Victor Strecher - 7th Annual Symposium on Mental Health in the Workplace

Author: U-M MHealthy

[ Music ] Welcome to the annual symposium on mental health in the workplace. My name is Carole Dubritsky and I am the Americans with Disabilities Act Coordinator for the university. I would like to acknowledge those attendees here at Palmer Commons today, and we had such a great response. This is also being live web cast. So welcome to our attendees who are visiting us and attending this presentation via their computer. I would first like to thank our co-sponsors for this event. The Office of Institutional Equity, and MHealthy with support from the Council for Disability Concerns. The council is sponsoring a number of very interesting and informative events this week for investing an abilities to raise awareness regarding disability issues.

So now the exciting part and the reason that we're all here. Our presentation today is on purpose, lessons in life and health from the frog and the dung beetle, and our presenter is Dr. Vic Strecher. Dr. Strecher is a professor and director of Innovation and Social Entrepreneurship at the University of Michigan, School of Public Health. Dr.Strecher received his PhD in Health Behavior and Health Education at the University of Michigan School of Public Health in 1983. Since 1995, Dr.

Strecher has been a professor in the U of M School of Public Health and until 2009, Director of Cancer of Prevention and Control at the U of M Comprehensive Cancer Center. Dr. Strecher founded the U of M Center for Health Communication's Research which is a collaborative research focused organization of health and behavioral scientists, educators, software engineers, and artists. Dr.

Strecher, and the organizations he founded have won numerous national and international awards. In 2010, Dr. Strecher won the University of Michigan's Distinguished Innovator Award, and his School of Public Health's award for translating research into practice. Currently as the newly appointed director for Innovation and Social Entrepreneurship, Dr.

Victor Strecher - 7th Annual Symposium on Mental Health in the Workplace

Strecher is working in the School of Public Health to create an environment that promotes more direct dissemination of research and teaching efforts to improve the public's health nationally and globally. Please welcome Dr. Vic Strecher. [ Applause ] Thank you so much, and thank you so much for being here. I know that's an interesting title. I'm going to try to explain that as we move on. About two years ago or so, I was up in Northern Michigan right on Lake Michigan actually, and I looked out, it's about 5:15 in the morning.

I woke up and I couldn't sleep, and I noticed an unusual sight. Like Michigan was calm, if you've been there, it's often roiling, but it was calm like just a gigantic plate of glass, it was absolutely beautiful and the sun was just starting to peek out under the lake. So, I thought, I'm just going to take my kayak and row out. And I did I just rowed out straight out for about a mile, it was so calm. I didn't feel any danger at all. And I just kept going, and going, and going, and then I stopped for a while and I started watching the sun come up.

And as the sun came up, I started thinking, and it was almost as epiphany. I'm sure all of you have had these kinds of events where its kind of a peak experience. Well, for me the sun was coming up, and the water is dappling gold, and everything started just shining and glowing around me. And I started thinking about things in a new way. And I just started to-- I made a decision out in the lake that I was no longer going to think the way I had before. As no longer going to approach our field in health behavior and health education in the same way I had before. And I was just going to start thinking about some problems that had been bugging me for a long time. So this is one of the problems that's bugged me for a long time.

The boiling frog metaphor. Does everyone or anyone familiar with this boiling frog metaphor? If you've seen Al Gore's inconvenient truth or, you know, this is on left wing and right wing everybody talks about the boiling frog. The metaphor being that if you put a frog in boiling water, it jumps out right away.

In other words, something sudden, you know, makes the frog jump out, whereas, if you put the frog in cool water and gradually increase the heat very gradually the frog boils to death. Now whether this metaphor is true or not, I'm not going to get into although there is a whole set of studies in 1800's done by John Hopkins that are the most gruesome studies you will ever read in your life. And I'm more than happy to send this you where they actually were testing this boiling frog concept, unbelievable. But, this to me is a wonderful metaphor whether it's true or not. The metaphor, aptly describes many truisms in the field of public health and mental health which is that as our sedentary behavior, just gradually increases, as our waste line gradually increases, as our climate change gradually gets worst and worst, we just don't attend to it, because it's so gradual. We're kind of all boiling frogs in a way. And this metaphor really has bugged me out for a long time because it is the metaphor of our society now.

It is really what's happening in public health and we need to do something about it. How do we do things about it? Well, we give people health risk appraisals. Now, I have nothing terribly against health risk appraisals.

I've built many of them myself. And I know they're used here, and you know, sometimes, good things happened from these. But first of all, health risk assessments are not really health risk assessments because they used data looking at mortality and morbidity, disease, and death, rather than health. So they really should be called death risk assessments, or DRAs. And the kind of feedback that they give you is, well you should quit smoking or you'll die, you know, you should eat right or die. Move more or die. It's-- it really is a death risk assessment.

And you know, it's funny because they pay people here at the University of Michigan to take this. HealthMedia, the company that I founded been taken over by, purchase by a Johnson & Johnson. They paid people 500 dollars a person to take these health risk appraisals.

What product do you know that you have to pay people to take? I mean that's crazy. Why do we have to pay people to do this? Well, because, somehow, they're resonating. And that's what I was thinking about out in the lake. It's just not resonating with us. That's one of the big issues. So, I started this little thought exercise of teaching a class. A metaphorical class registered asking questions such as what is health? Can anybody define health for me? And one of the students whenever I do this in my real class, and somebody always says, life expectancy.

That's really what's going on. So not dying basically, living a long life. And so that would be the country of Japan.

Japan has the longest life expectancy in the world. They also have-- right now, I think it's about the fifth highest suicide rate in the world. So somebody in the class, an elderly student says, "You know what, it's not the years in your life, it's the life in your years that's really important." And so I go, "Well, where are you from?" You know, that's different. [Laughter] He goes "Costa Rica." "Ah, Costa Rica, Pura Vida, pure life." That's their slogan in Costa Rica. They have had, over the last 10 years, the highest life satisfaction rate in the world, the highest life satisfaction, right, in the world. They live very differently than people in Japan do.

