Friendship Is Medicine: The Surprising Science Behind Connection | Simon Sinek

Coming up on this episode of the Dr. Hyman Show.

And I think that friendship is the ultimate biohack. I think if you can master friendship, a lot of those other things correct themselves. Friendship in the microbiome. Yeah. You know, get the microbiome right, a lot of stuff just falls into place.

Get friendship right, a lot of stuff.

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Welcome to the Dr. Hyman Show. Today we have an amazing conversation with one of my close friends, hero, and brilliant thinker about the things that matter in life, Simon Sinek, who's got an incredible vision of humanity that I love. He's a spark that ignites passion ideas. He envisions a world where people wake up inspired, feel safe and end the day fulfilled. He's an unshakable optimist, much like myself, a pathological optimist. I call myself. He's a trained ethnographer. He's fascinated by people and organizations that make a lasting impact. And he's discovered remarkable patterns in how they think, act and communicate, reveals how people perform at their best. And he's known for his TED Talk on why in his viral video on Millennials in the Workplace. I think his TED Talk has gotten over 80 million views. He's gotten many bestselling books. start with why in his podcast, A Bit of Optimism, which is amazing you should listen to, continues to inspire so many people. He's the founder of the Optimism Company and Optimism Press, and he shares all kinds of innovative views on leadership, which attract attention from all over the world. He recently had President Biden ask him to come to the White House to be on his podcast, to be on Simon's podcast. He worked with the US government, with the military, Rand Corporation, and he's just doing cool shit. So let's jump right into our conversation with Simon, where we talk about friendship, which I think is one of the neglected topics of our time, the thing that matters most about how we live and feel and At the end of the day, if we aren't connected, we can't be healthy. And so I think you're going to love this conversation about friendship, both from a humanitarian perspective and even a physiological perspective where we dive into the biology of friendship. So I think you're going to love it. Let's just jump right in. So Simon, it's great to have you back. I'm so excited about our topic today, which is friendship.

Thanks, Mark. Good to be back. It's such an important topic. So let's jump right in and get to it. So you are a world-renowned doctor on the cutting edge of functional medicine. You're one of the leaders of the functional medicine movement. you have a new company where you are helping people have easier access to those kinds of tests and community, etc. My big thing right now is I'm writing about friendship.

Yeah.

And I'm sort of mildly obsessed with it.

It's a good thing to be obsessed with it.

It's a good thing to be obsessed with it. So I'm sure people are asking, what do these two things have to do with each other?

Yeah.

Right? Now, they're a lot more closely related than I think, I mean, they're a lot more closely related, right? And I want to go down that path. I want to go down the path of the connection between health and community and health and friendship. You made a comment that you can't be a good friend if you're not healthy.

If you feel like shit, you can't show up and be present and be there for people. Be there for people. And be there for people. And yeah, just, even be present to have a conversation if you're foggy and fatigued and you feel like crap and you're dealing with all kinds of issues, it's hard to really be present and that's what you need to do to be a friend.

I'll give you a perfect example of this. A friend of mine is going through serious depression. He's going through, I mean, it's bad, bad, bad suicidal ideations, the whole thing, right? And he did this exercise where he Kept a diary for 28 days and he only answered three questions every night. What gave you energy? What sapped your energy? And what did you learn? And you're not allowed to read the entries until after 28 days. So for 28 days he did this and his career is up and down. And he thinks that it's this career stress that's causing his depression. Depression, yeah.

Right?

And so he went through this exercise and after 28 days he went back and he read all the entries. And what he discovered was career stress really accounted for like two days of sapping his energy. It really was a non-factor. Lack of sleep, poor diet, excessive cell phone use.

Excessive social media. It's a paradox because you need mental health to be a good friend. But if you don't have friends, it's hard to have good mental health.

Right.

So they're kind of synergistic and the depression, you know, is an interesting phenomena because we have such a crisis of mental illness in this country and part of it's because of loneliness, isolation, disconnection, you know, social media, all the things that I think you're thinking about and actually writing about, hopefully, with your new book on friendship.

Yeah, yeah.

But, you know, from my lens, you know, when I look at people's mental health. I look at it through the lens of biology because we now understand that the brain is obviously connected to the body, which has not actually been part of medicine. Isn't that a weird thing that that's.

A discovery that the brain is actually a part of the body?

The old joke in medicine is psychiatrists pay no attention to the brain and neurologists pay no attention to the mind. But now psychiatrists are paying attention to the brain and they're finding that brain dysfunction, brain inflammation is actually driving much of mental illness, everything from depression to anxiety to OCD to bipolar to schizophrenia to autism. All these things are connected to brain dysfunction. And yes, it can be caused by an external stressor, like a spouse dying or trauma or things that are external, but it also can be caused by nutritional deficiencies in your microbiome and environmental toxins and things that actually are treatable and measurable. And so I think, you know, I was just, for example, here a few weeks ago in LA and I was at an event. This guy comes up to me, Dr. Hyman, I tell you, I had severe bipolar disease when I was a teenager. I was on a pile of medications. I was on antipsychotic drugs. And I started, you know, reading your book on the brain and the mind called UltraMind Solution. And I followed your directions. I changed my diet. I took the supplements. I did that.

And now I'm good. And I got off of my medications and I'm a high functioning human. at a, you know, so do you have evidence? Do you have data to show that in our modern world with excessive packaged goods and processed foods and unhealthy microbiomes and unhealthy gut and all the junk and excess sugar, can you show from data that the the increased amount of shit that we're putting in our body in this modern day is directly contributing to the mental fitness challenges that so.

Many people are struggling. Absolutely, absolutely. I mean, so much data on this Simon. I mean, there's a very famous trial in Australia called the Smiles trial. They come up with all these great names for studies. But is Dr. Smiles? No, they essentially, I forget the acronym, but it was essentially they swapped out, you know, did a randomized controlled trial of giving people healthy whole foods and then versus processed food. And there was a huge improvement in mental health by eating whole foods on a depressed population. They've done studies, for example, in juvenile detention centers where there's a lot of mental illness and these kids, by swapping out the crap for healthy food, had a 97% reduction in violence and 75% reduction in use of restraints. 100% reduction in suicide rates, which is the third leading cause of death in teenage boys. Profound. And prisons is the same thing. You get prisoners healthy food compared to.

The crap, 56% reduction. And it's not like you're putting them on, like they eat the food you give them. It's not like they're going to the fridge and choosing. No.

So it's a great space for a controlled study.

It is, right. Because there's no choice involved.

It is, yeah. And so it's- It's not like they have a mindset of health. No. They're just eating whatever they're given. And then they violent crime goes down 56% in prisons. If you had a multivitamin, it goes down to 80%. and with functional health, we're finding a huge amounts of nutritional deficiencies. I just had a friend who's a vegan and he was severely Omega-3 deficient, very depressed, and he's piling on Omega-3s and his mood is completely different. And we know that Omega-3s play a huge role in mood. We know that folate and B vitamins play a huge role. And we know that many people are deficient in these nutrients.

And we can measure those biomarkers with testing that wasn't available before for people. Now it's accessible to anybody. Do you know what I think is really significant about this little insight? especially as we're relating it to friendship and having the mental capacity to be there for someone, to having the strength of mind to be present for someone else as they're dealing with happiness or sadness or whatever they're dealing with. They're just being there to be a friend. Is that so often when we talk about nutrition, we talk about eating right, we talk about you. We talk about so that you can be healthy, so that you can live longer, so that you don't suffer from chronic disease. And most of us, let's be honest, it's the same reason we don't save money. Eh, you know, if it doesn't have an immediate impact, It's the slow boiling frog. Nobody plans to get diabetes. It just kind of just shows up after years of being like, I'll deal with this tomorrow. In other words, we're crap at doing things for ourselves, even though the data is overwhelming that if you just exercise, sleep, and eat right, you'll be fine and healthier. But to think about eating well as an act of service to others, that I choose to eat well, not for me, Though I may get benefits from it, you know, as an unintended byproduct, I choose to eat well so that I can be a better friend to you. I choose to eat well so that I can be a better parent to my kids, so I'm less grumpy and less agitated.

That's right.

And to think of that, I think, as an act of service, you know, because like for me, like I am perfectly comfortable disappointing myself.

You shouldn't be.

No, I'm genuinely completely fine with it. Like if I wake up early, like before, you know, whatever my calendar says I have to do at the beginning of the day. And I was like, and I wake up, let's say I wake up two hours before my alarm, right? I'm like, oh, I could totally work out right now.

I have excessive time to work out.

Yeah, but I'd rather not. I'll just sit in bed and do the crossword puzzle.

Right?

And I'm fine with that. I suffer no guilt. I'm just like, ah, shit. And then I go about my day. But if I'm meeting someone early to work out before my day starts, I'll set the alarm, I'll be ready and I will not disappoint them.

