Welcome back to the Healing Pain Podcast with Lisa Feldman Barrett, PhD

We have a very special and distinguished guest joining us to discuss the topic of emotion and how emotion relates to chronic pain. If you follow this show or up-to-date on the latest pain science, you know that the definition of pain is that it’s both a physical as well as an emotional experience. Joining us is Dr. Lisa Feldman Barrett. Lisa is among the top 1% Most Cited Scientists in the world for her revolutionary research in psychology as well as neuroscience. She is a University Distinguished Professor of Psychology at Northeastern University with appointments at Harvard Medical School and Massachusetts General Hospital.

She is also the Chief Science Officer for the Center of Law, Brain & Behavior at Harvard University. In addition to the books Seven and a Half Lessons About the Brain and How Emotions are Made, Dr. Barrett has published over 240 peer-reviewed scientific papers appearing in Science, Neuroscience, and other top journals in psychology and cognitive neuroscience, as well as six academic volumes published by Guilford Press. She has also given a popular TED Talk, which has over 6 million views on the topic of how emotions are made. Dr. Barrett has also received a National Institutes of Health Director’s Pioneer Award for her revolutionary research on emotions in the brain.

In this episode, you’ll learn about some of the essential and new science behind how our brain perceives our experience and how that relates to how emotions are made. We’ll also discuss the neuroscience behind interoception and how it relates to the creation and perception of emotions, as well as how we can take these lessons and use them to cultivate pro-social values and improve global health care. I’m excited to share this guest with you. Lisa was extremely generous with her time. This is a little bit longer episode than normal but you’ll find lots of important tidbits and enjoy every moment of this interview. Without further ado, let’s begin and let’s meet Dr. Lisa Feldman Barrett.

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Emotions And Pain: Advances In Neuroscience And Psychology With Lisa Feldman Barrett, PhD

Lisa, welcome to the show. It’s a great honor to have you here.

Thanks so much, Joe, for having me on your show. It’s good to be with you.

I followed a little bit of your work specifically going into reception in the literature and your two books, which we’ll talk about, How Emotions are Made and Seven and a Half Lessons About the Brain. A good place to start is for us to approach the brain first in a way that’s easy for people. When most people think of the brain, they think of it as this vital organ that controls our body, in charge of thinking, and feeling, so to speak. As a neuroscientist, it’s a good place to start and ask you, what’s your view of the brain and how does it differ from what I just said?

I don’t think that it differs that much from what you just said. Your audience may be very aware of the fact that the brain is controlling the body. Most people don’t realize that. A lot of scientists don’t think that way. I could give you many examples, which I find amusing. The average person thinks about their brain as important for thinking, for feeling, and for seeing, like all the things that we think make us special as creatures on this Earth. The things that our brain does very silently when everything is working properly, like controlling the systems of our body. That comes as a surprise to people.

From an evolutionary standpoint and also from an anatomical standpoint, this is your brain’s most important job. It’s controlling the systems of your body to keep you alive and well. The way that your brain does this and the fact that your brain does this in the service of thinking, feeling, and seeing, it’s a hard insight to grasp because we don’t experience our lives that way. We don’t experience every hug that we get and every insult that we bear as having anything to do with the way that the brain is controlling the systems of the body. In fact, that is your brain’s most important job and everything you think, feel, and see is in the service, more or less, energetically of that task.

You mentioned evolution. I want to bring a little bit of evolution to the conversation because a lot of the research around pain pulls from evolution, draws from how our brain evolved, and its critical task is. With those real critical tasks looking at the brain, what would you say the brain’s critical tasks are with regard to us as functioning humans?

The brain’s critical task from an evolutionary standpoint is to keep you alive and well long enough to pass your genes on to the next generation and raise that generation to its reproductive age. That’s how evolutionary biologists would talk about it. Pain is an interesting phenomenon to approach in a comparative way because other animals have similar nociceptive. I’m assuming this is an audience that understands these. It’s pretty clear that there are some similarities in nociceptive pathways but the experience of pain and pain-related behavior is somewhat different in humans. Barb Finlay, the evolutionary neuroscientist, has written quite a bit about this in ways I find compelling. She writes about pain as having a social signaling function, communication function for requesting support because we are social animals and we regulate each other’s nervous systems. The mere presence of another person can make a nociceptive stimulus more or less painful to you.

