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House Calls Podcast
Why is Change So Hard?
With guest Maya Shankar,
Cognitive Scientist & Podcast Host

Description

We all experience change. Sometimes we plan a change, sometimes we’re thrown a curveball. It’s just part of life. But why do some changes feel harder to manage than others? And why does change seem easier for some people than others? Guest Maya Shankar is a cognitive scientist and host of the podcast “A Slight Change of Plans,” where she weaves people’s personal stories of change with the science of human behavior. As we kick off a new year, Maya and the Surgeon General talk about the nature of change and how to handle it, with the intention to help all of us navigate life’s curveballs, in whatever form they arrive. And if you’re thinking about making a change, tune into this episode for strategies about how to plan and stick to it.

Help us get the word out about House Calls by rating and reviewing wherever you get your podcasts. Email us at housecalls@hhs.gov with your feedback and ideas. Thank you!

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Transcript

Dr. Vivek Murthy

Hello and welcome to House Calls. I'm Vivek Murthy and I have the honor of serving as U.S. Surgeon General. I'd like to introduce you to Maya Shankar, a podcast host and expert on change. We believe conversations can be healing. And today, we'll be talking about how we cope with change, whether it's invited or not. Change is part of life. We all understand that. But there are many kinds of change. Sometimes change is planned, invited and exciting. Sometimes it's unexpected and unwanted. How we navigate, respond to and cope with change is a subject that fascinates my guest today. Maya Shankar is a cognitive scientist who hosts the podcast A Slight Change of Plans, which was selected as Apple Podcasts’ best show of the year in 2021. She blends compassionate storytelling with the science of human behavior to help us understand who we are and who we become in the face of big change. Maya is a senior director of behavioral economics at Google. She was previously a senior advisor in the White House under President Obama, where she founded and served as chair of the White House Behavioral Science Team, which worked to create better policy using insights from behavioral science. After the last few years of intense upheaval, and as we kick off a new year, I wanted to talk with Maya about the nature of change. How can we navigate life's unexpected curveballs? How can we create change that we want and actually achieve our goals? How does our identity fit into all of this? What I love about this conversation is how Maya shares deeply, deeply moving stories about how she navigated unexpected change that showed up in her life to become the person she is today. My hope is you will take away the practical nuggets of wisdom she offered about how to create the change we want, while managing change that is unwelcome. Also a request from the House Calls team. We'd love to hear from you about feedback and ideas for future episodes. Write us at HouseCalls@HHS.gov Or reach us through social media. We'd also appreciate if you take a moment to rate and review the podcast. Hi Maya. Welcome to House Calls.

Maya Shankar

Thanks so much for having me, Vivek.

Dr. Vivek Murthy

I am so glad that we are having this conversation. I was thinking earlier today, before we got on about the first time that I met you, and I believe it was actually at a meeting at the White House during the Obama administration and we were in a room at this big table. There were a whole bunch of people around the table. But the thing I remember about you most I actually don't remember what you said. That more has to do with my memory, not with the fact that you didn't say something memorable. But what I do remember is that you were brilliant. You were incredibly kind and you were really curious. And that was my my lasting first impression of you. And it is just been such a joy to get to know you over the years. And I'm so glad that we're having this conversation together.

Maya Shankar

Oh, it's so kind of you to say that. And you know, one thing I was talking about with your producers in advance of this is you taught me so much about the value of friendship. When we talked about the science of loneliness for my podcast, A Slight Change of Plans, and I was reflecting on the fact that you said, you know, your friends in the present can be friends from the past, too. And I feel like you have become that for me, and I'm so glad that we've been able to to invest in our friendship over the last couple of months. And it's been such a joy to build that with you. So it makes me happy.

Dr. Vivek Murthy

I feel the same way.

Maya Shankar

Staving off loneliness, one friend at a time.

Dr. Vivek Murthy

That's right. And I'm so glad that you and I are talking today because what I really wanted to get into in this conversation is about the topic of change. And I'm excited to talk about it with you in particular, because you have studied change. You've talked about change on your podcast and you've also lived change in so many different ways, some good, some painful, over the course of your lifetime, and I think this is such an important topic for right now because so many people feel like they are encountering a bewildering amount of change and some of it is change they sought out; some of it is not. But a lot of it is tough and hard to make sense of. And so I'm interested to get into a bunch of different areas around change. But I was hoping we could start this conversation by just diving into what the different kinds of change are that people experience.

