IRA FLATOW: Over the past few months, the picture of social life in this country has– well, it’s been very different, right? People staying home, encouraged not to touch, to stay six feet away. You can forget about the handshake or the hug, and some of us are isolated in our homes with just our screens and their two dimensional images to keep us company. But our brains are wired for social connections. We are wired to be together.

So what happens when they’re not available? Psychiatrist Julie Holland has looked at what’s going on in the brain’s chemistry when we connect and how devastating disconnections can be. She’s a practicing psychiatrist based in New York, author of the new book Good Chemistry– The Science of Connection, from Soul to Psychedelics. Always good to have you back, Dr. Holland. Welcome back to Science Friday.

JULIE HOLLAND: Thank you so much for inviting me back, Ira.

IRA FLATOW: You know, I’m struck that you wrote this book, and it’s coming out at this time of social distancing.

JULIE HOLLAND: Oh, definitely very ironic. I was worried, actually, at first that it would just be that all the information is– no longer applies, but it turns out it applies more than ever. The beginning of the book talks about this big epidemic that we’re all going through, which is a loneliness epidemic, and that the overdose epidemic is really because of loneliness and isolation. And the whole beginning of the book I talk about how bad isolation is for our bodies and our psyches, and how it can lead to things like insomnia, and obesity, and drug addiction, and also that it really interferes with learning.

But a big message in Good Chemistry was this idea that we’re not really getting what we need from our phones and from our laptops, and that we need to disconnect from our devices, and get things face to face and skin to skin. And we need to breathe in people’s pheromones, and hug, and cuddle, and that these are all things that will release oxytocin. So some of the advice in Good Chemistry now either needs to be sort of put on hold or taken with a grain of salt, but a lot of it really still holds.

IRA FLATOW: We are currently watching demonstrations where people are engaged to trying to engage. Can it applied to the point we are now, where people are trying to get people to understand their point of view in a large crowd situation versus an intimate family situation?

JULIE HOLLAND: Absolutely. Well, you know, there’s difficulty interacting on every level, right? Just trying to connect with yourself, but there are some sort of facets of your personality that– that aren’t on the same page. Or trying to stay in a relationship with a partner, or to stay in a small area with a lot of family– it’s all very challenging. So there are challenges sort of at every level.

And societally, yes, we are more polarized than ever, and we’re more sort of dug into whatever side we are on. And we’re sort of curating the information that we get because we like what we get, and we get what we like. But Good Chemistry talks a lot about oxytocin. Oxytocin is this hormone that’s also a neurotransmitter, and it helps to facilitate trust, and bonding, and connection. And the sort of classic examples of oxytocin are a nursing mother with a newborn, and the infant and the mother are sort of both flooded with oxytocin. And it’s helping to solidify their bond.

But you also have oxytocin in group situations. Oxytocin also helps us sort of figure out who’s in our tribe or who’s in the other tribe. So it can fuel things like social cohesion and xenophobia. It can make sort of clans even more tight knit.

IRA FLATOW: So do we get– so we’re getting a high then out of being in our clan, or being on our side in sort of a we versus them situation?

JULIE HOLLAND: Yes, absolutely. Unfortunately, we are. You know, oxytocin is– it may not necessarily cause pleasure unto itself, but the social interactions that are enabled by oxytocin create a cascade of chemistry in our brains. Things like endorphins, and endocannabinoids, and dopamine, and sort of all the little feel good chemicals that your brain is capable of creating– oxytocin is almost like a master player in deciding your– everybody has their own sort of proprietary blend of good chemistry and what gives them pleasure.

But yes, social connections– for most people, if we’re not sociopaths or psychopaths, then, yes, bonding, trusting, connecting, cooperating, altruism– these things give us tremendous pleasure. And if connecting weren’t pleasurable, we would not bond or have children, or take care of our children. So we are designed for this sort of– for this type of connection.

But yeah, as groups, we are also designed for social cohesion, because back when we were on the savanna, if you were not in the group– if you had been ostracized or shunned– you’re much more at risk of getting sort of picked off by a predator, or just dying out in the cold because nobody was helping you build a shelter or take care of you. So we have very deep sort of primal responses to being ostracized, to not being in the group. And we get tremendous pleasure from being part of the club, especially if it’s an elite club that doesn’t let in other people. Let’s be honest. So that is also about oxytocin and good chemistry.

IRA FLATOW: You also write that we are built for empathy, which means you put yourself in someone else’s shoes and guess what they might be going through. Isn’t that what Black Lives Matter and people who are on the streets are asking other people to do?