Yeah, that's right. Illness starts with I, wellness starts with we.

Oh, yeah. Isn't that true? And so I think the correlation, and this is the thing that drives me nuts, when we think about things like innovation or we think about things like so, or health, is we make it a very I thing. You have to get healthy, you have to take a multivitamin, you have to exercise, you have to sleep. But we don't make it about a we. And you know the data better than I do that when there's a group of people who are overweight and one of them decides to go on a diet, the disproportionately high number of them will decide to go on a diet. If there's a group of smokers and one of them says, I'm gonna stop smoking, disproportionately high number of them will say, yeah, getting healthy is a team sport. Getting healthy is a team sport and.

We are absolutely influenced by our friends. Yeah, it's only as healthy as your five closest friends.

So it raises the question, 'cause clearly we're failing as a people, as a nation, at doing all the things you recommend. Because most of the things you recommend, at the high level, what you recommend is a lot of work, right?

It can be or not, it's just what you set up.

But at a functional level, a lot of the stuff that you recommend is not difficult, not expensive and pretty basic.

Yeah, it's kind of silly, but it is.

Right?

And yet, for not any more money, I mean, you can buy broccoli cheaper than you can buy McDonald's, you know? For not more money, a little bit of effort, but not complicated things, you can live, we can all live much healthier lives, and yet we're not. And so it raises the question, you know, are we banging against, our heads against the wall, are we repeating the same, behavior expecting a different result that maybe the drumbeat from the health establishment of change the way you eat, get more sleep, you know, maybe work out, like we're all exhausted. We all know that. It's not like, it's not like, it's.

Not like you're like, I think a lot of us know it, but there's a whole subset of our population that doesn't know what it means to eat well.

Different problem.

Yeah.

Different problem. A completely agreed problem.

It's shocking to me, but it's true even in the, and it's because the food industry has been so good at manipulating the public to think that certain foods are healthy that are not. And they put health claims on labels of stuff that's the worst possible foods.

All natural, which means nothing.

My basic rule is if it has a health claim on the label, it's bad for you.

Don't eat it.

If it has a health claim on the label. Because it happens, if it's trying to hide something, it's trying to hide something. It's like low fat. Low sugar, sugar free. What else is going on in there? Right.

It's like, I love the fiber. My favorite ones are new and improved formula. What was in the old one? Uh-oh.

So you were kind of going in the rabbit hole of, we know what to do, why don't we do it?

Why don't we do it? And I'm asking the question, maybe if we refocused our attention in a different place, let's call it friendship. And I, look, the way I've been talking about it is with the rising rates of anxiety and depression and mental fitness challenges and inability to cope with stress and then the worst case suicide, even the obsession with longevity, I'll go and I'll throw that one in as well, friendship is the ultimate biohack. It is. Friendship literally fixes all of those things. We know the data that people who have close relationships live longer, people have close relationships, you know, are happier. And you look at Dan Buettner's work and the Blue Zones, and so much attention is put to them walking to the house and to the, and so much attention is put into what they're eating and how they're eating. But not enough attention is put into the fact that they're eating with their friends every single day.

You're so right, Simon. I actually, I spent a lot of time in Sardinia and in Korea, Carrie, however you pronounce it. And it was just stunning to see the level of community and connection. Even if someone, for example, like this woman Julia was 100 and she was, I'm 103 months.

Like, you know, like I'm five and three quarters. I'm 103 months.

I think when you're very young and you're very old, every month, half the quarter. And now she didn't have kids, but she lived with her niece and nephew and there were no nursing homes. People just took care of each other, you know, and it was really remarkable. And it was this guy, Carmine, who basically had this huge farm that he had his whole life and his family had. And he was 86 years old and he was raising animals and had fruit trees and gardens and he was feeding his whole community and family had meaning and purpose and he would live with his kids and his wife had died. But it was all this incredible sense of connection and community. And it's so essential. And I learned this lesson when I went to Haiti after the earthquake and I was the first medical team on the ground at the main hospital, the General Hospital in Port-au-Prince. And it was a disaster. I mean, you can't imagine the scope. It was 300,000 people injured and 300,000 people dead. It was an unbelievable massacre. That was a natural occurrence, but it was horrible. And so we got there and there were people helping, everybody was helping. There was a sense of community and service and connection. And I got to meet Paul Farmer, who was a hero of mine. He was a man doctor who went to Haiti and decided that even though the whole world had neglected this community of people who were suffering from TB and AIDS because they were poor, they didn't have sanitation, they didn't have clean water, they didn't have watches, they couldn't take the drugs, it's complicated at that point to take the drug regimens for multi-resistant drug resistant TB or for AIDS. And he realized it wasn't a medical problem, it was a social problem. And he called it structural violence, what are the social, economic and political conditions that drive disease? And it wasn't that we needed better drugs or surgery, we knew how to solve it, but the entire public health community had given up on them. So he started to help by building a network of community health workers, neighbors helping neighbors, friends helping friends. And I realized, and he called it accompaniment, It was French, but I'm not good at pronouncing French, so I'm going to skip that. Accompany mon. Accompany mon, yeah, something like that. And he built this whole model, it scaled around the world. It was adapted by the Clinton Foundation, the Gates Foundation to help. He did this in Peru, he did this in prisons in Russia, he did this everywhere where people were struggling in Rwanda, built hospitals. And it was an incredible model.

And I realized that most of the.

Diseases we have now in the West are not infectious diseases. their chronic illnesses, which are called non-communicable. What's the difference? Well, infectious diseases like malaria, right? Or measles or TB, right? These are the things that all were.

Killing us a century ago.

Now they're pretty much not, except in certain parts of the world. But the diseases we now have are what we call non-communicable diseases. But that's a fallacy because they are very communicable. They're not infectious, but they're contagious. And chronic diseases like heart disease, diabetes, cancer, dementia, autoimmune diseases. These are diseases that are driven through many things, including our diet and toxins, but also through our social networks. And I realized that our social networks were more important than our genes. That our, that the, that the, that the social threads that connect us are more important than the genetic threads. And that you're, and the data is really clear on this. Chris Dawes' work out of Harvard outlined this very clearly. He was He wrote a book called Connected about this, but he's published the research that showed, for example, if your friends are overweight, you're 170 times more likely to be overweight than if your family is overweight, where you're 40 times more likely to be overweight, that your social networks are driving your behaviors for good or bad. So I realized that, yes, we have a society where the default is to do the wrong thing, and that we as a society aren't supporting each other to do the right thing. And I realized that community was medicine. just like food is medicine and that love is medicine.

And that's our anthropology, right? We grew up in, we're tribal animals that grew up historically in tribes about 150 people and that's how we lived. We lived in these relatively small, we help each other communities, communes. I mean that's the history of humankind. We've only started farming 10 or 12,000 years ago. But for most of human history we lived in these small groups where we couldn't have populations larger than about 150.

Yeah.

What's very interesting about the little statistic that you threw out and the thought that I had, which is when our family is overweight, we're 40 times more likely-- 40%. Sorry, 40% more likely to be overweight. But when our friends are overweight, we're 170 times-- 100% I mean, we're likely to be overweight. And that's, you know, the immediate thing that popped into my head was when you think about children, right? Children, all-- All they want is their parents approval. Hey mom, hey dad, watch me, watch me, watch me, watch me.

Right?

And they have no inhibitions in the outside world. They don't care what the world thinks about them at all. I'm gonna dress like a princess, I'm gonna dress like Spiderman.

Yeah.

You know, but I want mom and dad to watch me jump off the step.

Right.

And I desperately want mom and dad's approval.

Right?

And that's where all of the learning.

About.

What'S appropriate, what's inappropriate comes from strictly from our parents, nothing else. Until they reach about adolescence. And that's peer group. And adolescence, we convert to only needing our parents' approval, to only needing our friends' approval. Frustrating for the parents, but very, very important for social animals because what we're doing is acculturating outside of our families, beyond our families, into the broader tribe. And that lasts for the rest of our lives. We don't actually go back to the family. It's all friends. Which is why I have to believe, and I'm just sort of thinking about this out loud now, I have to believe that's the reason so many of us go on Instagram and wish our parents happy birthday when our parents aren't on Instagram.

Right?

It's for the social approval that I'm a good kid and showing all the pictures of my dad holding me when I was a baby. scroll through all those pictures and everybody likes that I'm a good son. And yet my dad's not on Instagram. And so I have to wonder if that same drive, that same weird need to want social approval for being a good son, is the same, it comes from the same root.

I mean, 100%. If your friends are all drinking green juices and doing that.

Then you're gonna drink green juice.

Then you're gonna do the same thing. If all your friends, the amount of.

Shit that I take, Simply because a friend's like, you should do, you know what it's equivalent to? Because you're in the industry, I'm gonna say something that's potentially insulting to you now. Please. That's what I like to do. I like to talk to guests and then insult them.

