Relationships 2.0: The Price of Disconnection

The transcript below may be for an earlier version of this episode. Our transcripts are provided by various partners and may contain errors or deviate slightly from the audio.

Shankar Vedantam: This is Hidden Brain, I'm Shankar Vedantam. Some years ago, a homeless woman was being discharged at a Philadelphia hospital. On her way out, nurses noticed the woman was wearing flip-flops. It was January, and Januaries in Philadelphia can get very cold. Nursing director Julie Munger had an idea. Her daughter was a basketball player and had left a bunch of old sneakers in the trunk of Julie's car. Would one of those pairs fit the homeless woman? They went out and took a look, but the shoes were all a size and a half too small for the woman's feet. That's when Julie told a reporter from WTXF-TV, things took an unexpected turn.



Julie: So as I was leaving, she's like, your shoes are nice. I said, well, what size are your feet?



Shankar Vedantam: And she's like, a 10. Julie looked down at her own shoes. They were a size 10. They were also super comfortable, and she loved them.



Julie: I'm like, these are a 10. Do you want these? And she just cried and thought it would be great. So I just gave her the shoes.



Shankar Vedantam: Julie unlaced her shoes and handed them to the other woman. Perhaps you've had experiences like this yourself. Our sister show, My Unsung Hero, often features stories like this where people reach out to help one another in unusual acts of generosity. But the reason these stories stand out is because they're at odds with the way most of us feel treated as we go about our days. We don't feel seen and heard. We feel ignored and passed over. This week on Hidden Brain and in a companion story on Hidden Brain+, we examine the reasons behind the growing disconnection in our schools, hospitals, and workplaces, and what we can do about it. It's also the start of a series that has long been a favorite with listeners, Relationships 2.0. In the coming weeks, we will look at the art of negotiation and ways in which we can get along better with the people in our lives.



Shankar Vedantam: When boarding a train or subway or going shopping at the mall, we may take in hundreds of people at a glance. On a Zoom call for work, the faces of our coworkers fit into a grid. Even when we're spending time with close friends and family, our familiarity can get in the way of really seeing the person in front of us. Allison Pugh is a sociologist at Johns Hopkins University. She studies how we relate to one another and how this has changed over time. Allison Pugh, welcome to Hidden Brain.



Allison Pugh: Thank you so much for having me.



Shankar Vedantam: Allison, growing up, you were the youngest of five children. You have a story about the first new bathing suit you ever owned. Can you tell me that story?



Allison Pugh: Sure. The youngest of five, it was a generally loving environment. But I would say it was one, my mother still sometimes calls it benign neglect. So I did not get a bathing suit that wasn't owned by someone else until I was in college.



Shankar Vedantam: Wow.



Allison Pugh: And I went myself to a department store and picked out, I think, a pink bathing suit that I wanted. Instead of the scores of other kinds I had had over the years.



Shankar Vedantam: The Bathing Suit story is one of many incidents where Allison remembers she was seen as one kid in a crowd. It wasn't about being treated badly. It was about being ignored. Another time, Allison remembers coming home in middle school upset because some boys in her school were bothering her. She told her mother what had happened.



Allison Pugh: I remember coming home kind of full of outrage and being like, this is not OK. They shouldn't be doing this. And I was trying to figuring out. I just did not handle it. And she did not take it seriously at all, unfortunately. She just kind of said, oh, that's because they like you. That was her rationale. And at the time, I remember a really sharp disjuncture between my own, I would say, half-desperate outrage and her kind of semi-humorous, oh, you know, they just like you.



Shankar Vedantam: So you felt that you weren't really seen by your mom?



Allison Pugh: No, that was a big moment of a kind of cognitive dissonance between what I thought was going on and her response, for sure. I did not feel seen.



Shankar Vedantam: Allison is now a mom of three daughters herself. She remembers one incident when the shoe was on the other foot.