JULIE HOLLAND: Absolutely. Absolutely. I think that’s a great way of encapsulating some of what is fueling the rage of the injustice– is that, first of all, a lot of us have a sense of what is fair and what is unfair. And when we see things that are unfair, when we see people being victimized, or we see injustice, we get very angry at who is perpetrating it. And we also– many of us are capable of having a sort of empathic response where we feel bad for the person who is being victimized.

And in truth, all of us in our lives– in our childhoods, we were victimized. At some point, we were bullied. But also, we need to remember that, at some point in our past, we were victimizers, and we were bullies. And everybody has these things inside them. So there’s this thing called identifying with the aggressor, also, which is that you would rather be on the side that’s winning.

IRA FLATOW: We need to take a short break. We’ll be back with more conversation about the chemistry of the social brain. I’m Ira Flatow. This is Science Friday from WNYC studios. This is Science Friday. I’m Ira Flatow.

In case you’re just joining us, I’m talking with psychiatrist Julie Holland, author of the new book Good Chemistry– The Science of Connection, From Soul to Psychedelics. It’s all about the social human brain, and we’re talking about what our human brains are going through during these times that we’re living in. And you mentioned earlier a bit about the loneliness, and you say that there’s a loneliness epidemic in this country. And you said that time spent on the screens alone can generate brain chemistry similar to infatuation and attachment, the two stages of falling and staying in love? Are we falling in love, literally, with our machines?

JULIE HOLLAND: Yeah, well, it’s actually even worse than that. We are designed so that, if we have an orgasm, there is a release of oxytocin, which means that if some of us are having sex with our computers to some degree or watching porn, for example, that there may be that little surge of oxytocin helps you bond, and connect, and trust with your device.

So yeah, I mean, now more than ever, right? We’re on our phones. We’re on our laptops. And I’m a parent who was often sort of telling the kids to get off your phone and go play with your friends, or– I mean, they’re just– I’ve turned into a bit of a hypocrite. We are all on our devices more than ever, and I don’t think that the outcome of that is going to be very positive.

IRA FLATOW: And you say it’s bad news for those of us isolating at home. And this was amazing for me. You say social isolation has a lethality on par with being obese or with smoking about 15 cigarettes a day. I thought just being a couch potato was bad enough, but this is– you’re taking it up another notch, right?

JULIE HOLLAND: Yes, social isolation is bad for our bodies. First of all, it keeps you in the sympathetic mode, right? So that is a place where you’re not sleeping well. You’re not digesting your food very well. So you have insomnia. You’ve got GI problems. It creates anxiety.

We’re not built to be socially isolated. The human species is categorized as obligatorily gregarious. We are supposed to be social creatures. We’re social primates. It’s in the job description.

So that is our default state. That is when we can be in the parasympathetic state, which is where our bodies can rest, and digest, and repair. When we are isolated, we are much more likely to be in this sympathetic fight or flight state, and we are shut down. We are more paranoid. We’re more suspicious of other people.

The irony is, even though you’re socially isolated, you end up more suspicious of social connection when you get in this fight or flight state. So it’s like a self-fulfilling prophecy. It’s not good not only for our psyches. It’s really bad for our bodies. It makes us overweight.

We don’t sleep well. We’re more likely to have poor impulse control around healthy choices. So we’re more likely to eat bad food, or to drink more, or to smoke more, whatever your vices are, or to do more things online than you typically would. Social isolation, as we saw in Bruce Alexander’s work, makes us more prone to compulsive drug use and drug addiction.

IRA FLATOW: Well, how do we get ourselves into that state?

JULIE HOLLAND: How do you get yourself into parasympathetic? Right, so there’s lots of ways. If you happen to have a partner with you, then things like eye contact, and a soothing voice, and maybe somebody holding you or stroking your arms, cuddling– skin to skin is great for oxytocin– kissing, nipple stimulation, orgasm– all of these things can help make oxytocin happen. But if you don’t have a partner to do this with, family members work. Babies work. Pets, puppies, dogs– any kind of eye contact and connection can bring about an increase in oxytocin.

If you’re totally alone– no dog, no kids, no partner, nothing– you can– first of all, you can always breathe through your nose. That helps to keep you out of fight or flight and over into parasympathetic. Also, if your exhale is longer than your inhale, that helps the parasympathetic.

And also, you could do something called havening, where you actually sort of hug yourself and stroke yourself. You stroke from the shoulder to the elbow downward repeatedly. And you can say things to yourself while you’re havening, while you’re stroking from shoulder to elbow, and you’re sort of hugging yourself.

And you could say things like I am safe. I am cared for. I am looked after. I am loved. You need to feel safe in order to sleep, digest, have sex, learn, grow, change.

So if you’re feeling paranoid or unsafe in any way, and whether that’s physical or psychological, it does not matter. If you feel sort of emotionally unsafe, it’s the same thing. You’re going to be in fight or flight.