But this is potentially insulting.

Okay, we're friends, everybody, so I-- so this is potentially insulting, so I need you to work this through me. Okay, okay. It feels like, I can't say that it is, but it feels like that the complete explosion In the supplement industry, where nothing is evaluated by the FDA, and every influencer now has a vitamin or a supplement or powder or a drink with all kinds of nonsense claims, maybe they're good, maybe they're bad, it feels like we're living in the dot-com boom of supplements. That, you know, in the dot-com boom, you were like, I'm investing in this tech company because my neighbor told me I had to. And now that's been replaced with, I'm now taking these 87 pills per day because one friend told me to take these four, another friend, and just like the dot-com boom, you can't live in a bubble like that. It's going to have repercussions and it's going to be It's going to be unexpected and it's going to be pretty violent. So riddle me this, is it time for the FDA to get involved? I don't know. Is it like, you know, like it's like I can no longer tell the difference between a claim on a product you're selling or a claim on something that some, like literally their only qualification is they have a following on Instagram.

Yeah.

Isn't that a job? We're living in an influencer. Is that an influencer? Where was my course in college? Influencer 101.

We're living, I think we're living in a supplement boom.

Yeah, it could be.

And it's gonna, I don't know how, I don't know how it suddenly kicks back. Yeah. But this can't last forever.

Yeah, I think there's, and it's counted.

To everything you're trying to do.

Yeah. What I want people to do is do the right thing. And I think, you know, it's, it's what I've, I've spent my whole life trying to do is help people understand how to create health. And part of the, the new company I co-founded, function health is really empowering people with their own health data to make choices that are personalized that aren't just random because somebody said, do this or do that. And so that's what I love about the testing. I had a, for example, a friend the other day who showed me her results from function, and she was low in zinc, she was low in iron, she was low in vitamin D, she low in omega-3 fats. I'm like, oh, that's why you feel like crap. You need to take these things and here's what to choose. But most people don't have a way of navigating this sort of morass of products that have, again, no regulations in terms of quality or efficacy. Now, that was sort of a deliberate decision. It was sort of put forth by our own Hatch, who was from Utah where there's a big supplement industry and it was called the DSHEA Act. It's got a lot of problems because people aren't protected in the sense that they don't know if the product they're taking has the exact ingredient it says, if the dose is what it says on the label, if there's any contaminants in it, if there's any fillers or products that kind of may be harmful to you. So it's kind of a shit show. And so as a physician, I've spent a lot of time investigating which companies are using pharmaceutical manufacturing practices, which do testing before and after their products so they know that the purity and potency is exactly right. and they throw their product out if it isn't. So there are good companies that are doing that, but it's like, oh no. You can't, unless you know what to ask.

I did a thing a while ago.

Where, There's a way to learn about this.

Where they took my blood and they evaluated all of everything in my blood from, I mean, you name it. All the minerals and everything I'm supposed to get and have. And then they made a personalized cocktail. A personalized smoothie. that replaced all my things and I'm supposed to come back every six months. And it was really interesting and they introduced then I talked to a doctor who walked me through my results and then they give me my smoothie and the only choice I get is what flavor and it sounded good until I was like, I don't even know if this is bullshit. If they're just like, I don't ask.

Well, that's a problem. If someone's selling you something off of something else, that's that's that's the that can be a problem. It's not always a problem, but if you're thinking, I've done all of the.

Things for a little bit. Like, I took AG1 for a few months and that was fine until I was like, I don't know, maybe just vegetables better.

Did you do the customized shake that they gave you or not?

I just did the generic AG1 that.

They- no, no, but when you got your results of all the tests, they gave you the recommendation, did you try that?

Yeah, yeah, yeah. I mean, I do all these things, I feel the same. Like, I've done AG1, I've done colostrum, I've done, I mean, I've, you know, and again, all because somebody's like, you should try it. And there are people who I trust. That's why I did it. Yeah. And, you know, they, like, you take these things, like, it boosts your immune system.

And how do you measure that?

Right? I, exactly. I got a cold. So does it work or does it not work? Well, it would have been worse if you, I mean, like, I don't know. And I, you know, you, I start, I get very cynical. Sometimes I'm all in and sometimes I'm very cynical.

I'm in a very cynical mode. No, I hear that. I hear that. And I think it's And you're right to be cynical. And I think there's a lot of garbage out there and a lot of people pushing stuff. And there's a lot of companies, for example, doing tests and then selling you products on the back end. I think there's a problem with that. For example, Functional Health, we don't do that at all. We just say, okay, for example, you have these things that you found that you need to fix that are affecting your health and well-being.

And here's how to make a decision. For example, we have a 30-page guide.

On how to choose the right supplements. And you don't take- We don't sell any supplements.

And you don't take kickbacks from the.

Products that you recommend. No kickbacks.

No, no, no.

We're completely agnostic. We don't have any problem.

Do whatever you want, you just need this.

Yeah, but not only do I want it, but if you need something, here's.

How to choose the right product.

Got it.

Here's how to investigate the company, here's the questions to ask, and here's what to look for, and here's how to make a good decision. So we teach you how to fish, not giving you a fish.

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I like that you're doing this, but I remember I'm in a cynical mode.

What else is new?

Which is when there's a good business model, even if it's for the greater good, because money is fuel and that's totally fine, that means you will have competition and other people will start doing similar things. And then we're back at square one, which is all of these companies are going to be funded by VC, and you and I know too well, unfortunately, the way VC and PE works, which is they all are wonderful. They're all fantastic. in the beginning and they're so behind you in your vision at the beginning and just wait three to five to seven years and all of a sudden the pressures start to show up and the growth, we want growth because that's our business model, not your business model. And then all of a sudden, especially if you've given up controlling interests, you will have built up this beautiful brand, you get fired from your own company and they're, I mean, the number of companies that have like that where the brand Aveda, Burt's Bees, Kashi, you know, Amy's.

These were, well, they got bought by Kraft.

You know, they were all great brands that built their brands based on like Aveda or Burt's Bees, natural ingredients, Kashi. And we believed it because the founders were true, and then they sold to Kraft and L'Oreal and whoever buys these companies. They strip the beautiful things out, put the shit in because they can increase margin. But we're none the wiser. We don't know. which CEOs got fired from beautiful companies. We don't know that these companies are owned by large conglomerates that are driven by shareholder value. And then we end up suffering for these products that we were told were good and they were good until they weren't good. And we're back at square one. So I think we should just have friends.

Well, let's get back to the conversation about friendship because I think that the fundamental thing is-- we should We should.

Garden and farm with our friends.

That's right.

And then eat our own food.

Oh, we can't live, you know, I.

Mean, when you look at that, Subsistence farming. That's what it is.

I think that's right. I mean, I think, you know, community gardens are amazing. I think they're a great service for people. And I think that what we're finding is that loneliness is as big a killer as anything else. Some have said it's equivalent to smoking two packs of cigarettes a day. And how many, especially men, don't have someone who's a good friend? How many people don't have somebody to call when shit goes down?

I've talked about this before where, as I've been on this journey of understanding friendship and learning friendship, I was having a conversation with a friend of mine who's active duty military. And what people don't understand about active duty military and veterans, what people don't understand about military, is that it's a highly emotional enterprise. It's a very, very human enterprise because life and death is the thing. And higher calling and service are big, very human themes. And so I've hugged more people in uniform than I've ever hugged in suits. I've cried with more people in uniform than I've ever cried with in suits. I've sat around dinner tables with generals who were sort of telling stories at the dinner table and we're all crying. I've never done that with CEOs.

Ever.

And I remember he's a very close friend of mine and we were just catching up and at the end of our hour-long conversation, he getting off the phone and he says, I love you. Not love ya, not love you, I love you. And to your point, I think men really struggle with saying those words to the people who they genuinely love. And so I did an experiment with my friends. I remember that feeling of what it gave to me when he said those words to me. It took me aback and it felt amazing. Yeah, it felt amazing. And so I started experimenting. I have a couple of friends who, if you met them, you wouldn't describe them as warm.

They're wonderful people.

They're generous and they're kind.

They're not fuzzy.

But they're not warm. You know, if I told you this is one of my best friends, you'd be like, He's a little distant is what your reaction would be.

He has Asperger's.

They don't have Asperger's. They're just a little cold. They're just a little guarded. They're guarded. Let's call them guarded. And one of them, I was leaving his house and as I was getting ready to leave, I said, I love you.

And I watched him.

I watched him. No, he didn't freak out. I could see the reaction. And since then, he has been much more emotionally open with me, and I don't even think he realizes it. I don't think he realizes he wasn't before and that he's more now. And the other one I tried it with and I sort of said, I love you and I gave him a kiss on the cheek as I was saying goodbye. And he did not know how to react. And I did it again the next time I saw him and he hugged me the second time like I was his son, which he'd never done before. He's always nice to me. He's one of my best friends. He's never hugged me like that before.