Allison Pugh: At the time we were living in California, and there would be old boxes or, you know, interesting rocks or, you know, kind of things that they'd be on the sidewalk, obviously either somebody, part of nature that was just there, or some things that other people were putting out for either garbage or for people to pick up. And my daughter was always the one to pick them up. So she had a name for them. She called them her inventions. She was very young. I think she meant that they were a kind of art, or maybe that she was inventing, that she would be imagining what she could do with them or something. But I really viewed them as junk. I actually threw them out, and she still remembers that and reminds me. And to me, it's really a primary moment of me not seeing her and how she viewed these small, we'll call them treasures.



Shankar Vedantam: Allison started to notice these moments of unseeing or misseeing as she went about her days. One time, during a visit to a new doctor, her physician did a quick evaluation, saw some elevated numbers, and advised Allison to eat fewer cookies. Now, Allison happens to love cookies, but she also wanted to tell the doctor, shouldn't you learn more about me and my lifestyle before leaping to a conclusion?



Allison Pugh: It didn't land well at all. You know, I just, I have a very unusual lifestyle, I think, that she probably doesn't see very often because I row crew, and I have done so for 30 years. And right now, I'm involved in a team that's very intense in Washington, DC, which involves one to two hours daily. I also don't have any caffeine, I don't have any alcohol. There's just, I think I'm an unusual person health-wise. And so when she was like, these are elevated, try not to have so many cookies, she didn't see the person she was talking to. She didn't really have all that context that can produce a good witnessing moment, and along with it, good advice.



Shankar Vedantam: And I think many people have these experiences, right? You go to the doctor, and even if the doctor is very competent, he or she spends all their time staring at a computer screen and asking you questions and glancing at you once every 15 seconds. I think many of us have had experiences like that. And you have the sense, is my doctor actually listening to me or watching me or seeing me or not?



Allison Pugh: Yeah, the fabulous writer Abraham Verghese has called that the eye patient, that we're all to some degree an eye patient, meaning a patient that exists almost more by computer than in our holistic embodied selves in front of each other. And that, if that is how you feel, that often will affect whether or not you do what they say. Like it's going to take a lot more than that to have me stop eating cookies.



Shankar Vedantam: So as a sociologist, Allison, you've conducted some of your research by carrying out dozens of in-depth interviews. A few years ago, you interviewed a chaplain whom you call Hank. It was a very intense conversation, but at the end of it, he had something to tell you about what the exchange meant to him. Tell me that story.



Allison Pugh: Sure. Yeah, Hank. He started off as a minister in a very large church in the Washington, DC area. And he started a whole bunch of programs for low-income youth in the community. So he started tutoring centers and I think sports camps and all sorts of things to try and reach kids. And by his account, he did reach them. They would come to his tutoring centers and they would kind of hang out with him and share stories. And he felt like he had attained some real connection to those youth and he was so proud of it as he's telling me. And then he gets a job in another city, moves there, but he ends up losing that job and feeling really defeated in that moment. And so he leaves that and he comes to be a chaplain in the hospital in which I was doing some observations. And so he talks to me about this trajectory. And at the very end of the exchange, he talked to me about what it was like to be interviewed. And he said this was very powerful. And then he said, therapeutic, almost.



Shankar Vedantam: And this is not true just of Hank, right? You've heard this from other people as well?



Allison Pugh: Oh yeah, it's something that's very common. People who often say, oh, this was just like therapy. It's not like therapy because I'm not really there to solve any problems or really to counsel them in any way. And they know that. So it's more like, it's the language we have for that feeling of being seen.



Shankar Vedantam: Allison started to see that the act of really noticing another person, paying attention to them, being present for them, this was not just something that was nice to have. It was something that people craved. She heard from one doctor who told her that her patients often seem to need this kind of attention more than her medical expertise.



