0:00:18.640,0:00:21.577
Even before I became a psychiatrist,

0:00:21.578,0:00:25.559
I have always been fascinated[br]by human connection.

0:00:25.959,0:00:31.196
What makes us connect with others,[br]and what makes us disconnect?

0:00:31.580,0:00:36.004
All of us, at some point,[br]have been on a plane,

0:00:36.005,0:00:39.060
when we have just settled into our novel,

0:00:39.061,0:00:43.014
we are listening to music,[br]or getting our work done,

0:00:43.424,0:00:49.770
when suddenly, the air is pierced[br]by the sound of a shrieking baby.

0:00:49.771,0:00:51.021
(Laughter)

0:00:51.431,0:00:55.290
Now, I have watched[br]all kinds of reactions to this

0:00:55.291,0:00:58.950
from the very sympathetic look[br]toward the parents

0:00:58.951,0:01:02.926
to people who look[br]mildly annoyed or even frustrated,

0:01:02.927,0:01:03.966
to others

0:01:03.967,0:01:07.836
literally racing each other to the one[br]empty seat at the front of the plane

0:01:07.837,0:01:10.262
to get away from this noise.

0:01:10.782,0:01:16.654
But on a recent trip to the West Coast,[br]I saw the most amazing reaction of all.

0:01:17.241,0:01:21.630
A little three-year-old little boy[br]wiggled out of his seat,

0:01:21.631,0:01:28.238
toddled over to that screaming baby,[br]and offered him his own pacifier.

0:01:28.239,0:01:30.158
(Laughter)

0:01:30.159,0:01:31.488
"Wow!", I thought,

0:01:31.489,0:01:37.257
that little boy really heard and felt[br]the baby's distress."

0:01:37.258,0:01:39.416
And isn't that what all of us want?

0:01:39.417,0:01:43.992
To be seen, and heard,[br]and to have our needs responded to?

0:01:43.993,0:01:46.699
That's the essence of empathy.

0:01:47.499,0:01:53.260
So, about ten years ago, a student of mine[br]called me up with a fascinating idea.

0:01:53.261,0:01:55.412
He wanted to find out,

0:01:55.413,0:01:59.035
when there was empathy between people,

0:01:59.036,0:02:02.295
weather their heart rates[br]and other physiological tracers

0:02:02.296,0:02:05.853
actually matched up in concordance.

0:02:05.854,0:02:11.072
And he wanted to recruit[br]many doctor-patient pairs,

0:02:11.073,0:02:14.626
who were willing to have[br]their sessions videotaped

0:02:14.627,0:02:18.499
and to be hocked up to monitoring[br]during those sessions.

0:02:19.292,0:02:22.764
It took a bit of arm twisting for me[br]to agree to do this,

0:02:22.765,0:02:27.329
but it turned out to be[br]a career-defining decision.

0:02:28.065,0:02:30.815
One of my patients[br]who agreed to participate

0:02:30.816,0:02:35.510
was a young college woman[br]who had come for help with weight loss.

0:02:35.511,0:02:39.863
She made progress in many areas,[br]but not this one.

0:02:40.243,0:02:44.632
So, we were hooked up[br]to this skin conductance monitoring,

0:02:44.633,0:02:50.284
which, it turns out, actually can show[br]weather two people are in sync,

0:02:50.285,0:02:52.615
as you see on this slide,

0:02:53.015,0:02:55.790
where the physiology[br]actually mirrors one another

0:02:55.791,0:02:57.518
between the doctor and the patient

0:02:57.519,0:03:01.800
or if they are out of sync,[br]or if there is discordance.

0:03:02.270,0:03:06.228
So, later that afternoon,[br]my student called up, and he said,

0:03:06.236,0:03:08.565
"You have got to come over and see this!"

0:03:08.566,0:03:14.787
So I went down, I looked at our tracings,[br]and I was blown away.

0:03:14.788,0:03:20.104
This calm, very self-confident[br]appearing woman,

0:03:20.105,0:03:22.624
very articulate,

0:03:22.625,0:03:26.672
turned out to have massive anxiety.

0:03:26.673,0:03:29.999
So, our tracings[br]were actually quite in sync,

0:03:30.000,0:03:35.032
except that hers was going like this,[br]while mine was going like this.