I'm not saying Japan's bad. They have a very high life expectancy but the fact that they have this very high suicide rate, high depression rate, the fact that our country has the highest depression rate in the world, the fact that the Netherlands, a wonderful country to live in, also has a very high depression rate makes me nervous and a little bit queasy about how we're really defining health. Mark Twain said that the fear of death follows from a fear of life. Now, that's intriguing. And I go back to Mark and go, "You know what, Mark Twain, that's all we talk about here in public health.

We talk about death. We talk about disease and we talk about death. That's what we like to do." Our number one journal is morbidity and mortality weekly. [Laughter] It comes from the Centers for Disease Control. So that is our bible for public health. So absolutely, we follow death, we follow disease.

Is that the right track? Here is another article, and this is something that we really follow a lot in the behavioral sciences because it, as well as many articles state, that 55 percent of all deaths are related to our decisions that we make. You know, whether we smoke or not, how we eat, how we workout, things like that. All of that is important. And look at how the arrows are aimed. The arrows are aimed from something that you're doing bad, your lifestyles, your personal decisions leading to a cause of death which then leads to a medical cause of death which causes, you know, leads to death.

In other words, something like diet leads to being overweight leads to all these illnesses. This is in the public health model. This is-- and the medical model for that matter. We'd look at things, our behaviors, and then we say, "If you don't change that behavior then this bad thing will happen and then this bad thing will happen then you will die," right? And so when we decide to help people quit smoking, we decide to put scary images on the pack of cigarettes.

Now by the way, we've gone well beyond just the warning label. Now the FDA is considering having a dead person with staples going down their chest lying down on a morgue table. People smoking out of their trach tubes. You know, standard. This is like-- it's kind of we've slapped this people up enough and now we've gotten, you know, no response from them. Why? Because they're totally inoculated to these messages. And then we try to ratchet it up and we keep getting worse and worse.

We keep trying to scare people more and more because we're following those arrows. And that's what's key to me. So the big question is: How do I get this frog out of the boiling water? If we were just on the outside of this bowl, we all are right now, we're on the outside, what are we going to tell this frog? It's our natural inclination to say, "Frog, get out or you will die. Get out.

This is boiling water. Are you kidding me? This is dangerous. Your risk of death is very, very high now and it's going to up." What would the frog say? Frog would say, "What do you know? Are you an expert on boiling water? This water isn't so hot. Now go away. I'm getting kind of sleepy." In other words, the frog would, first of all, question your credibility, that source credibility, that question: Do you really know what you're talking about? Think about climate change. Think about any of these other behaviors that are boiling frog issues that we have in our society.

This is what we say. And then we deny it, too. "This water isn't getting so hot. Now, go away." So pretty much, that's what we like to say.

So these all reminds me of my second grade teacher, Ms. Schneider [phonetic], and I am using her real name because she was the worst, most horrible teacher that I have ever had in my whole life. And I hope she's still alive and I hope she's watching this webcast. [Laughter] So Ms. Schneider, my second grade teacher would say, "So why can't we get the frog out this way?" And I might go, "Uh, because you're so gross." And she would then, of course, go at me, "Wrong answer, Victor." And I'd say, "Ouch, okay." So now, I'm going to tell you why.

I'm going to tell you why and it's because we're all defensive. It's-- we're defensive because we have this big, it's almost like having a castle wall around our heads. And as we keep trying to force messages into this castle wall, a lot of us are educators here, we're trying to force these messages through the castle wall by scaring the crap out of the person, what happens? The wall just gets thicker. You know, the stones just get bigger and so it's harder and harder to get this person to even see out of this. Now, by the way, a lot of people call this castle wall "the ego." The ego is something and, you know, Eckhart Tolle and, you know, kind of a pop philosopher or whatever but he is-- I mean that in a good sense, he's a popular philosopher.

He calls the ego "the devil." But so does Buddha. Buddha talks about removing the veil. Just about every major religion and spiritual movement talks about having the self that is not real, that we project that we believe in ourselves.

We stay in this castle wall and increasingly, we're able to stay in this castle wall, and we're all defensive. I am, all of you are, we all have defensiveness and to some extent, it's helpful. It's really helpful to be somewhat defensive or you'd be led, you know, everywhere by every new movement, by every suggestion, of course, we need some defensive wall.

But now, I think we have a big problem in our society that we all have big, very thick castle walls. And so a big question again is, you know, if we're giving a person a health message or any kind of message, how do we get them to consider the message, rather than just simply rejecting it out right like this frog is, so that we can help the person make an important change in their life? One way might be to open a drawbridge of the castle wall. Every once in a while, just maybe once a week, maybe if you're a right wing person, maybe you could listen to Rachel Maddow, and if you're left wing, maybe once a week for half an hour, and I know this disgust many of you in the left. [Laughter] Maybe just watch Bill O'Reilly for half and hour. Just listen, why are they so angry? Why is the right so angry? The Tea Party is so angry. Why is the left so upset and indignant? There are many reasons to this and sitting down and listening to people just for even half an hour a week might not be a bad idea.

Just open the drawbridge, let some of these people in under armed guard, you know you can turn off the television, you know you can leave this person, it's okay, they won't hurt you. But that's the thing, you know, you're kind of saying, "They might hurt me," hurt, meaning change. They might actually change your opinion about something or broaden your perspective. I have this theory now that when, in the 1960s and '70s when I was growing up, we have three channels on television, and really, there is one major news host and his name was Walter Cronkite. And when Walter Cronkite came back from-- and pretty much everybody watched Walter Cronkite. And when people came-- or when he came back from the Vietnam War after interviewing soldiers, he said, "I don't know if this war is a good idea." That's what he said on television, and suddenly, we stopped the war.

It was as simple as that because everybody kind of listen to the same thing. Now, what do we have? We have the Huffington Post, we have Blaze, we have FOX, we have MSNBC, we have anything you want to stay in your castle wall. We can sit in our wall all day and night and do nothing but listen to things that agree with us. That's it. I mean, we're dead if that's the case. We will never ever talk to anybody else who disagrees or may have a different opinion as long as we keep moving in this direction.

