What's That Rash? - How important is a social life?

0:00ABC Listen. Podcasts, radio, news, music and more. Measles cases are climbing to levels that we have not seen in decades. Those disrespected cases of a deadly strain of bird flu. Diseases can feel like they're coming from all angles. But we've faced deadly threats before and every outbreak has taught us something. I'm Belinda Smith and in Outbreaks, the new series of science fiction, we uncover the courage and detective work that helped Australia respond.

0:31Outbreaks. Search for science fiction on ABC Listen or wherever you get your podcasts. Norman, do you consider yourself an introvert or an extrovert? Depends on the time of day really. Okay, what do you mean by that? Well, sometimes I yarn for other company and when I get into company I'm sort of out there, but other times I just like having a little bit of peace and quiet to myself.

0:53It varies. I'm the same, I think. I think I present as an extrovert, but I love being by myself. And I don't know whether that's because I'm a secret introvert or maybe because my life is so full of people, I really value when I do get to have that downtime. Yeah, one of my kids when she was very young, and this would be the child who was considered by everybody to be extrovert, very social and so on. And I'm not talking about Jonathan, by the way, because some people kind of know who my offspring are.

1:23She from about the age of three would have days when she was perfectly happy in her room by herself just playing. I think we all value a little bit of downtime every now and again. I guess the question is how much social connection do we need to be healthy, which is basically what we're talking about today on What's That Rash? That's the show where we answer the health questions that simply everyone's asking. Norman, everyone is asking about basically is it okay to be a hermit?

1:52So we've got three questions today. Gabby says, I'm thoroughly enjoying the podcast so much so I'm listening through them all from the corona cast days. I'm currently at June 2024. Gabby, can I just take a moment to say thank you for your commitment. But you're not getting out enough Gabby clearly. Well, this is what it's about. Gabby says a common theme along with the Mediterranean diet is that social interactions are beneficial for physical and mental health.

2:18I'm an introvert, says Gabby, and I find social connection physically and mentally draining. Don't get me wrong, I do enjoy catching up with my small circle of friends just not too often and not for too long. Anyhow, I've joined a weekly social group of people with like-minded interests so I don't get totally isolated. Should I be getting myself out there more often for optimal health benefits or am I just right as I am? So that's Gabby. Another from an anonymous writer says, listening to your podcast and to an extent in other media over the past three years. I've come to realise that my lifestyle and habits are highly supportive of a long and healthy life apart from one stark outlier. I'm not much good with people. I don't dislike them. I just don't want to be near them mostly.

3:03Given that I am, and this person says of themselves, that I am socially incompetent, well, I mean, I think you're allowed to self describe who you like. But they're asking, would the benefits of having a social life warrant the anxiety and discomfort of trying to connect with people, or am I better off dying younger in a happier state? I would genuinely like to have friends. I think I've just failed so frequently and been exhausted trying to make friends that I've resigned myself to the fact I won't have close friends. And one more along the same lines from Libby. Libby says, I'm feeling confronted by the messaging that tells me I need to be socially connected to support my mental and cognitive health. I find social contact demanding and exhausting. I do it because it's quote unquote good for me, but I react very badly before and after. Sometimes even wishing I just did not exist. At times I'm happiest when I'm alone. Lockdown during COVID was wonderful for me. There's studies that

4:01offer a more nuanced perspective or am I just an odd bod? So really good intelligent comments and questions. Yeah and I think really speaking too we have been banging this drum pretty loudly Norman that the importance of social connection is one of the important pillars of health and I guess just maybe we need to talk about dose or what counts when it comes to this because for some people the need for social connection feels like another chore to add to their list by the sounds of it.

4:28It does. And it gets wrapped up and we'll come to this later in notions of loneliness. And none of our writers describe loneliness. No, that sounds like they're happy. They're happy to be more or less solitary for a lot of the time. Yeah. And loneliness is a complicated... I mean, maybe we should just start off with loneliness here because it's a good place to start. So none of them describe loneliness or the one says they wouldn't mind having more friends, but they seem quite happy.

