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Conversations
14 December 2020

Johann Hari makes connections

Interview by Helena Norberg-Hodge

Johann Hari makes connections

Johann Hari knows how to answer a question. An introspective journey to better understand his own struggles with depression turned into a worldwide odyssey to research the fundamental causes of the world’s mounting mental health crisis. His travels brought him into contact with some of the world’s most cutting-edge scientists and doctors, as well as many extraordinary individuals and communities whose moving stories shed light on a topic that too often remains shrouded in darkness.

The resulting book, Lost Connections: Uncovering the Real Causes of Depression and the Unexpected Solutions is a New York Times best-seller—lauded by everyone from Oprah to Elton John—and has revolutionised mainstream understanding of depression and anxiety. Johann possesses an invaluable clarity when relating the global mental health crisis to systemic root causes. He is driven by two wisdoms: first, that depression and anxiety are not “disorders,” but rather signals of deep flaws in the systems we live in. And second, that systemic problems require systemic solutions.

Over the course of our conversation, I was moved by Johann’s rich storytelling and impressed by his ability to interweave personal openness and sensitivity with political expansiveness. His perspective, grounded in experience and framed by compelling research, is invaluable to anyone who intuitively knows that a healthier, happier future begins with connection.

Behind extraordinary ideas, there are extraordinary people. Dumbo Feather is a magazine about these people.

Discussed in this Story

HELENA NORBERG-HODGE: Are you happy to tell us a bit about your background? Your childhood and what shaped you and your interests?

JOHANN HARI: Yeah, well it’s very related to the subject of my book Lost Connections. I wrote the book ’cause there were these two mysteries hanging over me. The first is that I’m 40 years old and all throughout my life depression and anxiety have increased in the places that I’ve lived—in Britain, the United States, Switzerland, across the world. And I wanted to understand why is this happening? Why is it that with each year that passes more and more of us are finding it harder to get through the day? I wanted to understand this ’cause of a more personal reason which is that when I was a teenager I remember going to my doctor explaining that I had this feeling like pain was leaking out of me. And I didn’t understand it, I couldn’t control it. I felt quite ashamed of it. My doctor told me a story that I now realise was well intentioned and not a hundred percent wrong, but was really, really oversimplified. He said, “We know why people get like this. Some people just have something wrong with their brains. All we need to do is give you these drugs and you’re going to be fine.” So I was given a chemical depressant named Paxil or Seroxat (it’s the same thing with different names). And it gave me some relief, but I became depressed again so he gave me higher and higher doses. Until for 13 years I was taking the maximum possible dose you can take, at the end of which I still felt awful. So I ended up going on this big journey all over the world. I wanted to understand both for myself and for the society, what was happening? I travelled over 40 thousand miles. I met lots of people, from an Amish village in Indiana, ’cause the Amish have very low levels of depression, to a city in Brazil that banned advertising to see if that would make people feel better, to a lab in Baltimore where they’re giving people psychedelics to see if that helped with their depression. I learned a huge amount. But the core of what I learned is that there’s scientific evidence for nine different causes of depression and anxiety. Two of them are indeed in our biology. Most of them are factors in the way we live. Once you understand those reasons, it opens up a very different set of solutions and a whole different way of thinking about what human beings are, which is what so much of your amazing work has been about. So to my background—I grew up in a typical suburb of London called Edgware, my parents had come from quite poor backgrounds and they both thought of themselves as immigrants. My dad was from a tiny mountain in Switzerland and my mother was raised in tenement housing in Scotland. I say they thought of themselves as immigrants ’cause my mother thinks of Scotland as a foreign country to London. But they had really worked unbelievably hard to get into a middle class life. I’m very grateful for the work that they did to get me there. I only realised this in retrospect but the place I grew up was full of decent, admirable people who worked hard. My father had known everyone who lived in his village. And my mother had known most of the people who lived in her area. I was a baby when they moved to London. I remember my mother realising that you’re not meant to go out and talk to your neighbours ’cause it’s almost bad manners. There were times when she would just look at our street and say, “Where is everyone?” She could never really adjust to it. It was alien to me at the time, their way of thinking. I grew up very much in a world of individualistic values shaped by television and consumerism. I remember when I was about 10 years old a shopping a mall opened up in my suburb called the Boardwalk Centre. I absorbed from the culture of advertising the idea that this was the most incredible thing. Suddenly this shopping centre! And I would wander through the shops staring at things with this sense of awe which of course wore off very quickly. But if you had asked me what happiness is I would have said it’s being able to walk into the Boardwalk Centre and buy anything you want. So I was very much raised in a place where the dominant values were consumer values. Where isolation was the norm and your sense of home is your house and maybe your family. Where you worked hard at a job you don’t like to buy things you don’t need. That was the story of happiness I had. It was only much later that I began to question and see the problems with that story.