Now, there's a new book actually called the "Filter Bubble" which is all about this and it's all about something called "tailoring." And this is something that I've built a lot of my career and our center has built a lot of career around tailoring. And they say, "You know, as we tailor news media to the people, we dig rut deeper and deeper." Now, my wife warned me about these 20 years ago. She's an artist and she's right over there, Jeri, said, By the way, that as you tailor, you're going to be digging ruts deeper and deeper. They'll never get chance to explore something new. Now, of course, in our programming, we allow people to explore new things, to open the library to them.

But, you know, if you think about the news media, that's all we're doing, tailoring increasingly. Google is now your Google, it's not the same as my Google. The messages you get are totally different. It's based on you at the end of the line. So we're tailoring things so that we're allowed to stay in our castle wall.

Let's open that up. So that's one way we could think about getting through this castle. Another way is when the castle wall breaks open. The castle wall can break open when suddenly you lose your job, when you have a death of a loved one, when you have a divorce, when something significant happens, when you get sick. Working in the Cancer Center for 15 years, I discovered so many people who, once they had cancer, their ego wall broke open.

Suddenly, they didn't have those same defenses, that deep castle wall, and they saw things much differently. This is Ram Dass who is a psychologist at Harvard and he changed his name to Ram Dass and he became a Buddhist spiritual advisor. And Ram Dass is very impressive. When he was in his 60s, he suffered a major stroke. Here's what he said, "This stroke was an act of grace for me. Now that my ego is broken open, I can see who I really am." That's pretty amazing.

You see a lot of cancer patients that way, you see a lot of people who've lost somebody, who suddenly see a little more clearly and are going, "Wow, I have to do something." There's a wonderful book by Elizabeth Lesser called "Broken Open." It's one of the best books to read if something significant has happened to you because it's basically saying, "What can you do to change your life and think about things in a new way if something bad has happened to you?" When Steve Jobs knew he had pancreatic cancer, he knew he was going to die, he gave the commencement address at Stanford. Here's what he said, "Death is very likely the single best invention of life, it's life's change agent." That's pretty interesting thing to say at a commencement address to a bunch of 20 some things. You know, death is that very likely the single best invention of life. So, Epicurus actually said, "As far as death is concerned, we men live in a city without walls." Nice, the metaphor helped. And I would say that's absolutely true. So I started looking and researching this idea because this is philosophy, right? And, you know, I grew up thinking, okay, philosophy, fine, it's a bunch of people who are smart who pretend that they're smart and, are they really saying things that are smart? Are they saying things that are true, saying things that are wise? So, I'm a scientist and I like to look at scientific data. Well, here are some scientific data where-- entitled "Death, Life, Scarcity, and Value" where they had college students start thinking more about their deaths.

And as they start thinking more about their deaths, they actually started valuing their life more. They used an econometric model, and here's the model. If you have five dollars in your pocket and you're walking down State Street and somebody on the street is asking you for a couple bucks, it's kind of hard to give that couple of bucks when you only have five bucks in your wallet, right? If you have 10,000 dollars in your wallet and somebody asked you for a couple bucks, fine, no problem here's a 20.

No problem. So it's much easier. Now, think about that in terms of years of life that you might have.

So for example, Marcus Aurelius, a great Stoic philosopher who also happened to be the best emperor that ancient Rome ever knew said, "Do not act as if you were going to live 10,000 years. Death hangs over you. While you live, while it's in your power, be good." Marcus Aurelius and the rest of the Stoics would wake up every morning and assume they were going to die that day. That was part of Stoic training. Wake up in the morning, assume you are going to die. Kiss your child at night and assume that he or she will die through the night. Morbid, maybe.

At the same time, what these people did then is live their life much more fully that day. Every single day, they start living more fully with their children, and with their family, and with themselves, really, interesting philosophy 2,000 years ago that we have somehow failed to continue to acknowledge. We're much more afraid of death than the Stoics ever were. So again, Mark Twain said, "The fear of death follows from a fear of life." That's a very Stoic comment to have made.

Now, is there a third way? We've talked about one, open the draw bridge every once in a while. We all have these castle walls called egos to protect ourselves, right? We need to protect ourselves but maybe not that much. We could open the castle wall and see more clearly. We can also break open. We don't want to break open, right? We don't want catastrophic events to happen to us. We all understand that. So what could you do instead that's more meaningful than just opening up and watching Bill O'Reilly half an hour a week, more-- and less catastrophic or tragic than having your castle wall break open? Is there another way? Well, I know in the back, you might not be able to see this so I'll just read this. Self-affirmation reduces smokers' defensiveness to graphic on-pack cigarette warning labels.

Another one, don't derogate this message. Self-affirmation promotes online-- let's say, I can barely see-- online type 2 diabetes risk test taking, yes. So in other words, people are more likely to take a health risk assessment. They are more likely to intend to quit smoking by about 40 percent, by the way, if at first, they wrote down core values that they felt they had. Core values like, "I believe in my family, I believe in my children, I want to be a good father, I want to be a good communitarian." Core values that you might have, even some values like ,"I want to be attractive, I want to have-- be strong, I want to be in control, I want to-- " whatever. And we'll get into different kinds of core values in just a few minutes. But right now, I want to say, these studies had people writing down their core values in one group.

And in another group, they wrote down things like the routine events of the week, you know, what news events occurred over the week, in other words, the controlled condition. Then they showed both of them graphic warning labels and they found that the people who just written about these core values were significantly more likely to accept that and then to intend to change and in fact, actually change. Why? Why-- this is just simply writing down your core values which is what people call self-affirmation, so you're firming yourself by writing these down. Why does writing down your core values seem to reduce defensiveness? Why does saying, "I'm a good mother, I'm a good spouse, I'm in control, I'm attractive," lead this person to start actually considering quitting smoking? That's the big question. So it turns out somebody wrote this article, "Why does writing about important core value or important values reduce defensiveness?" Jennifer Crocker was a psychologist right here at the University of Michigan. When she did this study, and it's a fascinating study, what she found, first of all, is it is true, when people are writing down their core values, they're less defensive. But a lot of people thought that all you're doing is kind of if defensiveness is kind of like an equalizer or your self-esteem is an equalizer and what you're doing by affirming your core values is just increase your self-esteem, then you can slip something underneath the bar that's negative, that's kind of scary, right? It's almost like there's this equalizer and we could call that a homeostatic approach to this because you always have to main-- you know, you're maintaining a homeostasis of esteem, and she didn't find that at all. That's what most people have thought so far, that this is just a homeostatic process.