4:56I researched this whole area for a recent book that I wrote, and in fact, a lot of good research is happening at the University of Queensland, the Queensland Brain Institute in this area. And when you look at Dr. Sarah Granger there at the University of Queensland, talks about this complex interaction between your psychological state and feeling of loneliness, and she describes how some people can be surrounded by others and feel lonely.

5:22and some people not surrounded by others and socially isolated and feel lonely. And some people can have very few social contacts but not feel lonely. And it's a complex interaction between whether or not you're depressed, anxious and have other mental health issues going on.

5:38And who's in your life? Like, I suspect that most people, whether they're happy by themselves or enjoy a lot of social contact, know the feeling of feeling lonely in a group, that you're not feeling seen or that you're not feeling valued and that those things are important facets of feeling lonely or satisfied with the amount of companionship that you have. And I think that we need to get real about friendship.

6:01Because a lot of the questionnaires in this area is how many close friends do you identify? How many people can you call upon for support when you need to? And usually the number of five comes up. It's said that it takes up to 200 hours to develop a close friendship. That's a lot of time investment. And it's why when you go back to your school days, university days, early, your 20s, that's when you had time.

6:25to spend on friendship. You don't really realise it at the time. But when most people think back to who are their close friends, that's what they go back to. Yeah, I think about these sort of thrust together at school. And an interesting facet to what you're saying there, Norman, is that school and university, traditionally, you were really shoved together for better or worse with these people and you find the ones that you like and you connect with them. Whereas a lot of students, especially university students these days, aren't getting that experience. They're not having those intensive hours together with their

6:55classmates that you or I would have had at uni that maybe limits their ability to make those close friendships at uni. Yeah and of course Australia is a culture where kids don't go away from home to university. They stay in their home town. Yeah so this idea of friendships, you were sort of saying how the surveys are set up. It is a hard thing to try to quantify because people's relationships are different.

7:18I know for myself, two of my best friends are my sisters. Are they my siblings for the purposes of a questionnaire or are they my friends? How you sort of define those relationships is going to vary so much from person to person. So let's just talk a little bit about what's going on in the brain because that's really important when you're talking about friendships and families. Because when you look at successful brain aging, it's more than just family. What do you mean by successful brain aging?

7:46So when you're doing pretty well when you're getting older, your brain structure is developing nicely to cope with the years going by, so your cognitive function has not declined, it might even have improved. And when you look at maintaining, particularly after retirement, because retirement can be quite toxic for the brain, when you look after retirement, it's not enough just to have your family around you. You need cognitive work for your brain to develop.

8:12And cognitive work is helped by a lot of different things. It's not only social connection, but social connection mixing with other social participation stretches a lot of different parts of the brain. There's four different aspects to this cognitively. And it's a very complex cognitive activity. We don't often talk about it. People will say, oh, when they're getting older, I forget people's names. I'm not thinking as quickly as I used to. But people don't talk about the decline that may occur in social cognition, which can get involved in all this.

8:42social cognition. Okay, so that's a cool phrase I hadn't thought about before I'm going to chew over that. Talk me through these four dimensions. So social, they overlap with each other. So there's social perception. This is perceiving how people are responding in the world, their emotional state, and so on. There's effective empathy. In other words, how empathic you feel to the emotions in others. There's theory of mind, and theory of mind sounds very fancy, but it's understanding who you are, understanding who somebody else is, and where they're coming from, both socially and emotionally. And the fourth one is social behavior, which is about behaving appropriately in social situations. And those all exercise different muscles in the brain.

9:25are part of this whole process. It feels like almost a continuum that one would be necessary for the next. You've got to be able to see what other people are feeling, empathize and kind of know how you fit into that to be able to then respond to it in an appropriate way. Yeah, and it also helps to describe the sort of dad joke phenomenon or the Uncle Eric that you don't want to have to Christmas lunch. It's often older men who lose a bit of this social perception, lose a bit of the effective empathy and don't understand the effect that it has on others. Are you saying that?

