On Being with Krista Tippett

Christine Runyan

On Healing Our Distressed Nervous Systems

Last Updated

May 30, 2024

Original Air Date

March 18, 2021

The years of pandemic and lockdown are still working powerfully on us from the inside. But we have trouble acknowledging this, much less metabolizing it. This conversation with Christine Runyan, which took place in the dark middle of those years, helps make sense of our present of still-unfolding epidemic distress — as individuals, as communities, as a species. She has cultivated a reverence for the human nervous system. She tells truths about our bodies that western medicine itself is only fitfully learning to see. This quiet conversation is not just revelatory, but healing and calming. It holds startling prescience about some of what we’re navigating now. And it offers self-compassion and simple strategies for finding ease within ourselves — and with each other — as we live forward from here.

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Image of Christine Runyan

Christine Runyan is a clinical psychologist and professor in the Department of Family Medicine and Community Health at UMass Chan Medical School. She is also a certified mindfulness teacher, and she co-founded and co-leads Tend Health, a clinical consulting practice focused on the mental well-being of medical and health care workers.


Transcription by Alletta Cooper

Krista Tippett: It fascinates me how we human beings underestimate the imprint of what’s happening inside our bodies and brains on the people and the world around us. And I believe we are now walking around with the years of pandemic and lockdown still working on us powerfully from the inside. But we’re not really acknowledging or metabolizing this. It’s as though we’re living with the echoes of those years, but we’ve forgotten what made the sound. So, the conversation that follows took place in the dark middle of pandemic. But we’re offering it up again now because it helps make sense of our present of still-unfolding epidemic distress — as individuals, as communities, as a species. Christine Runyan has cultivated, as her quiet calling, a reverence for the human nervous system. She tells truths about our bodies that Western medicine is only fitfully learning to see. And this conversation is not just revelatory, but healing and calming. It holds prescience about some of what we’re navigating now. And it offers self-compassion and welcome, simple strategies for finding ease within ourselves and with each other as we live forward from here.

I’m Krista Tippett, and this is On Being.

[music: “Seven League Boots” by Zoë Keating]

Tippett: Dr. Christine Runyan is a clinical psychologist and professor in the Department of Family Medicine and Community Health at the University of Massachusetts Medical School. She also supports the mental well-being of healthcare providers in a clinical consulting practice called Tend Health. I interviewed her in 2021, with a pandemic-addled brain and a lockdown-weary spirit.

Tippett: Why don’t I tell you the story of how this came about, just as we start?

Runyan: Great.

Tippett: So I had been having the experience — which every time you talk to people now about this experience, they’re having some version of it — but just noticing this dislocation and disembodied, confused general feeling; and I got into this place of real despair about this, about a month ago. But it felt like there was something going on in the way I was functioning that was even beyond what was understandable in terms of the sadness — the understandable sadness and despair of everything that’s happened and everything that’s going on.

So I just started frantically searching online for somebody to be speaking to this thing — even as I’m talking to you now, I don’t know how to name it.

And I felt like the way you were talking about this, often to physicians, was — even though what you’re describing is itself unsettling, about what’s happening inside our bodies and brains, there’s something about giving words to it that had that calming effect on me. And so I said, “I want to have this conversation on-air.” And so here we are. And I’m just really grateful to have found you and to have a chance to draw you out right now.

Runyan: Well, equally grateful to be here. And you’ve just summarized, I think, really what has been one of my primary messages through this. And I can tell you, if you’re interested, how I came to understand it in that way.

Tippett: Please do.

Runyan: In March and in April, I began getting emails and calls from patients who I hadn’t probably seen in a while, some new patients. And the common experience was the activation of prior trauma. So these were all people who previously had traumatic experiences — some of which I knew about, some of which I didn’t — and began, really at a fairly alarming rate, reaching out and seeking care and were having trouble understanding what was going on with them, even as this had not descended upon us; was starting to descend in New York City.

And because people who have had prior trauma, their system is actually highly sensitized. And so it’s like their threat detection can go off — sometimes unnecessarily, [laughs] sometimes — but at a lower threshold. And so before a lot of us were really experiencing it, I noticed it there. And that’s what really got me thinking about, oh, this is dysregulation at the nervous system. And then the tsunami hit, and I think that’s so much of how I understand a lot of what you’re describing, a lot of what I hear all the time in my patients, in my friends, in myself. [laughs]

Tippett: And I’m curious, just before we dive into this, you actually started your career as a psychologist in the U.S. Air Force.

Runyan: I did, yes.

Tippett: How did that happen?

Runyan: So I actually come from a family with a lot of civil servants. My dad worked in the intelligence community, CIA and NSA, and I have a lot of West Pointers, actually, on my mom’s side. And my grandfather commissioned me. He was already suffering from Alzheimer’s at that time, so I think we pledged something close to allegiance to the Constitution — [laughs] may have a little variation in there — but he commissioned me in the Air Force.