Allison Pugh: Yeah, so, Greta was a pediatrician, and she was kind of surprised when she first started her practice how much she was supposed to be attending to the mothers rather than the children. That that was something that was a surprise to her. She often found herself giving, say, parenting advice or talking about car seats or talking about what it's like when you can't get any sleep or something like that. And the mothers kind of desperately needed that. She felt their need on the other end, but she often felt like she told me she didn't feel like she was practicing on the top of her medical license. That was the language she used to mean that she had all this expertise in children and children's symptoms and diseases and disorders. And really the bulk of her job was about like kind of listening, hearing, and being attuned to what the mothers were saying. And she ultimately ended up saying, you know, the mothers don't need me. They need an hour with a good listener.



Shankar Vedantam: I mean, all these stories in some ways reflect something that is an underlying theme here, Allison, which is that when we are not seen, when we're not heard, you know, we notice it. You know, we bring home a set of rocks and twigs, and our mom throws them out, and, you know, it feels like a big deal to us, even though it doesn't feel like a big deal to the other person. On the other hand, someone spends 10 minutes listening to you and looking you in the eye. It makes a huge difference to us. Talk about just the emotional effect of feeling seen and feeling unseen.



Allison Pugh: Yeah, I think that's the most important dimension of this, for me, is the emotional impact, because so many of the other impacts get kind of carried on along on the emotional impact. The emotional impact of being seen, people feel like they have dignity, people feel like they have understanding, people feel like they have purpose. Those are all things that other researchers, as well as my own research, has found. And when you're not seen, it can really dissuade you from following good advice, because you don't hear the good advice. You don't think that it's relevant to you, or it doesn't feel like it recognizes the particularities of your situation.



Shankar Vedantam: None of us wants to be just another face in the crowd. All of us want to be seen for the unique individuals we are. And yet, the experience of being seen in this way can be dispiritingly rare. When we come back, the psychological benefits of being seen and why it often doesn't happen. You're listening to Hidden Brain. I'm Shankar Vedantam. This is Hidden Brain, I'm Shankar Vedantam. Allison Pugh is a sociologist at Johns Hopkins University. In the course of conducting detailed interviews with people, she came to see she was performing a sort of therapy. She wasn't trying to be a therapist, but the people she talked with reported the experience of being deeply seen and heard felt therapeutic. Allison, as you noticed the effects of people feeling seen, you started to recognize the importance of this in different settings. You noticed this in your kids' schools, in doctors' offices, in community settings. In fact, you started to see this everywhere.



Allison Pugh: That's right. It's kind of most obviously true for therapists. It's also true for teachers. It's also true for primary care physicians. So those seem like almost the most obvious cases. But it's also true for, I interviewed people who were like community organizers. I interviewed people who were funeral home directors, home health care aides, sex workers, even police. I interviewed a detective. I interviewed somebody who works with prison guards, people you wouldn't expect to be particularly empathetic, or who themselves might not talk about relationship as an important part of their work. But seeing the other is part of how people do their jobs across many occupations.



Shankar Vedantam: When people sign up to be therapists, they know their job is to listen to other people, to try to really see them. But what Allison noticed was that people who went into lots of other fields were also discovering that an essential component of their jobs was paying close attention to the people around them. Being a great detective or dancer or computer programmer involves being skilled at human relationships. Allison started to call this work of seeing and hearing other people connective labor.



Allison Pugh: Connective labor is the act of seeing the other and the other feeling seen. This is very common in sales, for example. If you want to sell something to somebody, they're more likely to buy it if you convey to them that you see that they have a particular problem that this solves, or you see that they have a particular approach that this kind of works with, or whatever, you know, like the seeing is kind of the engine powering so many different outcomes that we are pointing at and thinking about that is so important in so many different occupations.



Shankar Vedantam: I mean, on the surface, you know, we might say we are sending a kid to a school because we want the kid to learn, you know, writing or algebra, or we go to a doctor because we want to get a treatment for an illness. But what you're saying is that underlying those things actually happening, underlying someone learning algebra, underlying someone listening to their doctor, involves this system of trust and feeling seen. And if you're not, if you don't experience that, you're much less likely to say, I want to play along.



