Allison Pugh
Appearances
Hidden Brain
Relationships 2.0: The Price of Disconnection
Connective labor is the act of seeing the other and the other feeling seen. You know, this is very common in sales, for example. If you want to sell something to somebody, they're more likely to buy it if you convey to them that you see that they have a particular problem that this solves or you see that they have a particular approach that this solves.
Hidden Brain
Relationships 2.0: The Price of Disconnection
you know, kind of works with or whatever, you know, like the seeing is kind of the engine powering so many different outcomes that we are pointing at and thinking about that is so important in so many different occupations.
Hidden Brain
Relationships 2.0: The Price of Disconnection
Exactly. What I felt was not known is how much these different occupations have in common and how it extends well beyond prototypical ones. So like the hairdresser also needs to be able to see you, to be able to give you a haircut that you want and have you accept that haircut. And it's actually a dynamic.
Hidden Brain
Relationships 2.0: The Price of Disconnection
And that dynamic is common in many different kinds of jobs, not just the ones that have articulated how important relationships are.
Hidden Brain
Relationships 2.0: The Price of Disconnection
So you can force yourself to learn, even though you hate that teacher and they're not really seeing you and you're sitting in the back of the class. You can kind of roll that rock up the hill, but it's not going to be a pleasant or joyful experience. And also, you probably won't go as far as you could go. And that's true in many different fields.
Hidden Brain
Relationships 2.0: The Price of Disconnection
Absolutely. This concept of connective labor, I'm really thinking of it can be deployed for all kinds of reasons. So it could be deployed for well-being, as the teachers or the therapists might do. But it could also be... Deployed for like persuasion, you could say, and that might be the sales people or it could be deployed for control.
Hidden Brain
Relationships 2.0: The Price of Disconnection
And that might be as, you know, the hostage negotiator or the detective or, you know. So many of those jobs, I'm sure you can hear, are occupied by men. So I think, for instance, lawyers definitely need this. Judges need this. And many of those are occupied by men.
Hidden Brain
Relationships 2.0: The Price of Disconnection
People would definitely come up to me afterward and say, you know, I'm a nurse and thank God that you're writing about this because I need to be able to go back to my employer and say, you know, I'm doing more than bedpans. I'm doing more than, you know, medication products. timing. You know, this is important work of sitting and seeing the patient, you know, or the client.
Hidden Brain
Relationships 2.0: The Price of Disconnection
And they felt, I suppose they felt seen themselves, but it felt like it had important potential impact for them in their conversations about their work.
Hidden Brain
Relationships 2.0: The Price of Disconnection
Yeah, they definitely used the word magic to describe what they saw of the effects of seeing patients or students. You know, people definitely would come up and describe it as magical. I think they use that word because we don't really understand it well. It's tied to this invisibility in that there's this really important...
Hidden Brain
Relationships 2.0: The Price of Disconnection
process that's happening underneath all these you know economic tasks that we value and this kind of underlying process shadowy you know opaque We don't understand it well. And that's why people use the word magic, because it feels like it just comes upon us as this great gift without really understanding what goes into it and what produces it.
Hidden Brain
Relationships 2.0: The Price of Disconnection
Yeah. I mean, I've had that experience. And what I like about that example, actually, is that you're talking not just about, you know, the impact of one person seeing you, but also how we can create a kind of culture in which people are seeing others, that you're not the only person doing the seeing.
Hidden Brain
Relationships 2.0: The Price of Disconnection
So it really, a warm, competent leader can make an enormous difference in part by catalyzing this kind of magic.
Hidden Brain
Relationships 2.0: The Price of Disconnection
Yes, I love that study. I think it's so well done. What they did was they had pairs of people who don't actually know each other tell stories to each other. And then they measured, I guess they had, you know, kind of... wires attached to them while they did this, but they measured the emotional arousal of the storyteller and the story listener.
Hidden Brain
Relationships 2.0: The Price of Disconnection
And they found that when the listener conveyed that they heard and understood the other person, and you can imagine that's through nods or facial expressions or encouraging noises. The storytellers actually noticeably benefited. They felt calmer. Their emotional arousal decreased. And the more their listeners conveyed this kind of affiliation, the stronger the impact.
Hidden Brain
Relationships 2.0: The Price of Disconnection
And meanwhile, it also had an impact on the listeners. So the more the listeners were allied in this way, you know, nods, facial expressions, encouraging noises, et cetera, the more they experienced increased arousal.