And so that is how I started my career, and actually my career with integrated care, which is bringing psychology, bringing behavioral health into the primary care setting, which is where most people access their care, the emergency room or primary care, and so really making psychology and mental health at the forefront of that instead of as this specialized, very difficult to access, and stigmatized part of our health care.

Tippett: It also occurs to me that working in that sphere — both the call to service, which is in the military as it is in health care, but also the backdrop of trauma that is involved in that profession — I can also see how that flowed into the broad perspective you have on the — almost the species-level trauma that we’re experiencing right now.

And what I’d love to just have you open up for us, to start, is just the nervous system effect that this virus in the world — kind of the baseline with which we entered into all the things that then later happened. And I just want to point back to something you said: the mind-body connection is sensitive as much to what is imagined as to what is real. We’re having emotional reactions all the time to what is imagined — and that uncertainty itself is an incredible stressor and that, just beginning with the news of this virus in the world, an invisible threat, and yet — and life and death threat — what started to happen in our bodies?

Runyan: So you stop me, if I’m getting too — [laughs] if I’m geeking out too much on the neuroscience here.

Tippett: I found it really — I’ve been geeking out on what you’ve been — I’ve been looking at your PowerPoint presentations to physicians, and I think it’s fascinating. So just go, and I’ll tell you if we get — [laughs]

Runyan: Fair enough. So in our bodies we have this autonomic nervous system and, most people understand what we call, often, our “fight-flight” system, which is part of the autonomic system, which is, in fact, automatic. And it’s our sympathetic nervous system. And it actually has more than those components; it has fight-flight-freeze. And I think that’s relevant to a lot of what we’re seeing now, as well. And so when our system — which is not happening at the level of our conscious awareness, threat is always detected by the nervous system — it can additionally be detected by our thinking brain, but it’s always first detected at the level of our nervous system. And it’s exquisitely designed. It is a beautiful evolutionary adaptation that, if we were to ever lose it, we would become extinct. So its job is to keep us safe and to keep us alive. And so it’s really sensitive. And when it detects threat, it activates a series of responses, and this cascade of neurotransmitters and hormones go off inside of our body to prepare us — to prepare us to fight, or flight, if we estimate the threat to be bigger than we can manage.

And that’s a very predictable response. It’s our source code, as humans. You have it, I have it, every one of your listeners has it. And when that goes off, it does a number of things. It releases glucose, so we have some energy. It increases our heart rate. It increases our blood pressure. It diverts blood to our major muscle groups. It temporarily gives our immune system a little boost. It stops our digestion. It does all these things specifically. You can see how — that increases our clotting factor — so that we can fight or that we can flight, and we have all the reserve necessary to be able to do that.

And then our parasympathetic nervous system, which is often called our “rest and digest” or relaxation system, is also innate within us. And when the threat subsides or when our thinking brain — our prefrontal cortex — sends a message that, Okay, we’ve absolved the threat, or the threat isn’t here, we’ve just imagined the threat, the parasympathetic nervous system can then calm things down and bring things back to baseline. And that’s really where, when we are most integrated and creative and aligned with ourselves, and we have present moment awareness, that is our natural homeostasis of our nervous system.

Tippett: The balanced state.

Runyan: The balanced state. Yeah, and some people will call that our “optimal zone of arousal,” if you will, and this “window of tolerance,” which does get quite disrupted, for example, for people who’ve had prior trauma. That window really shrinks, and so you can activate this nervous system at lower levels. And that’s one of the things that I think has been happening throughout this whole year, for various reasons, both related to the virus and related to our social circumstances in this country.

Tippett: So one of the things I’ve been thinking about and just talking to friends and colleagues about is how — obviously, just even as you describe that very clinically, it’s clear that here we are, a year on, and we never got to — the threat never went away. But what I’ve also experienced, as I look back on the year and its many chapters, including the death of George Floyd, the racial reckoning and rupture, the drama of the election — it feels to me — in our work, in my work, my colleagues and I — there was a lot of adrenalin that got generated at different points because of things that were happening in the world, and that’s just quite apart, again, from people having incredible losses and stresses in their lives. And then it’s just been this total — I feel like all of the energy flowed out of my body. [laughs] And it’s been really hard to feel even — it’s not just that I have felt low in energy; I’ve felt disembodied and like I’ll never be the same again. And I talk to other people who feel that way, too.

