekend where they completely unplug. And one of my favorite phrases that I've literally ever heard is that she said that she invites them then to go into what she calls the Great Quiet, which is to say, to leave all of that sort of thick of thin things behind and to just, you know, go to a beautiful place where they can just be present. And all of this is by way of saying that I fear that the rise of the digital revolution, in particular the rise of the connected and the Internet world and especially social media, I fear that part of what it's doing is that it is sort of drowning us in dopamine in in a way that we are less and less able, or at least less and less likely to experience awe because we're just caught up in bits and bytes, right? Like the metaverse seems like the quintessentially problematic, right? It's like an invitation to give up on the idea of awe completely and just be subsumed in this sort of, you know, half existence. That doesn't really count. But I, as someone who studies awe, does that seem like a fair analysis?
Dacher Keltner: [00:41:49] I do. And I think it's interesting. In our survey of awe around the world, 2600 people, 26 countries, no one mentioned a smartphone or a laptop or a Google search or a Twitter, you know, read as a source of awe for a lot of reasons that are probably pretty self-evident. But but the deeper point, you know, is our culture, I think, is facing a couple of crises for particularly for young people that Anna might see in her her practice, you know, and one is this and I think she's right, this immediate dopamine gratification through a video game or a fast trade if you're young people are trading money now you know on Wall Street pornography etc and that's problematic. And then the second one is the rise of what I write about in AWE, which is like too much self focus, taking selfies, comparing myself to another person on Instagram. Thinking about my my digital portrayal on Tinder or what have you. And both of those have conspired to and I had never thought about this, but I think you're right, Tyler like. One of our greatest capacities is to be quiet and to reflect and to wonder. And so much good comes out of wonder. And you need these conditions that the dopamine nation Lemke writes about and the self-focused the Jean Twenge and others writes about are working against. And it's part of the mental health crisis, frankly.
Tyler Johnson: [00:43:19] Yeah. I mean, as I hear you talk, I. It seems that so much of the digital world, you know, it's an irony that Mark Zuckerberg and company, when they introduced Facebook, introduced it as a way to build community. And there have been instances I don't want to, you know, dismiss that entirely. But so much of social media and the digital world is this kind of avatar based narcissism, right? It's just this a million different mirrors all focused on me. Right. And I feel like from what you were, you know, from your as scientific as we can get description of what awe means the one thing that cannot be awe is narcissism. Right? If you're in a room full of mirrors, you just can't experience that sort of connection with a greater reality behind the universe or whatever you want to call it.
Dacher Keltner: [00:44:12] You know, that's so interesting. People ask me often, like, what's the opposite of awe and in some sense you're offering a hypothesis and, you know, one is like alienation or horror. But I love your idea. Tyler Which is that actually the opposite of narcissism.
Tyler Johnson: [00:44:26] But here's the question. If there is a person, especially for this program, a medical professional, but really anybody. But if there is a person who thinks to themselves, Awe? Gosh, when was the last time I mean, I you know, I feel frustrated. I feel angry. I even feel happy sometimes. I can't remember the last time I felt awe, gosh, I'd really like to feel awe. Then what should they do?
Dacher Keltner: [00:44:52] Yeah. And Henry asked this earlier, like, you know, and throughout the book there are really simple things you can do. You can do an awe walk, which we've tested scientifically. Go out, look at things, observe them, be quiet, find awe. You can look at sunsets and other natural forces. I love just think hard about a piece of music that brought you awe at some point in your life. Almost everybody has one. And listen to it and just observe it and reflect upon that. You know, I do this a lot in teaching people in medicine, especially during the pandemic, is share stories of awe from your work. It is mind blowing to hear stories of awe in the medical context of saving lives. New medical procedures. Courageous patients, young kids. I remember one young child with cancer like turning to the doctor and saying, you know, thank you. Unbelievable. You know what humanity you find in medicine? Share stories of awe in a little group right about it yourself. So it's interesting, although it's ineffable and mysterious, awe turns out to be one of the easier emotions to get access to. And it has a lot of good reasons to do that.
Henry Bair: [00:46:09] So when I first entered my clinical rotations, I was struck by how medicine is brimming with moments of awe. I'll use a taxonomy of the eight wonders you've described. I saw moral beauty, right? You see plenty of courage and selflessness and resilience and grace under pressure and so much more. I saw religious wonder because patients frequently bring it up. As much as doctors don't like to tread upon that territory. If you open yourself up to it, patients are often hungering to share their spiritual reflections and distress, which so naturally accompany moments of suffering and existential crisis. And finally, I saw life and death, which is fairly self-explanatory. Yet despite the fact that we see these wonders every day, there is a trend that as you progress through clinical training, all that sense of awe just sort of dissipates gradually. And that's why I think it's so important to remind ourselves first that awe can still be found, and second, that this is something you can train yourself to be more perceptive to. The more you practice it, the more you get better at feeling it. So my question is what then does this do for us? How can awe help us cope with suffering and burnout?