IRA FLATOW: Do you think there’s going to be any lasting emotional fallout from this stressful period we’re in now? And I mean, both from COVID-19– we’re isolating ourselves– and the Black Lives Matter marches and demonstrations, and attacks by the police, and everyone involved in those things?

JULIE HOLLAND: Yes, I absolutely think that there’s going to be a lot of trauma coming out of this time. I mean, first of all, the medical workers who were surrounded by people dying, and– I will tell you, as a physician, I don’t like being wrong. I was not the kind of person who would settle for less than 100 on an exam, or 104 if I could get extra credit.

And doctors don’t like being wrong. Doctors don’t like losing. We don’t like losing patients. We do not like being surrounded by death.

We hate saying we don’t know. We’re not sure. All incredibly traumatizing. And the scale of the people who are dying and the people who could not be saved in March, and April, and May– it definitely took its toll on health care workers and front line workers, but then you also have people who have been completely physically isolated for months on end and have gone without any kind of human touch, which has never really happened in human history, and certainly not in our lifetimes. And that’s got its own level of trauma, or just being afraid that, if you go outside, you’re going to catch a lethal virus– potentially lethal virus, and you’re going to die. That’s traumatizing.

And then now, yes, the demonstrations, watching a 9 minute video of somebody being killed and watching all these videos of police brutality– that is also traumatizing. So I’ve got plenty of business ahead of me as a psychiatrist, I know.

IRA FLATOW: But in the meantime, it’s going to be very challenging. Let’s point to some of the specifics. For example, Dr. Robert Klitzman, a psychiatrist at Columbia University, writes in The New York Times about the lingering effects of COVID-19 survivors.

I mean, they’ve been in intensive care ordeals. They’ve been locked up for weeks on ventilators– suffering what he calls post intensive care syndrome, cognitive neurological problems, PTSD. And no one talks about these people at all, he says.

JULIE HOLLAND: No. No one is focusing on the fact that a lot of people who survive these ordeals– first of all, there’s physiological sequelae, and there are things like strokes and long lasting lung problems or kidney problems. So but there’s also the sort of physiological and psychological toll of being on ventilators and being at ICU, which, I mean, when you’re in there, there’s a lot of beeps and machines. And you think you’re going to die, and nobody lets you sleep for very long because they’re interrupting you to take your vitals, or else they put you in a coma, basically. But it does take its toll on the body, for sure. If nothing else, you come out of there really emaciated and sort of feeble.

And then there’s also this issue of survivor guilt, right? That– which we hardly ever talk about, but it is a real thing– that the people who survive or the people who are unscathed, but other people around them really suffered– there is also just this extra little icing on the cake of the trauma, which is that you have survivor guilt for somehow making it or doing better than somebody else did.

IRA FLATOW: So we’re creating long term effects. I mean, there are real changes, if I hear what you’re saying, going on in our brain– physical changes in our brain that are going to affect us possibly for a long time to come.

JULIE HOLLAND: Yes. The fact that we had sort of a loneliness epidemic and an overdose epidemic coincidentally was not a coincidence. So we were already sort of set up with a lot of isolation, a lot of injustice. And these diseases of despair– things like death from alcoholism, or from suicide, or drug overdoses– the diseases of despair were already going up before the pandemic, before the civil unrest.

So we’ve got a lot of problems that really need addressing, and Good Chemistry talks about very practical solutions to a lot of these problems. And then it also talks about psychedelics as a potential solution to how isolated we are and how disconnected we feel.

IRA FLATOW: Tell us more about that, because we’ve had a few guests on. I remember when Michael Pollan wrote his book a while back, he came on and talked about it, and actually went through the experience himself of using controlled psychedelic drugs. And we’ve talked to a couple of other researchers, so I’m eager to hear what you have to say about the potential it might have for helping people.

JULIE HOLLAND: Well, I guess, the first thing I would talk about is that, for a lot of people, when they have a peak psychedelic experience, sometime during the peak they have this sense that everything is connected and that they are part of it all. So it’s a feeling for most people of sort of awe, this sort of transcendent experience, but also this sense that it really makes sense that everything is connected, and we are all connected, and we are all interdependent. And the thing that is connecting us is light, or energy, or love.

When you tap into that kind of awesome mystical experience, it’s profound, and it’s life changing. And people who come away from those experiences will often have huge changes in their behavior, especially around substances. So there’s lots of interesting research going on with psilocybin, or ayahuasca, or ibogaine. These are all plant medicines that are psychedelics, but that can help people have healthier behavior around compulsive drug use.

So I understand the irony of using a drug to help somebody disentangle themselves from a problematic relationship with other drugs, but that is what’s happening. This is in the context of ongoing psychotherapy, right? So there’s psilocybin assisted psychotherapy or MDMA assisted psychotherapy, which allows people to sort of look at their– look at their trauma, look at their place in the world, and come to some measure of deeper, greater understanding about how interconnected and interdependent we all are.