Maya Shankar

Yeah. Yeah, there are so many types of change and I think, like you said, it's front and center for all of us coming out of the pandemic when when so many of us felt like the rug was pulled out from underneath us and nothing that we knew to be true remained true. And so there's many different types of change and as a cognitive scientist, one of the areas that I studied extensively has been the science of behavioral change. So how it is that we can motivate people to act in their long term best interest. And so, you know, when you and I were both in the Obama administration, you know, we got to collaborate on projects in which we were trying to apply our best understanding of human behavior to some of the health challenges that people face, for example. Right. Getting people to commit to going to the doctors more or getting them to, you know, build in that morning walk for for wellbeing or whatever it is. There's also changing other people's minds. This is one of the most intractable changes to inspire. I think, you know, as we think about, you know, coming out of the holiday season, many of us were, you know, we had the Thanksgiving chats. We had the Christmas Day chats. And it can be really challenging to disagree with people that we love about issues that we really care about. And so there's a burgeoning science about effective strategies that we can employ when it comes to really being curious about other people's mindsets and actually inspiring, inspiring change in that way. And then, of course, there's there's societal change and, Vivek, this is this is where you work, right, on on changing the ways that policies are designed, changing the ways that communities relate to one another. And so societal change is a big piece. I think the centerpiece of my podcast, A Slight Change of Plans, focuses on those big, thorny, external, unexpected changes that life throws our way. This is the most debilitating form of change in many ways because as humans we love having control. We love having our hands firmly on the steering wheel. And when life throws us these curveballs, they really challenge our our sense of agency, right? They make us believe like, oh my gosh, I guess I'm not as in control as I thought I was. And that can be a very scary feeling. And so what I do in the podcast is I explore with people, okay, how have these big changes in life changed you as a result? You know, I'm interested not just in that external shift, but I'm interested in the way the person's psychology has shifted as a result, the internal change that we endure as a result.

Dr. Vivek Murthy

Well, that's a beautifully said and and I like what you said at the end in particular, that when unexpected change happens, sometimes it feels like it can completely throw us off our game and it can be very hard to deal with. And when you think about how people handle change, how much of this is about the skills you learn, how much of it is inherently about your personality type?

Maya Shankar

It's a great question. I mean, I think one thing so many of us share in common, so this is more of a human universal, is that we feel very agitated by uncertainty and we will go to great lengths to try to avoid uncertainty. And naturally, change is accompanied by a lot of uncertainty. So there's an interesting study coming out of psychology showing that people who had a 50% chance of getting an electric shock were more stressed than those who had a 100% chance of getting an electric shock. So we would rather be certain, Vivek, that a bad thing is going to happen than to have to cope with feelings of uncertainty. And I mean, that is shocking, right? I mean, I can't believe that there's this study basically showing us that we would subject ourselves to guaranteed pain rather than, you know, have to deal with these feelings of uncertainty. And I think in part, the reason why that uncertainty in the face of change in particular can feel so jarring and so scary is that it can threaten our sense of self. It can threaten our sense of self-identity. So as you and I are going through our lives, we're building unconsciously, and consciously, these elaborate narratives about who we are, what our life is about, what our futures are supposed to look like, what our futures ought to look like. And then suddenly this change is thrown our way and you start to question who you are, right? You don't know, things don't fit together anymore. And certainly in my personal life, I've dealt with this loss of identity, You know, reflecting on the science of it has helped me understand why some of the losses that I've had, or the changes I've had in my life, have felt so potent. Right. And have really thrown me off kilter.

Dr. Vivek Murthy

Yeah, and actually, I want to get into some of your own story as well. Before I do that, let me ask you one other question, which is, you know, my my feeling, Maya, when I look at what's happening in the world right now, is that even though, you know, change is part of life and has been for generations, it feels like something is different right now in terms of the degree and the pace of change. But is that just my perception or is what's happening right now in the world in terms of change really different from perhaps prior time periods?

Maya Shankar

Yeah, so I think what we're falling prey to when we when we say that, oh, this is this an unprecedented time of change -- and look, empirically maybe if all the researchers got together and they calculated the total number of changes, there might be some disparity. But that's not really the relevant thing here. The relevant question is, is my brain equipped for change, period? And by virtue of being humans and having survived, we are equipped for change. And that should hopefully be an empowering message for for everyone who's listening to this, because I'm thinking about my personal life and I've had many experiences, certainly in 2020 when the pandemic was raging and racial injustice, upheaval was all around and I was dealing I was dealing with, you know, the loss of pregnancies, miscarriages with our surrogate in my personal life. I remember thinking, oh, my gosh, all of this is so unprecedented. I'm so unprepared for this moment. I'm so unprepared for the changes that are happening in my life right now. But then I put on my cognitive science hat and I thought, well, you know, even if the specifics of what the current moment are throwing my way are in fact unprecedented. My human ability to navigate change is absolutely not, right? I've done this change rodeo so many times before, just by virtue of being human, right? Because change is such a it's like a definitional part of what it means to exist. And so when I had that mindset, it was very empowering for me because I thought, okay, I have been building the skills to engage with change all along, and I shouldn't be intimidated by the fact that the details are slightly different. Some of these skills that I've been building can absolutely apply to the novelty of the situation at hand.