Runyan: I think that’s also part of the nervous system, both assault and response. We talk about fight or flight, but there’s also a state of freeze, which can look very much like you’re describing, this state of apathy, of detachment, of even disembodied or dissociative, and numbing, a lot of numbing. And that is a state of physiological high arousal, actually; there’s still a lot happening underneath the skin, in terms of the arousal, but the body has essentially tucked in. And it’s a protective stance. There’s a lot of protection there. And anybody who is at risk of depression, has previous depression, it can be a scary place to be because it has so many — there’s so much residue there, of, “oh, this seems familiar.” “I remember when.” So it can be really scary because it’s like, oh, is that coming back?

But it actually can be — if we understand that as a natural variation within our nervous system that may have a little protective factor as to not get into the rumination cycle where we’re constantly monitoring, how is it now? How is it now? And is this coming back? Is it coming back now? [laughs] And just to know that that’s actually a natural variation of our system, too. And what is often protective in instances of such widespread trauma, if you will, has been taken from us in this pandemic: connection. And it’s that connection and community that doesn’t ask, “What sign do you have in your yard? Are you on my side?” [laughs] “Are you voting for the same person as me?” People put those things aside, and they come together, and that’s how we express this common humanity. This is how we heal.

And so much of that has been taken from us during this time. We’ve had to do it in very different ways that our nervous systems don’t interpret as much. Our nervous systems know touch. They know closeness and a hug. And to not be able to do those things when people are really hurting has been a huge loss, and there’s much grief there.

Tippett: Someplace, you said, “Our nervous system calms down when we feel tended to.” But we are so physical, right? We need to have a physiological, sensory component.

Runyan: Yeah. There’s a part of our system that actually doesn’t get nearly as much air time, and it’s been labeled the “tend-and-befriend” system.

Tippett: Talk about that. You write about that a lot.

Runyan: It’s an affiliate of part of our nervous system, actually, that was not — and Hans Selye, original work in the ’50s — like most research at that time, it was primarily done with men…

Tippett: [laughs] That our research on stress was generalized to women, but it was about men, which is not surprising, but fascinating.

Runyan: And this tend-and-befriend response is mediated primarily by oxytocin, a little bit of dopamine. And if you imagine — again, if we think about this as an evolutionary component of us. Women, in order to engender some survival capacity, they would tend to the offspring, and they would befriend; they would gather in groups. And that actually portrays some survival benefit, because their ability to fight or to flight, which would mean leaving behind those less able, like offspring, was not really the first available response. So it’s tend-and-befriend.

And there’s some good neuroscience now that supports that there is a release of those neurotransmitters. Oxytocin both is released in the presence of that tending-to, and it actually gets released for us to seek that. If we’re feeling really disconnected, lonely, apart, our nervous system will release some oxytocin to help us go seek and find that connection. And that is part of why you see lower rates of PTSD, for example, with natural disasters as opposed to other kinds of trauma seen in combat or interpersonal trauma, because you have that built-in healing blanket.

Tippett: So we have had this idea — we generalize about the amygdala and the primitive part of our brain, which is also the part of our brain that is immediately, automatically activated, when there’s a threat. And there is this generalization — I certainly grew up with it, and I think I hear from you that the science is pretty new — that we’ve said fight or flight, fight or flight; but now we’re saying another way to describe what happens, for some people or some of us, some of the time, is “freeze.” But you also use this language of “affiliate,” which I think is another synonym for the befriending. And it’s that women more often, perhaps, than men, although not only women — in a crisis, in threat, will actually — their response is not fight or flight or freeze, but to reach out to others and form alliances, and do the opposite of social distancing — [laughs] which is what the crisis is now, that that major line of — there are so many crises, but that that is not available.

Runyan: It is not available, and that loss, we’ve seen it — we certainly saw it throughout health care, which is the space I know well, in terms of people dying alone, and the pain of that for their caregivers. But, for all of us, that loss is — it’s not just a conceptual loss, it’s a physiological loss. And I guess that is so much of my message, is if we can understand and appreciate what we are experiencing at that level — whoever you are, whatever you are feeling — of course, of course, you are feeling that; look at our current conditions — and that it’s a normal response to incredibly unfamiliar, unusual, unpredictable, uncontrollable circumstances.

[music: “Glimmer in the Haze” by Sanctus Music]

Tippett: I think probably you could make an argument that our entire societal nervous system was stressed, and people went to different places. You talk about, also, symptoms of this stress on our nervous system that I think I recognize in myself, and we all recognize as being more impulsive, moody, rigid in our thinking, irritable, lashing out, our frustration tolerance; and you could almost see that play itself out in our political life. And so I’ve been thinking about how social isolation is what you do to break people in war. It’s what you do to punish people in prison. And collectively, we were faced with this impossible choice — that the very thing that makes us human, which is our physical connection to other people, was the cost of keeping each other safe.

