Dr. Sunita Sah

And I remember meeting him in the corner shop that we had just down the road. And I was really scared, but he was so nice and friendly to me. And in my child's mind, I basically thought that was because he thought I was good. Yeah, you were good. He only beats bad people. He only beats bad people. And so I tried like hell never to be bad.

And I remember meeting him in the corner shop that we had just down the road. And I was really scared, but he was so nice and friendly to me. And in my child's mind, I basically thought that was because he thought I was good. Yeah, you were good. He only beats bad people. He only beats bad people. And so I tried like hell never to be bad.

So I wouldn't get treated like the way that boy got treated. But it really unnerved me, right? It left something there as to why are teachers expecting us to behave in this particular way?

So I wouldn't get treated like the way that boy got treated. But it really unnerved me, right? It left something there as to why are teachers expecting us to behave in this particular way?

And when I realized that people in authority can do things like that, they can be unethical, incompetent, and just plain stupid, then you start to question the people that are in charge maybe don't have our best interests in mind.

And when I realized that people in authority can do things like that, they can be unethical, incompetent, and just plain stupid, then you start to question the people that are in charge maybe don't have our best interests in mind.

In some ways, it's excessive at medical school. All right. Yeah. When I came to the US, it was fascinating when we were trying to find an apartment to rent. As soon as you say I'm a doctor.

In some ways, it's excessive at medical school. All right. Yeah. When I came to the US, it was fascinating when we were trying to find an apartment to rent. As soon as you say I'm a doctor.

Some of the people I know that are completely wild and off track are doctors. Of course. Yeah. There's a lot of stress release. Yes.

Some of the people I know that are completely wild and off track are doctors. Of course. Yeah. There's a lot of stress release. Yes.

Oh, yeah. We had some good nights.

Oh, yeah. We had some good nights.

That really haunted me because they were rookie officers. And the guy with the knee on the neck was their training supervisor. So that image of George Floyd is ingrained in lots of people's minds and it's horrific. Also, when I think about the rookie officers, I always think, what would I have done? Because they're obeying. They're in a line of hierarchy. They've been trained to obey.

That really haunted me because they were rookie officers. And the guy with the knee on the neck was their training supervisor. So that image of George Floyd is ingrained in lots of people's minds and it's horrific. Also, when I think about the rookie officers, I always think, what would I have done? Because they're obeying. They're in a line of hierarchy. They've been trained to obey.

And even though in the manual, if your officer is asking you to do something unethical and things you should defy or say something, it's impossible. And people are saying, why did they do that? Why did they not say no? It's so impossible to do that in certain situations, especially if you haven't anticipated it, confronted it before, know how to react appropriately.

And even though in the manual, if your officer is asking you to do something unethical and things you should defy or say something, it's impossible. And people are saying, why did they do that? Why did they not say no? It's so impossible to do that in certain situations, especially if you haven't anticipated it, confronted it before, know how to react appropriately.

practiced it rather than just intellectually knowing.

practiced it rather than just intellectually knowing.

Yeah. And so often our actions just don't align with our values. And we see this time and time again. And this is what I wanted to study in more depth. Why is that? We can sit here in our armchairs, right? And just say, oh, we wouldn't do that. We would act in this particular way. But when you're actually in that situation, it's so difficult.

Yeah. And so often our actions just don't align with our values. And we see this time and time again. And this is what I wanted to study in more depth. Why is that? We can sit here in our armchairs, right? And just say, oh, we wouldn't do that. We would act in this particular way. But when you're actually in that situation, it's so difficult.

Yeah.

Yeah.

That day, I had this immense central chest pain and I hadn't felt any pain like this before. So I was worried about it and I thought I need to get this checked out. I was fairly new to having moved to the US. And so I went to the emergency room and immediately there's loads of tests being done. And they did an electrocardiogram, which was the main thing I was concerned about.

That day, I had this immense central chest pain and I hadn't felt any pain like this before. So I was worried about it and I thought I need to get this checked out. I was fairly new to having moved to the US. And so I went to the emergency room and immediately there's loads of tests being done. And they did an electrocardiogram, which was the main thing I was concerned about.

Like, am I having a heart attack? Yeah. And everything was normal, thank goodness. And the pain was subsiding. It was going away. So I thought, great, I'm going to be discharged. And then the doctor came in. She was kind of young and confident. And she just said, oh, I'll need you to have a CT scan before you go. And I was like, why?

Like, am I having a heart attack? Yeah. And everything was normal, thank goodness. And the pain was subsiding. It was going away. So I thought, great, I'm going to be discharged. And then the doctor came in. She was kind of young and confident. And she just said, oh, I'll need you to have a CT scan before you go. And I was like, why?

And she was like, oh, we just want to make sure you don't have a pulmonary embolism. PE is a blood clot in the lungs. And it has a specific type of pain. And I worked for six months in respiratory medicine, which you call pulmonary here. And this type of pain when you have an embolism in the lung is what we call pleuritic chest pain. It's a sharp pain.