Allison Pugh: Exactly. What I felt was not known is how much these different occupations have in common and how it extends well beyond prototypical ones. So, like, the hairdresser also needs to be able to see you, to be able to give you a haircut that you want and have you accept that haircut. And, you know, like, it's actually a dynamic. And that dynamic is common in many different kinds of jobs, not just, you know, the ones that have articulated how important relationships are.



Shankar Vedantam: Connective labor can often be invisible. But when people don't have the skill to see and hear those around them, the lack of this invisible thing, it suddenly becomes very visible. Allison says, connective labor is like engine grease. When you don't have it, the engine might still run, but you're going to hear some screeching sounds.



Allison Pugh: So, you can force yourself to learn, even though you hate that teacher, and they're not really seeing you, and you're sitting in the back of the class, and you can kind of roll that rock up the hill, but it's not going to be a pleasant or joyful experience, and also you probably won't go as far as you could go. And that's true in many different fields.



Shankar Vedantam: I love the analogy to engine grease because it truly is, at some level, it's invisible, but yet when it's not there, you can see the results very plainly.



Allison Pugh: Mm-hmm, exactly, yeah.



Shankar Vedantam: I think there's an assumption that the work of seeing and caring for people is largely women's work. You say that this assumption leads us to overlook the connective labor that many men perform, both in the workplace and in communities?



Allison Pugh: Absolutely. This concept of connective labor, I'm really thinking of, it can be deployed for all kinds of reasons. So it could be deployed for well-being, as, you know, the teachers or the therapists might do, but it could also be deployed for like persuasion, you could say, and that might be the salespeople, or it could be deployed for control, and that might be as, you know, the hostage negotiator or the detective, or, you know. So many of those jobs, I'm sure you can hear, are occupied by men. So I think, for instance, lawyers definitely need this, judges need this, and many of those are occupied by men.



Shankar Vedantam: So when you started talking about connective labor in public, did people resonate with that idea? Did people recognize what that was, Allison?



Allison Pugh: People would definitely come up to me afterward and say, you know, I'm a nurse, and thank God that you are writing about this, because I need to be able to go back to my employer and say, you know, I'm doing more than bedpans. I'm doing more than, you know, medication timing. You know, this is important work of sitting and seeing the patient, you know, or the client, and they felt, I suppose they felt seen themselves, but it felt like it had important potential impact for them in their conversations about their work.



Shankar Vedantam: So when you started talking about connective labor in talks about your research with people, people would recognize that this was an important part of what it is that they were doing. But you say that they used the word magic to describe the power of connection, that they themselves had seen firsthand, that when they connected with other people, magical things seemed to happen.



Allison Pugh: Yeah, they definitely used the word magic to describe what they saw of the effects of seeing patients or students. You know, people definitely would come up and describe it as magical. I think they used that word because we don't really understand it well. It's tied to this invisibility in that there's this really important process that's happening underneath all these economic tasks that we value, and this kind of underlying process, shadowy, opaque. We don't understand it well, and that's why people use the word magic, because it feels like it just comes upon us as this great gift without really understanding what goes into it and what produces it.



Shankar Vedantam: I mean, I think we've all been in workplaces where, you know, perhaps, you know, one boss is replaced by another boss, and the new person basically, you know, really has a human touch to them. And within, you know, days or weeks sometimes, you know, a very toxic environment can be transformed, and people are suddenly working together, and they're cooperating together. And it does feel, you know, quite magical that something could have happened that quickly.



Allison Pugh: Yeah, I mean, I've had that experience. And what I like about that example, actually, is that you're talking not just about, you know, the impact of one person seeing you, but also how we can create a kind of culture in which people are seeing others, that you're not the only person doing the seeing. So it really, a warm, competent leader can make an enormous difference, in part by catalyzing this kind of magic.



Shankar Vedantam: You've tried to pinpoint the benefits of connection in different domains. One study by a group of researchers in Finland found that this type of connection helps us manage our emotions.