And all of that is terrible. Somewhere along the way, part of the dynamic was: you’re either on the side of the science, [laughs] or you’re interested in killing people. And so somehow — I guess what I’m saying is, this is an impossible — it’s a tragedy. But I feel like it stopped us from actually being really honest about the terrible effects of the social isolation.

Runyan: It’s beautifully, beautifully said, and I think it is not at all a coincidence, like you’re saying, that the level of social distancing that we needed to do, in order to have a societal cooperation to try to avoid further infection, actually really galvanized this in-group/out-group; this other-ing. We all entered into the same state of uncertainty and fear and are all really at that place of looking at safety, and then love and belonging. And I think that that need to belong really catapulted people to the extremes, to figure out, are you in my group, or are you of that other group?

And I really appreciate the language that you use, because it’s so resonant to the language of a lot of the mainstream media that is so inflammatory — you’re either on the side of science or the side of killing people. [laughs]

Tippett: Right, and the truth is, we’re all in a panic and in fear, and we’re in our bodies — we’re in our nervous systems, as you say.

Runyan: Yes, so we are all activated. That nervous system dysregulation is the source of where all of these other behavioral manifestations are coming. And we’re all patterned in different ways, and a lot of that — I’m a psychologist, so you know it’s going to draw back to childhood. [laughs] But a lot of that has to do with, what were the ways we met stress as a kid? How did we learn how to meet stress in a way to stay safe, as a kid? And, unexamined, those just continue to show up through our lives. And so not everybody manifests in the exact same way, because of that patterning and those histories, particularly if left unexamined, but you can certainly find plenty of people who are responding to that activation in a way that meets aggression, rigidity in thinking, getting very myopic in perspective, and not having much cognitive flexibility to share anybody else’s perspective or ideas. And so you have a massive loss of empathy. Massive loss of empathy.

Tippett: So I think one implication of that, for me — again, I feel like naming this feels relieving, even though what we’re naming is a really just impossible and terrible situation we’ve all been placed in. So what do we know about, what do you know about the effects on us as humans, as creatures, of what we’ve called social distancing, but what that entails — the isolation of this, the lack of touch, the lack of seeing and being seen, in a world of masks?

Runyan: [laughs] Right. I think about this on multiple levels. I had a patient one time who had pretty severe, very severe PTSD. And she described this “skin hunger,” because she so desperately wanted to feel connected and knew that that was also a source of incredible activation for her.

So that term comes up, for me. We all have — particularly people living alone. My mom is 80, and she’s living alone and being very vigilant and diligent about precautions, and I think about that for her, because our nervous systems know that.

I know my inclination, in being with somebody who’s suffering, is to lean in and to touch, if that feels safe to them, and to hug. And the loss of that at scale, I think, is really affecting our nervous systems quite a bit.

So this process of naming and — “allowing,” I think is the term that I would say — seeing it as a human response to the conditions that are, rather than something wrong with me. So many of us humans are prone to even ask that question, “What’s wrong with me?” “I’m not whatever enough,” resilient enough, strong enough, smart enough, funny — whatever our brains will do.

And I actually think that the other thing that we are very likely to miss is this tsunami of medical conditions that have at their basis an etiological or exacerbation factor from our stress response. So anything that’s — any kind of chronic pain, cardiac disease, hypertension, inflammatory processes, rheumatological things, even cancer — that when you have a disruption of the nervous system for so long, and you have this activation that is too intense, for many of us — it’s going on for a long duration — you have some breakdown, actually, on the physical side.

Tippett: Is this what you call allostatic load?

Runyan: Yeah, exactly. So we have — and allostasis is just that you deliver a stress to the system, and it buckles a little bit, and then it absorbs the stress, and it recovers, and it gets stronger. We all are very familiar with this because we go to the gym or we do whatever our exercise may be, and we do it in a dose, along with recovery — we get stronger.

What we have now is something called allostatic load, which is, the stressors just keep coming [laughs] with no opportunity for recovery. And our systems just literally break down; and the other thing that’s likely to happen is, we try to intuit solutions to make ourselves feel better in the short term that are often pretty effective in the short term but cause downstream problems. And those kinds of numbing things are alcohol, drugs, Netflix. [laughs]

Tippett: [laughs] Somewhere, you even said worrying — that even worrying — and I think that’s a personality type, too, and I fall into that sometimes. Somehow, it feels like you’re controlling it, like I am going to bear down and think this through. And if I worry about it, the worst thing won’t happen. You say that that’s one of these inclinations we have that is counterproductive but feels so natural.

Runyan: [laughs] Yes. We want to have control; that’s why the uncertainty, the unpredictable nature of this is so hard for us physiologically — and as a mindfulness teacher and practitioner, I really work at this intersection, too, of metabolizing the reality that there is no control. And it’s one thing to know that at an intellectual level. It’s another thing to really embody that as our lived experience, every day.