What she did find is as people were writing down their core values, they started becoming self-transcendent. Now, what does that mean? Self-transcendence, this is something that's bigger than yourself. Suddenly, you're thinking about things bigger than yourself. Jenny Crocker found that suddenly, you're thinking about love, or compassion, or empathy, or bigger things, things bigger than ourselves, self-transcendent activities. And in a way, what we're doing then is levitating, rising above our castle wall. So suddenly, we're starting to move up above it rather than having to have it break down. We're starting to lift up and seeing reality because reality is just outside of your castle wall. So that's what she found, that defensiveness is reduced as a result of the self-transcendent behavior.

So I've started exploring this concept more, self-transcendence, Jenny, I talked to her quite a while about this. "What do you know about self-transcendence?" "Well, you know, it's just like a psychological construct." "Yeah, but what's the history of self-transcendent?" "Oh, I don't really know a lot about it." Interesting, okay. So as part of my own journey, my quest, I decided to start learning more about self-transcendence. And I started with this little ancient character called the "dung beetle." I have always, since a child, been impressed with this dung beetle because they are-- look at how they have something much bigger than themselves. The other thing is I didn't like the word self-transcendence, you know, it seems so, you know, hoity-toity. And when I started thinking about that word, of self-transcendence, I thought, "What's the lowest creature on the planet, or one of the lowest," you know? So the flatworm goes, you know, that rate.

But I thought the dung beetle is pretty cool in that sense, too, because the dung beetle sits on the top of feces, a big chunk of feces, and rolls this ball. After they roll a ball-- and by the way, my wife can attest, I have five books about dung beetles in my office now, and I've been spending a lot of time reading about it and then talking to other, to evolutionary biologists, especially one from the University of Western Australia who is the world's dung beetle expert. And I said, "Tell me about what a dung beetle does after they roll the ball." He said, "They do a handstand." "A handstand, what do you mean?" They do a handstand and they release a pheromone that attracts other dung beetles, female dung beetles.

And these female dung beetles go, "Wow, nice ball." And they literally do because they look at the roundness, the sphere-- sphericity of the dung ball, because they're going to have to roll the ball for quite a while. And they look at whether this dung beetle that they're latching onto, it's going to hook up with, can also defend itself, because they're going to end up having to roll this ball in a relatively straight line for up to 100 yards. Imagine a little dung beetle, this big, rolling all the way across this room even, and then often, there are little cliffs, little valleys that the dung ball falls down. A biologist named Fabre from the 1800s in France studied this for 20 years, and he found that the dung beetle will roll the ball back up the hill up to six dozen times before giving up. They have a purpose. They a have a mission and they are self-transcending because they're looking at something that's much larger than themselves, this dung ball, right? That's their purpose.

So after they decide in some preordained area to stop, they dig a hole, they bury the dung ball, they have incredible tantric, slow dung beetle sex. [Laughter] Yes. And it's true, if you've ever seen films which I have of dung beetles schtooping, this is quite an amazing thing to watch. It's pretty romantic. So anyway, they have dung beetle sex and then the female lays the dung beetle eggs inside in the middle of the dung ball and the larva eat the dung ball out. Hence, that's their purpose really, to generate this new group. So let's think about self-transcendence then in terms of this dung beetle. I started looking around for other corollaries of this dung beetle.

And one thing that I found, I love to go to the British museum. I'm in London a fair amount of times and number of times and when I'm in London, I always go to the British museum and I always hang out for some reason in the Egyptian collection. In part, because it's the best Egyptian collection in the world even better than Egypt because the Brits stole everything from the Egyptians in the 17 and 1800s and moved it all up to the British museums. So it's enormous collection and it's absolutely fascinating because these statues and the pillars and other things are sometimes 3, 4,000 years old. Really, unbelievable! And so I started looking at this and I started looking at the different amulets, I started looking at different hieroglyphs, and I started realizing, wow, these are dung beetles. This scarab is the dung beetle.

This is the scarab god. The scarab god is named Khepri and this one of their most ancient gods and also the most sustaining god that they had. The very first sentence in the Egyptian book of the dead praises Khepri.

Khepri is the Egyptian god related to transformation, to rebirth, and transcendence oddly enough. So I didn't know that when I just started on this track thinking about dung beetles but suddenly, I realize that the Egyptians understood this. And if you look at this photograph that I took on the right, you see literally the dung beetle with this ball rising above what looks like a castle wall to me, and it's pretty amazing so I just had to take this photo.

But you see this everywhere. You see over 100 of this in the British museum. So I started thinking about this, Khepri, the scarab god, rolled the sun up every morning. That was Khepri's job, a sisyphean kind of job. But the idea was that we can be reborn every morning.

Imagine, you know, an entire incredible civilization like the ancient Egyptians deciding we're going to take this little dung beetle and turn him into this god of rebirth, transformation, and transcendence. I was fascinated by this quiet honestly. So it turns out in looking more at self-transcendence that Maslow talked about this. Abraham Maslow was the Father of Humanistic Psychology.

He wrote a lot in the '40s, '50s and '60s but he wrote a lot about something on what he called the top of the pyramid which is self-actualization. So after you have all of your other needs met, you start thinking about your own human potential and how to reach your highest human potential. And you call that self-actualization. We talked about people having peak experiences. Now, a lot of people have criticized it because it turns out you can be a self-actualizer and still not have many of these needs met. You look at a lot of Vedantic Hindus who have-- you know, who lack many of these needs and yet have certainly self-actualized.