Dacher Keltner: [00:47:37] Yeah, man. Big questions, right? And you can get better at it. I taught for two years at the Permanente Medical Group. All kinds of teams. Part of the pandemic chaos. 30% understaffed people dying in plastic bags. It was, you know, it was one of the hardest work contexts I've ever been around, was what medical health care providers were doing during the pandemic. And they were creating ways to get better at awe. Like Team Huddles share a story of awe go back to your work. You know, Henry, you so nicely lay out where awe is right there in medical practice, from life and death to moral beauty. And there are a lot of good reasons to do this. And this is all replicable, rigorous science, peer review. It makes you better at reasoning scientifically, awe does. It makes you know what real strong evidence is as distinct from weaker evidence. Awe does. It allows you to see systems more clearly like, oh, you know, I'm diagnosing this weird fever. You know, I don't I'm not a doctor. But now I look at the full system of the body, all the systems and get a sense of what's going on there. And then socially, it it makes you collaborate better, It makes you more humble, it makes you share more, and then it makes you feel less stressed, right? So it does a lot of good work for us. If we can find 3 to 5 minutes of awe a day.
Tyler Johnson: [00:49:04] You know, I can't help but think as as we're talking about sort of a practical way to approach cultivating an appreciation and sensation of awe in our lives as medical practitioners. One of the very first interviews that Henry and I did was with an ICU doctor, Dr. Adjoa Boateng, who, when we asked her to name I don't remember the exact prompt, but it was something like her most, I don't know, beautiful moment or meaningful moment or.
Henry Bair: [00:49:32] I think it was it was literally just tell us about a meaningful moment from your work. I think that was something like.
Tyler Johnson: [00:49:36] And so we we fully expected her to talk about, oh, there was this person and they were super sick and in multi-organ failure and this and that. And then they came in and we did 29 different things and they were on the vent and equo and yada yada. And then they got through and now they went back to their life and whatever. Right? Because she's an ICU doctor, that's what she does. Right? Instead, the story that she told us with no other prompting than that was of a patient who was in the ICU, got really sick. They could tell that the patient was going to die. So they invited the family members in lit candles, put on beautiful music, and then created this beautiful atmosphere within which the person passed away. And that was the story. And like the more times I've thought about that, that was the answer that she gave to that question, the more I go back over and over and over against myself and think like, that's so. Profound that that's the answer that she gave. And that says so much about how you can even find awe - I mean, I know that one of the eight things is life and death, but still, like in what many people would label a failure in the ICU, there was still an opportunity for awe and beauty to be found when understood and approached in the right way.
Dacher Keltner: [00:50:57] So, so resonant. What a great observation.
Henry Bair: [00:51:00] Yeah, well, I know that we are just about out of time. We want to be respectful of, you know, of the time you've shared with us, and it's been so insightful. We appreciate your stories and wisdom. Thank you for your work. And I encourage all of our listeners to go pick up your book. It's transformative.
Dacher Keltner: [00:51:18] Thank you, Henry, and good luck with your Ted Talk. And and you too, Tyler. You know, it's heartening to be a lab scientist and hear about how the medical field has this opportunity, you know, with simple ways to bring awe back to what is one of the most awe-inspiring careers one could imagine is to be in medicine. So thank you for this conversation.
Tyler Johnson: [00:51:39] Thank you so much. We really, really appreciate your time.
Henry Bair: [00:51:44] Thank you for joining our conversation on this week's episode of The Doctor's Art. You can find program notes and transcripts of all episodes at www.thedoctorsart.com. If you enjoyed the episode, please subscribe rate and review our show available for free on Spotify, Apple Podcasts or wherever you get your podcasts.
Tyler Johnson: [00:52:03] We also encourage you to share the podcast with any friends or colleagues who you think might enjoy the program. And if you know of a doctor, patient or anyone working in health care who would love to explore meaning in medicine with us on the show, feel free to leave a suggestion in the comments.
Henry Bair: [00:52:17] I'm Henry Bair.
Tyler Johnson: [00:52:17] And I'm Tyler Johnson. We hope you can join us next time. Until then, be well.