Tippett: And is it your understanding that metabolizing that — I think you said “allowing that to be true” — is that the closest we can come to recovery right now? [laughs] Or is that part of a more productive coping or a more healthy coping?

Runyan: I think it’s part of it. If I had to categorize what I think are those strategies or elements — and I really appreciate this conversation, because sometimes I think some of the “self-care” solutions that are out there are, actually they can sound quite trivial or trite. And I don’t want to be dismissive of anybody’s individual experience, but when we can package them through an understanding of this physiology, when somebody says, “Oh, just take a deep breath” — [laughs] it’s working at that level.

But I guess what I would say is, being curious — if we can be curious, just what’s going on inside of our own bodies — the neurotransmitter of curiosity is dopamine, so if we can be curious, we can give ourselves a little hit of dopamine. And then compassion, if I had to say the one thing that probably supersedes all of those, is compassion, including compassion for oneself.

Tippett: Do you — I just lost my thought. There you go. [laughs] I just completely — this never happened to me the same way, it happens all the time now. I think what you’re saying — when you said a minute ago, “Just take a breath” sounds trite, but that for example, taking a breath, from what you know scientifically about our bodies that there’s a way to talk about that; that that actually is a strategy that makes sense physiologically. So, what are some of those strategies?

Runyan: So one that you’ve come to is the naming it, which is, that’s part of the self-awareness. But that’s also leveraging your thinking brain. Our nervous system is really acting at this very primitive level. And in fact, when it goes off, it compromises our thinking brain. And so when we can name, Oh, this is anxiety, or, This is anxiety showing up as, What was that thought? — [laughs] When we can just name it and put it out there, it brings our thinking brain back online. And we can begin to quiet our nervous system by leveraging our thinking brain, as well. And so that’s what happens when you name something, is that you send a message. You can send a message to your nervous system, like, “Oh, OK, I see what this is. I got you; it’s OK.” We’re just having a conversation. It’s OK to lose your train of thought. I’ve probably done it seven times already and just glossed over it. So that naming it is a really powerful strategy.

The breath, with a caveat that the breath is not neutral for everybody, and so I do want to be sensitive to that. And certainly, as a mindfulness teacher, last spring, teaching and encouraging around the breath was precarious.

Tippett: What we’ve discovered about breathing.

Runyan: There’s various techniques you can do with the breath, but if you’re going to do one thing, a long exhale, because that’s part of our sympathetic nervous system, that dorsal part of our sympathetic nervous system that activates our calming; so, a long exhale. The inhale can have an activation part; a long exhale can — that alone can actually be quite calming, although there are some other breath techniques that one can use as well.

The other things that, again, sound — if you don’t understand this at the nervous system, they sound almost, I don’t know, New Age-y or kind of froufrou. But scents — so I always work now with a candle in my office.

Tippett: And why is that? What does that do for us?

Runyan: So any of our senses, because that’s really the information source of our nervous system, is through our senses. And so a scent that I like, that I enjoy, it bypasses that thinking brain and goes right to that part of my nervous system. And so I’m creating a space where my senses can interocept safety and pleasantness. And so that may be music, for some people — background music or — we all know this experience of, you hear a song and you’re immediately taken back to someplace, some point in your life, some point in time, not because you’ve thought about that memory; it’s like that memory spontaneously emerged.

Tippett: You’re in experience, and you’re in a suite of emotions.

Runyan: Yeah. So scent and sound can be really pretty accessible tools to just send those messages of comfort or safety. And then we can work with the body, too, the body quite directly, to send messages of safety and of calming to our nervous system. So our body is this incredibly rich, textured source of data for us. But we can also intentionally be in postures, be in ways that the nervous system senses safety. So a very simple one — and we could do it now, together — is just putting your feet on the floor so that your legs are uncrossed, and your feet are fully making contact with the Earth, maybe pressing down through the heel, pressing through the balls of the feet, feeling a little of that sensation coming up through the legs, and feeling yourself in your seat, being held.

Tippett: Yeah.

Runyan: How is that?

Tippett: I feel that.

Runyan: So fight or flight has a body posture of being on the toes, as like, “I’ve got to move here, somewhere, towards or away from.” Feet flat on the floor is like, “OK, I’m here. It’s OK to stay here. It’s OK to be here.” So we can work with the body directly in those ways to send messages of safety.

And then, one of my common go-to’s is around this affiliative stress response, tend-and-befriend, and particularly if I don’t have people around me, is to just make contact with myself. I put my hand on my heart, on my chest —

Tippett: Oh, you mean literally.

Runyan: Literally. [laughs]

Tippett: And you’re saying, from the science, this is something that is truly, truly acting on us.