You will experience more or less pain when someone is present, depending on who that person is and what their intention is towards you. My main research interest is not pain, but I do find pain to be compelling. I wrote about it in How Emotions are Made because the experience is constructed in much the same way that all experiences are constructed by, in particular, the way emotions are constructed. Your brain is always regulating your body. Your body is always sending sense-data back to your brain. This is continuous throughout your whole life. Your brain’s job is to make sense of that sense data to figure out what it means to be able to make decisions about what to do about it. That’s where things get complicated and also interesting if you’re a scientist.

If you look at the International Association for the Study of Pains’ definition of pain, it’s both a physical as well as an emotional experience which is why I wanted to have you on to talk about emotions. You touched on it briefly there and your theories, perspectives, and constructs that you’ve helped build out with regard to emotion. Emotion is a perception. That perception happens ahead of time, even before it comes to our consciousness.

There are so many things that are fascinating about how brains work. I was telling my husband, we were talking about prediction in particular. I was saying, “If I wasn’t a neuroscientist when I see the evidence with my own eyes, I’m not sure I believe it because it sounds so preposterous.” Here’s an example that illustrates it nicely. I use this in Seven and a Half Lessons About the Brain. When we’re thirsty and we drink a glass of water or some cool refreshing beverage, we drink the whole thing. We’re not thirsty anymore but it takes twenty minutes for the liquid that you’ve imbibed to be to reach your bloodstream and change the osmolarity of your bloodstream to tell your brain that there’s more hydration there.

Twenty minutes earlier than the biological signal is there, you stop feeling thirsty. Why is that? The answer is the same answer that I would give if you asked me what is so interesting about baseball? How does a batter swing a bat at a ball that he can’t see where it’s going to be but he’s swinging where it’s going to be in a moment from now? The answer in both cases is your brain is predicting. For your whole life, you’ve had many occasions where you’ve drunk liquid and then at some point later, you stopped feeling thirsty. Your brain is preparing your experience before the sense data arrived. In the case of drinking water, it’s twenty minutes, that’s a long time. In the case of most things, it’s very quick.

There’s an example that I use when I’m demonstrating how the brain predicts. I get people to imagine an apple. I would say 70% or 80% of the time people would say, “I’m salivating.” I’m like, “You’re salivating because I got you to predict that you were going to eat an apple.” You don’t believe that you’re going to eat an apple but for your brain to even understand what an apple is, it has to engage in the same neural pattern. Part of that pattern is preparing you to digest it. That’s why you salivate in advance of eating food. Ivan Pavlov won a Nobel Prize for this at the turn of the century. His explanation for this phenomenon was completely wrong. It was wrong for about 100 years but that’s what’s happening.

Your brain is a prediction organ. It’s predicting on the basis of how things are now. If we were to stop time, your brain has some representation of what’s going on inside your body and outside in the world. Your brain is predicting on the basis of past experience what is going to happen next. The prediction is your brain changing the firing of its own neurons to prepare, to receive the sense data, and to act on it. Your brain starts to prepare your experience and your actions before it makes itself aware of that preparation. If that’s not crazy enough, the prediction begins with motor responses and ends with sensory prediction.

Based on how things are now, your brain will predict and prepare to change your internal motor patterning. That’s patterning, that’s your heart rate, expanding your lungs, and so on. It will prepare your motor response. That takes some number of milliseconds to get done. As a consequence of that, it’s predicting what you’re going to see, hear, feel, taste, and so on. The whole thing’s happening predictably and outside of your awareness. It takes a much shorter time than it took me to even explain it and it’s happening all the time.

It’s a great description of a lot of your work. Those predictions are for pleasant experiences, unpleasant experiences, as well as what we might identify as relatively neutral experiences.

Humans care a lot about valence, pleasantness and unpleasantness. We care a lot about that. It’s a feature. Those are features we have experienced that we get out of our brains. It’s not clear that those are the features that the brain computes on, though. As a biological system, your brain cares a lot about energy regulation and glucose but it’s not clear that it cares a lot about comfort per se. There are these interesting experiments that were done with mice who were bred to not have the genes to taste anything. These animals wouldn’t ever experience pleasure in tasting or aversion in tasting. Nothing experiential. They were able to learn to eat high calorie foods as well as the animals who could taste things.