10:00I mean, now I've got a picture of that person in my mind, no one that I'm related to, of course. But like, are you saying that they're losing that because they're not having enough social connection? I don't think enough is known about it. It may be an effect of brain aging or it may be an effect of that you have just become socially isolated and lost that ability to interact with others. Right.

10:20So there's this sort of sense that for healthy brain aging, these social connections are important for those four dimensions that you mentioned. Social connection comes in a lot of different forms though. You mentioned family before. I'm thinking about romantic relationships. You've got people that you might see in your neighborhood. You've got people who you might see at work. And then there's sort of the network that you might see, your barista at the coffee shop, the librarian that you might run into each time, that all of these interactions are playing a different kind of role.

10:49they are, and most research has been into more prolonged interactions. So as people get older, they tend to, the evidence suggests, tend to rely more and more on family as their protection against loneliness, which is fine. Turns out, by the way, that for all grandparents listening, well actually for all children of older parents listening, they're asking your parents to babysit your kids is actually good for the brain. So it turns out that's that degree of complexity. Mum I'm doing you a favour. Absolutely doing a favour. So forgive me all the grandparents listening who think you know actually I've just pissed off but nonetheless it turns out that user or loser is probably not quite enough for cognition as you get older.

11:32you've got to put extra demand on your brain. And social participation is a pretty good way of putting extra demand on your brain. And it turns out that when you actually connect with your family, you know who they are, you know what you're going to get, it's comfortable, and that's not to condemn it. But interaction with people who are more friends or people you don't know, say you're going to a class, you're learning to dance, so you do it in a class, you're learning a new instrument, you're learning in a class, you're doing some exercise classes.

12:01You're learning to do that with other people. They don't have to become your best friends, but you do interact with them. And it's one reason probably why work is really good for the brain because you actually do have to interact with other people. So one of our question askers though, our anonymous question asker did ask about some like stats around socializing, wanting to know how many friends people have, kind of what's normal when it comes to friendship.

12:27The number five emerges frequently from research, which is really usually about rather than asking about friends, the proxy for that is how many people you can call upon to help you out there. People do talk about friendships that you would call close. Again, the number five comes up. And then at the top end, a researcher called Robin Dunbar has written that the maximum number that anybody can cope with in their social world is 150, which sounds to me...

12:55totally exhausting but it's it's the idea that we grew up in a village and this would be the maximum village and that's measured by how many Christmas cards you might send and the days when we used to send Christmas cards how many people you invite to a party he reckons that 150 is about it 150 mates that sounds like a really good barbecue I'm interested in this world of like virtual connection of how this factors in like your best mate Norman. I don't know where your best mate lives, but they could live anywhere in the world. You're an international man of mystery. You've lived in various places. I'm also a migrant. Well, this is what I mean. Like, is what you're getting from a good friend from your uni days who might live in the UK the same as what you would be getting if that person lived in the same city as you? Well, it's a very, it's a very good question. I mean, I think like many migrants, I would answer that question that my causes friends are people that I

13:42grew up with, not so much at school, but after school, and after those school years. And there's a degree of comfort, actually, when you get back together with those friends, which may belie what I'm talking about because that degree of comfort is a bit like family. So you're not necessarily being challenged by that, although you enjoy it and you get a lot of support out of people from those times. And it's quite hard to redevelop those friendships. And it is just simply a matter of.

14:11time, how much time you've got to spend with people and just hang out. And most of us just don't have time to hang out anymore. And like our correspondence this week, some of them find it totally exhausting. You know what was interesting when we were looking into this friendship research that stood out to me is that people tended to assume that their friends had more friends than them. Like you just kind of assume that everyone else has got more mates than you, but actually we're all kind of operating with about the same number. That's right. Yeah.