0:03:35.033,0:03:40.353
And I had not realized[br]what was going on inside of her.

0:03:40.354,0:03:44.431
When I showed[br]the tracing to her, she said,

0:03:44.432,0:03:46.749
"I am not surprised by this at all.

0:03:47.279,0:03:50.067
I live with this every day,

0:03:50.527,0:03:55.727
but no one has ever seen my pain."

0:03:56.647,0:04:00.511
Not only as her doctor[br]but as a fellow human being,

0:04:00.512,0:04:03.022
this moved me to the core.

0:04:03.602,0:04:09.502
So I went back, watched that video -[br]this time, as an emotion detective -

0:04:09.503,0:04:15.328
and tried to see what was happening,[br]because clearly, I had missed something.

0:04:15.329,0:04:19.148
I noticed that the highest peaks[br]of her tracings

0:04:19.149,0:04:21.846
coincided with[br]these subtle motor movements

0:04:21.846,0:04:25.679
such as just flicking her hair,[br]or looking down in a way,

0:04:25.680,0:04:29.105
or subtle changes in her tone of voice.

0:04:29.106,0:04:30.595
Our work continued

0:04:30.596,0:04:34.749
and as I paid attention to these signs[br]and responded to them,

0:04:34.750,0:04:37.170
our work went to a much deeper level.

0:04:37.171,0:04:40.379
She unburdened herself emotionally

0:04:40.380,0:04:43.864
and started to exercise[br]for the first time in her life.

0:04:43.865,0:04:45.374
And this woman,

0:04:45.375,0:04:49.227
who had only gained weight[br]and never lost weight before,

0:04:49.228,0:04:54.020
went on to lose[br]almost 50 pounds in the next year.

0:04:54.759,0:04:56.777
This was groundbreaking for her.

0:04:56.778,0:04:59.687
It was also groundbreaking for me

0:04:59.688,0:05:04.272
because I realized[br]that with this careful attention,

0:05:04.273,0:05:06.520
I had learned to be more emphatic.

0:05:06.521,0:05:08.408
Now, back then, everyone thought

0:05:08.409,0:05:11.358
that empathy was something[br]that we were born with or without,

0:05:11.359,0:05:15.515
and that we were kind of stuck with[br]whether we were or we were not.

0:05:16.170,0:05:19.884
Imagine what implications there were

0:05:19.885,0:05:24.113
if doctors, nurses, teachers, employers,

0:05:24.114,0:05:27.113
parents, boyfriends, and girlfriends

0:05:27.114,0:05:30.028
could learn to be[br]more emphatic with each other.

0:05:30.738,0:05:36.371
So I learned everything I could about[br]the neuroscience of empathy.

0:05:36.943,0:05:40.518
And this was a very growing field[br]at the time.

0:05:40.808,0:05:44.657
And through what I learned,[br]I developed empathy training.

0:05:44.787,0:05:50.921
And this training was grounded in[br]the neurobiology of emotions and empathy,

0:05:50.929,0:05:55.859
And the training went on to be tested[br]in a randomized control trial

0:05:55.860,0:05:58.338
at Massachusetts General Hospital,

0:05:58.339,0:06:02.643
where doctors that were rated[br]by their patients,

0:06:02.644,0:06:04.713
were rated much more higher

0:06:04.714,0:06:06.770
if they were trained on,

0:06:06.771,0:06:10.185
"My doctor really listened to me,[br]really showed care and compassion,

0:06:10.186,0:06:14.075
treated me like a whole person,[br]and understood my concerns" -

0:06:14.076,0:06:17.264
some of the components[br]of the empathy scales -

0:06:17.265,0:06:19.653
than the untrained doctors.

0:06:20.023,0:06:25.314
So, this seemed like[br]a very important message to get out,

0:06:25.321,0:06:30.118
because some of my training[br]is just about opening your eyes

0:06:30.126,0:06:33.829
to the receptive and perceptive aspects

0:06:33.830,0:06:36.830
of empathy into the empathic responses.

0:06:37.160,0:06:41.299
To make it easier, I created[br]the acronym E.M.P.A.T.H.Y.

0:06:41.300,0:06:43.248
which actually lends itself

0:06:43.249,0:06:46.918
to remembering the key pieces[br]of how we connect to people.

