Inaudible. Were currently offering books on our website pretty click on the button below. We know that everybody search night. Thank you so much for that. You can ask your author a question by clicking on ask questions about of your screen. You can vote. Its a reminder that we include author and host. Inaudible. From 2014 2017. The author of facebook the healing power of the Human Connection. Hes been president ial candidate joe biden 20 and what we can do and spreads pretty. Inaudible. Is breaking up because you are speaking so quickly. And just start again. With the bio. He served as the 19th Surgeon General of the united and he is the author of tonights book together. In his one hour in the sometimes lonely world. He is been busy providing joe 20 and what citizens can do when it spreads. The doctor is joining conversation tonight. President obama as well as michelle obama. The book was released in 2019. The Services Tonight are provided. We welcome him here. It is such a joy to be here with my dear friends someone who i admire so greatly. It is a joint especially to talk about this book. It is by far for the most important books i have read in a very long time. Probably change my understanding of loneliness. Personally thankful as well is really enlightening. Thank you sarah for being here. And indulging me. In the Surgeon General of the United States of america. An athlete of Obama Administration ended, someone of memoir or leadership book wouldve been, golden airports everywhere. But you decide to write a book about loneliness. Serious problems here in america and around the world. Why did you decide to write this book and what makes it such a serious problem. Restate how wonderful it just to be here. To finally be sharing this book with the world. From the years in the Obama Administration, if you have secrets to share anyway. It was not an option for me. This equinox of this book, i did have some book ideas. Like coming out of office, and something on sort of a new view of Public Health. And maybe for the country to rebuild our Public Health infrastructure. The might time in office when i learned in government but some of what happened is sometimes you big plans and then the universitys in june a pretty thats what happened to me. So in 2017 wrote this article on loneliness in the workplace pretty and i really think the editors asked me to. I wasnt entirely sure how interested they would be in this book. What i found an days and weeks that followed the publication in the article, as i was getting so many messages from around the world. The media and folks who said we think this is a real problem in our country. Over the United States, india, japan, south korea, countries across europe and south america. Then he got of other messages this end, you know ive been struggling with loneliness for a long time. There might as has been didnt realize it was so common. The maybe dont need to be ashamed of it. And that was really striking to me. Long story short of that, it became clear that experience in the suggestions and of good friends and confidence. This is actually the issue that i would write about but i realize the more i talk about it, the more about a scene. It was resonating with my own experiences as a child and as a doctor. So that is what me led to ultimately focus on this topic. When i travel around the country and Surgeon General, and met people in small towns and big cities everywhere. I heard stories that were not surprising pretty stories about people struggles with substitute disorders and addiction. I heard about parents who had lost their own children who overdo waste photos from opioids. No parent should ever have to go through that. I heard about parents who were worried about depression and anxiety producing to be rising among kids and other children and generations. But what i started to see behind the stories was loneliness. And heres heart presented. Wasnt somebody coming up and saying hi my name is jack, im struggling with loneliness. People would say things like this. Enough, if you like we have to deal with all of these problems and appeal than i have to do it on my own. They would say that i feel is if i do this tomorrow, no one would know. I feel absolutely invisible. At that time after time hearing that, and started to register for me that there is something bigger going on here pretty he reminded me of my experiences in the hospital where the earliest days of doctoring i remember seeing patients who would come in and they had nobody with him. And sometimes when a really important diagnoses that we would make sure we had to make a really big decision about treatment. I would ask them, who put a call so that we could have a family conversation that these are really tough issues to deal with. And so often i would get the answers that there was no one to call. And even at the last stages of life, those final days and hou hours. I was seven people to be with them until the final moment. A lot of times it was just me and my colleagues in the hospital who were those witnesses. There was nobody else. No one is there. So it was reminded of those experiences of what i was traveling the country. In the more i looked into it, the more i realize that loneliness was more common and more consequential in terms of its impact on our health. And i even realized. Sounds like you were seeing it in many different populations. We typically think of the elderly is being lonely. But im hearing you saying that its affecting all ages and backgrounds pretty. Absolutely. And ive even traveled abroad and talk to people in england. In other countries. What i found is that most people have this notion is the elderly it was troubled with us. I thought as we get ogres, sometimes we have ailments or disability. Or maybe also the experience of losing most of her family and friends as we get older and others get ill. And we arent connecting to people as well. All this is true. But what i found out really interesting late is that loneliness is affecting people across the age gap. Theres a spike in young people. Millennial