Dr. Vivek Murthy

Well, I think that's very reassuring and so well put. And I would say that probably even going back generations as a species like we have encountered an extraordinary amount of change over millennia and we have evolved to to be able to handle that and to deal with that. So that's reassuring what you said. And I want to come to your your personal story as well, Maya, because you have again, this is more than just a theoretical exercise for you, thinking about how to navigate change. It's something you've studied and talked about. But as I mentioned earlier, it's something that you've also lived as well. And I'd love if you could talk to us a little bit about what's shaped how you think about change. You know, you mentioned also the experience you went through in the pandemic, the incredible painful experience of losing a pregnancy. And I'm so sorry that you you went through that. I'm curious, you know, if there are other experiences as well that may have shaped how you thought about how to manage change.

Maya Shankar

Yeah, Thanks, Vivek. I had a really formative experience with change that I think has taken me years as a scientist to unpack and I feel really edified having gone through that process. And so I'm always eager to share the lessons I've learned from, you know, retroactively analyzing the change and why it had impact on me. So, long story short, when I was six years old, my mom went up to our attic and brought down my grandmother's violin that she had brought with her from India when she immigrated to the United States in the 1970s. And my grandmother had played Carnatic style music. So not not in the Western tradition, but my mom knew that I was very, very attached to my grandmother, to my Paatti. And so she showed me the instrument and I just immediately fell in love with it. So much so, Vivek, that my mom never had to tell me to practice. I would like, run home from school. After my afternoon snack, I would get at it and like my mom had to tell me to do a lot of things. But for whatever reason, the practicing the violin was not one of them. And then the pace really picked up. When I was nine, I auditioned for the Juilliard School of Music in New York. They have a pre-college program, and fortunately I was accepted. And that began weekly trips from Connecticut to New York, where I'd spend 10 hours every Saturday studying, studying the violin. I'd wake up at 430 in the morning. We come back around nine or ten at night, and I would just bounce out of bed. So again, this is such a passion for me. You know, I never knew whether I had what it would take to to go pro. But then when I was in high school, Itzhak Perlman, who's, you know, considered one of the best violinists of our of our time, invited me to be his private violin student. And that was really this vote of confidence that I felt I needed because, you know, you're you're you've got lots of insecurities when you're operating in these kinds of circles. And so I always felt like a light imposter. I was watching all these prodigious kids around me being like, Oh, you know, I'm actually also in the school play and I have other hobbies and likes as well. And my, you know, my life has more. And I also don't I'm not willing to practice the age equivalent. Like I literally had friends who were eight who were practicing eight hours a day. So just to give you a sense of the intensity around me. And so so anyway, I felt like once I started studying with Perlman, Wow, like, this could be my future, you know? And then when I was 15, I had a sudden hand injury that just ended my career overnight. I tore tendons in my hand, and it led to a very complex medical process, which I won't get into right now. But, the, you know, the outcome was Maya, you can't be a violinist anymore. And it was it was so interesting, Vivek, because I feel like I expected to grieve the loss of the instrument. But what I did not expect was to grieve the loss of myself. My identity was so tethered to being a violinist. I mean, I was just I was first and foremost a musician. Like that was my core identity. And that's when I started to realize, Oh, wow, the things we do in life, the passions we have, the things we pursue, they become a deep part of who we are, who we believe we are, right? And so when those things are taken away from us, we have to kind of reassess who we are and who we can be without that thing. And so it took me a while to find my way again. You know, I ended up becoming a cognitive scientist and studying the human mind. But what I learned, reflecting back on my experience and for anyone who's listening right now, who's going through an unexpected change and un-willed change, if you will, at the end of the day, our desire to have a strong identity is not going to go anywhere because having an identity is a huge source of stability and motivation and it's a huge driver of joy for us as humans. Otherwise, we really are just operating in this world of randomness and chaos. And so it can be very grounding to attach ourselves to specific identities. So I don't think that's going anywhere. But what I did learn is that we can choose what we attach our identity to. So in the case of the violin, I try to strip away the superficial features of this particular pursuit, right? Playing, playing this instrument and try to figure out, well, what remains under the surface when I take away the violin aspect. And what I realized is that the thing that really got me to tick, the thing that got me to really light up was human connection. I was obsessed with the emotional connection that I could forge with an audience or my fellow musicians when we were playing chamber music or orchestra like that was so intoxicating for me that with sometimes total strangers, we could feel something new together. And when I identified that it was human connection that made me tick, I was then able to find that particular trait in other pursuits, when I lost the violin. So I found it in my role as a cognitive scientist where I literally study the science of the mind. Right? I'm studying how it is that we even connect with one another and how our brains are wired. And then I was able to have that kind of connection when I was working in the Obama White House. And, you know, not only forging wonderful connections with my colleagues, people like you, but also meeting with people on the ground in Flint, Michigan. Right. Who were in the throes of a lead and water crisis and dealing with people who had been recently incarcerated and were looking for a second chance. And that emotional that set of emotional connections really fueled me. Right. I found so much sustenance in that. And then today with my podcast, A Slight Change of Plans, it's all about forging emotional connections with others, right? I get into this room with someone else and I don't know who they are, and I'm like, Hey, let's cut through all the platitudes, all the pleasantries and dig right in. So, that's a way of saying I would encourage everyone listening to ask themselves, you know, even if you've done disparate things in your life or even if you've been robbed of the thing that you love the most, you're the most passionate about, is there a through line for you? Is there something that can connect your life experiences, maybe in the past or moving forward, that you could hold on to and that you can attach your identity to that that's more stable, right? That feels more robust because even when life gets in the way, even when life throws you your slight change of plans, you can still feel that it's a core part of your identity.