Yeah.

And I realized that to take the risk to say, I love you, if you mean it, it's got to mean something. It's hard, it's easy to say love you. It's easy to say love you. It's very hard to say, I love you.

Right?

Those three words together are brutally hard to say, especially for men. And I, to your point, you know, I wonder, and this goes to this idea of service again, which is whose responsibility is it to say it?

Right?

And I go back to the work that I did some years ago when I was writing Leaders Eat Last with Alcoholics Anonymous. You know, if you want to overcome alcoholism as a 12-step program, most of us are familiar with the first step, you know, admit you have a problem.

Yeah.

Okay, let's say I'm depressed or I'm lonely. Let's admit that's the problem, right? But it's the 12th step that people don't talk about.

Right.

And Alcoholics Anonymous knows, exactly. Alcoholics Anonymous knows that you can master 11 steps and not the 12th, and you will succumb to the disease. And it's exactly to help another alcoholic, it's service. And so I think to find the courage to say, I love you, I think the people who are the most lonely are the ones who have to go first. Because the way to solve your problem is to help your friend who's suffering from the same problem. If you're an alcoholic, you help another alcoholic. If you're lonely, help a friend who's lonely. And I think that the therapeutic benefits of helping someone who's struggling with the same thing that you're struggling with, rather than worrying about yourself, goes right back to the gym.

There's a huge biology to it, too. I don't know if you know, but there's a whole field of sociogenomics, which is how our social interactions affect our gene expression.

Say more?

So if you're in a conflictual relationship with someone, your inflammatory genes are turned on. Literally, not just your emotions are inflamed, but your biology turns on the inflammation system. Like fight or flight kind of stuff. Not fight or flight, just if you're in a shitty relationship or if you're fighting with someone or you have a conflict, you turn on inflammatory genes that then increase expression of cytokines that cause inflammation and that cause disease. And all chronic disease from depression to heart disease to diabetes to obesity, Alzheimer's are all inflammatory diseases. Conversely, if you have a connected, loving relationship with somebody, it turns on anti-inflammatory genes.

And inflammation is the core of everything. Yeah.

And maybe the study with entrainment, where if you sit with someone and you have an authentic connection that you can put EEG and EKGs on, basically brain waves and heart waves, you can see the heartbeat of someone you're having a deep connected relationship with in your brain waves. It's wild. So it's not just a feel-good thing on an emotional level. It's a physiological response that happens of being in connection. If you take animals and put them in cages and separate animals and feed them exactly the same thing and have everything else the same, the one that's isolated versus the ones that are connected, will shrivel and die and get sick. And so humans are the same way. And we've gotten into a situation where friendship and connection is sort of like...

Okay, so why aren't doctors prescribing to spend more time with friends?

I do.

Like doctor, I'm suffering from X, Y, and Z. Okay, I'd like you to try and get an extra hour of sleep, go to bed a little earlier, I'd like you to stop eating before, you know, eat no don't eat past eight o'clock at night, and I want you to spend at least three hours a week with a friend.

How come that's not on a prescription? It should be. It should be. I prescribe it. In fact, I actually, based on this work that I did in Haiti, I met a pastor after Rick Warren, who wrote the Purpose Driven Life, and had a church with 30,000 members. And I met him, he came to my office, and we started talking, and I said, Hey, Rick, tell me about your church. Because, I'm a Jewish doctor from New York. I don't know much about evangelical Christian churches. Like, yeah, we got 30,000 people. Like, wow, that's a lot of mega church. He's like, yeah, we got 5,000 groups that meet every week, small groups in the church to help each other live better lives. I'm like, oh, this isn't a mega church. This is thousands of mini churches. And I had that light bulb moment. I'm like, well, I just come back from Haiti. I said, why don't we put a healthy living program into the groups and see what happens? He said, great idea, because I was baptizing my church last week, after about the 800th person, I'm like, man, we're a fat church and I'm fat and we gotta do something about it. And so we put a program together through the small groups where people were just helping each other. There was no doctor, nutritionist, health coach, nobody. There was just a curriculum. We had a big rally, sort of a big event where we talked about, and Rick talked about the biblical rationale for why God wants us to be healthy. I gave a bunch of speeches and talked about how God lives in you, why you feeding him crap and things like that. I mean, if Jesus came to dinner, what would you feed him?

Big mac fries and a coke.

And they got it.

Ain't that the truth? Ain't that the truth? If Jesus came to dinner, what would you feed him?

Exactly. So they got it. I said, you know, if you feel like crap, how are you going to serve God? How are you going to serve each other? You've got to take care of your body. And so they got it. And they did this together in community. It was jogging for Jesus and all these incredible. It was incredible. And they lost together a quarter million pounds in the first year, and they did it together. And then I took that same model and I applied it at Cleveland Clinic, where we created small groups where people helped each other. And we did research on us and published it. There were three times better health outcomes on validated metrics of health outcomes compared to one-on-one visits for the same condition with the same doctors. So the doctors at our clinic could see them in one-on-one or they support.

Them in a group.

The group was three times as good as seeing the doctor one-on-one in terms of health.

But why aren't these things then being implemented across the medical field.

Trying.

Why aren't we going to the doctor with our friends? Yeah. To dealing with similar issues. Why aren't we, like, everything's so siloed, literally.

It's in, it is essential. I mean, I think, you know, the models of support, whether it's coaching, whether it's one-on-one coaching or support, whether it's group models, they have to be the thing that's going to change because our We get healthy together or we get sick together. So the quote from Benjamin Franklin is, We must all hang together, or surely we will all hang separately. I mean, and I think that's kind of where we're at in society.

That's kind of where we are, yeah. I'm very glad that we are talking about this because I have a lot of respect for your work and the fact that you're validating all this friendship stuff that I'm doing from a physician's standpoint. Not a Kumbaya, it's nice. No, no, no, no, no.

There's so much science on this. We wrote a book about this work called the Daniel Plan, after Daniel from the Bible who resisted the king's temptation of rich food and was better for it. And we talked about the five Fs, you know, food, fitness, focus, which is your mental fitness, faith, and friends.

Why are not friends number one?

Well, they were maybe in there somewhere. I do not know. I do not know the order, but it was like, no, no, but the whole point is friends are such a key part of our well-being, whether it is understanding the blue zones or how, whether it's AA or Weight Watchers, it's how we change.

I mean, AA, all of these things, Weight Watchers, they're all community-based things. 100%. And one of the problems we have in our society is community things, you know, bowling leagues don't exist anymore. You know, church attendance is down. Yeah. You know, so in church attendance and faith are not the same thing. You know, you can have faith and not go to church and you can go to church and not have faith. That's right. You know, the church would rather that they're overlapping.

Yeah.

But, But the idea of doing things in commune, in community, this is why I love things like Comic-Con or Burning Man or whatever you're, you know... Now.

You'Ve never been to Burning Man.

I have been to Burning Man. You have? Yeah. Or Sturgis. Is that what it's called? Yeah, it's called the motorcycle thing.

Yeah, Hell's Angels.

Like all of these things, like, I don't care, like politics aside, I don't care what it is, going to church, you know, doing things in community with people who have common interests. And, you know, one of the questions I'm getting since I've started talking about friendship, it's amazing how many people are coming up to me who are of all ages, of all income levels.

Who.

Are saying to me, I don't know how to make friends. I struggle to make friends.

Because they're afraid to be authentic.

I mean, that's the hard part, right?

Is it. Have you ever struggled to make friends? When I was a kid, I didn't have any. I was a weird kid. I just was in my head, read a lot of books. It was a little weird and, you.

Know, kind of a nerd.

-Huh and I just didn't. And you had a lot of health issues when you were younger. Not. Not. Not really. They came later. When I was in my 30s. Okay. Okay. And I just. I was living in Toronto in the 70s. It was spiritual Wasteland and. I was just did not kind of relate to anybody. And it wasn't until I left and went to college and went to Cornell that I found other people who were like, oh, wow, you actually think like me and you read the same books, you do the same things. And in fact, I actually, my first real friend I met on the top of a mountain in the Canadian Rockies, we were backpacking and it was a week out. in the middle of nowhere by myself. And he was a week out and we crossed over on Badger Pass in Alberta in Banff National Park. And we just had this kind of moment of connection. And we both found out we're going to be at Cornell in the fall. He was in Ithaca College. I was at Cornell. We climbed this mountain the first night called Brachyopod Mountain. It was like 11,000 feet. It was like this kind of prototypical pointy top mountain. We sat on the ridge and watched the sunset at 11 o'clock at night and then ran down the screen. We just had this extraordinary experience and we got back and we got together and, you know, we didn't know if we were going to be friends or not. But we, we became like brothers and still friends today. He's my best friend.

Yeah.