And that feeling of connection is extremely pleasurable and also enables neuroplasticity. The oxytocin enables neuroplasticity, which is that feeling of bonding and trust, but also the psychedelics themselves enable neuroplasticity. So you’re talking about new synaptic connections, new dendritic connections, and sometimes full on neurogenesis with neuroplasticity in these substances, not to mention that they are– many of them are also anti-inflammatory.

IRA FLATOW: So you foresee a day not too far in the future when this will be part of the medicine chest that doctors have?

JULIE HOLLAND: Well, psychiatrists need it desperately, so I really hope that that is the case. Yes, we’ve always needed better ways to treat post traumatic stress disorder. We’ve always needed to help people process the fact that they’re going to die. This end of life sort of existential dread is one of the other indications for psilocybin assisted psychotherapy in particular.

So the field of psychiatry having more tools at its disposal is great news for us, and it’s coming just in time, because we’re going to have a lot more people who need to process their trauma. And these plant medicines are very helpful for helping people to debrief and process their trauma.

IRA FLATOW: I’m Ira Flatow, and this is Science Friday from WNYC studios. The fact that they work in the brain means that there have to be receptors in the brain where they hook into, right? Doesn’t that mean that, evolutionarily speaking, we should be used to having these plants around us? Because we– there’s a place for them to work in the brain.

JULIE HOLLAND: Right, well, I often say that about cannabis. The fact that we have an endocannabinoid system and that we’ve got receptors that so well– so sort of neatly fit the main psychoactive chemicals in these plants, then I would say yes. We certainly co-evolved on the planet with things like the cannabis plant, or the poppy plant, or psilocybin containing mushrooms.

And ayahuasca is a combination of two plants. It’s a psychedelic tea that consists of two plants. So these are plant medicines.

And I also think, just in terms of drug policy, there is a real movement now for these plant medicines to be decriminalized. So that’s one avenue, and then this other avenue is that there’s tons of really interesting research going on with psychedelics and with MDMA assisted psychotherapy. And they’re getting huge effect sizes from these double blind placebo controlled trials.

And you could certainly argue that the placebo is questionable, because it’s pretty clear, I think, to people eventually whether they’ve gotten the psilocybin or not, or whether they’ve gotten the MDMA or not. But every once in a while, we have been surprised by people who have had very strong responses to placebo, which is a whole other thing I’d love to talk to you about another time.

IRA FLATOW: Wow. Wow, to the placebo?

JULIE HOLLAND: Yes. Yes.

IRA FLATOW: Placebo effect on this? Wow.

JULIE HOLLAND: Yeah, I know.

IRA FLATOW: OK, we’ll save it for another time.

JULIE HOLLAND: Exactly.

IRA FLATOW: Because I want– you said you wanted to tell a story about me?

JULIE HOLLAND: The last time I saw you, when I came to talk about The Pot Book– the thing I remember when I left your studio– I don’t know if you remember this or not, but I actually kissed your head on the way out as a way to say goodbye, because I had such a good experience with you. And I felt close with you afterwards– that I wanted to demonstrate that.

And I was thinking about how now I can’t even shake your hand or anything like– I’m in a bunker in my house, and you’re in your house. And I can’t shake your hand. I can’t kiss your head goodbye, but I’m– I did want to just express my real sincere appreciation for the work you’re doing. It’s very important to me to educate people about science, and it can be hard to do that. So I really appreciate the work you’re doing.

IRA FLATOW: Well, thank you very much.

JULIE HOLLAND: I’m giving you a virtual kiss on your head right now.

IRA FLATOW: Thank you, thank you.

JULIE HOLLAND: I hope you can feel it.

IRA FLATOW: I can. I can. It’s coming right through the lawn mower noise outside. Yes.

JULIE HOLLAND: It’s like a tiny little bit of oxytocin maybe.

IRA FLATOW: Well, thank you, but I’m equally– I’m in awe of the kind of work that you’re doing, and the kind of work that you keep doing, and have been doing, and please, keep doing more of it, because we need more of it these days. And probably and possibly– certainly into the future. Thank you for taking the time to be with us.

JULIE HOLLAND: Yeah, well, it’s my pleasure.

IRA FLATOW: You’re very welcome. We have run out of time. I want to thank Dr. Julie Holland, practicing psychiatrist based in New York, author of the new book, Good Chemistry– The Science of Connection, From Soul to Psychedelics. It’s published by Harper Wave, and what a great writer she is, and a terrific person who can speak about science. Thank you again, Dr. Holland.

JULIE HOLLAND: Thank you so much, Ira.

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