Runyan: Yeah, and that’s when you said, the brain doesn’t — [laughs] this incredible brain we have, but it doesn’t know much between imagination and real. [laughs] And I will sometimes say to people, “I want you to imagine cutting open a lemon, a juicy lemon, and bringing that half of the lemon onto your tongue. And just let it rest there. And what do you notice?”

Tippett: I notice the tart. [laughs] I notice the tart, almost I would pucker up from the thought.

Runyan: And maybe even a little saliva in the mouth?

Tippett: Yeah.

Runyan: And I trust there’s no lemon in your — [laughs]

Tippett: No.

Runyan: We’re not together, but there’s no lemon in your studio. [laughs] We can create a physiological response through our imagination, which is — it’s a double edge. [laughs] It’s a gift and a curse because that is worry.

Tippett: But you’re saying we can also activate that to comfort ourselves if we take it seriously enough.

Runyan: Exactly, exactly.

[music: “VK Mendl” by Blue Dot Sessions]

Tippett: I know what I was going to say a minute ago when I lost my train of thought for the thousandth time in the last few months. I was going to say how I appreciate the reverence you have for our bodies and our nervous systems, and to me that also feels helpful, to remember that our bodies are doing their best to take care of us. And it’s out of control. But somehow, even that example you just gave — that we also have probably more power than we realize to reorient that and tap into those same powers to help ourselves.

Runyan: It’s both been a professional pursuit, but a deeply personal one, as well, as many of these things are. I’ve had a lifelong struggle with my own body, and probably up until maybe about five years ago. And this reverence — and now it is just a wonder and a source of curiosity, and I can appreciate it for all the ways it’s working on my behalf, even when I meet it with frustration.

And I had hip surgery in December and had a fair amount of pain. But it was fascinating to watch my own relationship with that because I knew that — I had this sense of, of course, there’s pain. You have a lot of inflammation, there’s a lot of healing that has to happen — of course, it’s pain. And I didn’t get into that cycle of, well, why do you have so much pain? And why can’t you do this? All of that rumination that I think we do with our emotional selves [laughs] — why do I feel so tired? And in the Buddha’s teaching, that would be the second arrow stuff. Do you know the parable of the two arrows?

Tippett: Well, tell it.

Runyan: So it’s just, if you get hit with a single arrow — back in days of hunter-gatherer, you get hit with an arrow — that’s unavoidable. That is some pain and suffering that’s here. And yet, what we often do is, then we begin with our ruminations and the tyranny of the mind that will say, “Why was I at this place at this time? I can’t believe I got hit with that arrow. Now I’m going to miss dinner, and this is so terrible, and this hurts, and when will I be whole again?” And all of those things. And that’s the second arrow. The first arrow was unavoidable; the second arrow is all us. [laughs]

Tippett: You said you have children.

Runyan: I do. I have two.

Tippett: So I don’t know if this question I’m going to ask is in that category of “let’s summon the second arrow,” but I feel like because my phone and my computer have become my portal to reality — to everyone, including my own children — I feel like the addictive quality of it is intensified. It’s like an appendage, even in a way that it wasn’t before. And I feel like the way I’m constantly turning to it is disrupting my attention span that’s already fragile from these nervous system effects that you’re talking about. Is there science around that?

Runyan: There is; I think what you’re describing is what’s being activated is that addiction pathway, if you will — sort of dopamine pathway that — The neuroscience that we have is, it’s fascinating to me, because it’s this explosion in the last 20 years. But, as most science is, in its way, it is so largely decontextualized from what happens when you have competing things at the same time.

But I think what you are individually experiencing can certainly be explained by neuroscience and the activation of that habit loop. And that both is supported by a little hit of dopamine and then is additionally supported by the habit loop and the fear of not having it there. So you have something that connects you to something so deeply meaningful to you — your kids — and you have this association of this device to your kids. That association is really strong. If that device was not associated with something pleasurable, you’d have more of an aversive response to it. And now it’s all mixed together. [laughs]

Tippett: Well, right, and the other thing is, I hear you saying that it’s associated with things and people and relationships and interactions that are meaningful to me, but I also turn to these devices to go down a rabbit hole about some celebrity’s love life. I turn to these devices…

Runyan: Or some bizarre psychologist somewhere and her story about the nervous system. [laughs]

Tippett: …I turn to it, also, in ways that are not good for me at all and that have nothing to do with those meaningful associations. But just I think the thing about the disruption — not being able to pay attention in the same way, which feels connected to the underlying problem of now.