Dr. Vivek Murthy

As you were telling that story, I was just trying to imagine what it was like to be a young person who was suddenly told that the dream you had pursued your entire life, the identity you had built, was somehow no longer one that you could pursue, and, you know, it sounds like you have grown so much and reflected so deeply and built an incredible path for yourself in the years that followed. I'm curious, you know, there are probably people out there who are listening, as you said, who are going through different types of change in their life. I just actually got off the phone with a friend who unexpectedly lost his son-in-law and now is dealing with the fact that his 11-year-old granddaughter, you know, is no longer has her dad and needs some support. I have another friend who I was just speaking to yesterday who was healthy and doing incredible things and traveling the world and suddenly got a severe infection and ended up with meningitis, which is an infection around her brain and is now, you know, in a difficult place, you know, and in intensive care. So, you know, these thing changes happen in our lives. So either people who are listening may be going through that change. You may know somebody who's going through that change. In the immediate setting, what helps for us to manage the pain that can come with abrupt change?

Maya Shankar

I think it's pulling people in closely. And I think one of the things that we sometimes fail to appreciate is that when something changes in our own lives, it also changes the way that others interact with us. And that can, there can be a huge distortionary effect that actually really erodes the quality of the relationship. So I was talking with with Michael Lewis’ daughter, Quinn Lewis. She lost her her baby sister in a car accident when her sister was 19. So just total horrible tragedy. And what she was telling me is, you know, she was she's a college student. And she said, you know, I expected that I would just feel shattered inside. But I didn't expect that it would it would almost cast a shadow on every social interaction that I had from there on out, because everyone knew me as the person who had just lost her sister. And it was kind of the elephant in the room, right, that like no one was talking about. And I feel like in these moments of change, because people are so concerned about saying the wrong thing or not being there for you in the way that you want them to be there for you. The greatest gift that we can give others and then in turn ourselves is to be explicit with people about what we need from them to get rid of the guessing game. Because everyone's guessing, everyone you're guessing, you're not even sure what you need. Right. But if you can try to unpack that and internally and be really vocal about that with the people who want to be there for you, who care for you, I think it will help to expedite some degree of healing because you don't want to add on an additional burden of, Oh my God, my friend really let me down because they said the wrong thing. Or, you know, my sister-in-law wasn't there for me in the way that I hope she would be. As much as you can try to be really forthcoming because everyone grieves differently, everyone processes change differently. And so we need to be open with one another about what our own desires are in any given moment.

Dr. Vivek Murthy

Yeah, that that's such a good advice to pull people close. And I think you're absolutely right that sometimes people hold back, they're not sure what to say. They don't want to be intrusive. They want to give people their space, their privacy, sometimes it's not clear what to do. So if you have somebody in your life who is going through unexpected change and you're not sure what they need, what do you recommend that people do?

Maya Shankar

So it's actually pretty simple. You ask them what they need and sometimes the person won't know. So let me let me just give you a let me just share a personal story with you. So my my husband and I have in our in our pursuit of parenthood have been had been working with a surrogate and she was pregnant with our baby girl in 2020. And then unfortunately, she miscarried. And then in 2021, we had a second pregnancy. This time, Vivek, it was actually identical twin girls. So our embryo had split and we were just over the moon that we'd been given two blessings. I mean, I've only ever asked for one. And so that was amazing to me. And then sadly, there was a miscarriage there as well. I mean, I was just shattered in both scenarios. I mean, talk about like lack of control as a type-A person who likes to hustle her way to to end goals and, and, and feels like she can outwork most things. This is a this is a case, fertility is a space, where no amount of “hard work” pays off. Right. It's a much more random system than that. And so I definitely felt that loss of control and I felt really defeated. And one of my brothers, who I'm really, really close to, he has three girls and he was calling me and trying to, you know, comfort me. And I found myself being really short with him, like not my most loving self. And, however he reached out, didn't feel like it was adequate in some way. And I don't even know honestly what I was expecting. I think I was confusing just the deep pain that I was feeling with him, not, you know, being there for me. And ultimately what I told him. Ultimately, he actually just asked me the question. He said, Maya, it would just be really helpful if you told me what you need from me right now. And I remember reflecting on that and saying, you know, I don't actually know what I need from you right now. So I think we have to figure that out together. And that was a turning point for me because I was now bringing in a loved one into this process of discovery around how it was that I was going to heal. And it it allowed a greater emotional intimacy to form. So one thing I realized is that the reason I wasn't feeling very comforted by my brother was simply the fact that he has three daughters. And I love my nieces more than anything, but I was really jealous. I was really envious of his situation. And so part of the problem was just what his life is like. That's not my brother's fault that he has three kids. But I felt like I was subconsciously taking it out on him. Like, you have the life that I want and I can't have it. And so I was able to actually share that with him because we were building this more intimate dialog about how it was that I was going to be grieving and the things, the thoughts that were in my head that I wanted to express out loud. And so it really can be as simple as a question and I know that that sounds it almost sounds too obvious, but how many times have you asked others or yourself what you needed when you were in the throes of pain or in the when you were facing loss? We don't really ask ourselves or others this question enough.