Hidden Brain
Relationships 2.0: The Price of Disconnection
So it was like the arousal moved from the storyteller to the listener as the storyteller was telling the story and as the listener was conveying that they understood and saw the other person. So it was a real sharing or spreading of the emotional load. It's a really beautifully designed study.
Hidden Brain
Relationships 2.0: The Price of Disconnection
Tell me the story she told you. Sure. Erin, she sees one patient. who is intubated and he is so angry at being intubated. He didn't want to be intubated, even though the doctors told him he had to be because he would die otherwise. He couldn't speak, obviously, through the tube. He also couldn't write because he was on, I guess, medications that made that difficult.
Hidden Brain
Relationships 2.0: The Price of Disconnection
So he's just steaming full of fury. And then comes Erin and she sees him And she sees this bottled up anger. And she says, you know, why don't you take this Kleenex box and like throw it, throw it against the wall. And he says, He was so astounded, so relieved and powerfully moved by that, that he like grabs her arm and pulls her in and she sits with him for, you know, 15 minutes or 20 minutes.
Hidden Brain
Relationships 2.0: The Price of Disconnection
And then the next time she sees him, it's about, it's a couple of days later and he's emerged from the procedure and he's no longer intubated. And he says to her, there is nothing like being in the worst moment of your life and you feel like someone understands you. And that is such a perfect capture of what being seen feels like and what it can do for you in your worst moments.
Hidden Brain
Relationships 2.0: The Price of Disconnection
Exactly. And there's actually a lot of research by psychologists and neuroscientists that show that, you know, when someone's holding your hand, it can alleviate pain. But here's an articulated moment where Hiram, the patient, is saying to Erin, you saw me, and that was transporting.
Hidden Brain
Relationships 2.0: The Price of Disconnection
So this is a really voluminous area. I have a couple of favorites. One author reviewed 1,000 articles with 355,000 students and came away with this meta-finding that, you know, among school-age children, he says, the effect size of teacher-student relationships is bigger than most typical educational innovations or curriculum changes.
Hidden Brain
Relationships 2.0: The Price of Disconnection
So like the teacher-student relationship that underlies whether or not someone is learning algebra or can, you know, parse a sentence, that is more powerful, has a greater impact than, say, standard curriculum changes or other innovations. You might expect that to be true for the younger kids, maybe, but maybe less true for middle school or high schoolers. And actually, it's the opposite.
Hidden Brain
Relationships 2.0: The Price of Disconnection
The effect sizes are larger in studies that are conducted in higher grades. And Teacher-student relationships are even more important when kids are academically at risk. You know, kids from disadvantaged economic backgrounds, for example, and kids with learning difficulties.
Hidden Brain
Relationships 2.0: The Price of Disconnection
So it's like even more important for adolescents, even though we don't usually structure those schools to enable it to happen very well.
Hidden Brain
Relationships 2.0: The Price of Disconnection
There's a lot of research that talks about how being seen by one's doctor leads to better health outcomes. and leads directly to patient well-being. And my favorite, perhaps, study here is a meta-analysis that has extremely strict inclusion criteria. So it's only randomized controlled trials in which the relationship between doctor and patient is experimentally manipulated.
Hidden Brain
Relationships 2.0: The Price of Disconnection
So they tell the physicians to do or don't make eye contact or do or don't interrupt, et cetera. And based on that, these scholars, researchers conclude that the impact of clinician-patient relationship on health outcomes was significant and exceeded that of taking an aspirin every day to ward off heart attacks.
Hidden Brain
Relationships 2.0: The Price of Disconnection
Exactly. I mean, think how many people take an aspirin every day to ward off heart attacks. And this is something that actually exceeds even that.
Hidden Brain
Relationships 2.0: The Price of Disconnection
Yeah, they've done great work on this stuff. The study that I most enjoy thinking and talking about is they experimentally varied how cafe customers interacted with baristas, and then they measured their well-being afterward.
Hidden Brain
Relationships 2.0: The Price of Disconnection
Sure. You know, right. The youngest of five. It was a generally loving environment, but I would say it was one my mother still sometimes calls it benign neglect. So I did not get a bathing suit that wasn't owned by someone else until I was in college. Wow.
Hidden Brain
Relationships 2.0: The Price of Disconnection
And they gave some participants, they gave them instructions to like, you know, have a genuine interaction with the cashier, smile, make eye contact, and have a brief conversation. That was the social condition. And then they had the efficient condition.