When you look biologically at the signal that’s driving their eating behavior, it’s how well the cells in their stomach are metabolizing the glucose. It’s not even the amount of glucose in their bloodstream. It’s about how efficiently are the cells metabolizing glucose. How efficiently are they turning it into products like ATP in order to fuel themselves? Valence, arousal, pleasantness, and unpleasantness are features that are subjectively important to us and they’re features that our brains produce. It’s not clear that they’re features that our brains compute on. I know that sounds crazy because every psychology textbook and paper talks about how the brain makes valuation judgments and so on. I’m less convinced and it’s still a question of how does the brain produces these features. It’s not clear that the features that produce are also the features that are computing on.

That’s so interesting from a biochemical perspective. Some of that starts to talk to interoception, which you’ve done some work around. I know you have a metaphor for that, which is the body budgeting. Can you describe what body budgeting is?

I can do it in a little more depth because it’s important enough. The first thing I’ll say is that, in the scientific literature, interoception is defined as your awareness of sensory signals from your body. That’s incorrect. Your brain is running a model of your body in the world. The way to think about it is that your brain spends its entire life in a dark, silent box called your skull. It’s receiving outcomes. Sensory changes from your body and from the world. It has no access to the causes. It only has access to the outcomes. This is what philosophers call a reverse inference problem. Your brain has to guess what the causes are. That’s true in your body and it’s also true in the world. If you hear a loud bang, is that a car backfiring? Is that a door slamming? Is it a gunshot? What is it? Whatever your brain guesses it will be, it’s going to dictate what you do next.

Similarly, if you have a tug in your chest, is that indigestion? Is that anxiety? Is that the beginning of a heart attack? That particular quandary has killed more women over the age of 65 in Western countries than you might be surprised to know. How people make sense of their sensations and more specifically how their doctors make sense of their sensations is gendered and it’s problematic. The thing to realize is that your brain is making sense of these sensations. These sensations from your body come from this ongoing regulation, which I described as body budgeting. The technical term is allostasis which means the brain’s attempt to anticipate the needs of the body and meet those needs before they arise. Think about it as you want to have glucose there before you need it. As your brain is standing you up, it’s going to raise your blood pressure as it stands you up so that oxygen can get to your brain and you won’t faint. Fainting is metabolically costly.

You’re saying allostasis is a state of the brain. Most people would identify allostasis as a state of a snapshot of the body’s physiology and time.

I would say allostasis is any physiological process that is predictively regulating for the purposes of efficiency and balance like energy balance. It is something that the brain does with respect to the body. It is also something that organ systems in the body do with respect to each other. The brain certainly doesn’t have all the control over bodily systems. What I would say is that partly the reason evolutionarily why we may have a brain. It may be that the reason why we have a brain is that we have a lot of complex systems. There are a lot of animals that have less complexity inside their bodies. They’re usually smaller.

Waste can get to the periphery of the body by osmosis and they don’t require these fancy-schmancy organ systems that we have. Those animals tend not to have brains. They don’t need them. Brains are expensive organs. That three-pound blob between your ears costs you about 20% of your entire metabolic budget. That’s the most expensive organ that you have. When you have all of these systems, all have to be coordinated, and all using the same resources, you need to have an organizer. That’s one way to think about what the brain is doing. I described this as body budgeting.

Your brain isn’t budgeting money. It’s budgeting, glucose, salt, water, oxygen, and all the nutrients that your brain needs to keep you alive and well. You can think about some of the things that you do as deposits like eating healthily and sleeping. You can think of some of the things that you do as withdrawals. Anytime you move your body or learn something new, those are two expensive withdrawals or exercise, for example. Exercise is a withdrawal but it’s a great investment. You’re expecting a return on that investment. You’re spending at the moment but you’re expecting that you’re going to get a return on your investment in terms of a healthy brain, healthy memory, attention, mind, and so on. Regular exercise does lead to more successful aging and less memory loss as quickly so on and so forth.

You can start to think about the ways in which other people can metaphorically make deposits and withdrawals into your body budget or the way that you can contribute to theirs. You can start thinking about stress. It’s your brain preparing your body to make a metabolic outlay. You can start to think about stress in terms of costs. You can start to think about things like depression or failure to learn something new like your brain is making predictions but it’s not updating based on new information as might happen in chronic pain. You can start to think about those as being related to deficit spending.