Dr. Vivek Murthy

So, Maya, There's so much in what you said there that I'm going to be thinking about, but a couple of things that strike me as one, I'm just amazed that your brother had the courage to ask and the clarity to ask what it is that you needed. And I'm so glad that both of you ended up being partners in figuring this out together, as opposed to him pulling away or you shutting him out. And I'm curious, how has that affected where your relationship is with him now? Like, did it bring you closer together in the end?

Maya Shankar

Absolutely, because, you know, when we when we're feeling sad, I mean, you talk about this Vivek, right? You talk about how loneliness is this vicious cycle. Right. And that really stuck with me. It's a self-perpetuating cycle because when you are feeling lonely, you maybe don't assume the best in others. You start to, you know, your self-esteem is chipped away at, right? There are these negative ripple effects that happen in the face of loneliness, that feed on, on, on each other and help just increase loneliness. And I think the same kind of thing can happen with sadness and grief, right? You you might take a comment that was meant to just be really kind and loving and see it differently than it was intended to be said. And I and I felt like I was not at my best in in the throes of grief. I remember feeling like I was interpreting things through a less generous lens than I normally would, right? I felt like I was in so much pain that in some sense I felt like no one was going to give me what I wanted. What I wanted was those babies back and like, how could anyone give me that through words? That was never going to happen. And so I think being able to talk out loud about this and being able to recognize where I was falling short and that I just needed his help guiding me through this and him stating like, I love you and care about you so much and just establishing that so I didn't have to question it, you know, I didn't have to guess whether that was the case. It brought us incredibly close, you know, and I'm so grateful for that kind of transparency, because not only did it bring us closer over this particular set of losses, but I think it set a really healthy precedent for the future, because inevitably in my life, in my brother's life, and my other my sister's life, my other brother's life, like we're all going to experience change and loss and tragedy and it's good to have it be the norm that we ask one another what the other person needs.

Dr. Vivek Murthy

I'm so glad that you have pulled closer together as a result of this. And I want to touch for a moment on the identity point that you brought up earlier, which I think is such an important concept that you raised, which is that when we when we experience change, we're not just sometimes losing a job or an opportunity or a loved one. We're losing a sense of our own self, a sense of identity. And that certainly speaks to me. I think about the experience I had when I served as Surgeon General the first time, when my tenure ended very abruptly, and it took me some time to realize that part of what I was dealing with in the aftermath of that was not only the loss of the community that I had at work, not only the loss of the opportunity to contribute and serve the public, not only the loss of the opportunity to do something I really enjoyed, but it was actually the loss of identity as well. I had built up an identity that was around my job and now I was a private citizen and functioning in a different capacity and I had to really grapple with what my actual underlying identity was. And it took me some time to to really come to grips with not just intellectually but viscerally, that my fundamental identity had not changed, even though the the coat that I had been wearing or the garb that I, you know, I had over me for two and a half years had perhaps been removed. And so I think that point you raise about identity is so important because that, I think is one of the toughest parts of change, is that it really pulls out and pushes us to question what our real identity is.

Maya Shankar

Yeah. By the way, I so resonate with that. And oh my gosh, I remember that Election Day like it was yesterday. I mean, I you know, I remember building this behavioral science team at at the White House and then imagining this bright future for it. I was, you know, in my my personal time chatting with the Hillary campaign and figuring out how he could bring this team to the next level. And then, oh, my gosh, that was it was it was so tough. And I also felt like I had this identity crisis as well. And I think you're helping me discover that in this moment, which is I was you know, you're figuring out, okay, on January 21st, I don't have a job. So you're figuring all these practical considerations, like, what am I going to do next and what comes next? And I you know, I've been a in this political space for for a while. And then but but I also felt that it it did come to define me, right? All the things we do come to define us in these really powerful ways. In fact, in some ways it's a gift, right? How lucky are you and I that we loved our jobs so much in public policy that they have come to define us. So I don't want to frame this as all negative. I think it's wonderful to be given that gift in life. But what that means, too, is, you know, when we attach ourselves very closely to that, then there is a risk. There's that threat of potential loss and having to find oneself again.