You see a lot of these around the world. If you travel to developing countries, you find very self-actualized people were not at this top of modern, western type of pyramid. On the other hand, I think he-- what he said made a lot of sense about self-actualizers, but after a while, he started saying, "You know what, there's something beyond self-actualizers." When he is older in age, he discovered that many of the self-actualizers who are really focused on their own human potential were also, and gradually evolving into being interested in human's potential, not just their own human potential but human being's potential, our society's potential, how could we do things, and this people thought much bigger than themselves. Maslow said a few things about self-transcenders. He said that trancenders find it easier to transcend the ego, what we've just been talking about, this castle wall, that kind of defensiveness that surrounds us, the self, the identity. To go beyond self-actualization, these people are doing something bigger than just their own self, focused on just themselves.

Transcender-- transcendence is likely found in the-- and I forgot to read, I'm sorry, with my glasses, because I'm freaking old. Found in highly creative or talented people and highly intelligent people and very strong characters and powerful and responsible leaders and managers and exceptionally good virtuous people and in heroic people, read Joseph Campbell's "Hero's Journey" by the way, heroic people who have overcome adversity and who have been strengthened by it rather than weakened by it. Maslow also said that transcenders are far more apt to be innovators and discoverers of the new. Why? Because they're not in their castle wall anymore, they can-- and transcending and thinks about-- thinking about a purpose and things that are bigger than themselves. They start thinking about things in a new way. As Ram Dass had said that if the castle wall breaks open, I can see more clearly now, they become the innovators in the world. Finally and very, very importantly, transcenders have a sense of humility, a sense of ignorance, a feeling of smallness, a feeling of awe before the tremendousness of the universe.

Think about our greatest scientists. I would argue that our very greatest scientists actually have this sense of humility, a sense of ignorance, a sense of awe. They don't know everything.

In fact, they're learning a lot by the things that are the negative results in their findings. They go, "Oh, my gosh, I thought that would happen, I didn't. Their castle wall just broke open, they're seeing more clearly and suddenly, they're doing things that are innovative and new because they're not following the old school," very important. So Maslow also wrote all about management later in his life. And so he started saying, "Identify the transcenders. The transcenders can see other transcenders, the transcenders are the innovators, help them-- help other people transcend." So there's another study that had just come out with Jennifer Crocker and Aleah Burson who was a doctoral student here, and I'm not sure if she's still here and I'm not sure whether she's even watching this.

I hope she is. But she had a wonderful study with Jenny Crocker where they're looking at two kinds of self-- of value affirmation, and I'll explain that to you. They took 92 college students from the University of Michigan. They have this college students write out their name, gender, information on an information sheet. And then they said there are two other people-- just follow me here, there are two other people in a triad, all three of you are writing these information sheets. I'm going to give you the sheets from two other people and you pick the one you would like to work with, 'cause in the study, we're only going to take two. So, one of you will kind of be booted out, so to speak, by the other two.

Does that make sense? Okay. This is all totally faked, by the way. They never did any of this. All they did was either tell people, "You weren't picked by the other two". Wow, bummer, ego threat, right? So you weren't picked for the basketball team. You weren't picked to be part of this group, who is going to work on such and such. So your ego is threatened, right, or no ego threat.

You weren't actually pick-- oh, you were picked by the other two but we decided to just randomly select who is going to be part of this and you were randomly selected to go along. So that's a controlled condition, right? Now, we know, by the way, from about six studies that people who have an ego threat like this are more likely to smoke more cigarettes, are more likely to exercise less, and are more likely to eat more, especially eating more. So when your ego is threatened and it will be today, I can almost guarantee it. Everybody's ego is threatened every once in a while.

And as it's threatened, you will eat more or at least want to eat more, okay? So that was one of these tests they want to engage in. But here's what they did in both groups, the ego threat group and the no ego threat group. They have them write out either the daily routine in both groups. That's a controlled condition, right? Or they had them write out their values. And they broke those values out into two kinds of values.

Self-transcending values, these are things like empathy, support needs, things that are bigger than yourself, what we've just been talking about, your family, your community, things that are bigger than yourself. Maybe the scientific knowledge in the world, relationships, or self-enhancing values, think Charlie Sheen values, you know, so power, wealth, independence, crack cocaine, attractiveness, prestige, whatever. You know, these are things that the people value but they are called self-enhancing values.

So big question is: Is there a difference? That's what Jenny Crocker and Aleah Burson wanted to find out. That's a very good question. So if we're having people just write down a bunch of values, the question is: Are some more important than others? Right? Okay. So here's what they found. The real test in this whole thing, the real manipulation was we have this fresh chocolate chip cookies, they just came out at the oven and there's this other experiment we're doing, too, I don't know if you want to part of this experiment, 92 college students from the University of Michigan but we do have this warm chocolate chip cookies we need taste tested, do you mind? You can have as many as you want. Oddly enough, 92 out of 92 said, "Yup, I'm in. I'm in the study.

Great, no problem." So this is a real study, how many chocolate chip cookies did they eat, right? Now, we already know and I already suggest that if you were just threatening your ego, this controlled condition should be compared to this controlled condition. Ego threat in green, no ego threat in red, correct? So that's the first test we'd want to do here. And sure enough, we find that people with the ego threat ate eight cookies on average and people with the no ego threat ate four cookies. You notice when your ego is not threatened, it didn't matter whether you're writing down values or not, it's when your ego is threatened, it's when you feel threatened, it's when your castle wall is under siege, right? So let's look at that, so that's the initial test, check, six other study is fine, no big deal. Here's the other one that we wanted to look at, just basic self-affirmation theory. Does writing down core values work better than not writing down core values? Yes, they do. So, these two groups together are statistically significantly greater than this group.

Okay. Now, the big acid test, are some values more important than others? This test, right? Sure enough, statistically significant, people ate almost half the number of cookies if they were writing transcendent values, still better if you're writing down any value, but better if you write down transcendent values. This make sense so far? Okay. So there's another study, fairly recently done, 2009, called "The Path Taken: Consequences of Attaining Intrinsic and Extrinsic Aspirations in Post-College Life." I'm bringing this up because we are in college. So these were college seniors at the University of Rochester. Before they graduated, they were asked to write down their core values in their life and then factor-analyzed or separated out into two groups, one group had individuals writing mainly about the self-enhancing values.