It’s interesting to me from that perspective. I understand what you mean by the sense of emotion is a perception. Everything in some way your brain is doing is a perception. It can be a little difficult for people with pain to know that because their body is responsible. Is it correct to say an error in prediction, so to speak?

Some people feel that way but the reaction that I get from people is a relief. There are aspects of the way that your brain works that you have no control over at the moment. You do have more control over what your brain does. This is a very Cartesian language here, which is you are your brain, your brain is you. It’s not like your brain is controlling you. When you start to realize what’s happening under the hood, it’s hard to change it at the moment. What you can start to do is expand the period of control that you have. You can start to do things in advance or after the fact that can improve your wellbeing, even if it doesn’t remove your discomfort, which I know sounds like a crazy thing to say. There’s ample research to show this. I will also say as someone who has been a long-time migraine sufferer, I have had experience in my family with chronic pain. My sister-in-law suffers from fibromyalgia. We have members of our family who are depressed and so on. It helps.

It’s helped in remarkable ways. Your brain is always sending predictions to your body to control your body. Your body is always sending sense-data back to your brain, including nociceptive input. A prediction is your brain changing the firing of its own neurons in advance of receiving sense data. When it receives sense data from the body or from the world if it’s predicted that data, then the firing doesn’t change. All the sense data did was confirm the prediction. Nothing about the information from your body created that experience at that moment. It’s all in your brain even when there is tissue damage. When there is tissue damage in your body or impending tissue damage, your brain is starting to construct and predict the experience of pain and then the nociceptive input comes and confirms that prediction. That pain was still constructed in your brain. It was confirmed by your body.

Hopefully, as your body heals, your brain learns information that it didn’t predict to update its ability to predict in the future. Learning is metabolically expensive. It’s one of the most expensive things your brain can do. Move your body and learn something new. For whatever reason, if you are metabolically encumbered, your brain will learn less well. Everything you’ve experienced is in your brain. What you see is in your brain, it’s not in your eyes. What you hear is in your brain, it’s not in your ears. If you pinch yourself, that pinch that you feel is not on your skin. You’re feeling it in your brain.

Everything you feel is in your brain. Your brain is constructing everything you feel but when things go on in your body or in the world that is not predicted, your brain has an opportunity to learn that new information and update its predictions. If it doesn’t, for all kinds of reasons, this can happen, you will continue to experience pain. You can think about chronic pain as a brain disease. It’s a biological illness just the way that depression is a biological illness. They both have a basis in metabolic issues. Not only that but certainly, partially that. Once people understand that, at least what I’ve heard from, they don’t feel released.

It may take away the impending threat value from their body saying, “It’s not something wrong with my body, per se, even though my brain is my body but there’s something else happening other than what I thought it was or what I perceived was happening.” It’s interesting to me that you say the highest metabolic activity is moving your body and learning. In most chronic pain programs, that’s what the focus is. The focus is on moving your body and then actually teaching people about pain or other cognitive-behavioral interventions.

I had a real epiphany when I was learning about some chronic pain treatments, which are a little bit like exposure therapy but in small doses. You’re having people move into the pain in small doses. What that’s doing is it’s giving the brain a teaching signal. Sometimes, we talk about prediction errors like stuff your brain didn’t predict. Either sense data that’s there that your brain failed to predict or sense data that isn’t there that your brain did predict. Those errors are teaching signals. They’re opportunities to learn. If you titrate it just right where it’s not too big and not too small for a person at their given state, what you’re doing is you’re teaching the brain to recalibrate itself. That makes a ton of sense. Constantly, I’ve worked out with a coach for many years. We had to come up with this language like, “Are you aware of a feeling in a muscle or a part of your body? Is it an awareness? Is it more of a sensation? Is it discomfort or is it distressfully painful?”

That language has been useful, especially when you’re recovering from an injury. Sometimes, I get exuberant and I’ve injured my rotator cuff, and I’ve injured my back. By the way, I have a fantastic physical therapist. He’s Barry Meckler. He’s amazing. My coach is Michael Elvis. These guys kept me together basically while I was writing these books because I was sitting for How Emotions Are Made to write 7 days a week, 16 hours a day, not exaggerating. These guys kept my brain doing its body budgeting job.