Allison Pugh: Yes, I love that study. I think it's so well done. What they did was they had pairs of people who don't actually know each other tell stories to each other. And then they measured, I guess they had, you know, kind of wires attached to them while they did this, but they measured the emotional arousal of the storyteller and the story listener. And they found that when the listener conveyed that they heard and understood the other person, and you can imagine that's through nods or facial expressions or encouraging noises, the storytellers actually noticeably benefited. They felt calmer, their emotional arousal decreased, and the more their listeners conveyed this kind of affiliation, the stronger the impact. And meanwhile, it also had an impact on the listeners. So the more the listeners were allied in this way, you know, nods, facial expressions, encouraging noises, etc., the more they experienced increased arousal. So it was like the arousal moved from the storyteller to the listener as the storyteller was telling the story and as the listener was conveying that they understood and saw the other person. And so it was a real sharing or spreading of the emotional load. It's a really beautifully designed study.



Shankar Vedantam: In your own research, you followed a chaplain you call her Erin as she went about her rounds at a hospital, and she recounted an incident where she helped a patient regulate some very intense emotions. Tell me the story she told you.



Allison Pugh: Sure. Erin, she sees one patient who is intubated and he is so angry at being intubated. He didn't want to be intubated, even though the doctors told him he had to be because he would die otherwise. He couldn't speak, obviously, through the tube. He also couldn't write because he was on, I guess, medications that made that difficult. So he's just steaming full of fury. And then comes Erin and she sees him. And she sees this bottled up anger. And she says, you know, why don't you take this Kleenex box and throw it, throw it against the wall? And he was so astounded, so relieved and powerfully moved by that, that he like grabs her arm and pulls her in. And she sits with him for, you know, 15 minutes or 20 minutes. And then the next time she sees him, it's about, it's a couple of days later, and he's emerged from the procedure and he's no longer intubated. And he says to her, there is nothing like being in the worst moment of your life. And you feel like someone understands you. And that is such a perfect capture of what being seen feels like and what it can do for you in your worst moment.



Shankar Vedantam: And of course, the fact that she was sitting with him and holding his hand, it doesn't take away or change any of the physical things that he's going through, but some of what he's going through is not just physical. He's also experiencing emotional pain, and presumably Erin was able to reduce some of that pain.



Allison Pugh: Exactly. And there's actually a lot of research by psychologists and neuroscientists that show that, you know, when someone's holding your hand, it can alleviate pain. But here's an articulated moment where Hiram, the patient, is saying to Erin, you saw me, and that was transporting.



Shankar Vedantam: A feeling of connection might also help us learn new things. What have researchers discovered about the effects of being seen and heard for students, Allison?



Allison Pugh: So this is a really voluminous area. I have a couple of favorites. One author reviewed a thousand articles with 355,000 students, and came away with, you know, this meta-finding that, you know, among school-age children, he says, the effect size of teacher-student relationships is bigger than most typical educational innovations or curriculum changes. So, like, the teacher-student relationship that underlies whether or not someone is learning algebra or can, you know, parse a sentence, that is more powerful, has a greater impact than, say, standard curriculum changes or other innovations. You might expect that to be true for the younger kids, maybe, but maybe less true for middle school or high schoolers, and actually, it's the opposite. The effect sizes are larger in studies that are conducted in higher grades. And teacher-student relationships are even more important when kids are academically at risk, you know, kids from disadvantaged economic backgrounds, for example, and kids with learning difficulties. So, it's like even more important for adolescents even though we don't usually structure those schools to enable it to happen very well.



Shankar Vedantam: So this type of emotional connection also seems to be related to physical health. We touched on this a little bit earlier in our conversation, Allison. What is the effect on patients of feeling seen and heard by their doctors?