Dr. Vivek Murthy

You know, you've studied behavior change so deeply over the years, formally, you know, in your education and then later in your work. I want to pivot to talking about what science teaches us about change. And in particular, when we think about change that we want to make in our life, whether it's making a New Year's resolution or making a commitment, you know, to be in a new relationship or to start a new diet or whatever it might be. What does science teach us about how we can inspire the kind of change we want in life?

Maya Shankar

Oh, it teaches us so many things. It's had such a radical impact on my personal life, so I'm excited to share, hopefully these little gems, nuggets of wisdom with all of you. So the first thing that we should think about is how it is that we are defining our goals. So there are two at least two different frames for defining a goal. We can define a goal as an approach goal. For example, I want to eat healthier foods, or we can define a goal as an avoid goal, an avoidant goal. So I want to avoid unhealthy foods. And what we find from research is that do goals right? These approach goals can be far more motivating and promote endurance and can be met with pride and do not goals inspire, different kinds of feelings. They can inspire urgency or be met with calm and relief, right when the thing doesn't, when the bad thing maybe doesn't happen. And so sometimes we can subconsciously articulate our goals in one way or the other. And I'm not saying that one is always better than the other. You want to be experimental with your approach, depending on the domain, but you should definitely be very thoughtful about the way that you're even framing these goals to yourself because it can have an impact on your motivational level. And then can I share another one?

Dr. Vivek Murthy

Yeah. Please go ahead. Yeah.

Maya Shankar

There's a bunch so we can get through them. But the other thing I wanted to share, Vivek, is -- actually it goes back to our early earlier conversation about the importance of agency and control. So I mentioned earlier, we love being in the driver's seat. We love having our grip on the steering wheel, and that applies to goal setting as well. So we want to be really careful about who is setting goals, because when we have our own targets, when we've defined our own targets for ourselves, we're far better at achieving them. And someone who's listening is thinking, okay, well, one Maya, like I have a boss, so I don't actually get to control, right, what I'm told I need to do. Or, you know, I'm working out with a personal trainer coach or, you know, a nutrition coach, whatever it is, that's fine. It's you can make this system work for you. What you can do is you can have that, for example, personal trainer give you a set of options from which to choose. So they're saying you can do X, Y or Z and all of these will help you achieve the longer term goal, but I'm giving you some agency in the process so that you feel like you're the one who's establishing the goals and committing to them. And so just remember to preserve as much as you can some degree of agency in that.

Dr. Vivek Murthy

Well, I’m glad you brought up goals, Maya, because the other thing that 00:32:26,083 --> 00:32:30,375 I've been thinking about is, is in what time frame we should think about our goals. Like, is it better to set short term goals? So for example, if I'm trying to lose ten pounds is it better to say, okay, this week or this month I want to lose X amount? Or is it better to say, you know, over the next six months, here's where I want to be and then drive toward that? How should people think about the time frame for goals?

Maya Shankar

Yeah, so I would recommend shorter time frames when it comes to goals. And the reason for that is research shows that our motivation is not stable over the course of goal pursuit. We tend to feel a huge boost in motivation at the beginning of a goal and then there's a waning of motivation and then there's another big bump towards the end of the goal. So as we're about to reach the goal, we get a surge in motivation. And so this creates what's called what my my friend and colleague Ayelet Fischbach calls the dreaded middle problem, right? So there's this lengthy middle and we know that motivation is going to be lower during this middle phase. And so the question is, well, what can we do about it? We can't get rid of middles. Just mathematically speaking, middles will exist. And so the advice there is to keep middles as short as possible. So if you're defining a weekly goal for yourself, okay, the middle is going to be a day or two. If you're defining a yearly goal now, you've got multiple months in the summer where you can just kind of kick back and take your foot off the of the gas. And so I would recommend and actually no this, that this is really I want to share this actually very charming study where people people were given a pair of scissors and were asked to cut out five identical shapes. And at the beginning of this exercise, they cut their shapes really neatly. And then by the time they got to the third shape, they literally started cutting corners, Vivek. So they became a lot sloppier and less motivated to do the task well. And then, lo and behold, by the fifth shape, their shapes became neat again. Okay, so just keep that in mind. Like we will literally cut corners as we go towards the middle as the middle of a goal. So, yeah, keep your your middle short, keep them nonexistent. And that way, you also you also feel like you're working towards progress, right? You actually are able to measure progress over a shorter, shorter time frame. And the other thing I would say about setting goals in particular is that we really want to set goals when we are in a similar psychological and physiological state as a one will be in when we're actually striving for that goal. So of course there's the aspirational Maya and there's the aspirational Vivek who on a Sunday afternoon after being very well-rested and well-fed, is thinking, okay, I'm going to get up at 5am, I'm going to get that hard workout in. I'm going to eat salad all week. Whatever the goal is, There's an empathy gap between your present self and your future self when you're engaging in that kind of exercise. So what you want to do is actually get a pulse of how you feel at 5 a.m. on a weekday when you're up. Be in that mental state, the in that physiological state and then say what is reasonable for me to expect of this current self right now? And so I think that's really valuable advice because I think if you're going to make a goal again to get up early in the morning or work out at night, make sure you are making that goal when you're in one of those states doing the said activity because that's going to help you bridge whatever empathy gap that you have between your present self and your future self.