What do you think triggered that awareness? Do you remember?

I think the biggest change was in the research for my book. I was experiencing depression and anxiety like a huge number of people in our culture were. And I was taught not just by my doctor but by the wider culture to regard my depression and anxiety as malfunctions inside myself. As biological malfunctions. What I learned from the leading experts in the world when I interviewed them is that there is a biological component to depression and anxiety to be sure, but it’s one part of a much bigger picture. And depression and anxiety are not malfunctions, they’re signals. They’re signals that are telling us something. Everyone knows we have basic physical needs like food, water and shelter. Clean air. If I took those things away from you obviously you’d be in a lot of trouble. But there’s equally strong evidence that all human beings have natural psychological needs. You need to feel you belong. You need to feel your life has meaning. You need to feel that people see and value you. You need to feel you’ve got a future that makes sense. This culture we’ve built is good at lots of things, I’m glad to be alive today, but we’ve been getting less and less good at meeting these deep, underlying psychological needs. So I was experiencing these signals that my needs weren’t being met. But I had an incorrect method for interpreting those signals. I had been given the wrong story about what I felt. A psychologist I once read said one of the most powerful things you can ever do is give someone a narrative for their pain and distress. If you’re given a narrative that is wrong, it trains you to seek happiness and meaning in all the wrong places. In my research, I interviewed a wonderful South African psychiatrist named Dr Derek Summerfield who told me a story that really changed how I thought about depression. He explained to me that in 2001 he happened to be in Cambodia when they first introduced chemical antidepressants for people in that country. The local doctors had never heard of these drugs. So they were like, “What are they?” And he explained. And they said to him, “Oh we don’t need them. We’ve already got antidepressants.” And he said, “What do you mean?” He thought they were going to talk about a herbal remedy, like St John’s wort or something. Instead they told him a story. There was a farmer in their community who worked in the rice fields. And one day he stood on a landmine left over from the war with the United States and got his leg blown off. So he got an artificial limb and after some period of rehabilitation went back to work in the rice fields. But apparently it’s extremely painful to work underwater when you’ve got an artificial leg, and I’m guessing it was very traumatic for him to go back to work in the field where he got blown up, so the man started to cry all day. He refused to get out of bed. He was obviously, what we would call, depressed. “That’s when we gave him an antidepressant,” the Cambodians said. And Dr Summerfield asked, “What was it?” They explained that they went and sat with him. They listened to him. They realised that his pain made sense. If you listened to him it was perfectly understandable why he was depressed. One of them figured if they bought this guy a cow he could become a dairy farmer, and he wouldn’t be in this position that was screwing him up so much. So they bought him a cow. Within a couple of weeks his crying stopped. Within a month his depression was gone. They said to Dr Summerfield, “So you see doctor, that cow, that was an antidepressant. That’s what you mean right?” Now if you’d been raised to think about depression and anxiety the way we have in western culture that sounds like a joke, right? I went to my doctor for an antidepressant, she gave me a cow. But what those Cambodian doctors knew intuitively is what the leading medical body in the whole world, the World Health Organisation, has been trying to tell us for years. If you’re depressed, if you’re anxious, you’re not weak. You’re not crazy. You’re a human being with unmet needs. And what you need is love and support to get those deeper needs met. So I think we need to really transform our understanding of what depression and anxiety are and then radically expand our idea of what an antidepressant is. Anything that reduces depression should be regarded as an antidepressant. For some people, for some time, that will include drugs, and that has value. But precisely because this problem goes so much deeper than our biology, we need to find solutions that go so much deeper than our biology too.