Power, "I want money, I want fame, I want to look better," et cetera, those are self-enhancing values. The other group, self-transcending values, "I'm interested in my community, I'm interested in being a good partner, I'm interested in those types of things," okay? Here's what they found. Oops, here's what they found, I can just read this to you real quickly. Results indicated that placing importance on either intrinsic or extrinsic, extrinsic meaning the self-enhancing values, the Charlie Sheen values-- I'm sorry if Charlie is watching this, my apologies, don't sue me. Extrinsic aspirations related positively to attainment of these goals.

In other words, whatever goals you set when you're a college senior, you were more likely to attain those than if you didn't set them. That's great, okay, goal setting works. Yet, whereas attainment of intrinsic aspirations related positively to psychological health, not just psychological health, it turned out physical health as well two years later. There's a follow up study to this and also found physical health improvements. Attainment of extrinsic aspirations did not. Indeed, attainment of extrinsic aspirations related positively to indicators of ill being, of depression, of anxiety, of stress, and of physical illness. So they attain these things and then suddenly they got sick, that's pretty interesting to me. So they are may be better values than others.

There's one thing that I'm purposely not dealing with in this presentation and that is: Should we-- who gives us these values? Does God give us these values or could evolution have built these values? And there-- actually, there is wonderful data that suggests that evolution could have built these values. That empathic altruistic behavior can be evolutionarily biologically selected for on the Savanna. We know that bonobos, that chimps, that dolphins, that even rats exhibit emphatic behavior. Even young children who are in their early months before they have any real socialization, so to speak, that we know of exhibit emphatic behavior. They only stop after the parents start trying to get them to engage in emphatic behavior, and that's true. So Viktor Frankl who spent time in three concentration camps saw people dying everywhere around him. And what he found, he's a psychiatrist, and what Viktor Frankl found is that before they died and this is even before they were sick, they lost their purpose in life.

So he started talking about this in terms of self-transcendence. And he said, regarding self-transcendence, "Man's wife always points to something beyond himself. It is always directed toward a meaning to fulfill." So let's think about that meaning or purpose.

Let's look at four people. Simone de Beauvoir, who is a partner to Sartre, Jean Paul Sartre. Soren Kierkegaard-- and by the way, Simone de Beauvoir was a devout atheist.

Soren Kierkagaard is a very religious person. George Bernard Shaw, atheist. Friedrich Nietzsche, there is no god, atheist. That's one of his famous quotes. So Simone de Beauvoir, and I'm just pointing out their backgrounds, and it could be anything. It could be religious or nonreligious.

Okay. All of them, though, were related to a philosophy called existentialism. Simone de Beauvoir said, "There is only one solution if old age is not to be an absurd parody of our former life, and that is to go on pursuing ends that give our existence a meaning." In other words, what she is saying is that we need a purpose, whether it is meaningful or not. Kierkegaard said, "The thing is to find a truth which is true for me. To find the idea for which I can live and die." He spent a long time talking about how hard it is and how important it is to identify that purpose in one's life. George Bernard Shaw said, "We should all be obliged to appear before a board every five years and justify our existence on pain of liquidation." A little harsh there, George, but all he's saying is that we should be justifying our existence, justifying our purpose. And then Friedrich Nietzsche said, "He who has a why can live for-- can bear almost any how." That's really interesting. In other words, if I have a why or a purpose to live, I can live through just about anything.

Viktor Frankl certainly found that. So the purpose can drive you through things. It can drive you through barriers.

In our field, we spent a lot of time trying to address people's barriers, to quitting smoking, to eating right, or to whatever. But Nietzsche is saying if you have a strong enough motive or purpose in your life, these things can go away. And there's some new thought about that seems to really make sense in some good data. So let's look at meaning and life. Neal Krause, who is a professor here in our School of Public Health at the University of Michigan, studied this with the national aging study and what he found is that people who had a purpose in life indeed live longer. And in fact, it's not just meaning in life but there is a subscale that was purposeful, that was related to purpose in life, that's kind of a subset of meaning in life.

And it was that purpose that really related to living longer. Here's another. People who are elderly-- I'll just read this, effect of a purpose in life on risk of incident Alzheimer's disease and mild cognitive impairment in community-dwelling older persons. These people are starting out just fine to begin with. And then, thus, a person with a high score in purpose in life was approximately, get this, 2.4 times more likely to remain free of Alzheimer's disease than was a person with a low score. They followed people for seven years.

What if we had a drug that did that? It'd be on our water system. We'd be drinking it now with our coffee. It'd be little tablets we'd be putting on our coffee.

It's unbelievable. In other words, you can go back to the first one. You live longer, you are less likely to get Alzheimer's disease.

This predicts success with cocaine treatment. I'll just read this. Purpose in life was unrelated to cocaine or alcohol use during six-month pretreatment. So this is before they got in. After controlling for age baseline in years and depressive symptoms, purpose in life was significantly predicting relapse, meaning lower relapse, to any use of cocaine or alcohol.

And a number of-- well, I won't get into it. But findings suggest that increasing purpose in life may be an important aspect of treatment among cocaine-dependent patients. Here's another one. A higher sense of purpose is associated with sexual enjoyment in midlife women. Nice! Okay. So, higher sense of purpose is associated with more enjoyment in sexually intimate activities, adjusting for all these other known factors. I can send you any of these articles.

It's pretty fascinating. Having a purpose is associated with lower coronary heart disease at a two-year follow up. Now, why is all this the case? Well, here's a fascinating study ran by-- one of the authors is Elizabeth Blackburn.