Allison Pugh: There's a lot of research that talks about how being seen by one's doctor leads to better health outcomes and leads directly to patient well-being. And my favorite, perhaps, study here is a meta-analysis that has extremely strict inclusion criteria. So it's only randomized, controlled trials in which the relationship between doctor and patient is experimentally manipulated. So they tell the physicians to do or don't make eye contact or do or don't interrupt, etc. And based on that, these scholars, researchers, conclude that the impact of clinician-patient relationship on health outcomes was significant and exceeded that of taking an aspirin every day to ward off heart attacks.



Shankar Vedantam: Wow. So I mean, it has sort of actual physical consequences here, not just psychological consequences.



Allison Pugh: Exactly. I mean, think how many people take an aspirin every day to ward off heart attacks. And this is something that actually exceeds even that.



Shankar Vedantam: You know, an experience of being seen by a chaplain or a teacher or a doctor can be quite intense. But research has also found that, you know, being seen by a passing acquaintance can also make a difference to our well-being. We featured Gillian Sandstrom and Liz Dunn on Hidden Brain before. Tell me about some of their work, looking at the effects of even casual acquaintances noticing us as we go through our day.



Allison Pugh: Yeah, they've done great work on this stuff. The first, the study that I most enjoy thinking and talking about is they experimentally varied how cafe customers interacted with baristas and then they measured their well-being afterward. And they gave some participants, they gave them instructions to like, you know, have a genuine interaction with the cashier, smile, make eye contact, and have a brief conversation. That was the social condition. And then they had the efficient condition. Those participants were told, make your interaction with the cashier as efficient as possible, have your money ready, and avoid unnecessary conversation. And it found that people who took the time to have a social interaction with the barista, that increased people's sense of belonging.



Shankar Vedantam: You know, the study and its two conditions point to one reason many of us don't stop to see one another. And that's because many of us, in fact, are frenetically busy and harried as we move through the day. And it's hard to notice the person in front of you when you feel like you have to be in two places at the same time.



Allison Pugh: Yes, that is a quite profound observation, actually, because what makes us busy? There's a couple of things that lead to it, but in the United States, a lot of times what makes you busy is an inordinate work schedule, kind of overworking, can really shrink the amount of time we have for the other parts of our lives. And if research like this suggests that if you don't kind of give the time and space to those unscripted, trivial encounters throughout your life, if you're always trying to make everything so efficient so that you can maximize the time that you have available for other pursuits, that can have well-being effects.



Shankar Vedantam: I mean, it is the case that sometimes when we see people who are masters of communication, people are just really good and fun to be around. They often have an unhurried air about them, and sometimes these are very busy people, but they somehow are able to communicate a sense that they're not in a rush.



Allison Pugh: Yeah, I mean, I've seen that too. I'm always amazed. One of my brothers, for example, is always really good at honoring the moment, kind of, just being there present with the other person, but he's also often late. And I, on the other hand, am really almost never late, and I really need to teach myself. I have needed to teach myself to pause, and, you know, who's this person that I'm kind of blowing by.



Shankar Vedantam: Yeah, I've had relatives like this as well who are often perennially late, but they're often people who are more than happy to have a conversation. And when, you know, they ask someone, how are you? And the person actually gives you a five-minute answer. They actually sit and listen, and they will ask follow-up questions. And then it's not surprising that they don't show up on time to wherever they're going.



Allison Pugh: Yeah, I mean, like, maybe we should, we who are not late should be more understanding that those who are are helping to knit us together as a society, you know.



Shankar Vedantam: Seeing others for who they truly are has many benefits, for their emotions, for their health, for their learning. It also has benefits for us, and yet many of us feel it occurs too infrequently in our harried world. When we come back, how to actually see another person and the surprising transformations this can produce in them and in us. You're listening to Hidden Brain, I'm Shankar Vedantam. This is Hidden Brain, I'm Shankar Vedantam. Allison Pugh is a sociologist at Johns Hopkins University. She's the author of The Last Human Job, the work of connecting in a disconnected world. Allison says it's possible for people to learn to get better at seeing other people. In fact, she teaches this skill to students.