14:40During dark moments, I think I don't have any friends. I'll be a friend Norman. And then when you have a party, you think, how do you cut down the numbers? Exactly. So one of the things that stood out to me when I was reading these questions from our wonderful correspondents, all of whom seem to be very, very comfortable with their own company, is I started thinking about hermits and the fact that throughout history there have been people who have sought out solitude on purpose. But I didn't realise how formalised it was in certain parts of history. Norman, have you heard of an ornamental hermit? No, I haven't. So this is a thing... Is this a little person you put on your mental piece? No, well, this is probably the origin of the garden gnome, right? But it was an actual human being. So this was, I think it was quite a small moment in time and it was mostly people who I think had 10,000 pounds a year like Mr Darcy.

15:32back in the UK in about 18th century, wealthy landowners wanted sort of wild style gardens and they often would have like little tree houses or things in them, like ornamental, but some people, rich people, hired people to live as hermits in their gardens. There were actual advertisements from the time the criteria were wear a goat's hair robe, never cut your hair nails or beard, no shoes, be silent. Norman, I'm interested to know whether you would take on a paid gig as a professional garden gnome. I might pass on that one, and I suspect our correspondents would pass on that one too. I personally am quite intrigued. Are there books in the treehouse? If so, I'll be a paid hermit just for a little while. Just for a little while, yeah. One of the things that

16:19kind of shines through in a couple of the letters that we've gotten this week. Norman is perhaps a sense of social anxiety that you might prefer your own company, but in addition to that, when you are around others or when you're going to be around others, that is a very draining experience. And that's something that actually makes you feel a bit nervous beforehand or a bit exhausted after the fact. Yeah. And there is help for that.

16:40you can do this thing called mental time travel, you project yourself forward into the future and you feel that anxiety or worry about connecting with others and the bad things that can happen. And that's a sign that maybe you need the help of a clinical psychologist and cognitive behavioral therapy or one of the other psychotherapies to make you realize that anxiety is probably unfounded and can take your hand through that a bit like dealing with a phobia.

17:04and learning that, in fact, it's worth trying out and it's not necessarily going to be a bad experience. On the other hand, you cannot overestimate how good it's going to be, and you need to be realistic about that as well. So it's a journey. So the word exhaustion coming up there is something that you often hear from people who are neurodivergent, that social interaction is an exhausting activity sometimes.

17:28Yes, and you have to accept that neurodivergence has to take account of different ways of interacting with other people. But it depends on whether or not you're happy with that or not because while it will be hard to work if you are unhappy in that situation, again it may help that psychotherapy and having somebody assisting you into greater social contact and learning how to deal with that may well be helpful.

17:51I actually interviewed at some friendship researchers on Life Matters, one of our other Radio National programs a couple of weeks ago and sort of asked them for some parting advice on having friends or being a good friend or whatever. And the one that stuck with me was one of them said, more people like you than you think.

18:08sort of basically like, don't worry so much about what people think of you or don't think of you. They probably either don't think of you or they like you. And it was just a nice way of dampening down that feeling you can sometimes have either before or after a social interaction where you're like, am I or did I make a fool of myself? And it was just a nice gentle piece of advice.

18:28Well, we've talked a fair bit about the cognitive benefits of social interaction, Norman. Can we talk a bit about the physical health benefits or otherwise, such as we have evidence for? Well, the evidence is that loneliness is quite toxic, but you've got to be careful, as I said, right at the beginning of this concept of loneliness, because some people who do not have many people around them feel okay with that, and some people...

18:51feel bad about it and interacts with depression. So it's your interpretation of your social situation that often dictates loneliness. So let's just talk about social isolation. There is a bit of evidence that social isolation does affect or is associated with poorer physical health. So I think the message for the people who've written in and people who are interested in this topic is that if you don't have a lot of people around you, you probably need to pay a bit more attention see how much exercise you're getting and your diet because it's easy to fall into habits. So I'm not going to go out and do exercise. I'm going to stay at home. I like my own company. I'm not going to go to the supermarket and buy all the variety of fruits and vegetables that I need for a healthy diet. I'll just have a cheese sandwich is that that isolation can compound the physical and nutritional aspects.