Absolutely. I can’t tell you how much I agree and how wonderful it is to hear you say this. One of the reasons I’m so motivated to get out this message about the need for structural economic change is just this aching sadness I have at how many people around the world are made to feel that they are idiots—and that they are to blame. Everywhere in the world, the message is that if you want to be happy, if you want to be seen, to be valued and connected, you’ve got to live up to a certain ideal. You’ve got to look like an urban, western consumer. You’ve got to be successful, which means getting a “good” job, earning lots of money and living in a big city. The implicit message is, “If you can’t live up to that ideal, it’s your fault.” So people blame themselves. Or they blame their parents or their cultural heritage or their governments. But this misses the bigger picture, which is that mental illness is on the rise across the globe because of the corporate consumer culture, linked to an economic system in which GDP increases with these illnesses. It is such a tragedy.

It is. For thousands of years philosophers have said, “If you think life is about money and status and showing off, you’re going to feel like shit.” That’s not an exact quote from Confucius but it’s basically what he said. But nobody had scientifically investigated this in an empirical way until this amazing man named Professor Tim Kasser who’s at Knox College in Illinois. He made a huge number of breakthroughs. The first was discover that the philosophers were right. The more you think life is about money and status and showing off, the more depressed and anxious you become. He also showed that as a society—as a culture—we have become much more driven by this way of thinking. Everyone knows junk food has taken over our diets and made us physically sick. But junk values have taken over our minds and made us mentally sick. What junk food does is appeal to the part of us that needs nutrition, gives us instant gratification, but actually makes us sick. Everyone needs a system of values to guide them through life, but these junk values arise—in the form of advertisements, for example—and actually train us to seek happiness in all the wrong places. One of the most important experiments Professor Kasser did was to work with teenagers and their parents to explore the underlying reasons as to they were becoming obsessed with consumer products, and then becoming angry and anxious when they didn’t get these products. They got the group together every week for a few months to discuss these things. It didn’t take long for people to actually voice the fact that they wanted the new running shoes, the new handbag or the flashy new car because, at a deeper level, they were actually looking for approval, attention or belonging. The next thing they did in the group was ask people about moments in their life when they did feel meaning, purpose and connection. And people named different things: playing music, running on the beach or whatever. And the group started to talk about how they could spend more of their lives pursuing these moments of meaning, and less time pursuing these consumer things that they could see weren’t really making them feel good. What was really interesting was that the researchers were measuring changes in the participants’ values over the course of the few months. They found that just having these conversations and checking in with each other led to a marked shift in the values of these people. It was like a kind of Alcoholics Anonymous for consumerism! And we know that those shifts in values lead to a reduction in depression and anxiety. So this system we have cuts against the grain of human nature and people get that. People get that there’s a much larger context to mental health struggles than what goes on inside the individual’s brain. But we’re in this weird situation where that underlying truth is both obvious and deeply challenging and revolutionary! Which is a sign of how awry the culture has gone! There’s a great quote from the great Indian philosopher Krishnamurti, “It’s no sign of good health to be well-adjusted to a sick society.”

I often use the example of a friend of mine in Sweden who did this study asking if higher education leads to greater self-esteem. She knew as a sociologist that the answer wasn’t going to be yes. But what she discovered she hadn’t expected. She found that what did lead to higher self-esteem was a larger number of “significant others” in one’s life. People with the lowest self-esteem were the ones who had very few. So we know that what every human being longs for is to feel loved and connected. But we’ve been told that the way to get that is through separation, comparison and competition.