We 40, 46 years later.

Wow. Yeah.

46 years later, we do mountain bike trips all over. We were, we're very close and, you know, we help each other. And when one's down, the other picks one up. When I'm down, he picks me up. When he's down, I pick him up. and we've had this really sustained, deep, authentic, intimate relationship for 45 years.

That's amazing.

And we love each other, we hug each other, we cry together, we laugh together, and it was a place where I could say and be and do anything. And it was a remarkable experience for me to actually feel seen and loved. It was like the first person who loved me who didn't actually have to love me like my parents.

They didn't have to love you.

They just didn't have to love me. That was like, and that friendship for me has been like an anchor in my life. Throughout all the troubles and tribulations and successes and diseases and, you know, his wife committed suicide. I went through three divorces. I got very sick. He's such an overachiever.

Yeah, I know. I'm an expert at relationships.

I mean, what did WC Fields say?

Quitting smoking is the easiest thing I've ever done. I've done it hundreds of times.

That's right.

Marriage is the easiest thing I've ever done. I've done it four times.

I got it right though.

Here's something I discovered about close friendships, right? Which is we always talk about close friends as the person you would call when you're in need, when you need help, the person you can cry with, the person when you're in pain. And I actually think that's true. That's a level of close friendship. that you can call that person in a time of struggle or need. But I think there's even a closer level of friendship, which is when you can call somebody when something amazing happened. Yeah, and they're not jealous. And there's no jealousy, and you can call them, and what you're doing is bragging, but not really. You just need to tell someone about this amazing thing that you accomplished, or that was given to you, or that you won, or that, you know, whatever it is. And if you were told anybody else, they'd be like, they think you were bragging? Yeah, yeah. But to that friend, they have unbridled joy with you and for you. And what I've learned is the number of people I would call with good news is actually smaller than the number of people I would call with bad news.

That's interesting. But you can call me with good news.

Oh, thank you.

I'll celebrate.

But do you know what I mean? It's like to, you know, and, and like a friend of mine called me recently about something amazing that had happened in his life. And I was the first person he called. And I had no jealousy. And I was like, I was kvelling like a parent. I was so proud of him for what he did. And you realize that that was actually more intimate than being there in pain. And so I started making lists of who are the people I would call for the insanely good things. And it's a smaller number.

Well, it is. It's important to take an inventory of your life and your friends. And if you don't have good friends, it's really important to cultivate them, to invest in them, to find them. And there's ways to do that. I mean, there's ways to put yourself in environments and situations. And part of it's like who you are, right? For me, you know, I wear my heart on my sleeve and I'm just who I am. Like when we met.

Oh, I remember.

It was a weekend and I just got through this very intense emotional process. I worked a lot of this trauma that I had experienced as a kid, and I was just kind of like in this altered state, and then I met you and I don't remember.

Oh, I remember.

I think that's why we became friends.

You put it on your sleeve.

Because I just shared authentically and we just then had this connection. And that's kind of what I'm talking about is in order to actually create friendship, you have to be open. You have to open your heart.

I think people sometimes treat... And not.

Be afraid of being judged.

I think people sometimes treat friendships like bad food.

Right?

So...

I don't get that.

But here's what I mean. I just had this conversation with a friend of mine just very recently. She's in a relationship and... She's afraid of being alone. She knows the relationship is imperfect. She knows that if she were in a different place in her life, she wouldn't be with this person. But that partner fills a space for her for where she's at. She's more afraid of the loneliness than being in an imperfect relationship.

Yeah, doing that.

And I don't know how healthy that is.

The devil you know is better than.

The devil you don't know. And she can rationalize it, like they go on adventures together and they laugh a lot together, which is all true. But then now as I'm talking to you, it kind of sounds like cake, which is, I know I shouldn't eat this, but it's so tasty and so chocolatey.

Yeah.

And just so good. And I'll worry about it later.

Yeah, yeah.

You know, what's another little piece? I'm just having a little piece of cake. And the good, I can, I can, I can, I enjoy the goodness so much that I can ignore the badness. Yeah. And- We tolerate a lot.

We tolerate a lot. And, you know, this is one of.

The downsides of human beings, which is we're incredibly adaptable people. We're incredibly adaptable.

Oh, I did that for so many years in relationships. I was like, oh, it's good enough. Oh, this bad stuff, I just rationalize away.

So how do we, okay, you're a doctor. You know, one of the things I'm exploring in this friendship book is how to make friends, how to foster friendship. That's the thing I think most of us fall down on. How to navigate tension in friendships and how to end friendships. How to recognize that I really like this chocolate cake, but I think I need to not be in friendship or in relationship with this chocolate cake, and maybe we'll just hang out now and then. Yeah. You know, because I do have fun with you, and I do like you, but this is not healthy. At a certain dose. At a certain dosage. There's a certain dosage. And I've adopted wholeheartedly, by the way, just as a quick aside, you know, something you say regularly, which is treat sugar like a recreational drug.

That's right.

You know, I enjoy sugar, but I know to do it just occasionally. It's all right. You know, it's okay. I don't, I read once, and you can affirm whether this is correct or not, that when people stress about eating dessert, the cortisol released from the stress about eating the cake is actually worse for you than the chocolate cake.

It might be, yeah.

So, if you're gonna have a little piece of chocolate, just enjoy it.

Well, I did, you're right, Simon. And the greatest pharmacy is the one between your ears, and it can actually kill you. or it can heal you, literally. I mean, that's how, you know, voodoo works. It's not like they just kind of like put a hex on you and you die. I mean, people, that actually happens.

Yeah.

So I, I think how we think about things matters. So if you, you want to eat a cookie, eat that cookie and love the, just enjoy it.

And treat it like a recreational drug. Just have one, two at the most. You know, in one of, one of my tricks, if there is like a bowl of M&Ms.

Yeah.

If you take a handful of M&Ms and throw them in your mouth, that counts as one. That's one mouthful. And then you take another handful and put it in your mouth, that's two. But if I have one M&M, that's also one. And if I have another, that's because you count mouthfuls, not M&Ms. And so if you just go from handful to one or two, you drastically reduce the sugar intake. Anyway, but we digress. How have you ever, I want to understand the health issues of staying in unhealthy friendships or unhealthy relationships where we know, and when we're in the dark parts of the night, we'll admit to ourselves or out loud, this is not a good relationship and I shouldn't be in this, but I fear the alone more than the thing that I'm in. Talk about the physiological impact of being in an unhealthy relationship.

Yeah, well, we sort of touched on it before, but when you're in conflictual relationship. Your physiology changes to a state of disease. Cortisol goes up, your inflammatory cytokines go up, your microbiome can change. I mean, a whole series of things happen in your body that make you more sick. And we see this happening. We see people who are in bad relationships just do poorly and get sick more often. And so I think the data is there. It's just really, the question is how do we navigate a world where friendship is not of value? It just seems like the last thing on the totem pole. And after work, after success, after social media, after whatever, or else we're doing exercise, food, it's not something we invest in. It's a crisis. It's a severe crisis. I mean, I don't know, you probably saw the articles in the New York Times about men and friendships, and it was just so heartbreaking. And for me, it's been a value I've had my whole life, and I've intentionally invested in friendships. And when COVID happened, you know, we're all isolated, we're all alone. And September 2020, my wife and I split up. I had just had back surgery. I was alone. it was COVID. And what did I do? I sent an email to my closest men friends, six other men who I've done men's work with, done men's retreats with, done medicine journeys with. And I said, Hey guys, can we start a little Zoom once a week for an hour maybe? And they're like, How about we do two hours every week? And we've been going for It's plus four years now. And it's remarkable to have this container. And what's been interesting to watch is that even though these were all my close friends for 40 years, 30 years, that the depth of our friendship has gotten more profound, the more vulnerable we've gotten, the more we open our hearts, the more we share our fears, the more we share our successes, the more we share whatever is going on in our life doesn't matter. there's always something with one of us.

And.

To me, it's like an anchor. And most of us don't have that. And in Okinawa, one of the Blue Zones, they have something called a moai, which is when you are born, you're stuck together with like three or four other kids, babies, and that's your basically group for your life. That's amazing. Yeah, and you're there throughout everything.

You didn't even pick the friends. I mean, this happens with like the Marine Corps. or any boot camp for that matter. These become lifelong friendships because you go through hardship together. Or in the Israeli army, one of the reasons they're historically been very successful is when you go through boot camp, that's your unit for the rest of your military career. You don't get split up. So what I think is really interesting is these friend groups aren't chosen. They're kind of like arranged marriages. You're just thrown together by zip code or in the case of babies, like, oh, you're born on the same day, you're friends.

Friends. Yeah, exactly.

Right. And I think what's really interesting about that, which is, you know, sometimes just like, I think sometimes we over analyze, you know, who should be a friend. Am I, is that right? Well, I mean, listen, we have to, I'm trying to think, maybe I disagree with myself as I'm saying the right thing. I mean, it depends on the situation.