Runyan: So when we’re in an activated stance from our nervous system, some interesting things happen, actually, with our focus and our attention. One, it can get pretty myopic and singularly focused, so we don’t have space for a lot of other things at a high level. And that’s really adaptive — if you have a particular threat, you want to be solely focused on looking, smelling, sensing that out. And so that can happen a little bit with hyper focus, if you will, which may be that rabbit hole you’re talking about. So the attentional partner to that activation is hyperfocus and a little bit hard to peel away from when we’re activated. And this is why, when I think about what are the superpowers that we all hold in us that is also part of our source code, it’s that self-awareness. Is there a pause point to be able to step out of that automatic pilot and then be able to make an intentional choice?

There’s a quote that’s attributed to Viktor Frankl, and he wrote Man’s Search for Meaning, but I actually just reread that within the last month, and the quote is not in there, but I think it’s in one of his other books. And he says, “Between stimulus and response, there is a space. And in that space lies our power to choose. And in our choice lies our growth and our freedom.” (Editor’s note: Though often attributed to Victor Frankl, the actual author of this quote is unknown. Learn more here.) And it’s such a beautiful encapsulation, I think, of that self-awareness and that pause, which is so hard to do at this time because we’re so activated.

And so it’s just recognizing when we can pause and say, oh, that’s what that is.

Tippett: And I think, having just been steeped in your world of thought and knowledge, I understand that better, actually, the physiology of that quote. So you’ve been talking about this, but we haven’t — we talk about the amygdala and the fight or flight; that’s all the most primitive parts of our brain. But that that’s the part of our brain that is most natural, and those connections are fast and automatic. And what I’ve been learning from you is — and of course, I knew about our prefrontal cortex, where we — the thinking brain. You call the primitive brain and the thinking brain. That takes a little more effort. It is our superpower, but, as you’re saying, we have to take that space and make that choice.

Runyan: Yeah. It’s really that power of the pause. And it’s imperfect. There’s plenty of times where I have done that pause and then just went right back down the rabbit hole. [laughs]

Tippett: [laughs] Right, right.

Runyan: But every so often, every so often, I’m able to catch myself and to make a very intentional choice to turn towards, closer towards my values, closer towards what’s really meaningful to me.

Tippett: When we were speaking about — when you talked about just strategies and techniques — actually, one that I had written down that I don’t think we talked about was gratitude. But you also coupled it with this word, “savoring.” And you talked about — again, from the scientist in you, which is about how we’re so oriented, we’re so good at, skilled at, looking out for what’s wrong, both physiologically and also culturally. But this “savoring” is inclining the mind to look, moment to moment, for what’s going to release oxytocin in us. [laughs]

Runyan: Yeah. You’re such a good student. [laughs]

Tippett: [laughs] Thank you.

Runyan: Yeah, exactly. It’s so easy to pass over how things — “Oh, this is how it’s supposed to be,” so we don’t actually drop into the wonderment of whatever is here, and to do that as much as we can, through our sensory experience. And we do have to incline the mind. And when we know that that’s not a personal failing or that somehow we didn’t get the update in our particular neurobiology, [laughs] that that’s true for all of us, because of needing to stay alive and needing to stay safe. And that’s how our nervous system is wired. And so we actually have to put some effort in towards noticing that which is neutral or pleasant; in fact, if we can really notice, most things that are even neutral become pleasant because they become fascinating. But we do have to create those conditions. And it’s so worth it if we do.

Tippett: If I ask you this huge question, this ancient human question, “What does it mean to be human?” — I wonder how you would just start to answer that right now, today. And I’m curious about — this subject we’ve been talking about and how you’ve been tracing what the pandemic has disrupted and done to us and been teaching us, or perhaps bringing about the essence of us into relief — maybe some of that flows into how you would start to think right now about what you’ve learned about what it means to be human.

Runyan: That’s a big question.

Tippett: It is.

Runyan: And there’s only one word that comes to mind, to be honest — love. And I don’t mean in a romantic love. I just mean, to love; to give love, to be loved, to be vulnerable enough to do both of those, and to love even when it seems unwarranted or inconvenient. And that is really — that is very much where I am, at the edge of my own practice of trying to do that into the places where it seems unwarranted, [laughs] with people where it seems unwarranted. And I think it’s probably, in part, because of what we’re experiencing in this pandemic and a massive loss of being able to act in love, in all the small ways that we can express love and connection with one another.

Tippett: Right. It’s those things we never even thought about before, like the eye contact or — so many things we miss that we never even paid attention to.

But we will move into something different. How do you think about — I’m curious what you know about the effect this has had on all of us, physiologically. Somewhere, you talked about — you use this language, “clinical hopelessness.” And I don’t want to end on clinical hopelessness. [laughter] But I guess I want to — how do you think about how we work with that, move beyond that? I don’t know. I don’t know.