0:06:46.919,0:06:49.923
So, the 'E' stands for eye contact.

0:06:50.373,0:06:54.223
Eye contact is usually[br]the first indication

0:06:54.224,0:06:58.971
that we've been noticed by someone,[br]even though cultural norms can vary.

0:06:59.651,0:07:06.364
Also, eye gaze goes back[br]as early as maternal infant bonding.

0:07:06.380,0:07:10.972
It turns out that the infant's[br]sharpest focal point is 12 centimeters,

0:07:10.973,0:07:15.052
which is the exact distance[br]between a baby's eyes and a mother's eyes,

0:07:15.053,0:07:17.815
when the baby is held like this.

0:07:19.045,0:07:22.603
Eye gaze is also important

0:07:23.123,0:07:27.092
when we say hello or greet one another.

0:07:27.093,0:07:31.270
In our country, our greeting[br]is usually "Hi" or "Hello."

0:07:31.400,0:07:34.576
In the Zulu tribe, the word for 'hello'

0:07:34.577,0:07:38.867
is "sawubona" which means "I see you."

0:07:39.277,0:07:45.385
Every human being has a longing[br]to be seen, understood, and appreciated,

0:07:45.515,0:07:50.243
and eye gaze is[br]the first step toward this.

0:07:50.244,0:07:53.328
The 'M' stands for muscles[br]of facial expression.

0:07:53.329,0:07:58.948
The human face is the one part of us[br]that we almost never fully cover up.

0:07:58.949,0:08:02.914
Our faces are actually a road-map[br]of human emotion,

0:08:02.915,0:08:04.914
and because of this,

0:08:04.915,0:08:08.529
our facial expressions[br]can not only save our lives

0:08:08.530,0:08:11.397
but can actually preserve our species.

0:08:11.398,0:08:14.613
Imagine the disgusted look[br]on someone's face

0:08:14.614,0:08:17.224
who's just eating rotten food

0:08:17.225,0:08:19.420
and can signal to a whole tribe

0:08:19.421,0:08:23.787
to stay away and save them[br]from getting sick or dying.

0:08:23.788,0:08:26.611
Or the look of startle[br]in your friend's face

0:08:26.612,0:08:30.135
just before a baseball is about[br]to hit you in the head,

0:08:30.136,0:08:32.796
and you might move[br]just in time not to get hit.

0:08:33.549,0:08:40.201
Also, the flirtatious glance[br]that's returned may be the first sign

0:08:40.202,0:08:43.416
that you have just found[br]the love you are looking for.

0:08:44.236,0:08:46.628
The 'P' stands for posture.

0:08:46.629,0:08:49.808
Posture is another powerful[br]conveyor of connection.

0:08:49.809,0:08:52.520
Our open or close postures signal

0:08:52.521,0:08:56.357
powerful approach and avoidance[br]signals to others.

0:08:56.358,0:08:58.116
In one study,

0:08:58.117,0:09:01.957
doctors, who were told[br]to sit down on rounds,

0:09:01.958,0:09:06.338
were rated as much warmer,[br]more carrying, and estimated

0:09:06.339,0:09:10.485
to have spent three to five times[br]longer with their patients,

0:09:10.496,0:09:14.926
than doctors how stood up[br]but used the exact same words.

0:09:15.779,0:09:18.203
The 'A' stands for affect.

0:09:18.204,0:09:21.677
We are trained to label[br]our patients' affect

0:09:21.678,0:09:27.185
as a way of orienting ourselves[br]to the emotional experience of the person.

0:09:27.186,0:09:31.035
Affect is the scientific term[br]for expressed emotions.

0:09:31.036,0:09:35.300
When you're with someone,[br]try just sort of labeling, you know,

0:09:35.301,0:09:38.673
"Is Jacob sad?", "Is Jane excited?",

0:09:38.674,0:09:42.338
"Is Sally upset?",

0:09:42.339,0:09:45.345
and it will change how you hear[br]what they are saying.

0:09:46.116,0:09:48.415
The 'T' stands for tone of voice.

0:09:48.416,0:09:49.802
We have all heard

0:09:49.803,0:09:53.974
the crack in someone's voice[br]who is about to cry.