generations. But i also found interesting late was that it seems to be the great equalizer the sense but found that whether you were rich or poor, i was hearing stories of loneliness. Rural areas. And traveled to fishing villages and i heard stories of loneliness. Members of Congress Washington dc who would tell me in hushed tones that they were struggling with loneliness. In many of the parents were too. Moms debts, and people who were rich. Everybody seem to have an experience to share, they need somebody in their life who are struggling. And also when he realizes something is different going on here. They need to come together on but i found interestingly enough, and the environment that were living in, and talking about the subject of loneliness and social connection it resonated with everybody. And i would say there was no topic including the Opioid Epidemic that touched on in my tenure, the seem to be struck a chord within people. In terms of the effects of it, seems like their Mental Health effects. It struck me how it actually has physical Health Effects two. See equivalent of smoking a number of cigarettes a day. Was talking. This was surprising to me as well. I learned through the conversations with people that i had and also did the research afterwards that loneliness is more. It has deep consequences to our health. It turns out that it has major consequences outside of her health as well. There is a Strong Association between loneliness and the risk of Heart Disease and dementia and depression and anxiety, people who struggle with loneliness have more fragmented, the quality in the sleep is impaired, given everything we are learning about the importance of sleep of her Overall Health in the increaser east of obesity, we are realizing that sleep is important and the impact of loneliness is profound, perhaps most striking is that you reference the study done by Brigham University and it shows the association between loneliness and longevity is quite interesting and the mortality impact or the degree, when you struggle with loneliness the mortality impact of smoking 15 cigarettes a day in the mortality impact of obesity, i see this as someone who served as Surgeon General that has spent decades working on smoking, obesity and physical activity, it has not focused on the issue and we never appreciated the impact to had on her health. That is extraordinary. , just to think back very quickly, when you say loneliness i want to define, what do you mean in your book you distinguish between loneliness and solitude, is loneliness being alone or something more to it than that . Its a great question, loneliness is a subjective term, its determined about how we feel about the quality of our connection, i would say if you had to define it further, loneliness is a gap between the social connection and we feel that we need and the ones that we have in our life, the gap is where we experience loneliness. Theres a couple things that i want to say that are important, loneliness has unfortunate stigma around it, many people feel to admit your lonely you are not likable or socially broken in some way, i see that not as a theoretical point, i see that from practical experience, personal experience because of my own struggle as a child, thats how i felt, thats why never talk to my family about loneliness, i felt deeply blessed to have my mother and a father and his sister who deeply love me and i knew that from my youngest memories so i always felt secure filled love at home. For the essential belonging when i walk into school in the morning, i felt the sinking pit in my stomach and each day when my mom carpooled up right in front of school to drop me off, i was scared about the moments on the playground when everyone would be picked for a team and id worry about being the loss from being picked even though i had good athletic ability, i worried about lunchtime and walking into the cafeteria and not knowing if there would be somebody to sit next to or rake room for me and i cannot wait until 3 00 p. M. When the bell rang in Elementary School to find my parents to go back home i felt myself secure and i know from firsthand experience that the shame that comes in with loneliness is profound and it keeps us from admitting to ourselves what is happening but it makes you feel youre alone because everyone else is hiding their loneliness. But the reason i bring this up, i think theres an important reason for us to understand that loneliness is not something to be shameful but a natural signal that our bodies have, just like we experience hunger or thirst when we need something for survival, when we lack social connection or something that we do need for survival, evolution has led us to, we feel a similar signal unlawfulness and if we respond to the signal by seeking out meaningful connection in our lives by calling a parent or dear friend by going to visit, the loneliness needs time of the lonely is processed for a long period of time, then we can start to see and run into the consequences that were talking about an interesting thing happened when loneliness is chronic, we start to develop patterns which can dig deeper into loneliness, when we experience loneliness, what is happening from an evolutionary perspective, we are wired to feel that were in a state of threatened danger when we are lonely. The reason has to do with how we evolve over the thousands of years, when we were hunter gatherers, safety really did depend on numbers and if we Work Together and trusted relationships, there was a greater chance that we could take turns watching out for predators and make sure that we did not start. When we became separated from her tribe the chance of survival automatically dropped and that became based into our nervous system, we perceived separation and loneliness and we experienced it with elevated threat level, with an increased focus of herself and worried about safety. The evolutionary context, the transfer to the modern world into think about what happened in the modern world where you are feeling lonely when youre more suspicious