When you're, if you go through with somebody, even if you don't, you don't have all the same background, you can get close.

Right.

Yeah.

And I, I mean, I was in Haiti. I was thrown together. Yeah.

Yeah.

Because we know that shared hardship produces cortisol. I mean, shared hardship produces oxytocin. So when you go through shared hardship with someone, it creates a bond of, it creates bonds. But now that I think about it, I'm gonna go back on what I said, which is I also know friendships and have had friendships where time is the only bond, where we really don't...

That's not enough, though.

We used to grow together, but now we've sort of grown apart. And we have fun, I guess.

Sometimes being a friend is actually calling people out. In other words, if you're growing up.

But I think we stay in friendships unnecessarily simply because, oh, but we've been friends for 30 years. So what? So what? If it's no longer, it's like you wouldn't stay in a marriage that is dysfunctional just because you've been married.

That's right.

And yet we seem to have a different standard for, like, nobody says, when you say, you know, I've been married to my wife for 25 years, but, you know, we've struggled for a lot of years, and quite frankly, I think we've just decided mutually, you know, it's amicable, but we've decided to call it quits. Nobody says, I think you should stay in the marriage.

You've been married for 25 years.

Like, I think you, I think you should try and go another 25.

But nobody says that.

But part of the friendship, but we say that in friendship. Like, how can you end the friendship?

You've been friends for 25 years. Well, you can if it's, but I'm saying people It's a different standard.

Time becomes the only bond.

It's true, but sometimes when you drift apart or some people change, like if you're changing and you're growing or I was changing and growing and your friend isn't, and you see this sort of hard split happening, you have one of two choices. You can either go, okay, well we're just moving apart and it was a nice while it lasted. Or you can actually kind of go in for kind of a surgical, spiritual surgery. And sometimes it's painful, but I've done this with friends where I've seen them be in bad relationships or be in a job they didn't like or doing things that were contracting their life and becoming smaller when they were expansive open beings when I knew them earlier. And I had a choice where I was going to just kind of let this happen or was I going to go in for.

Yeah, yeah.

A surgery and I was.

Was I going to do a spiritual surgery on this person?

And.

And some of those people are open to it. Some of them are not. Yeah, but, you know, I had to drug them. Literally, I had to give them MDMA. I don't like. literally spend hours acid and basically get him to really see how his life. That's a little extreme. Contracted. And he needed that, you know, like, and he needed to kind of break the cycle of his pattern of thinking. And now, you know, he's lost 40 pounds. He's out of the relationship. He's free. He's got out of his job. He's, you know, kind of having the time of his life. He's exploring his own development. He's growing. He's let go of his fears around money and this and that. I mean, it's amazing to see a transformation, but it wouldn't have happened if I hadn't leaned in.

Yeah, yeah. I have a friend who sat down with me to give me some life advice. Yeah. And the conversation started like this. I need to tell you something and you need to hear this. And I need you to know that you're not going to like what I have to tell you.

But I love you.

He didn't say that. He said, you,'re not going to like what I have to tell you. And I recognize that you may be so angry with me for telling you this that you might end the friendship with me. And I want you to know that I'm willing to risk our friendship to tell you this because you need to hear it.

Wow. And how did that land for you?

I mean, he picked the right person, because I'm like, yeah, I mean, you're not going to lose the friendship, but bang, game on, right? And he gave me something that was very hard to hear that needed to be said. And I love him even more for risking the whole friendship out of love. Like he was willing to throw away the friendship because he cared about me so much to tell me this. And so that is, that's a high bar.

I mean, I think that speaks to, I think what's, what, you know, he's a remarkable friend. He finds friendship, you know, in my mind, what defines friendship is the ability to be authentically who you are and to be authentic and transparent with your friend. just like your friend was. Yeah.

Right.

I mean, he gave me the whole Preamble.

Yeah.

And that's, that's a, that's a, it's a very scary thing for people to actually let down their guard.

Yeah.

Right. To be open and to risk. And, and it's fearful, but, but that's what creates real friendships.

Yeah, I think so.

That's what creates real friendships.

Another friend of mine is struggling. I'm, like, I'm so attuned to friends these days. Another friend of mine. is struggling with one of her friends. And she asked herself, if I was in a marriage or just a romantic relationship, a long-term romantic relationship, and the relationship was struggling, we wouldn't just break up. We would get help. We would seek therapy, couples counseling. And so she went to her friend and said, this attention has been going on for too long. We're going to go to therapy together. Friends therapy. And again, why do we instinctively understand that if a marriage or a relationship friendship is struggling, that we expect people to at least try, to at least try the couple's therapy before you call the whole thing quits, before you call the whole thing quits. And yet we don't do that with friendships. When we have tension with friendships, we're quicker to end the friendship or sit in weird tension or avoid the person than to go to the therapy with the person to try and work through the struggles. We may still end up breaking up.

Yeah.

But let's at put in the effort to rescue this friendship that we claim we care about. I love the idea of friendship counseling.

Yeah, and it speaks to that same point about not just co-living in a sense of just doing things together.

Existing together.

Yeah.

Going to movies together and having fun together.

Yeah, just superficial dinner.

And by the way, I will stress that I don't believe all French friendships need to be at this level. It is perfectly fine to have friends. You need at least a handful. Some have more, some have fewer. But having friends where they're not deep, you know, bonds of vulnerability, you just have fun together. Totally fine. You have adventure partners or activity partners. Totally fine. I don't mean, and I think that's one of the problems we have in our country, if not the world. I don't know about other languages. I only know about English. But one of the problems, I think, is language. So for example, if you have stage four liver cancer or you have a mild melanoma, the problem is both of those things are called cancer. But they are clearly not the same thing. But we use the same word. Right.

I have a skin cancer.

Right. Exactly. I was like, you,'re fine. What did Larry David say? It's the good cancer. And I think we do that. I think we have very few taxonomies. We have very few words. for friends, you know? And so I've started using... Best friend, best friend. Yeah, that's pretty much it. And even then best friend is sometimes a little overused, you know? So I've started really trying to add more language. When somebody says, Hey, aren't you friends with them? I go, I'm friendly with them. Or somebody says, Aren't you close with them? I'm like, no, they're an acquaintance. Or they're a work friend.

Yeah.

You know? And so I've actually started to use the language for my own clarity and for other people's clarity, that everybody that I know is not my friend. I know them, sometimes I like them, or I'll say it's a new friendship, or we're friendly. And I've become really good about sort of categorizing people because some I want to invest in, and some I'm okay with them being at that level, but I want both myself and everyone around me to make no mistake. Not everybody I know is my friend that I'm gonna like.

You can't have an infinite number of friends. I can't have an infinite number of friends. It takes time.

It takes time. Investment is a real thing.

Yeah, and that's the thing I think we neglect, right? Is making a deliberate effort to spend time with friends, to do special things, to kind of take the time to slow down and stop.

I think so.

And actually have conversations that matter. and it's kind of the last thing we tend to think about. But as we talked about earlier on, this is a central part of happiness, of joy, of longevity, of health.

By the way, go back to that longevity thing. You're in that space and you know more of them, but I know some of the folks who are sort of like the longevity folks. And I find a lot of them are very unhappy people. Joy, right? Where's the joy? These guys, mostly men, who are obsessed with longevity and they're taking all of the measurements and they're taking all their vitamins and supplements and they're doing all the exercises and they're doing all the things and everything's scheduled and highlighted. And I find them not very happy people.

No, no. You know, find the joy.

Find where, like, wear, like, maybe work out a little less. Don't worry about if you miss the supplement and maybe just. Hang with friends, I bet. I mean, the data will prove it out. Like, we have to wait a bunch of years because the longevity obsessives, the only way we'll know if it works or not is when they die. Yeah. And if they will be happy and healthy in old age. Yeah. Because nobody wants to live a long time and be decrepit.

No.

You know? And so we have to wait it out.

That's why I like, I'll have to wait it out. My friends are in their 30s and 40s now because So, like, you know, a lot of my older friends have just sort of checked out.

But.

We have to redo this podcast in 40 years and see if all the longevity obsessives, if they're still around or if they're dead, I'm gonna do a Vegas betting pool here, which is I would bet that the people who are healthy-ish, they're not unhealthy, but they're not obsessively healthy.

Yeah. Right?

Yes, they get enough sleep. Yes, they eat mostly well.

They do the basics.

They do the basics. Sometimes a little better, sometimes a little worse. Like on vacation, they're terrible. They're not obsessive, but they're not unhealthy is the way I would define them. But they spend a ton of time with friends, and they have a fantastic sense of humor, and they love to laugh. I will bet money that those people will live longer Then all of the folks who are measuring and powdering and-.