And she was like, oh, we just want to make sure you don't have a pulmonary embolism. PE is a blood clot in the lungs. And it has a specific type of pain. And I worked for six months in respiratory medicine, which you call pulmonary here. And this type of pain when you have an embolism in the lung is what we call pleuritic chest pain. It's a sharp pain.

It catches your breath when you breathe in and breathe out. And I didn't have that type of pain. I didn't want to have this CT scan she was talking about because it's on average, 70 times the amount of radiation of an X-ray. And even though it's still small, why have ionizing radiation, which can cause cancer many years into the future, why take the risk, right? If it's unnecessary. Yeah.

It catches your breath when you breathe in and breathe out. And I didn't have that type of pain. I didn't want to have this CT scan she was talking about because it's on average, 70 times the amount of radiation of an X-ray. And even though it's still small, why have ionizing radiation, which can cause cancer many years into the future, why take the risk, right? If it's unnecessary. Yeah.

So I had the knowledge in that situation and I should have said no. And yet I just couldn't say no. And so I was then wheeled into the room with a CT scan and the technician and I couldn't even say no then. I would just ask questions in this polite way like, oh, it's not a lot of radiation, is it?

So I had the knowledge in that situation and I should have said no. And yet I just couldn't say no. And so I was then wheeled into the room with a CT scan and the technician and I couldn't even say no then. I would just ask questions in this polite way like, oh, it's not a lot of radiation, is it?

Even though I knew because I wanted them to pick up on my discomfort and say, oh, do you not want this?

Even though I knew because I wanted them to pick up on my discomfort and say, oh, do you not want this?

And that didn't happen.

And that didn't happen.

So I ended up having this CT scan. Why couldn't I just say no in that situation? It was safe for me to say no. It would have been effective. And yet something held me back. The only reason I had it was because the doctor told me to. So here's the doctor in a safe situation. She's even smiling. I can't say no. And I'm a doctor myself.

So I ended up having this CT scan. Why couldn't I just say no in that situation? It was safe for me to say no. It would have been effective. And yet something held me back. The only reason I had it was because the doctor told me to. So here's the doctor in a safe situation. She's even smiling. I can't say no. And I'm a doctor myself.

So what would I have done in this situation with George Floyd with a police officer wearing a gun? That's how difficult this is. It's terrifying when you think about it. And there was a survey of 1,700 crew members of commercial airlines. About half of them did not feel comfortable to speak up when they saw an error. Yeah.

So what would I have done in this situation with George Floyd with a police officer wearing a gun? That's how difficult this is. It's terrifying when you think about it. And there was a survey of 1,700 crew members of commercial airlines. About half of them did not feel comfortable to speak up when they saw an error. Yeah.

So there's this psychological process that I call insinuation anxiety disorder. that I uncovered in my experiments. But the actual experience, I experienced it when I was having the CT scan. I knew this feeling for years and years. The name for it only came after I started doing research in it.

So there's this psychological process that I call insinuation anxiety disorder. that I uncovered in my experiments. But the actual experience, I experienced it when I was having the CT scan. I knew this feeling for years and years. The name for it only came after I started doing research in it.

And insinuation anxiety is this aversive emotional state that we have when we believe that not complying with someone else will be a signal of distrust to that person. So it basically insinuates that the other person is incompetent, biased, corrupt and trustworthy in some way. And you don't want to give them that signal. And so the co-pilots telling the pilots, you haven't observed this.

And insinuation anxiety is this aversive emotional state that we have when we believe that not complying with someone else will be a signal of distrust to that person. So it basically insinuates that the other person is incompetent, biased, corrupt and trustworthy in some way. And you don't want to give them that signal. And so the co-pilots telling the pilots, you haven't observed this.

You're doing something wrong here. Like, I don't think we should do that. It's really difficult.

You're doing something wrong here. Like, I don't think we should do that. It's really difficult.

And I see it in experiments in the hospital as well in surveys. Nurses can't speak up when they see a colleague making an error for the same reason. Wow.

And I see it in experiments in the hospital as well in surveys. Nurses can't speak up when they see a colleague making an error for the same reason. Wow.

How can you? Even with physicians in this particular survey, it was less than 1% whether you had a supervisory role of the physician or not. Less than 1% could actually tell them if it was something about the physician's incompetence. You don't want that. You want your co-pilots to speak up.

How can you? Even with physicians in this particular survey, it was less than 1% whether you had a supervisory role of the physician or not. Less than 1% could actually tell them if it was something about the physician's incompetence. You don't want that. You want your co-pilots to speak up.

You want supervising physicians and nurses working with physicians to speak up if they see something going wrong. Because these life and death situations are huge. But even when it's not life and death, and sometimes you don't know, like as the rookie cops, right, they probably didn't know this was going to turn out to be an unfolding murder or life and death type of situation. Yeah.