Hidden Brain
Relationships 2.0: The Price of Disconnection
Those participants were told, make your interaction with the cashier as efficient as possible, have your money ready, and avoid unnecessary conversation. And it found that people who took the time to have a social interaction with the barista, that increased people's sense of belonging.
Hidden Brain
Relationships 2.0: The Price of Disconnection
Yes, that is a quite profound observation, actually, because what makes us busy? There's a couple of things that lead to it. But in the United States, a lot of times what makes you busy is an inordinate work schedule, kind of overworking schedule. can really shrink the amount of time we have for the other parts of our lives.
Hidden Brain
Relationships 2.0: The Price of Disconnection
And research like this suggests that if you don't kind of give the time and space to those unscripted, trivial encounters throughout your life, if you're always trying to make everything so efficient so that you can maximize the time that you have available for other pursuits, that can have well-being effects.
Hidden Brain
Relationships 2.0: The Price of Disconnection
Yeah. I mean, I've seen that, too. I'm always amazed. One of my brothers, for example, is always really good at honoring the moment, kind of just being there present with the other person. And but he's also also often late. Yeah. And I, on the other hand, am really almost never late and I really need to teach myself.
Hidden Brain
Relationships 2.0: The Price of Disconnection
I have needed to teach myself to pause and, you know, who's this person that I'm kind of blowing by. Yeah.
Hidden Brain
Relationships 2.0: The Price of Disconnection
Yeah. I mean, like, maybe we should we who are not late should be more understanding that those who are are helping to knit us together as a society, you know.
Hidden Brain
Relationships 2.0: The Price of Disconnection
And I went myself to a department store and picked out, I think, a pink bathing suit that I that I wanted instead of the, you know, scores of other kinds I had had over the years.
Hidden Brain
Relationships 2.0: The Price of Disconnection
Yes. I realized that the in-depth interviewing that I do that involves this kind of seeing is a clinical practice. And it's a clinical practice like nursing and like teaching and like... And what do all of those professions have in common is they have an apprentice model of teaching in which someone does something in front of other people and then gets immediate feedback.
Hidden Brain
Relationships 2.0: The Price of Disconnection
One of the first things that they have to do is kind of get out of the way. And I often like to think about airspace as like a soccer ball and who is controlling the soccer ball. And you want to pass the soccer ball, you know. If you're too present, then the other person just doesn't have the space to put themselves in there. Right.
Hidden Brain
Relationships 2.0: The Price of Disconnection
And that can preclude, that can impede seeing of the other for sure.
Hidden Brain
Relationships 2.0: The Price of Disconnection
Yeah. So if you're like completely sure that the other person is really passionate about such and such and you say that to them and they're like, no, actually, it's more like this. This is what I actually care about. You have to hear that. And actually, the correcting process. can help people feel even more seen. If they are able to correct you and you say, oh yes, now I get it.
Hidden Brain
Relationships 2.0: The Price of Disconnection
The other thing I would say is in our quickness to leap into a conversation with somebody with our own views or assumptions, what I think is really important is actually hearing what the other person is not saying, hearing the emotion that they're not naming. If you can hear an emotion behind what someone's saying and say, wow, it sounds like you're feeling nervous about that.
Hidden Brain
Relationships 2.0: The Price of Disconnection
Or it sounds like you're feeling, it sounds like that gives you a lot of pride. It doesn't have to be a negative emotion. It's like, if you can kind of hear whatever emotion is behind, that's very powerful for people. If they didn't say it and you name it, they feel very seen. And kind of in the naming, when you're doing that kind of naming, you're making it safe for them.
Hidden Brain
Relationships 2.0: The Price of Disconnection
Exactly. That's why it's a boost, a huge boost. Now, I would also say it's a little more challenging, maybe. But it is true that if you can bump it up a level and go to what's not being said out loud, but that you really perceive, that is very powerful. Yeah.
Hidden Brain
Relationships 2.0: The Price of Disconnection
Yeah. So Sarah was a therapist at the VA hospital. And so she was seeing veterans. And she said she had she told me about a woman she had been seeing who had experienced sexual trauma in the military. And at the end of like the third or fourth week. The woman leaves the session with a comment saying that she might not be able to come back.
Hidden Brain
Relationships 2.0: The Price of Disconnection
You know, how she might get busy is what she said to Sarah. And Sarah said to me, you know, something was just kind of off. Like it didn't feel the same. It just didn't feel right. So she calls her before the next week. And she says to her, you know, I think I said something. You know, I'm wondering if I maybe missed something or didn't hear something right. The session felt different today.