I mean, it's evolutionary. I mean, I don't know if you know, E.O. Wilson wrote a book called the Social Conquest of the Earth about, from ants to humans, how we have to work together to survive. And in fact, altruism is a built-in phenomena and that it activates the same neural circuits as heroin or cocaine or sugar in terms of the nucleus accumbens and the pleasure. and I remember this. It sounds kind of weird to say, but when I was in Haiti and I was sleeping four hours a night and I was working, you know, helping people all day, you were barely eating anything, you know, probably dehydrated in the hot sun.

I felt like the sense of happiness.

And joy, like I'd never felt. And it was weird because I was in the middle of this disaster with people, you know, with limbs amputated and dead people everywhere. It was. It was. The stench was amazing, but something was happening in me where. I was in service of others. I wasn't thinking about myself. And it's sort of why do what I do? I mean, I'm always in service of others and I always am happiest when I'm serving others. You know, like before this podcast, I came because I was helping somebody and I was late because this person said to my kid, you know, needs help and he's sick and he's got this issue. Could you also help him? And I'm like, okay, yeah, yeah, I get it.

And you know, because I can, I do. There's a book called Survival of the Friendliest.

That's good.

And it makes an argument that we've completely misunderstood Darwin, that the idea of survival of the fittest, we have always attributed to brute strength. And so if you can overpower someone, you're more likely to survive. And they make an argument for social animals and mammals that that's actually completely incorrect, that what he meant by fittest was most fit to create community and take care of each other. And survival of the fittest is actually nothing to do with brute strength. Fascinating. But it's actually to do with the.

Ones who are better at taking care of each other. So as you started thinking about this book, Simon, and I can't wait to read it, even though you haven't written it yet.

That's a good sign. I should put it up on Amazon.

Drive those pre-sales before.

I'm going to pre-order it. Cover to come, title to come, yet untitled book.

And as I think about it, I don't, I can't think of a lot of books on friendship.

Well, this is the reason my friend Will and I decided, my friend Will Gadda and I decided to write this, because it seems to make sense that you should write a book about friendship with a friend. Writing a book about friendship by yourself doesn't make sense. So, Will and I decided to write it together. And, you know, we came to the realization that there's an entire industry to help us be better leaders. An entire industry to help us be better parents. An entire industry to help us thrive in our relationships, how to eat better, how to exercise better, how to live longer, and yet precious little- I've written.

Many of those books.

And yet you've written all those books, and yet precious little, yet precious little on how to be a friend.

That's right.

And when you look at all the challenges, as we said in the world of depression and anxiety and all of these epidemics that doctors and well-intended folks are talking about, no one is talking about friendship as the antidote. And I think that friendship is the ultimate biohack. I think if you can master friendship, a lot of those other things correct themselves. So let's talk about that. Because it's like friendship in the microbiome. You know, get the microbiome right, a lot of stuff just falls into place. Get friendship right, a lot of stuff.

Just falls into place. It's true. It's true. So as you're thinking about this book.

The reason I said that is because that's your thing.

The microbiome. You like a microbiome. I do. If your bugs aren't friendly, you love a gut health. If your bugs aren't friendly, you're not happy.

Can I just go, I have to interrupt here. Can you talk to me about probiotic.

Sodas if they're a pile of shit or not? Well, if there's sugar in them and.

There'S artificial sweeteners in them, they definitely.

Aren'T good for your gut. Okay, so just that they put, okay.

Simply- that's why I said if it.

Has a health claim on the label, I avoid it.

Got it.

What about kombucha?

Again, it's like- Depends on the sugar.

It's a lot of sugar. I was surprised, one of my favorite kombucha brands, I looked at it the other day.

A lot of sugar. 22 grams of sugar in the bottle.

I was like, that's ridiculous. That's four and a half teaspoons of sugar.

Or five and a half teaspoons of sugar. You would never put five and a.

Half teaspoons of sugar in your coffee.

And why are you putting five and a half teaspoons of sugar in your quote unquote healthy drink? Yep. My rest my case. If it has a health claim, donate it. If it has a health claim, donate it. High fiber, low fat, low sugar. Low sugar, I didn't know. It's just, if an egg doesn't have a label on it, broccoli and apple doesn't have a label or a barcode or an ingredient list, stick with that. So speaking of friends, let's go back to friends. I think this is really important. We're talking about the importance of friendship. We're talking about how critical it is for your health. We're talking about how critical it is for your overall mental health and well-being. But a lot of people listening are isolated and disconnected and don't know.

Clearly they're listening to a podcast.

Maybe.

I listen to podcasts. With your friends?

Nobody listens to podcasts with their friends. My wife and I do. It's a lonely experience.

My wife and I listen to podcasts together quite a bit, actually.

Podcast listenership should be going down if we want the world to be healthy. You know, there's a great book I read once called Refrigerator Rights, which is how many people in your life do you have the right to go in their house and open their fridge and eat whatever you want? Love that.

And that's a measure of the quality of your friendships.

And the health of your social network.

I love that. I have one friend that makes fun of me. Their family makes fun of me that I just go into their pantry.

That's right. That's good. You want that. I'm staying at a friend's house and I went in their fridge this morning and I took out some food because I had to go and I was busy today.

Yeah, you didn't ask permission.

I know. I just took out the veggies. Well, you politely go, I'm going to tell him after, but there were these Maui Nui venison sticks and I knew I had a long day and I didn't have time to eat and I was like, Yeah, so I had refrigerator rights in that house.

That's very good. The New York version of that is you go into a friend's house that you have refrigerator rights, an apartment, there's no houses. You open up their fridge and you see, there's nothing in there except half a carton of milk and a box of Chinese takeout. And you say to your friend, can I eat this Chinese? You scream out and they scream back, I wouldn't, it's been there for two weeks. You go, okay, and you just close the fridge and you leave the Chinese food in there. that's refrigerates in New York City.

So if it's so important, people listening, I imagine are thinking, oh, this is great. I feel this. I know this how important. And I feel the the disconnection.

Yeah.

But I don't know how to make friends. I don't know how to where to start. I don't know how to take the friends I have and make them better or find new friends. I don't know how to make friendship the medicine that I need in my life. Yep. Where does the drugstore for friendship? You know, how are you thinking about this? And as you start to think about this book, how are you thinking about.

Yeah.

Supporting coaching, imagining how to build that network.

So the good news is there's new organizations that are starting that are encouraging people to come and have a dinner, you know, fight with five strangers and stuff like that. So there's like, there's these new businesses that are trying to replace the bowling leagues and stuff like that. You used to sign up for the bowling league and you'd be put on a team. That's your team. Maybe one of them was your friend, maybe not. But that was your team. We're going to church. So I think starting with with common interests. Sign up for a ceramics class and go by yourself. Or if you're too nervous to go by yourself, go with a friend. But talk to the person you're sitting next to first time, you know, because the great thing about doing a thing with common interest is the icebreaker is really, really easy. You just have to say, is this your first time here? Have you done this before? And it pretty much starts the conversation. And so.

And.

And if you don't. You don't have to form a. deep meaningful relationship out of it. But I think starting to do hobby things and I think having hobbies and we've seen a decline in hobbies even, you know, and doing hobbies with people. That's why I said Join a club. Yeah, that's why I said go play chess, you know, in a park, you know. That's why I've said I think things like Comic-Con and things like that are spectacular because when you find a group of people who, you know, when people laugh at your hobby, And you find a group of people who we've all been laughed at, but now we're the norm here. It's incredibly easy to make friends. And like the thing that's so, I've been to Comic-Con many, many times.

And.

You know, it's Nerdvana.

What is Comic-Con?

You don't know what Comic-Con is?

No.

Vaguely.

Well, it's changed over the years, but basically it's a comic book convention.

That's what I thought.

That's the history. But these days, comic books are only a part of it. It's also science fiction and hero movies, you know, Marvel stories and Star Wars and, you know, DC and all of that. And it's all that nerdy kind of pop culture-y stuff. And there's a lot of cosplay that happens. So people will dress up as their favorite cartoon character or superhero or, you know, some obscure character. And some of them are super creative and some and some people are there for the content of the convention and some people are there just to walk around in costume and have fun. And what's so wonderful about it is it's an incredibly polite group of people. So if you are in a great costume where you see someone who's in a great costume and you want to have a picture with them or they want a picture with you, everybody asks. Everybody goes, can I have a picture with you please? Or hey, may I have a picture with you please? And so there's a lot of interaction. You can go up to somebody and say, I love your costume, and they will be friendly back. There's not a lot of cynicism. And the, it's, you know, I met one of my ex-girlfriends there. I literally went up to her and said, you, look amazing. Can I have a picture with you? And she goes, Absolutely. We took a picture together, 'cause I just loved her costume. I don't remember how the conversation started, but we ended up talking a little bit for just a few minutes. I don't know how we got to it, but we ended up trading phone numbers, and then we ended up having sort of a really great relationship. And the best part about that is I still have the photograph, not from our first date, I have the photograph from the moment we met, which doesn't happen in relationships. You don't say, Nice to meet you, let's take a selfie just in case. Right. You know, but I have the photograph of the time that we, the minute we met. And it's just, again, I think when you go to places where people like the things you like, it's going to increase the odds. It's not that you increase the odds that you'll find a deep meaningful relationships, but it makes it easier to break the ice.