Dr. Vivek Murthy

Oh, this is really good advice. I feel like you're helping me figure out how to live my own life and deal with some challenges that I've been struggling with really for a while. In fact, I'll share one of these with you. One of the things I've been trying to do, and this is the question behind this, one of the things I've been trying to do is to reduce the amount of sugar and processed food that I consume. And, you know, I know that I feel better when I'm eating foods that have less added sugar in them and foods that are less processed. Yet I somehow find that they end up in my diet, you know, in higher quantities than I want.

Maya Shankar

Even the Surgeon General, folks, see even the Surgeon General, how relatable.

Dr. Vivek Murthy

It’s tough. So, you know, I've set the goal and sometimes that you know I'll go long stretches and do really well, but more recently I was falling off the wagon, so to speak, and I realized that I had gotten to a point where just me telling myself, you got to do this wasn't quite cutting it. So I actually reached out to two close friends who are in my Moai which is this, you know, a tradition that you and I have talked about before where, you know, you make a conscious commitment to a couple of other folks in your life to to be there for each other and to take care of each other and these two two guys are old friends of mine. And I reached out to them and I said, Hey, listen, this is what I’ve been trying to do, but I need you to hold me accountable because I'm finding that I'm falling off the wagon here. And so they as they always do, they stepped up and they've been checking on me and making sure I'm doing okay. And you know what? It's been great and it's been now a couple of weeks. I feel a lot better because I've been able to to stick to that goal and the moments where I feel like, you know, slipping. I remember that, you know, I've told the two of them that I'm going to do this and they're they're going to check on me. So it has helped. But I'm curious, as you think about goal setting, what is the role of people around us, of friendships, of communities in keeping us accountable, keeping us on the path, helping us achieve our goals?

Maya Shankar

Oh, commitment devices involving other people can be exceptionally powerful. And that's because as humans we are really influenced by social factors and social norms, right? We really care what our peers think about us. So we really care about reaching our goals in the eyes of others. And so I think what you've employed is a really brilliant strategy. I know there's a few other strategies where people will commit to their friends and say if I don't follow through on this goal, I'm going to donate X amount of dollars to my least favorite charity, like a charity that I oppose on moral grounds. And that's also can be a good way to, you know, make sure, ooh, I'm looking at that cookie, but I'm also thinking about a donation to this horrible charity. Okay. Nope, not not interested in the cookie anymore. So that can be really useful. And you know, the power of commitment devices, Vivek, even if you don't have, you know, a set of people who are enforcing it. It's a really powerful internal tool. So you'll appreciate this one as the Surgeon general. There was research done on getting flu shots and people were simply asked to articulate where when and how they plan to get their flu shot. So it was a commitment device of sorts, but you're also articulating a plan of action. And so people would write down on this little form. Okay, You know, at 6 a.m. on my way to daycare to pick up Bobby, or let's say, Ravi, in this context, because, you know, we're both Indian, I'm going to turn the corner and I’m going to go to CVS and that's when I'm going to get my flu shot. Okay? Even when they didn't send this commitment to anyone else, it was just a little thing they filled out and kept on their dining room tables, they were far more likely to go and get their flu shots. And so the mere act of engaging in that mental commitment, and articulating a clear action plan, can help us act on our long-term goals.

Dr. Vivek Murthy

Oh, I love that. I love that. Are there any other devices like that, whether it's centered around commitment or, you know, other sort of non-commitment related devices that you find to be helpful in ensuring that you can engage in change?