Runyan: Well, time only goes in one direction. And we — of course, we will, as a species, really. As a species. As these biological creatures with — social creatures; our brain is a social organ — of course, we will. And I think, unfortunately, we will with some non-trivial sequelae, certainly, in what we now codify as mental health difficulties and, I think, in physical health difficulties. We’re going to be seeing a lot of that. I hope that we see some real reverence around the things that we’ve lost and some real commitment to, again, like I said, sort of learning — what lessons are we willing to learn? And individually, I think, my scope of agency and influence is relatively small; at a national level, it’s pretty small. But each one of us, I think, can do that and have a pretty massive collective input, to learn something from the slowing-down. So not the distancing, I think — I’m hopeful we will learn a lot from the pain of the distancing. But maybe something really precious is there in the slowing down.

Tippett: I’m just realizing there’s a question I didn’t ask you that’s so basic. And partly what you just said is, we always have to qualify that some people haven’t slowed down. It’s become harder than ever, including the healthcare workers you work with. But those of us who’ve been consigned to home, there’s this puzzlement at how — why are we so exhausted and so much more exhausted, when we feel like we’re doing less, and certainly, getting less done? What is that about, physiologically?

Runyan: That’s an easy one, in part from in my own body. I am somebody who probably hummed along at six-and-a-half, maybe seven hours of sleep for many, many years, and I’ve been getting like nine hours of sleep. And I think it is because of this activation; that we’ve slowed down — to the casual observer of what your body’s doing, and not getting on a plane and flying here and flying there.

Tippett: Not necessarily even getting dressed.

Runyan: [laughs] Right. But this activation is a very heavy metabolic load on our system. The requirements to actually be in whatever level of fight, flight, or freeze system you are in is a pretty heavy metabolic load. And so we actually probably have a larger sleep requirement that doesn’t quite match that activity level. And it’s true, not everybody is slowing down. And I see exhaustion actually at scale, among the healthcare professionals that I work with. I see — between the cognitive, emotional, and physical lift that is demanded of them — just pure exhaustion that is not going to be remedied by a week or two vacation which they can’t even take [laughs] to anywhere other than home. And so I do spend some time thinking about that. That concerns me.

Tippett: So I think we’re not going to be able to end on an upbeat note. [laughter] And that’s OK, I don’t know, something I’ve — there’s been so many uncoverings in this year, so many things that surfaced that were true but they really surfaced. And one of them is that we don’t know how to mourn and grieve, in this society. And there’s something in us — also, isn’t there something in us physiologically that needs to do that, that needs to …

Runyan: Absolutely.

Tippett: …to sit with our losses? And so maybe that’s the — it’s not upbeat, but it’s a step towards health, a step towards that balance that we need to recover.

Runyan: We are pretty conditioned to turn away from discomfort and suffering in our society. And it’s actually a space that I feel probably the most calm and regulated. Give me ten people who are in distress; if that’s my day, I’d much rather do that than clean my house [laughs] or fix dinner. But as a society, we are not very good at allowing for grief, which is always on its own timeline, and it’s unpredictable in its own right. And this is a tough one because it’s not a pinpoint experience. I don’t know what it looks like to have a day of remembering or some sort of ritual around — because we’re still in it, is the other thing. We’re trying to grieve a trauma that is still ongoing. And I don’t have the answer to how to do that, other than one breath at a time.

Tippett: OK. Thank you so much. It’s been helpful for me and healing in some way, and it will be for others, too.

[music: “Eventide” by Gautam Srikishan]

Tippett: Christine Runyan is a professor in the Department of Family Medicine and Community Health at the University of Massachusetts Medical School. She is a Certified Mindfulness Teacher. And she also co-founded and co-leads Tend Health, a clinical consulting practice focused on the mental well-being of medical and healthcare workers. Learn more about that at Tend.Health.

The On Being Project is: Chris Heagle, Laurén Drommerhausen, Eddie Gonzalez, Lucas Johnson, Zack Rose, Julie Siple, Pádraig Ó Tuama, Gautam Srikishan, Cameron Mussar, Kayla Edwards, Tiffany Champion, Andrea Prevost, and Carla Zanoni.

On Being is an independent nonprofit production of The On Being Project. We are located on Dakota land. Our lovely theme music is provided and composed by Zoë Keating. Our closing music was composed by Gautam Srikishan. And the last voice that you hear singing at the end of our show is Cameron Kinghorn.

Our funding partners include:

The Hearthland Foundation. Helping to build a more just, equitable and connected America—one creative act at a time.

The Fetzer Institute, supporting a movement of organizations that are applying spiritual solutions to society’s toughest problems. Find them at fetzer.org

Kalliopeia Foundation, Dedicated to cultivating the connections between ecology, culture, and spirituality. Supporting initiatives and organizations that uphold sacred relationships with the living Earth. Learn more at kalliopeia.org.

And, the Osprey Foundation, a catalyst for empowered, healthy, and fulfilled lives.

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