Hidden Brain
Relationships 2.0: The Price of Disconnection
And I think it could be helpful to talk about that if you're able to come in again. So the woman comes in. She comes back. And they were able to talk. And Sarah said at that point, the relationship really shifted. And she ended up making tons of progress there. And so at the end of the treatment, Sarah asks the woman, you know, what worked for you?
Hidden Brain
Relationships 2.0: The Price of Disconnection
And the woman said, there was this point where you noticed that I wasn't happy with whatever you did. And the fact that you even noticed that was a big deal. And so Sarah took away from that this notion of actually therapists have written about this. They call it therapeutic rupture. And that if you can redeem yourself there, if you manage a reconciliation, it can be very powerful.
Hidden Brain
Relationships 2.0: The Price of Disconnection
I remember coming home kind of full of outrage and being like, this is not okay. They shouldn't be doing this. And I was trying to figure it out. I just didn't know how to handle it. And she did not take it seriously at all, unfortunately. She just kind of said, oh, that's because they like you. That was her reaction. That was her rationale.
Hidden Brain
Relationships 2.0: The Price of Disconnection
So Bertie was a nurse practitioner in California. She had this bright smile, you know, a high beam smile. And she was quite kind of bustling and friendly and very warm. And she told me that she had always assumed she would be a doctor like her father until she failed organic chemistry. And she then kind of was like, what am I going to do next?
Hidden Brain
Relationships 2.0: The Price of Disconnection
So she actually decides to become a nurse practitioner. But even as a nurse practitioner, she said she struggled with ego issues. This is what she said. But the good thing about being a nurse, she said, is that she could focus on the human element. And she told me an example of what she considered really to epitomize what nursing meant to her. And that was the example of this homeless man.
Hidden Brain
Relationships 2.0: The Price of Disconnection
He came into her clinic. He had been on the streets for years. She said he had probably walked cross-country homeless back and forth. He had never really been in a shelter. She said he had some wounds on his feet. They were, she said, just gnarly, calloused. And she said he was so hunched over from years of osteoporosis and walking.
Hidden Brain
Relationships 2.0: The Price of Disconnection
And so few people would be able to even have eye contact with him because he physiologically couldn't even really look up. And I just sat and did wound care for his feet. So she just sat and washed and cleaned his wounds. And she said it wasn't going to do much. He was still going to be on his feet all the time. He was so resistant to going into any shelter.
Hidden Brain
Relationships 2.0: The Price of Disconnection
It was just a band-aid over a really big problem. But for her, it captured what nursing was about, like this humility, this service, and the witnessing. So she said, she tells me just to give him that moment of I'm seeing you. I'm acknowledging you. This is me caring for you. She said it was powerful for both of us.
Hidden Brain
Relationships 2.0: The Price of Disconnection
The power of just connecting to another human being. And by doing that connecting, you're saying to the other person, you are a person of value. You have... Humanity, just like I do, and together we are sharing this moment, it confers dignity and humanity to both participants.
Hidden Brain
Relationships 2.0: The Price of Disconnection
And at the time, I remember a really sharp disjuncture between my own, I would say, half-desperate outrage and her kind of semi-humorous, oh, you know, they just like you.
Hidden Brain
Relationships 2.0: The Price of Disconnection
No, that was a big moment of a kind of cognitive dissonance between what I thought was going on and her response, for sure. I did not feel seen.
Hidden Brain
Relationships 2.0: The Price of Disconnection
At the time, we were living in California and there would be old boxes or, you know, interesting rocks or, you know, kind of things that they'd be on the sidewalk. Obviously, either somebody, part of nature that was just there or some things that other people were putting out for either garbage or for people to pick up. And my daughter was always the one picking. to pick them up.
Hidden Brain
Relationships 2.0: The Price of Disconnection
So she had a name for them. She called them her inventions. She was very young. I think she meant that they were a kind of art or maybe that she was inventing, that she would be imagining what she could do with them or something. But I really viewed them as junk. I actually threw them out. And she still remembers that and reminds me.
Hidden Brain
Relationships 2.0: The Price of Disconnection
And, you know, to me, it's really a primary moment of me not seeing her and how she viewed these small, we'll call them treasures.