Elizabeth Blackburn is a 2009 Nobel Laureate out of Berkley in Medicine, so very well-known person. And she was-- she won the Nobel Prize for looking at people's chromosomes and discovering that the ends of our chromosomes are kind of like the aglets or little plastic things at the end of our shoelaces. She called them-- or they are called telomeres and she found that telomeres are protective. They protect the unraveling of our chromosomes. So telomerase is an enzyme that helps fuel these telomeres, and that Elizabeth Blackburn won the Nobel Prize for this. What she then did, though, was put people into a meditation program.

She had two groups, one was the meditation program for three months of meditation, the other was three months on the waiting list waiting to get into the meditation program. But they're similar people, right? Okay. So a waiting group but the-- she found that the meditators, as she had hypothesized, had greater telomerase activation.

In other words, their telomeres were repairing more. Interesting, I mean, we need to go back to evolution to try to figure out what's going on there but she found certainly that as peoples-- as people were meditating more, they had greater telomerase repair. But here's the interesting part. The real mediator in this relationship that explained almost 100 percent of the relationship was that these meditators were developing a stronger purpose in their life. So it wasn't the meditation.

It was the purpose in life that was built up in this experimental design. That, to me, is fascinating. So a lot of these could be associations and you could say, "Well, you know, people who have a purpose or a different kind of people," yeah, we get that. But, you know, no matter what people try to adjust for statistically, here is an actual experiment where they tried an intervention related to meditation.

So let's think about this and what we could do with the general population. What if we could get people at the University of Michigan or in our society to start transcending, to start thinking about bigger values in their lives? What if they all had these balls that were, you know, dung, in a way, that were inflated and they were transcending above our defensiveness and we started thinking about how that could help in our lives. Let's say a person who was working here says, "I want to be a role model for working moms." Such a great purpose to have in your life, right? And then you could look at what's underneath there, community, generosity, integrity. This is her root system of values that support this tree and the dung ball is kind of, in a way, fueling these values. And then what does that fuel? It fuels your life. So let's say this is a person who's a custodial person here at the University of Michigan or in a school system and in this elementary school. He is giving the children in his school a clean building and he's serving God.

That's his purpose in life. Now, if he is very connected to the school like that, do you think he's going to have higher, average, or lower absenteeism rates in that school? I'm just guessing lower. I don't have data on this but it might be a nice study that once you start helping people develop a stronger purpose or mission that's even associated with that elementary school would you have higher average or lower absenteeism rates.

Another might be from a cancer patient. I paint pictures that express the emotions of my breast cancer experience. I was just in New York talking to a person, who's a Harvard physician, who runs a foundation for art and healing. And he talks about the stories or the paintings or the art, the poetry, the dance other people do who've just had cancer, who've just gotten back from the Iraq or Afghanistan war, anybody who has some sort of significant event happened to them, and he says, "They have a trauma narrative that they need to share with other people." And this is her trauma narrative. So that trauma narrative comes out and it's healing.

It's almost like a poison that's in you and you have to vomit it out but at the same time, it's important to be sharing and listening to other people's trauma narratives at the same time. You can have a mission or purpose in a family. This is an actual family mission written by a family, "To maintain an environment where each of us can find support and encouragement in creating a better society." Imagine that family getting together over the gathering place of the dinner table and they say, "That is our mission? What is our mission as a family? Do we have one?" You know, who does that? How cool could that be? Let's look at this in terms of organizations. You know, Emile Durkheim, Marx Weber, Marx Weber coined the term "bureaucracy." These guys were thinking a lot about modernization and the problems of modernization.

So that's why Charlie Chaplin wrote a, you know, had a movie, filmed a movie called "Modern Times" and in that Modern Times, he's a cog in a wheel. So we know that with modernization, GDP has increased significantly in our country as has-- it has in all modern countries. We know that increase-- there's been a significant increase in money. We also know that in the United States, satisfaction in life has not increased at all during those same times. From 1920 to modern times, right now, we have not increased the satisfaction in our lives even though we are far wealthier individually as we were in 1920. And one might disagree with that but the data is there. It's very clear. So this, to me, is fascinating.

How do we develop organizations that don't dehumanize us and turn us into cogs in a wheel and keep thwarting that life satisfaction? There's a good example right here in Ann Arbor of a company that does that, and that's called Zingerman's. Zingerman's has a mission statement that was organically developed by the employees of Zingerman's. It's pretty amazing.

When Ari Weinzweig and Paul Saginaw decided to build a mission, they didn't bring in some marketing company who then-- and then they went off to some little golf event for a weekend and come up with some mission statement, come back and tell their HR group, "Oh, make sure everybody knows this mission. You know, we're going to have mission workshops." No, instead, what they did is talk to all of their employees and say, "Why do you work here?" Now, if you did that in your own school or in your-- in a hospital system or wherever you are in this university, you start asking people, and I've done this, you ask people who are secretaries, "Why do you work here?" They will tell you some of the most amazing stories you've ever heard. It's really incredible. People, all, almost everybody has a mission that can be pulled from them if you just ask them. So Zingerman's mission is amazing and this really was an organically developed mission. We share the Zingerman's experience for selling food that makes you happy, giving service that makes you smile, and passionate pursuit of our mission, showing love and care in all our actions to enrich as many lives as we possibly can.

You see that. When you walk into the roadhouse, you see that mission right on the face of the person greeting you, on the people-- well, and Ari who is walking around pouring water for people. Ari, the founder, the owner, the multi-gazillionaire probably, who walks around pouring water and says, "Do you have enough barbecue sauce there, Vic?" And cleaning up stuff from the floor. He actually wrote an article called "Pouring Water" and it's all about giving back to the customer and actually serving the employee. He feels it's his job as the manager to serve the employee.

Because if no one is-- if the employee is not served, how can the employee possibly serve his or her customers. Quite an amazing story. So if you have all of these people working there, they all say, "Yeah, it's my mission" and they get the mission, they all get it at Zingerman's. Even if you have a dung beetle [inaudible] or a dung ball [inaudible].

Okay. So let's get back to this 'cause I'm going to close up now. We've talked about these arrows pointing in this direction. We always think about our personal health decisions leading to various conditions that we might get and those conditions related to morbidity which are then related to mortality.