of People Development around you and you can see how it makes it harder to connect with people when youre in the mindset and as it shifts away with the selfesteem and start to convict if they were not likable makes her harder to venture out, and the paradox of both, you find when you are lonely you can be further and further into your shells just when you need to reach out, thats one of the reasons it can be so persistent unless we understand how to approach her correctly. That is heartbreaking to think about the spiral where loneliness and leads to deeper loneliness and is a very painful place to be. Stepping back, all historical trends and societal trends have led to loneliness, and particular interested in the role of the internet and social media and not just causing loneliness or alleviating loneliness. Which is it, the responsible for loneliness, do people feel less lonely, what is the role of that in the transit we are seeing . Let me say this from the onset, the talk of loneliness, you might say that sounds like a downer but ill tell you in my experience talking to people about the subject and studying over the last few years has led me too feel deeply inspired and hopeful in the story about loneliness is also about the office of loneliness which is the extraordinary power of Human Connection in the power of the connection to heal not only our body and our mind but to heal the Broader Society in which we live in those stories that emanated from those that meaning realize that we have at our fingertips the ability to build the world that cannot only sustain us in a fulfilling way but it can also support our children in the way so we hope they can live so i know we will talk more about that but i want to mention that because its important to recognize out of the challenge of loneliness comes a discovery with the deeper resource that can be deeply deeply sustaining. Where did this come from, it turns out loneliness is on you, it did not happen when the internet started but people have been lonely for generations and generations and we have not written about it for the longest of times, it seems like shakespeare should be writing about it. And what strikes me as mobility, the opportunity and we move away from communities that weve come to know over time and the other challenge is a cultural challenge, its one of the most insidious and difficult to address, even though if i went onto a Street Corner and asked ten people, what is your number one priority, i almost guarantee they would say a person or group of people or kid or spouse or et cetera. Even i would not say that, if you look at how we live our lives and judged by where we put our time, our attention in our energy, for many of us and certainly this is been the case for me over the last many years, that focuses not on other priorities. Or because we dont value human relations, we do this because we live in a poulter that tells us that success is defined in a particular way. It is designed not by your ability to build positive relationships and nurture them over time it is defined by your ability to acquire one and rethink, power, reputation. If i build a company to sell and make a lot of money, im called successful in the media, if i have lots and lots of followers on social media and to have people around me all the time, people that are well known and i really hate it, i made a name for myself, we hear that term all the time and if i acquired a position of power and become president of the United States, ceo of my company and a manager of my organization, principal of my school, people say he has made it and contended achieved his position of power. When you talk to people who have achieved in these three areas or any one of them, they will almost uniformly say the pursuit of the goal contrasted with how they felt after the achieved which is a moment of exhilaration, not a lasting fulfillment that they wish that they had, this is a culture that leads us to prioritize and define success in a way that is different and separate from human relationships and is one that ultimately needs to focus on things that separate us and ultimately need us to d prioritize human relations in our life. Technology is the single most common question we get asked about, parents in particular who see their kids on devices all the time and even into weekends want to know is this hurting my child, is it making my child more lonely, these are really important questions to ask, my belief about technology from everything that i had seen and understood now, technology itself is a tool and the question of how do we use it, we can use technology in ways, for example if we live far away from a relative and we cannot go in travel to see them often but we can facetime with them on a regular basis, that can actually be using technology to connect with people offline, that can be powerful too. And were coming to florida for example, i post on facebook and my friends free to hang out or catch lunch or dinner and we actually meet up, thats a great way of staying connected. If you also find yourself that are many people around to raise their ethnicity and find that youre gay for example, there not many gay people around you in the community, Online Platforms can be colorful to helping people connect with others who have shared experiences. All those ways have to be helpful, what i worry about with technology, predominantly where you think technology is in a way that for the disconnects, i think what is happening with the use of technology is number one, the time that we spend on social media on her email or devices is taken away from the time that we would normally spend with somebody in person, there is an attraction for only 24 hours in the day, the second thing, technology dilutes the interaction that we have quite often, how many of us have had lunch or dinner catching up with her friends at a restaurant and have found that each of us are checking our phones in between her getting distracted when alerts pop up on our phone, it certainly happens to me but even worse than that, many experi