Hidden Brain
Relationships 2.0: The Price of Disconnection
it didn't land well at all. I have a very unusual lifestyle, I think, that she probably doesn't see very often because I row crew and I have done so for 30 years. And right now I'm involved in a team that's very intense. in Washington, D.C., which involves one to two hours daily. I also don't have any caffeine. I don't have any alcohol. I think I'm an unusual person health-wise.
Hidden Brain
Relationships 2.0: The Price of Disconnection
And so when she was like, these are elevated, try not to have so many cookies, she didn't see the person she was talking to. She didn't really have all that context that can produce a good witnessing moment, and along with it, good advice.
Hidden Brain
Relationships 2.0: The Price of Disconnection
Yeah, the fabulous writer Abraham Verghese has called that the eye patient, that we're all to some degree an eye patient, meaning a patient that exists almost more by computer than in our holistic embodied selves in front of each other. And if that is how you feel, that often will affect whether or not you do what they say.
Hidden Brain
Relationships 2.0: The Price of Disconnection
Like it's going to take a lot more than that to have me stop eating cookies.
Hidden Brain
Relationships 2.0: The Price of Disconnection
Sure. Yeah, Hank. He started off as a minister in a very large church in the Washington, D.C. area. And he started a whole bunch of programs for low-income youth in in the community. So he started tutoring centers and I think sports camps and all sorts of things to try and reach kids. And by his account, he did reach them.
Hidden Brain
Relationships 2.0: The Price of Disconnection
They would come to his tutoring centers and they would kind of hang out with him and share stories. And he felt like he had attained some real connection to those youth. And he was so proud of it, as he's telling me. And then he gets a job in another city, moves there, but he ends up losing that job and feeling really defeated in that moment.
Hidden Brain
Relationships 2.0: The Price of Disconnection
And so he leaves that and he comes to be a chaplain in the hospital in which I was doing some observations. And so he talks to me about this trajectory. And at the very end of the exchange, he talked to me about what it was like to be interviewed. And he said, you know, this was very powerful. And then he said, therapeutic, almost therapeutic.
Hidden Brain
Relationships 2.0: The Price of Disconnection
Oh, yeah. It's something that's very common. People often say, oh, this was just like therapy. It's not like therapy because I'm not really there to solve any problems or really to counsel them in any way. And they know that. So it's more like it's the language we have for that feeling of being seen.
Hidden Brain
Relationships 2.0: The Price of Disconnection
Yeah, so Greta was a pediatrician and she was kind of surprised when she first started her practice how much she was supposed to be attending to the mothers rather than the children. That was something that was a surprise to her. She often found herself giving, say, parenting advice or talking about car seats or talking about what it's like when you can't get any sleep or something like that.
Hidden Brain
Relationships 2.0: The Price of Disconnection
And the mothers kind of desperately needed that. She felt their need on the other end, but she often felt like she told me she didn't feel like she was practicing on the top of her medical license. That was the language she used. to mean that she had all this expertise in children and children's symptoms and diseases and disorders.
Hidden Brain
Relationships 2.0: The Price of Disconnection
And really the bulk of her job was about like kind of listening, hearing, and being attuned to what the mothers were saying. And she ultimately ended up saying, you know, the mothers don't need me. They need an hour with a good listener.
Hidden Brain
Relationships 2.0: The Price of Disconnection
Yeah, I think that's the most important dimension of this for me is the emotional impact because so many of the other impacts get kind of carried on along on the emotional impact. The emotional impact of being seen, people feel like they have dignity. People feel like they have understanding. People feel like they have purpose, right?
Hidden Brain
Relationships 2.0: The Price of Disconnection
Those are all things that other researchers as well as my own research has found. And when you're not seen, it can really dissuade you from following good advice because you don't hear the good advice. You don't think that it's relevant to you or it doesn't feel like it recognizes the particularities of your situation.
Hidden Brain
Relationships 2.0: The Price of Disconnection
That's right. It's kind of most obviously true for therapists. It's also true for teachers. It's also true for primary care physicians. So those seem like almost the most obvious cases. But it's also true for, you know, I interviewed people who were like community organizers. I interviewed people who were funeral home directors, home health care aides. sex workers, even police.
Hidden Brain
Relationships 2.0: The Price of Disconnection
I interviewed a detective. I interviewed somebody who works with prison guards, people you wouldn't expect to be particularly empathetic or who themselves might not talk about relationship as an important part of their work. But seeing the other is part of how people do their jobs across many occupations.