0:09:53.984,0:09:56.731
We have also heard the edge[br]in someone's voice,

0:09:56.732,0:09:58.752
who is about to get angry.

0:09:59.395,0:10:01.905
The area in our brainstem

0:10:01.906,0:10:05.538
that is responsible for[br]the fight-and-flight response

0:10:05.539,0:10:07.173
is the same area

0:10:07.174,0:10:13.002
where the nuclei for tone of voice[br]and facial expression reside.

0:10:13.003,0:10:16.182
This means that when we are[br]emotionally activated,

0:10:16.183,0:10:20.714
our tone of voice and facial expressions[br]change without our even trying.

0:10:20.715,0:10:21.752
So, this means

0:10:21.753,0:10:26.879
that our emotions are constantly[br]kind of leaking out for all to see.

0:10:26.880,0:10:30.902
Some people's emotions are[br]a little more concealed than others,

0:10:30.903,0:10:37.600
but with careful looking, we can hear[br]and see what these emotions are.

0:10:39.507,0:10:42.798
The 'H' stands for hearing[br]the whole person

0:10:42.799,0:10:45.494
far more than the words that people say.

0:10:45.495,0:10:47.198
Hearing the whole person means

0:10:47.199,0:10:50.905
understanding the context[br]in which other people live.

0:10:50.906,0:10:54.816
It also means keeping your curiosity open

0:10:54.817,0:10:59.787
and not judging till you really understand[br]where that person is coming from.

0:11:00.354,0:11:03.712
The 'Y' stands for your response.

0:11:05.002,0:11:09.366
We respond to other people's[br]feelings all the time.

0:11:09.380,0:11:12.356
We might think that we only experience[br]our own emotions,

0:11:12.357,0:11:16.670
but we are constantly absorbing[br]the feelings of others.

0:11:16.671,0:11:22.528
It turns out that a helpful guide is[br]that most feelings are actually mutual.

0:11:23.888,0:11:27.830
Think about how you feel[br]when you're at the airport,

0:11:27.840,0:11:34.530
and you see a mother embracing her son,[br]who has just returned from active duty.

0:11:35.360,0:11:39.247
Think about how you feel[br]when you see the face of a father,

0:11:39.248,0:11:43.862
who has just lost his daughter[br]to dating violence.

0:11:43.863,0:11:47.742
Think about how you feel[br]when you see the looks on people's faces

0:11:47.743,0:11:51.313
who have lost their homes[br]to hurricanes and tsunamis.

0:11:51.328,0:11:53.733
And the look on parents faces

0:11:53.734,0:11:57.924
who have just lost their children[br]to school shootings.

0:11:58.317,0:12:03.218
Our inner experience and feelings[br]mirror those of others.

0:12:04.798,0:12:09.616
Our human brain is actually[br]hardwired for empathy

0:12:09.617,0:12:12.295
because our survival depends on it.

0:12:13.265,0:12:16.499
We reflect the feelings of others

0:12:16.500,0:12:20.810
because that's what is required[br]for our survival.

0:12:20.811,0:12:25.517
We all are here more[br]because of mutual aid and cooperation

0:12:25.518,0:12:28.441
than because of survival of the fittest.

0:12:28.442,0:12:31.283
If we were only wired[br]for survival of the fittest,

0:12:31.284,0:12:36.067
we'd be wired to dominate others[br]and to only look out for ourselves,

0:12:36.068,0:12:38.502
but that's not how we're made.

0:12:39.022,0:12:41.294
As the Dalai Lama said,

0:12:42.244,0:12:47.018
"Love and compassion[br]are necessities not luxuries.

0:12:47.019,0:12:51.554
Without them, humanity will not survive."

0:12:52.701,0:12:54.468
So, how does this all work?

0:12:54.469,0:12:58.871
We've all heard the expression[br]"I feel your pain."

0:12:58.872,0:13:02.149
Now, for a moment,[br]imagine you are in a parking lot,

0:13:02.150,0:13:06.508
and you've just seen someone's hand[br]get slammed in a car door.

0:13:06.938,0:13:08.826
Now, I've seen people flinched,

0:13:08.827,0:13:11.338
even though nothing's[br]actually touched them.