As a fellow author, I completely appreciate that. When I read your book, How Emotions are Made, it’s like reading all of your literature in Pub Med but folded into a way that has a story, theory, application to the modern world, and applications of chronic diseases. When I read it, I was like, “This book is massive and it’s wonderful.” Along those lines, I’ve had pain and I’ve written some books. Part of that is from sitting. I think sitting is an awful thing for the body. Both you and I, as professionals, can agree to that. Writing a book has learning involved in it on some level because you’re taking what you know. You’re trying to repackage it and repurpose it for the reader. It’s a little bit different. How does body budgeting play into us regulating our emotions? It seems like body budgeting sounds like it’s very physical and most people think of emotions as a psychological experience.

Everything that is psychological is also physical. I don’t mean that in a mystical, airy theory way. Here’s the way that I would describe it. Your brain is always controlling your body. Your body is always sending sense-data back to your brain. For the most part, we’re not aware of those sense data. You’re not aware of your heart beating most of the time, your lungs expanding, or liver making bile. You have all kinds of changes in temperature that you’re very rarely aware of. Joe, we’re both sitting here talking to each other and inside each of us, there is drama going on of great proportion. Every reader, there’s this whole drama unfolding that mostly we’re unaware of. It’s only when something goes wrong that we become aware. If you doubt that at all, think about the last time you had some GI distress or a fever of any magnitude. The outside world fades away and you’re completely focused on your body. This is what philosophers call Tragic Embodiment. We’re largely not wired to experience those sensations in any real precise way the way that we experienced the world. Our visual sense has a lot of precision to it.

It would be inefficient if I felt every organ moving and pulsing throughout the entire day.

If you felt any organ, even when you feel your heartbeat, you’re not feeling your heartbeat. What you’re feeling is your heart slamming against your chest. You’re feeling the vibration. It’s more of a touch feeling. As anyone can tell you who’s had a heart attack, you don’t want to feel your heart beating. It’s incredibly painful when you’re in the beginnings of a heart attack and you can feel what’s going on or think about appendicitis. What you have is like a dull ache over your whole abdomen for most of the time until your appendix is about to burst. It’s only at that moment that you feel a very specific pain, usually over your appendix, but not always. It’s vague and we are wired that way.

If you look at the wiring neurons that bring the signals from the body up to the brain, they’re not built for this high-precision sensation. Instead, what evolution has given us is a workaround, which is the brain as it’s receiving the sense data is compressing them and summarizing them. What we get is a more of a general feeling of feeling pleasant, unpleasant, comfortable, uncomfortable, worked up, quiescent, and calm. Those feelings, which most people call mood and scientists refer to as affect, are with you every waking moment of your life. Sometimes they’re in the foreground, sometimes they’re in the background, but they’re always with you because your brain is always budgeting and your body is always sending sense-data back to your brain. These are features of consciousness, which are always with you.

Sometimes, when your brain makes meaning of the sense data as an emotional event, you will experience these as emotions but you don’t always. The effect is these are generally simpler feelings. There’s a cool evolutionary story here about why it works this way, which we could talk about. When you feel unpleasant, usually you don’t know why. If it’s a feeling of unpleasantness like you’re distressed and you’re feeling uncomfortable, your brain has to guess how much information is there and I feel bad. What do you do about it? What’s causing it? There’s no information. Your brain has to link this to other information in order to make sense of it.

An emotion is your brain is making sense of your physical state in relation to what’s going on around you in the world using events from your past, which you learned were emotions. Your brain is using that information to make sense of the present and predict the immediate future. You can think about emotions as predictions. They’re predictions for making sense of what is causing the sense changes in your body in relation to what’s going on around you in the world. It’s not just emotions that are constructed this way. All experiences are constructed this way. Even pain. The experience of pain is constructed this way. There is lovely research that I’m sure you know about showing that people who have chronic back pain or chronic pain who are dependent on opioids, which by the way work because they work on the affected piece of pain, which is the one reason why when people become addicted to them.

They’re becoming addicted because they’re regulating a disruption in their body budget. You could teach people with mindfulness meditation to separate out to deconstruct their distress into discomfort. Discomfort is still uncomfortable. Discomfort is more like what you feel when you have the flu even though the symptoms that you experience are almost identical to being very depressed, maybe with the exception of a fever. Your nervous system is playing a causal role in making you sick when you have the flu. You don’t feel like you’re responsible and you don’t berate yourself. You just feel like shit. There is a value in not mentalizing everything and not experiencing everything as a psychological state. To answer your question, you can better regulate your emotions by keeping your body budget solvent.