Allison Pugh: Yes, I realized that the in-depth interviewing that I do that involves this kind of seeing is a clinical practice. And it's a clinical practice like nursing, and like teaching, and like therapy. And what do all of those professions have in common is they have an apprentice model of teaching in which someone does something in front of other people and then gets, you know, immediate feedback. One of the first things that they have to do is kind of get out of the way. And I often like to think about airspace as like a soccer ball and who is controlling the soccer ball. And you want to pass the soccer ball, you know. If you're too present, then the other person just doesn't have the space to put themselves in there. And that can preclude, that can impede seeing of the other for sure.



Shankar Vedantam: It's also the case that sometimes as people talk, you know, we have very quick interpretations of what it is that they're saying, and sometimes we have very quick reactions to what they're saying. Talk a moment about the importance of trying to set those things aside as well, setting aside, you know, our assumptions and expectations in order to be truly good listeners and how difficult that can be to do.



Allison Pugh: Yeah, so if you're like completely sure that the other person is really passionate about such and such, and you say that to them, and they're like, no, actually, it's more like this, this is what I actually care about. You have to hear that. And actually, the correcting process can help people feel even more seen if they are able to correct you and you say, oh, yes, now I get it. The other thing I would say is, in our quickness to leap into a conversation with somebody with our own views or assumptions, what I think is really important is actually hearing what the other person is not saying, hearing the emotion that they're not naming. If you can hear an emotion behind what someone's saying and say, wow, it sounds like you're feeling nervous about that, or it sounds like you're feeling, it sounds like that gives you a lot of pride. It doesn't have to be a negative emotion. It's like, if you can kind of hear whatever emotion is behind, that's very powerful for people. If they didn't say it and you name it, they feel very seen. And kind of in the naming, when you're doing that kind of naming, you're making it safe for them.



Shankar Vedantam: In some ways, being able to get one level below what they're saying, to sort of say, I can recognize that you're feeling pride, or I can recognize that you're feeling sad, that might be even more effective than just simply repeating back to people, here's what I'm hearing you say, or repeating back their words to them, because it really shows that you have actually taken in what they have said, you've understood it, and you're actually trying to give the essence of it back to them.



Allison Pugh: Exactly. That's why it's like, it's a boost, a huge boost. Now, I would also say it's a little more challenging, maybe. But it is true that if you can bump it up a level and go to what's not being said out loud but that you really perceive, that is very powerful.



Shankar Vedantam: You see, Allison, that if we happen to not see someone accurately, if we mis-see someone, this can itself be an opportunity. If we stop to show the other person that we really do want to see them and to correct ourselves. You interviewed a therapist whom you called Sarah, who told you that an episode of mis-seeing was actually crucial to her patient's progress. Can you tell me that story?



Allison Pugh: Yeah, so Sarah was a therapist at the VA hospital, and so she was seeing veterans. And she said she had, she told me about a woman she had been seeing who had experienced sexual trauma in the military. And at the end of like the third or fourth week, the woman leaves the session with a comment saying that she might not be able to come back. You know, how she might get busy is what she said to Sarah. And Sarah said to me, you know, something was just kind of off. Like, it didn't feel the same. It just didn't feel right. So she calls her before the next week. And she says to her, you know, I think I said something. You know, I'm wondering if I maybe missed something or didn't hear something right. The session felt different today. And I think it could be helpful to talk about that if you're able to come in again. So the woman comes in, she comes back, and they were able to talk. And Sarah said, at that point, the relationship really shifted, and she ended up making tons of progress. And so at the end of the treatment, Sarah asks the woman, you know, what worked for you? And the woman said, there was this point where you noticed that I wasn't happy with whatever you did. And the fact that you even noticed that was a big deal. And so Sarah took away from that, this notion of, actually, therapists have written about this. They call it therapeutic rupture. And that if, you know, you can redeem yourself there, if you manage a reconciliation, it can be very powerful.