0:13:11.339,0:13:16.971
And most people will actually feel like[br]something physical just by imagining it.

0:13:17.571,0:13:20.949
Neuroscientists have done[br]some amazing studies

0:13:20.950,0:13:24.305
trying to map the substrate of empathy.

0:13:24.985,0:13:26.563
In one study,

0:13:27.973,0:13:33.583
16 couples were recruited,[br]and the women were put in head scanners

0:13:33.586,0:13:37.656
while they received[br]painful electric shocks to their hands.

0:13:38.326,0:13:41.905
As you can see here,[br]the area in green represents

0:13:41.906,0:13:47.535
that the entire pain matrix lit up[br]when they received the shocks.

0:13:48.375,0:13:49.908
Later, they were told

0:13:49.909,0:13:55.875
that their partners had just received[br]the same similar shocks to their hands

0:13:55.935,0:14:01.495
and you see the area in red[br]represents almost the entire pain matrix;

0:14:01.496,0:14:05.371
just knowing that someone else is in pain.

0:14:05.372,0:14:10.776
Our brains are working[br]with shared neural circuits,

0:14:10.777,0:14:14.502
shared neurons, and some mirror neurons

0:14:14.503,0:14:18.549
so that we actually have[br]an internal experience

0:14:18.550,0:14:21.519
of what happens to others.

0:14:21.520,0:14:25.027
So, when we hear the expression[br]"I feel your pain,"

0:14:25.028,0:14:27.551
it is not just a figure of speech;

0:14:27.552,0:14:31.863
we're made for this, and it happens[br]not just with our loved ones.

0:14:32.375,0:14:37.503
We are at a critical precipice[br]with technology.

0:14:39.103,0:14:44.186
Outsiders coming in and observing[br]our society might guess

0:14:44.187,0:14:49.112
that we have more intimate relationships[br]with our smartphones

0:14:49.113,0:14:51.545
than we do with our significant others.

0:14:53.155,0:14:57.541
Cyberbullying is probably on the rise[br]because it is much easier

0:14:57.542,0:15:01.713
to inflict harm on people[br]whose pain you never see.

0:15:03.158,0:15:07.405
It is much harder to have[br]a meaningful conversation,

0:15:07.406,0:15:12.696
if what you're used to[br]is 140-character tweets.

0:15:12.697,0:15:16.828
And how do you know whether to say,[br]"Do you need for me to come over?"

0:15:16.829,0:15:23.491
if what you have just gotten is a text[br]that says, "Lousy day" with an emoticon?

0:15:24.311,0:15:26.435
As Jonathan Safran Foer said,

0:15:26.436,0:15:32.875
"When we accept diminished substitutes,[br]we become diminished substitutes."

0:15:33.805,0:15:37.531
So, the good news about empathy

0:15:37.532,0:15:42.232
is that when it declines,[br]it can also be learned.

0:15:43.092,0:15:46.929
Employers who want to have[br]an engaged and productive work force

0:15:46.930,0:15:50.086
need to get tuned in to the people.

0:15:50.087,0:15:52.601
Patients who don't feel cared about

0:15:52.602,0:15:58.055
have longer recovery rates[br]and poorer immune function.

0:15:58.225,0:16:02.698
Students who are disengaged[br]are more likely to drop out,

0:16:02.699,0:16:06.635
and marriages without empathy[br]are more likely to fail.

0:16:06.636,0:16:11.538
So, empathy matters[br]in every corner of your life.

0:16:12.501,0:16:18.178
As the Zulu say[br]not 'Hello', but 'I see you, '

0:16:19.719,0:16:25.862
we all need to see each other[br]to bring out the full potential in others.

0:16:26.412,0:16:32.914
Most people need to have their specialness[br]reflected back in the eyes of others

0:16:32.915,0:16:35.688
in order to see it themselves.

0:16:35.689,0:16:39.750
Everyone in this audience[br]has the power to do this.

0:16:39.751,0:16:41.755
And when we empower others,

0:16:41.756,0:16:46.888
we can collectively come together[br]to bring our best selves,

0:16:46.889,0:16:53.745
to solve the world's biggest, smallest,[br]and most vexing problems.

0:16:53.746,0:16:56.844
That is the power of empathy.

0:16:58.006,0:16:59.236
(Applause)