If it’s easier for your brain to regulate your body and you’re not running a deficit, you’re going to have less opportunity to feel like shit and there’ll be less opportunity for negative emotion. That’s the bottom line. I’m not saying it’s a cure-all for everything. When it comes to your emotions and your wellbeing in general, as you know and your body for sure, you have to stop thinking about simple, single causes of things, you have to start thinking more like there are a lot of little nudges that you can nudge the system in one direction. Lots of little tiny causes which all influence each other. Your job is to architect your life in a way that presents the maximum opportunity for well being.

You just said it is critical because your model and theory lends itself well to an integrative model of care whether you’re talking about chronic pain or any other condition, acute or chronic. Even as you mentioned, a simple cold involves many other aspects than the physiologic event that’s happening.

When COVID-19 hit, this drove me slightly mad. There’s good research by a psychologist named Sheldon Cohen at Carnegie Mellon, he did what are called Viral Challenge Studies. What he did was he sequestered people way in hotel rooms and he controlled everything. How much they slept, what they ate, temperature, and so on. He would place a virus in their nose and he controlled the dose. The viral load was the same for every single person. One of these was a Coronavirus. Depending on the study, only 20% to 40% of people developed symptoms. Right there, that tells you that exposure to a virus is not the same thing as infection. Only some people became infected.

They were exposed to the virus and they carried the virus but they didn’t have symptoms. They didn’t become sick. It also tells you that a virus is a necessary cause of respiratory illness but it is not a sufficient cause, which means there have to be other necessary causes that all work together. This is a hard point that people have a hard time with this. The state of the immune system of the host, meaning you, the state of your body, which is controlled by your brain, is also a necessary but not sufficient condition for getting sick. It’s necessary because not everybody got sick. That means the state of your body budget can make it easier or harder for you to fight off a pathogen.

This is always true. I was reading about cholera and it turns out that many people carry the bacteria in their gut that would cause cholera, even now. Most people don’t get sick from it because the way that their gut is physiologically constructed doesn’t allow the bacteria to get what they need to reproduce so they can’t. Occasionally, if you’re exposed to a pathogen, if your body budget is in good shape and your immune system will be in good shape because they’re very linked, you’re not going to be as likely to get sick. Now that we’re in the time of vaccines, you should also know, that the state of your immune system very much determines the efficacy of a vaccine to a new pathogen. Things like chronic stress, which means lots of withdrawals that you didn’t replenish, make deposits to cover, or lots of times, your brain prepared you for a big metabolic outlay that never came, your body doesn’t keep score. Your brain keeps score and your body is the scorecard.

Thank you for saying that because I have heard people say this over and over and things like emotions are stored in your muscles, emotions are stored in your body, it drives me up a wall.

When I say to my daughter, “You carry a little piece of my heart around with you everywhere you go.” That’s a nice metaphor but she isn’t literally carrying. That’s why I was saying to you before about metaphors. Metaphors are great. As a writer, you have to use them in order to communicate complicated things to people. We use them with each other too. They often give the illusion of knowledge when, in fact, they aren’t knowledge. They’re giving you a gist-level explanation. Sometimes, that gist-level explanation can suggest the wrong thing. It’s great that people understand that when your body budget is not efficient, there are all kinds of reasons.

Some of which could have nothing to do with your behavior. Your mitochondria aren’t up to snuff or you go through menopause for example, or you’re getting older as a guy. As we get older, we lose sex hormones. Women do it over a couple of years. Men do it very slowly throughout their whole lives. Sex hormones, dopamine, and serotonin are metabolic regulators. That’s how they evolved. I’m not reducing everything to metabolism. I’m just saying that whenever something adverse happens to you, you pay a little tax. Those little taxes, if you don’t take care of them, will add up over time.

The way to think about it is when water is dripping on a solid steel pipe, it doesn’t bore a hole in the pipe the first time, or the second time or even the thousandth time. Eventually, it will for a hole in that pipe. Your body works in the same way. You are not storing emotions in your muscles but you do receive sense data from your body that your brain either is predicting or is not predicting so it can learn. It has to make sense of those. It will make sense of those as emotions if that’s what you learned to do but it doesn’t always have to if you learn to make sense of your sense data in another way. Your body doesn’t keep score of anything. Your brain keeps score and your body is the scorecard.