Shankar Vedantam: So, Allison, we've seen how, you know, being seen and heard can be powerfully transformative to the people who are being seen and heard, but you also are finding that the act of seeing and hearing others can be powerfully transformative for us. You tell the story of a nurse practitioner whom you call Birdie. Can you tell me her story, Allison?



Allison Pugh: So Birdie was a nurse practitioner in California. She had this bright smile, a high beam smile, and she was quite bustling and friendly and very warm. And she told me that she had always assumed she would be a doctor like her father until she failed organic chemistry. And she then was like, what am I going to do next? So she actually decides to become a nurse practitioner, but even as a nurse practitioner, she said she struggled with ego issues. This is what she said. But the good thing about being a nurse, she said, is that she could focus on the human element. And she told me an example of what she considered really to epitomize what nursing meant to her. And that was the example of this homeless man. He came into her clinic. He had been on the streets for years. She said, he had probably walked cross-country, homeless back and forth. He had never really been in a shelter. She said, he had some wounds on his feet. They were, she said, just gnarly, calloused. And she said, he was so hunched over from years of osteoporosis and walking, and so few people would be able to even have eye contact with him because he physiologically couldn't even really look up. And I just sat and did wound care for his feet. So she just sat and washed and cleaned his wounds. And she said, it wasn't going to do much. He was still going to be on his feet all the time. He was so resistant to going into any shelter. It was just a bandaid over a really big problem. But for her, it captured what nursing was about. Like, this humility, this service, and the witnessing. So she said, she tells me, just to give him that moment of, I'm seeing you, I'm acknowledging you, this is me caring for you. She said, it was powerful for both of us.



Shankar Vedantam: You know, I'm reminded of this new story I just saw about Pope Francis in 2024, he washed and kissed the feet of 12 women who were incarcerated at a prison in Rome. You know, the Pope was in a wheelchair, so the women were sitting on a raised stage and he was wheeled from one person to the next. What was remarkable to me when I watched the video of this event was to see the reaction of the women. I mean, uniformly, they were weeping. And it was clear that no one had put them on a pedestal in a long time, no one had seen them. And so, the effects of seeing someone really has transformative effects on both the seer and the person being seen.



Allison Pugh: Exactly. The power of just connecting to another human being. And by doing that connecting, you're saying to the other person, you are a person of value. You have humanity, just like I do. And together, we are sharing this moment. It confers dignity and humanity to both participants.



Shankar Vedantam: In our companion episode, available exclusively to subscribers to Hidden Brain Plus, we look at how powerful forces are getting in the way of us seeing one another as people. These forces are everywhere, and they're systematically making it harder for teachers, doctors, parents, and caregivers to really see and hear the people they are working with. If you're a subscriber, that episode is available right now. It's titled, Recovering the Human Touch. If you're not yet a subscriber, please visit support.hiddenbrain.org. If you're using an Apple device, you can go to apple.co. slash hiddenbrain. You'll get a free 7-day trial in both places, and you'll instantly have access to all our subscriber-only content. Again, that's support.hiddenbrain.org or apple.co. slash hiddenbrain. Allison Pugh is a sociologist at Johns Hopkins University. She's the author of The Last Human Job, the work of connecting in a disconnected world. Allison, thank you so much for joining me today on Hidden Brain.

Allison Pugh: Thank you.

Shankar Vedantam: If you have a follow up question for Allison, and you'd be willing to share it with the Hidden Brain audience, please record a voice memo on your phone. Once you've done so, email it to us at ideas at hiddenbrain.org. That email address again is ideas at hiddenbrain.org. Use the subject line connection. Hidden Brain is produced by Hidden Brain Media. Our audio production team includes Annie Murphy-Paul, Kristen Wong, Laura Quirrell, Ryan Katz, Autumn Barnes, Andrew Chadwick, and Nick Woodbury. Tara Boyle is our executive producer. I'm Hidden Brain's executive editor. Thanks for listening. See you soon.