-To just get started.

-To get started. And that's I think where people struggle.

They struggle on how to start. -One of the things I'm curious about, I love your opinion on this, is my experience is two things really help foster deep friendships. One is curiosity. So being deeply curious about who that person is and asking questions about what are they afraid of? What makes them laugh? What makes them most excited in life? What brings them joy? You know, what are they struggling with? What's going on? Just getting curious about somebody and then letting them talk, because most people don't get that chance to have someone really be present and listen. And the second is to be vulnerable yourself. So to let down your guard and to share what's in your heart. because it all of a sudden gives permission for the other person to start to do that. And then once you get past that kind of first layer of soil, you get down into the mother lode of authentic human relationship.

It's a seesaw, right? Which is you kind of expect someone to be vulnerable if you're not willing to be vulnerable back because it creates imbalance. And I actually met some new friends just very recently. They're friends of friends. I went up to Seattle for work. And one of my friends who's from Seattle said, oh, you need to meet my friends. They live up there, you guys will get along. So we all showed up as strangers. The three of us showed up as strangers. I mean, they know each other. They're married. But I went out with them just because our mutual friend said, you guys should meet. And so we all took time to meet.

And.

I can't remember who started, but there was a lot of vulnerability happening. and you could feel that one side had opened up more than the other. It was lopsided, right? And I think it was me who opened up a lot, and then they said, Here, let us balance this out. And they were keenly aware of the balance of vulnerability. They started opening up an offering to make me feel safer, because it was lopsided, which is, you feel safe for a while until you start to feel insecure because it's so lopsided.

Yeah.

And they were so aware of that seesaw that they literally said, let me balance this out for you.

Yeah.

Or do you want us to go first so that you're comfortable to speak? You know, and we were it was amazing. And we talked about it. We actually that became one of the topics of conversation is how we were managing vulnerability as we were getting to know each other for the first time that we were we were keeping the balance. We were both taking turns to manage the balance. I thought it was incredibly interesting and sophisticated. And by the way, amazing people. Now they're like, I'm mad about them. You know? Like genuine friends. Yeah, and I think it's hard for.

People to do that though. How do you invite people to- well, you can't do it with everyone.

I think that's where people get it wrong. It's not a prescription. You can't say, here are the five things you need to do, because if somebody's not willing to match you or go with you, it will feel unbalanced or insecure, or you might open up so much and the other person doesn't want to, and then you'll make yourself feel uncomfortable, you make them feel uncomfortable too. And so this is why I say it's a dance, which is, you give a little bit, do you get a little bit back? And if you don't get anything- If.

You show me yours, I'll show you mine.

Yeah, exactly. And if you give a little bit and you get nothing back, you can take another risk and give a little bit more, but at some point you're gonna have to stop. And it's not that they're bad people or that they won't make friends, it's some people are a little slower at opening up. And some people are a little quicker and we have to allow these things to go at their own pace. But I think you have to manage the balance or you can say it out loud, Hey, usually I come out and sort of share everything, but I'm gonna be a little more measured today because I don't wanna, I feel a little insecure today, if I'm honest. I don't really know you. And I think that's okay. But I think that's where people get it wrong, which is there's no prescription and everybody's different. and you kind of have to read the room. I think that's where people make the mistakes. I've definitely made that mistake. I've projected safety where it didn't exist. Or I started opening up because I wanted them to make me feel safe.

And then did you feel like you suffered because of that, or was it just kind of like- no, I created.

Uncomfortable situations by accident, either for myself or for them. I overshared.

I overshared. Yeah, it's an interesting question, like is oversharing- Depends on the person. A problem. Depends on the person who's listening.

For some people, if you overshare and they are able and have the skill set to hold that space without judgment, there's no problem at all. But if somebody is ill-equipped to hold space for an oversharer, it's gonna be uncomfortable.

Not even just asking, hey, I'd like to share this.

Yeah, I think asking permission. I think asking permission. Yeah, I think that's great. It's like when you have a difficult-.

I think people that kind of resets their barometer.

Because that's the technique for having difficult conversations, right? You're like, I need to have a difficult conversation with you. Can I have that with you now? And people be like, can we do that later? You know? Like I think asking permissions, like I need to give you some difficult feedback. Can I give that to you? Go ahead. You know, like my friend. Like your friend, right? My friend said, I gotta tell you something. You know, this may risk the whole friendship. And you're like, okay. You know, like that little preamble that lets you sort of take the breath. And I think that's very wise counsel, which is to say, can I share something personal with you? And they may say, honestly, I don't think I'm comfortable. But if they say yes, then I think they're co-conspirators.

So what's your goal with your book? What's the sort of aim you're targeting?

It's everything we said before, which is there's so much advice on how to succeed as a leader, as a parent, as a, you know, in a romantic relationship. And I want people to succeed in friendship. I'm somebody who has had very few long-term relationships in my life, and the world criticizes me for that. I'm seen as unhealthy or I've been judged as having commitment issues. In love relationships or just friendships? Love relationships. I've never been married. I don't have a 10-year romantic relationship. I haven't had it. And even some of the women I've.

Dated, they're like, what's wrong with you?

Me neither. I've been divorced four, five, six times. What's wrong with you is what I hear a lot. And I have a friend who was in a a 16-year relationship, an unhealthy relationship for 16 years. She freely admits that she should have stayed in that relationship for one year.

Oh, yeah.

And yet, Society looks at her and says, she got it right and I got it wrong, which is Twisted. And if you look at the quality of my friendships, like, I have a lot of really, really good friends, and I am fulfilled in almost every aspect of my life, but just not necessarily all from one person.

That's right.

And look, I like relationships and I love being in a relationship and I love being a partner to someone. And, you know, people say, well, why haven't you been married? I'm like, isn't it obvious I haven't met the right person yet? That's such a stupid question.

But.

I found comfort in recognizing that by fostering friendship, I don't have to feel guilty or bad or explain myself why I haven't had a marriage or a 10-year romantic relationship.

And friendships outlast relationships.

And friendships outlast and friendships are there to help you through relationships. And if you don't have good friendships, you'll struggle in your relationships, because you have to have somebody to ask advice or vent to. You can't always go to one person. It won't work. And so I think we don't give enough credit to friendship, clearly, because nothing's written about it, or so little is written about it. We don't give enough credit to friendship and we don't give credit to people who are good at friendship. We give credit to people who stay in relationships, even if those relationships are unhealthy. And I think we just need to reevaluate how we're managing relationship in general in our lives. And I want to be a part of the friendship movement.

I love that. I mean, it's interesting that one of the chapters of our book around how to get healthy is friends with five Fs.

Yeah, exactly.

Amen.

And on that note, my friend, Thank you so much.

So, yes, Simon, thanks for talking about friendship and your vision and your incredible kaleidoscopic mind focusing on this topic because it's, I think, one of the most existential topics of our time. The disconnection, the isolation, the loneliness, and that investing in friendships, understanding what they are, how to cultivate them, how to create them, how to foster them and nurture them, how to be a good friend. It's the best medicine.

If you love this podcast, please share it with someone else you think would also enjoy it. You can find me on all social media channels at Dr. Mark Hyman. Please reach out. I'd love to hear your comments and questions. Don't forget to rate, review and subscribe to the Dr. Hyman Show wherever you get your podcasts. And don't forget to check out my YouTube channel at Dr. Mark Hyman for video versions of this podcast and more. Thank you so much again for tuning in. We'll see you next time on the Dr. Hyman Show.

Show.

This podcast is separate from my clinical practice at the Ultra Wellness Center, my work at Cleveland Clinic, and Function Health, where I am Chief Medical Officer. This podcast represents my opinions and my guests' opinions. Neither myself nor the podcast endorses the views or statements of my guests. This podcast is for educational purposes only and is not a substitute for professional care by a doctor or other qualified medical professional. This podcast is provided with the understanding that it does not constitute medical or or other professional advice or services. If you're looking for help in your journey, please seek out a qualified medical practitioner. And if you're looking for a functional medicine practitioner, visit my clinic, the Ultra Wellness Center at ultrawellnesscenter.com and request to become a patient. It's important to have someone in your corner who is a trained, licensed healthcare practitioner and can help you make changes, especially when it comes to your health. This podcast is free as part of my mission to bring practical ways of improving health to the public. So I'd like to express gratitude to sponsors that made today's podcast possible. Thanks so much again for listening.

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