I appreciate that deeply because that has been said on this show in a certain different context. The whole point of this as a public service announcement is education. You start to learn about how the body works. Obviously, your brain and mind are a part of your body and the influence there. A lot of your model has an impact on social and cultural aspects. As you’re talking about Coronavirus and immunizations, we’re rolling these out now. They started to roll out during a time of incredible economic turmoil, social unrest, and political problems. How does your model help us to construct a better society and even with regard to chronic pain? Still, the prevailing thought is that chronic pain is a problem with your body, which it isn’t. It’s a problem with your nervous system. How do we use these theories where we can have, in essence, one body budget affects another body budget in a way that is healing for all of us?

The best thing for a human nervous system is another human and the worst thing for a human nervous system is another human. We evolved as social animals. We are the caretakers of each other’s body budgets. It doesn’t matter what your political opinion is, what you believe, and what you think. It’s just the way things are. We live in a culture that has a profound disconnect in the sense that we value individual rights and freedoms but we have socially dependent nervous systems. It’s not the things that we do that affect each other. It’s also the things that we say that affect each other.

The system in your brain which allows you to understand language and speak also regulates your body. It’s not by accident that it’s this way. In songbirds, for example, who have a system that’s thought to be somewhat homologous to the human language system, it works exactly the same way. The systems that influence a bird’s ability to learn a song, to sing, and to understand a song controls the bird’s body. That means that I can text three little words to a close friend of mine halfway across the world. She doesn’t have to hear my voice. She doesn’t have to see my face. She will just read those words and I can change her breathing and her heart rate. You can read something that was written, a poem or a religious text from thousands of years ago. You can find solace in that. It can also infuriate you. Meaning it will change your metabolism, heart rate, or breathing rate. That’s the power of words.

We influence each other in all kinds of ways, like other animals who are social. We can influence each other’s body budgets through touch, smell, sight, and sound. We also have this extra way that we have with words. I can say a word to you. I can say, “Joe, I had pizza for dinner.” I have 40 features in my head that my brain is conjuring to tell you about what my meal was like but I say one word and then you conjure some number of those features in your brain. If there’s enough overlap, we’ve communicated. That’s what it means to communicate.

Not everything is going to be perfect. I’m from the East Coast so I’m thinking thin crust. If you were from Chicago, you would be thinking thick crust. We could debate about the importance of the value of thin versus thick crust. The point is even as you think about the pizza, if we were measuring your stomach motility or your salivary output and it was around lunchtime, you might start salivating at the thought of pizza. Pizza is so good, you might start salivating at any time if I just mentioned the word pizza. That’s your brain in its predictive mode, which it’s always doing.

What this means is that we don’t just have more control over our own experiences, making sense of the sense data in ways that are beneficial for us, but we also have more responsibility for other people’s wellbeing in this culture, more than we might like. It’s so hard for people even to consider that this is true. Even if I raise the issue, some people become very irate. To answer your question, we’re in a political era that is a massive public health risk for people. When a brain can’t predict its member, not being able to predict, and having to learn is very metabolically expensive. Uncertainty and things being random or unpredictable are hard on the human nervous system. We have all of that plus we have COVID-19, and we’re socially distanced from one another.

Many people are struggling with social isolation, which means they’re managing their body budget is on their own, which we did not evolve to do. There is an extra tax to that. It’s a challenging time. That’s why it’s particularly important. I certainly didn’t write Seven and a Half Lessons knowing that there would be a pandemic but there are some lessons there about how to treat each other and be a little more compassionate with yourself, perhaps, about all the kinds of things that can be influencing your body budget. Therefore, influencing your experience of yourself in the world and your way of being in the world. It gives you a different perspective and it gives you some choices that you didn’t know that you had.

It’s one of the first books that is written in a way that’s simple and approachable. In the beginning, it starts out like many books on the brain and the mind. It sounds a little scientific and clinical. By the end of the book, you take it out of the science and the clinic and you put it into real life for people. That’s the beauty of that book, particularly because it’s like, “I have this brain, mind, and body. I have some influence and control over it. At the same time, I’m on a pro-social level. Whatever I’m doing is going to influence my family, my town, and my society.” If we take the concepts of neuroscience in a way that aren’t so scientific, it helps people connect to, “Now I feel like I know what this thing is in my body and how to use it.” It’s very similar to pain. We educate people about pain. They have a reconceptualization of what pain is and then they can make different decisions.