We can look at it this way just graphically. So we see our behaviors relating to conditions, relating to mortal-- morbidity, relating to mortality. What if we think about, if we're dealing with chronic disease in our country, and chronic diseases include depression and anxiety but also diabetes and many other things that relate to some of the decisions that we make to some extent, relate to some extent to some behaviors we could engage in, rather than always scaring people with messages trying to encourage them to change.

Which I really think is kind of the last vestige of the incompetent communicator quite honestly, because I think people become inoculated to these kinds of scary messages. Let's try to reverse the arrows. Let's think about trying to anchor a person's life with a purpose. Let's think about how we could help a person develop purpose, develop a mission and that could e an individual purpose, it could be a family purpose, it could be an organizational purpose, it could be a world purpose. That's fine. The idea, though, is to have a self-transcending purpose in your life. Then where do these behaviors go? These behaviors lead to greater energy to give you a mission or purpose in your life.

So let's think about the arrows going in that direction. Now, by the way, for the last year and a half, I've been studying the data looking at: What behaviors actually give you more energy or vitality? And there's a form called the SF-36. This stands for short-form 36 or 36 measures. And part of this includes a whole area called vitality. So if you look epidemiologically at all the data, all the behaviors that seemed to relate to vitality, here's what we find. There are five things that seemed to really relate to vitality.

One is sleep. We don't get enough sleep in this world, right, in this society. Sleep is very important. So sleep eight hours a day if you can. Presence or mindfulness is very important. Meditation. Remember the Elizabeth Blackburn study, meditation. But also things just walking in a park, trying to observe things.

If you're washing dishes tonight, think about washing the dishes only. Try not to multitask. Just focus on washing those dishes. Feel the warm soap in your hands. I think Jeri would say, "Yeah, I wish you would think about that more." [Laughter] But, you know, start thinking about the-- being present in things that you're doing that you normally wouldn't. Think about how you put your shoes on.

Think about changing that for a second. How about when you walk in the shower, you put soap on where to begin with? I don't want to know. But let's say you'd start here and then try changing that, putting it on here first. Just do something to break this up and you'll become more present, more mindful. That gives people more vitality. Think about physical activity. More physical activity is good.

It gives you vitality. We know that. Creativity, it turns out gives you more vitality.

And there are a number of sweet studies that have shown where they gave free tickets to the opera, to jazz, you know, a lot of musical or gallery events. They found that even attendance at creative things increases your vitality, your energy. And then finally, we know that eating well increases your vitality. And I don't have time to get into all of these but the idea would be rather than eating enormous meals that give you this great big jolt of glucose and then suddenly, an hour later, you have, you know, the glucose spike is going down to nothing and you're going, "God, I feel so tired and I'm also hungry again.

I can't believe it." Try eating smaller snacks or smaller meals. You know those bars out there, those energy bars, pick up one or two of those and take them with you today and don't eat as big of a lunch but eat an energy bar in between breakfast and lunch and around three o'clock or so and see how you feel. See if you feel different. Like, when you're home and you feel like having a glass of scotch or a glass of wine or something because you're tensed and you need to chill a little bit and I totally get that because I do that. But instead, try going home and working out just a little bit. Try taking a walk and see what happens to you. You might be more vital rather than being there.

You may think you're present at the dinner table but you're not. You're reading the paper. You're listening to NPR. You're doing something but you're not there.

You're not there with your family. You're not present. So think about how some physical activity at the end of the day rather than the beginning of the day might help you. I put all these together to form this little moniker called space. Just give yourself space. Sleep, presence, activity, creativity, and eating well. So, to close up, we talked about this frog, and how do we get the frog out of the boiling pot? William James who is one of the fathers of psychology, but he started as a philosopher.

He is a philosopher and a psychologist. In the 1800 he said, "To change one's life, start immediately. Do it flamboyantly, no exceptions." I'd say that still holds. But I have an even better ancient philosopher and haiku artist, haiku about this.

Basho in the 16th century said, "Into the ancient pond, a frog jumps, water sound. Into the ancient pond, our lives, our civilization, our family, a frog jumps." The frog decides to jump out of the, that water that's gradually boiling to change their life. Water sound. Suddenly, you changed.

Your family changes. The University of Michigan changes and society changes. Thank you. [ Applause ] I can answer any questions if you want. Even dung beetle biology. Yes sir? First of all, I'm really grateful that you gave this talk and have reached so many people through it, which brings me to the question, what does the literature say about gratitude? I know personally, listing 50 things a day that I'm grateful for helps me to connect to people that have given me stuff and have helped me in my own purpose by seeing their purpose in their lives. And so is there literature on the role of gratitude in terms to those things related to vitality and yes, SF-36. That's an absolutely wonderful question.

Do you know the hormone cortisol? Cortisol is called the stress hormone in our body. If you don't want too much cortisol, you need some but you don't want too much. What a woman named Stephanie Brown found while she was here at the University of Michigan is that, people who gave to charities, people who exhibited gratitude actually had reductions in cortisol levels as a result of those activities. If you want your stress hormone which causes heart disease and all sorts of other problems to lower, think about what you could do. What charity you're going to-- charitable organization you could engage in. Think about gratitude. Now if you needed a little just a reminder or something, I have a little gratitude app that's on my cellphone.

If you just go to your iPhone App Store or whatever, if you happen to have an iPhone, there's a gratitude app. And everyday, you write down what you're grateful for. I couldn't agree more. It's a wonderful comment. And it really does fit I believe very strongly in this idea of self transcendence. You are transcending when you are more grateful to other people. Thank you. Thank you.

Yes, great question. Yes, John Graden [phonetic].

Vic, I'm also grateful. Thank you, and thanks to everyone else for being here because we need voices. I was sitting back, they're really learning and then simultaneously thinking about the symbolism of today. Much of what you're putting forth overlaps with a perspective that also had roots at the University of Michigan.

Chris Peterson was a voice for that, his memorial service is today. And I think if we could do some things that would allow your messages to come through rather than waiting for events that are somewhat tragic to mobilize us to do things, it would be a nice take home message. Chris Peterson was one of the fathers of positive

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