Maya Shankar

Yeah, there are two that I use a lot in my life. So the first is from a friend of mine, Katie Milkman, and she talks about what's called temptation bundling. And it's a very simple concept. All you're doing in this case is you're pairing an unpleasant activity with an immediately rewarding activity. So it might be being on the elliptical or doing the dishes or folding laundry, but the rewarding activity is maybe listening to your favorite podcast with Dr. Vivek Murthy, or you know, watching your favorite show on Netflix or listening to your favorite Taylor Swift song, right? And so what you do and in my case, for example, I love pop songs, but they have a limited life time for me, so I can probably listen to a song like 20 times before it loses a little bit of the magic. So like I’m very sparing about how I consume music and I only allow myself to listen to my favorite songs when I am exercising. Like, that's a rule in the house. And my poor husband because he'll be like, Hey, we're cooking dinner. Let's play this like cool new album that came out. And I'm like, No, that's my only when I'm working out album. The key is you have to deny yourself that pleasure in other parts of life so that it's exclusively bundled with the thing that you hope to do because it's in your long term best interests. And then it's interesting, over time, you kind of start looking forward to doing these more unpleasant activity because you're like, Oh, I'm so, so eager to know what happens in this Netflix series. Like, I can't wait to, you know, go to the gym because that's where I'm going to be able to watch the show. So I find temptation bundling to be really effective. Another device that I use is to capitalize on what are known as fresh starts. So fresh starts can be anything. It can be the presence of the new year. It can be moving to a new city. It can be taking a new job, getting married. It can even be a Sunday. It could be the beginning of the week. But this fresh start signals to the brain that you're departing from the past in some way. Now, we talked a lot about identity, right? Sometimes it can be a shift in identity. Oh, I feel like I'm a different person now that I've moved to this new place. I feel like I'm a slightly different person now that I started this new job or I'm now married. And so these identity shifts can actually fuel a lot of behavior change. So we want to take advantage of those moments. Fresh starts are often also accompanied by physical changes. So we're breaking with a lot of the routines and patterns of behavior we used to have. So I used to have a route to work in which I would always stop at the donut shop, for example. And now with my new job, I have a totally different route. And so it's much easier for me to break from that early morning indulgence, right, to see my patterns of behavior as being more of a clean slate that I, Maya, get to build from scratch with a lot more intentionality.

Dr. Vivek Murthy

In this conversation, I feel like you've given us so many helpful ways to think about change and so many devices. Whether it's thinking about human relationships and how to pull people close when we're dealing with unexpected change, but also how to lean on them when we're looking to drive proactive change in our life. You talked about temptation bundling, minimizing the messy middle, which I'm going to remember in terms of setting shorter timeframes for our goals. And I love this idea of capitalizing on fresh starts, recognizing that we don't, as you put it, always have to wait for something to change our life to create a fresh start. We can drive a new, fresh start by creating a new route that we take to school or to work. These are all so helpful and I think at a time where a lot of people are grappling with change in their life, some intended, some unintended, I think these lessons are going to be incredibly helpful. Maya, as we wrap up our conversation, I want to ask you one last thing, which is, as you look into the future, what gives you hope?

Maya Shankar

I think the thing that's given me hope is a lesson that I've actually learned from my podcast, A Slight Change of Plans, which is problems can feel so daunting and so much larger than life and so intractable. But there is so much power in humans connecting and expressing and sharing their stories with others. That is the that is one of the easiest ways for people to heal and to feel like they have a new say framework for thinking about things, a new philosophy on life. And I have felt that power in my own life. I feel like I'm so much wiser because of the insights and wisdom and stories that my guests have shared with me on the show. And it just feels like they're helping chip away at these massive problems. But are are are giving us access into some of that access to some of the most personal, most personal, intimate parts of their life. And in doing so, they're giving me some hope that that we can have a brighter future. And so I feel really reassured by those sorts of conversations, and I hope we can have more of them.

Dr. Vivek Murthy

Oh, that that warms my heart. I mean, I find that human connection and conversation and moments of authenticity are such powerful, powerful sources of hope. And I'm so glad you have that in your life. You know, that insight you had about your identity early on that you weren't only a violinist or a musician, but that you're somebody who enjoyed connecting with other people. I'm so glad you found that, because now I can see just from your own story and what I know of you, that throughline through your life and how it feels like in each stage of your life, you've come closer and closer to that identity of thriving on human connection, of cultivating it in your life, and now with your podcast, creating opportunities for other people to feel the benefits of that human connection as you forge them with others through honest, authentic conversation. So thank you for joining us today. Maya. Thank you for being such a wonderful friend to me for being an inspiration in my life. And I would just say that in addition to those three words I mentioned that struck me about you when you and I first met at the White House years ago, I would just add two more, which are wise and warm, which are certainly two words that I think are so appropriate to associate with you. So thank you for being with me today and for having this wonderful conversation. I think a lot of people are going to find it really helpful.

Maya Shankar

Well, I hope so. And it's always such an honor to get a chance to talk with you. And I should mention one other thing that gives me hope. I'm filled with hope because people like you occupy roles like the U.S. Surgeon General. It is it is a gift for us as a nation to have someone with your humanity and your kindness, your ability to introspect in a position of power. And I really don't take for granted that you've been able to serve in this role twice. And I, I hope everyone can appreciate what you bring to this role and how much you've shaped it just by being the kind of person you are. So I just want to extend my gratitude to you for leading our nation in this way.

Dr. Vivek Murthy

Oh, you're so kind. You're making this brown man blush. Thank you very much. That’s so kind of you.

Maya Shankar

Thanks, Vivek. I appreciate you.

Dr. Vivek Murthy

All right. You take care, Maya. Thanks for being with me today. That concludes this conversation with Maya Shankar. Join me for the next episode of House Calls with Dr. Vivek Murthy. Wishing you all health and happiness.