It’s important to understand, as I’m sure you teach people, that discomfort is there for a reason. You would never want to get rid of it. It’s useful. Similarly, the goal here isn’t to always make everybody happy. That’s not the goal. The goal is for everyone to feel that they can be the best self and live their best life. I’m not a neuroscientist as much as taking what I know about neuroscience and applying it in the way that you asked me to. We live in a culture of casual brutality. People speak to each other in ways that strip them of their human dignity that are completely unnecessary. Joe, you and I can disagree on a lot of things, even important things, but we can still agree that we’re both human and we’re both deserve a certain amount of basic human dignity.

We don’t always have to be nice to each other. We absolutely can be critical of each other. We don’t have to agree on everything. We can debate. It’s important that everyone have the opportunity to have their say. We can do it in a way that’s respectful and in a way that doesn’t strip people of their basic human dignity. Based on what I know about the nervous system, if I had to engineer an environment that would drive a human body budget into bankruptcy, it would be the one that we are currently living in.

Those implications on chronic pain are also profound. When you look at chronic pain, as you mentioned before, all of our conditions have mind-body components. Chronic pain sticks out as probably the one that most people can identify the easiest. In a lot of ways, you’re saying, we’ve created a societal context that is stripping everyone’s body budget down day-by-day. With that, that’s why we have chronic disease whether it’s physical, mental, and I can’t even separate the physical from the mental anymore.

Remember, we’re not talking about simple single causes. Nothing works that way. It’s all about lots of little ingredients which all interact with each other. It’s not like chronic stress is going to cause you to develop a respiratory illness. It’s one of the necessary preconditions. Anything that is going deplete your immune system, which is related to having an encumbered body budget running a deficit, anything that drives your body budget into that state is going to make you more likely to be sick. When you encounter a pathogen, that’s always going to be true. The way that I would say it is that people are suffering. There’s a lot of suffering.

Some of the suffering people experience is mental and physical. There’s a lot of suffering. Some of it we can’t escape but a lot of it is self-inflicted. By self-inflicted, I don’t necessarily mean you yourself are doing it to yourself. We’re participating in a culture that makes it hard right now. There are also small things that we can do. Not everybody has control over everything but everybody has control over something. I wrote this piece in The Guardian about human connectedness in the time of COVID-19 that there are these lurking in our social distanced lives. There are these little opportunities that people are availing themselves of to maintain a connection through the words and other means.

I didn’t think that this piece was going to be all that special, but there was an outpouring of gratitude from emails, texts, LinkedIn posts, and whatever about this piece. We always write about people who do momentous things. One of my neighbors is a quiet guy who lives a fairly small life. What I mean by that is he has his neighbors and family but he’s not on the national stage. He’s not doing anything, but this guy touches more people in a positive way on a day-to-day basis because he’s kind. That’s not an investment. It’s not a deposit in somebody else’s body budget. When you are kind, it’s also helpful for you.

I’ve been speaking with Lisa Feldman Barrett and she has two wonderful books that I have personally read. They’re earmarked. Lots of pages with great notes. I recommend you read them. They’re Seven and a Half Lessons About the Brain and How Emotions are Made. Lisa, thank you for your time. Please let everyone know how they can learn more about you and follow you.

I have a website, LisaFeldmanBarrett.com. I’m also on Twitter. I’m not using Facebook so much anymore. You can send me an email. You can find on my website access to both of these books but also all of the popular science writing that I’ve done for the New York Times, The Guardian, other newspapers, and magazines, and some videos that I’ve made. My TED Talks are there. This episode will be there.

Make sure to share this episode with your friends and family who are interested in the brain neuroscience and how emotions are made. It’s been a pleasure.

Important Links:

• Seven and a Half Lessons About the Brain
• How Emotions are Made
• TED Talk – You aren’t at the mercy of your emotions by Lisa Feldman Barrett
• @LFeldmanBarrett – Twitter
• LisaFeldmanBarrett.com

About Lisa Feldman Barrett

Lisa Feldman Barrett, PhD, is among the top one percent most cited scientists in the world for her revolutionary research in psychology and neuroscience. She is a University Distinguished Professor of Psychology at Northeastern University, with appointments at Harvard Medical School and Massachusetts General Hospital. She is also Chief Science Officer for the Center for Law, Brain & Behavior at Harvard University.