One of the heroes of my book is an amazing man named Dr Sam Everington. He’s a general practitioner in east London who had loads of patients coming to him with terrible depression and anxiety. Like me he’s not opposed to chemical antidepressants, he thinks they have some role to play. But he could see that, in the vast majority of cases, his patients were depressed and anxious for perfectly understandable reasons. Like they were really lonely, or financially insecure. He could also see that chemical antidepressants gave them a bit of relief but didn’t actually solve the problem for most of them. So one day he had this idea to try something different. A patient came to his practice called Lisa Cunningham who I got to know later. Lisa had been shut away in her home with crippling depression for seven years—she’d barely left the house. Sam said to Lisa, “Don’t worry. I’ll carry on giving you these drugs. I’d also like you to try something else. I’d like you to come a couple of times a week here to the doctor’s practice to meet with a group of other depressed and anxious people—not to talk about how bad you feel, although you could do that if you want. But I want you to find something you can do together that would be meaningful.” So the first time the group met, Lisa literally vomited with anxiety. It was just so much for her. But there was an area behind the doctor’s surgery that was scrubland. And this group started talking, these are inner city east London people who didn’t know anything about gardening, but they were like, “We could turn this into a garden! That would be a nice thing to do.” So they started to get books out of the library, they watched clips on YouTube about gardening. And they got their fingers in the soil. They started to learn the rhythms of the seasons. There was this study in Norway of a very similar program that found “therapeutic horticulture” was more than twice as effective as chemical antidepressants. So they started to reconnect with the natural world they’d been cut off from. And they started to form a tribe. They started to care about each other. If one of them didn’t show up, the others would go looking for them, figure out what was going on, help them solve their problem. Lisa said to me: “As the garden began to bloom, we began to bloom.”

What you say there is, for me, absolutely perfect. Localisation is the way to actually create those relationships between people and the living world. That sense of interdependence. Even in cities, just a bit of land to work on can help connect these people deeply with each other, and then connect with the soil and give rise to this remarkable healing. It would be far cheaper and far easier to shift the current system—the taxes, subsidies and regulations that are currently favouring inhuman scale—towards supporting human and planetary wellbeing.