19:42of your lifestyle. So it's not necessarily cause and effect that social isolation is causing you to have poor health. It's that these things can end up going hand in hand. Correct. Which means that you can do something about it without necessarily having to come in contact with other people if you find that too hard or unpleasant. Is there a sweet spot in terms of dose of social connection or the variety of social connection that we should be having? I don't think so much does as what you're getting from it. So some people you come in contact with It's simply transactional. It's like you were saying earlier, it's the barista. It's the people who serve you in a restaurant and so on. They're not your best friends. You just transact with them. And then there's people who you're closer to. So some people are enriching. You just love being with them. They give, they take, they're interested in you. You are interested in them. And there's this wonderful enriching relationship. And then there are people you're coming. So I'm not talking about doors now. I'm talking about quality. And then there are people who just take.

20:40and they don't stay your friends for very long, or if you do, you don't want to see them very often because you just feel so crap after a night with them. So Norman, bottom line to Gabby, Libby and our anonymous writer, how much should they be forcing themselves to get out and be social for the purposes of their long life and health?

20:57Well, I think that the two people who feel anxious about it, but kind of want to do it, should seek help in order to minimize that anxiety. And if you are happy with your own company and not highly motivated to go out and do more, then you just got to pay attention to your lifestyle because nobody's giving you feedback on what you're eating and how much you're exercising. You're going to have to do a lot of that self-generated. Norman does hanging out with your favorite podcasters count as social interaction. 100 percent.

21:23Oh well, Gaby, Libby, and anyone who has written to us, thank you for your company. It's fun to hang out with you, even if it's in a slight time delay. And remotely, if you want to ask us a question, our email address is thatrash at abc.net.au.

21:37So what's in the mailbag? We have an email from Claudia about hypnotherapy and irritable bowel syndrome. Claudia writes, long time listener, first time writer here. I live in Melbourne and after a particularly nasty bout of food poisoning in Mexico, I returned home and found myself struggling with debilitating IBS symptoms for years afterwards. It felt as though my gut and nervous system simply couldn't settle down. After ruling out more sinister causes, my GP referred me to the functional gut clinic at St. Vincent.

22:06hospital in Melbourne. Following an assessment, I was told that one of the best evidence-based treatments for my particular situation was gut-directed hypnotherapy. I underwent approximately 10 sessions and was given a recording of each session to listen to daily at home throughout the treatment. This involved lying down for about half an hour each day and following the guided hypnosis. Now Norman, I'm going to pause here and I want you to guess how effective this was for Claudia.

22:33Well, I hope it was effective because as we said in that show it is one of the relatively few conditions which hypnosis has been shown to work. Well, that is Claudia's experience. She says the results were quite remarkable. I experienced around a 70 to 80% reduction in symptoms and that improvement lasted for years. She goes on to say, what fascinated me just as much as the improvement in my gut symptoms was the experience of hypnosis itself.

23:00Even when listening to the recordings at home, I would enter an incredibly deep, trance-like state. When the recording counted me back out of hypnosis, I would emerge feeling extraordinarily sharp, alert and ready to go, quite different from the relaxed or slightly sleepy feeling I sometimes get after meditation. Often I would have virtually no recollection of what had actually transpired during the session.

23:24Claudia says, I wanted to share my experience because I found the treatment genuinely life changing and I suspect many people are unaware that it's even an option. I would wholeheartedly encourage anyone struggling with IBS to investigate it. She signs off. Thanks for the wonderful podcast. Thank you very much, Claudia, for that. And the only thing I would say is that if you get new gastrointestinal symptoms, don't jump.

23:49to the conclusion that any weird gastric symptom is irritable bowel syndrome. It could be lots of other things, some of which are quite serious. Get it checked out. Well, thank you Claudia for the email. Our email address is that rash at abc.net.au. See you next week. See you then.