Right. Actually, the people who taught me the most about this subject were not scientists and doctors, it was a group from Berlin, and if it’s okay I’ll tell you their story. In the summer of 2011, in a big anonymous housing project in Berlin, a Turkish-German woman named Nuriye Cengiz climbed out of her wheelchair and put a sign in her window saying, “I got a notice that I’m going to be evicted from my apartment next Thursday so on Wednesday night I’m going to kill myself.” This housing project is in a very poor part of Berlin. Basically only three groups of people have lived there—recent Muslim immigrants like this woman, gay men and punk squatters. No one integrated, no one knew each other, there was a huge amount of depression and anxiety. And people started to walk past Nuriye’s window, see the sign and knock on her door and say, “Do you need any help?” And Nuriye would say, “No, fuck you, I don’t want any help, I’m going to kill myself.” Right across Berlin there had been rising rents for a really long time. A lot of people were being evicted. So a lot of people identified with this woman’s struggle. They started talking outside her apartment one day and came up with an idea. There’s a big thoroughfare that goes through this housing project, and they decided that if they blocked the road for a day and protested, they could create some fuss. They’ll probably let Nuriye stay. There might even be some pressure to keep rents down across the city. So Saturday came. They blocked the road. They wheeled Nuriye out. She said, “Well I’m going to kill myself, I might as well let these people push me into the middle of the street.” And they protested. The media did come and it was a bit of a news event in Berlin. Then it got to the end of the day and the police said, “Okay, you’ve had your fun. Take it down.” The residents replied, “Actually we’ll take this barrier down when Nuriye gets a guarantee she can stay and we get a rent freeze for our entire housing project.” Of course they knew the minute they walked away from this barricade the police would tear it down and that would be the end of it. So one of my favourite people there, a woman called Tania who’s one of the punk squatters, went up to her apartment and got a klaxon, those things that make loud noises at soccer matches, and said, “Okay we’re going to draw up a timetable to man this barricade 24 hours a day until we’ve got guarantee Nuriye can stay, we’ve got a rent freeze for all of us. We’re not going to stop until we’ve got what we demand.” So people start signing up to man this barricade. People who would never have met. Tania in her tiny punk miniskirt paired up with Nuriye who’s a very religious Muslim in a full hijab to do the Thursday night shifts. And the first few nights they were like, “We’ve got nothing to talk about. We couldn’t have less in common.” As the nights went on they started talking. They realised they had something incredibly powerful in common. Nuriye had come to Berlin when she was 16 with two babies. She was meant to earn enough money to send back home for her husband in Turkey to join her. She was there for a year and a half, worked every job she could, was looking after her babies as best she could. Then sitting there in the cold with Tania, she told her something she’d never told anyone in Germany before. She’d always told people that her husband in Turkey had died of a heart attack. In fact, she told Tania, he died of tuberculosis which was seen as a shameful disease of poverty at that time. That’s when Tania told Nuriye something she never talked about. Tania had come here when she was 15, thrown out by her middle class family ’cause they thought it was insane that she loved punk. She got pregnant not long after she arrived. They realised they both had children at the same age, alone in this place they didn’t understand. Lots of connections like this were happening during the protest. A young Turkish-German man who was about to be thrown out of school started learning from a grumpy old white guy. A homeless man with learning difficulties was protected by the community. The nearby gay club offered their premises and free food for meetings. And eventually they got a rent freeze for their entire housing project. They then launched a referendum initiative to freeze rents in Berlin. It got the largest number of written signatures in the history of the city. Berlin now has a rent freeze. But the last time I saw Nuriye I remember her saying to me, “I’m really glad I got to stay in my neighbourhood. But I gained so much more than that. I was surrounded by these amazing people all along. And I would never have known.” I remember one of the Turkish-German women who was a big part of the protest said to me, “When I grew up in Turkey I grew up in a village. And I called my whole village home. Then I came to live in the western world and learned that here what you’re meant to call home is just your four walls. And if you’re lucky, your family.” She said when the protest began she started to call all these people and this whole place her home. She realised that in some sense, we are homeless in this culture. There’s a wonderful Bosnian writer, Alexander Hayman who said home is where people notice when you’re not there. By that standard we are homeless in this culture.

It’s such a beautiful story. It’s so clear that genuine place-based interdependence and face-to-face relationships are the foundations for a type of care that creates healthy, secure and strong identities—identities that have much greater tolerance and respect for diversity. And what emerges from that is a profound compassion for all life. Which was true in most spiritual traditions throughout the ages. The same messages telling us that if you strive for wealth, if you strive to be better than your neighbours, if everything is based on comparison you’ll be forever unhappy is also true in Buddhism. They were reinforcing a way of life where that deep interdependent community and neighbourhood was a fact.

That’s so important. And those Buddhist ideas, as I understand it, were almost like the formalisation of the practice of living in embedded communities. And in a much more disturbing way—and I want to phrase this carefully—we could say Donald Trump is an expression of the sickness of the culture. Right? Donald Trump is the worst of the culture. There’s a lot of positive aspects in our culture. But if you look at Trump, he’s a profoundly lonely person, he has literally no friends. He is a person who on his terms has won the game. He’s the most powerful person in the world, he owns golden towers everywhere. Yet he is as unhappy a person as you will ever see. You can tell just by looking at him. I will stress again, Trump is a very extreme manifestation of this, he’s not the norm, but the fact that this society has produced Trump just like the fact that an embedded healthy community produced those Buddhist ideas is not a coincidence. The fact that this society’s produced Trump is like a horrific mirror which we can look into and say, “This is what these values have produced. We really need to choose a different path, because otherwise this is where that path will take us.”

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