You want supervising physicians and nurses working with physicians to speak up if they see something going wrong. Because these life and death situations are huge. But even when it's not life and death, and sometimes you don't know, like as the rookie cops, right, they probably didn't know this was going to turn out to be an unfolding murder or life and death type of situation. Yeah.

But you don't want to end up in those situations because you're so wired to go along with it. You're so socialized to say, OK, I'm going to obey.

But you don't want to end up in those situations because you're so wired to go along with it. You're so socialized to say, OK, I'm going to obey.

The Oxford English Dictionary definition of defiance is to challenge the power of someone else boldly and openly. And I shouldn't really disagree with that having been brought up in English. It's the best. I do. I think it's way too narrow.

The Oxford English Dictionary definition of defiance is to challenge the power of someone else boldly and openly. And I shouldn't really disagree with that having been brought up in English. It's the best. I do. I think it's way too narrow.

And I think a better definition of defiance, considering everything that we've spoken about, is that to defy is simply to act in accordance with your own true values, your core values, when there is pressure to do otherwise.

And I think a better definition of defiance, considering everything that we've spoken about, is that to defy is simply to act in accordance with your own true values, your core values, when there is pressure to do otherwise.

And also values can involve other people too. Speaking up when you see somebody causing harm to someone else is really a communal act in a way. So redefining, reframing defiance from this negative connotation to being a proactive positive force in society. Because if you think about it, every single act of consent and dissent and compliance, that creates the society that we live in.

And also values can involve other people too. Speaking up when you see somebody causing harm to someone else is really a communal act in a way. So redefining, reframing defiance from this negative connotation to being a proactive positive force in society. Because if you think about it, every single act of consent and dissent and compliance, that creates the society that we live in.

So if you're socialized to comply from a young age, if you're rewarded for being compliant, and I know I was, you probably were. I don't know if you were.

So if you're socialized to comply from a young age, if you're rewarded for being compliant, and I know I was, you probably were. I don't know if you were.

That's fascinating. So for many of us... Yeah, yeah.

That's fascinating. So for many of us... Yeah, yeah.

That was encouraged, right?

That was encouraged, right?

One of the things that I really noticed in the people that I've interviewed is if you have seen your parents defy as well, it's so powerful. And I do have one or two moments where my parents did defy, even though they were compliant most of the time. And that stayed with me.

One of the things that I really noticed in the people that I've interviewed is if you have seen your parents defy as well, it's so powerful. And I do have one or two moments where my parents did defy, even though they were compliant most of the time. And that stayed with me.

Yes. And it changed my view of compliance and defiance being personality traits. I realized this is a skill. We can choose to use it or not, because even the most compliant person, my mother, she does all the shopping, the groceries, looking after all the family. I had very neatly put her into the box of being compliant. And one day when she was defiant, I just... just blew my mind.

Yes. And it changed my view of compliance and defiance being personality traits. I realized this is a skill. We can choose to use it or not, because even the most compliant person, my mother, she does all the shopping, the groceries, looking after all the family. I had very neatly put her into the box of being compliant. And one day when she was defiant, I just... just blew my mind.

I was like, wow, that's so impressive. She's actually really strong and she can be defiant when she needs to be.

I was like, wow, that's so impressive. She's actually really strong and she can be defiant when she needs to be.

If I can do it with the upbringing I had, I think most people can learn how to defy. It's just you have to learn that skill set. You have to get out. So if you're talking about neurological I was rewarded for being compliant. That's when the neural pathways start to form like obedience. It becomes our default. We start equating obedience with being good, compliance with being good.

If I can do it with the upbringing I had, I think most people can learn how to defy. It's just you have to learn that skill set. You have to get out. So if you're talking about neurological I was rewarded for being compliant. That's when the neural pathways start to form like obedience. It becomes our default. We start equating obedience with being good, compliance with being good.

Absolutely. So we become what I call wire to comply, right? It becomes the default without thinking. Somebody says to do something, we go along and we do it. And so that's really powerful socialization, the messages that we get to obey, to be polite, you know, don't make a scene, don't question authority, listen to them.

Absolutely. So we become what I call wire to comply, right? It becomes the default without thinking. Somebody says to do something, we go along and we do it. And so that's really powerful socialization, the messages that we get to obey, to be polite, you know, don't make a scene, don't question authority, listen to them.

And that makes a difference to the rest of our lives in a way and our default setting. But if we think about situations where we learn how to defy We need to really practice so we can change that default setting. The more that we practice, the more those other pathways start to strengthen. For example, I have these five stages of defiance.

And that makes a difference to the rest of our lives in a way and our default setting. But if we think about situations where we learn how to defy We need to really practice so we can change that default setting. The more that we practice, the more those other pathways start to strengthen. For example, I have these five stages of defiance.

So the first one, like usually when we're in a situation where we want to defy or we think we should, we feel some kind of tension. So our body immediately tells us we don't think this is quite right. So I felt it with a CT scan. I'm sure you've been in situations where you felt like, oh, I don't know about that. Yeah. And so often we just ignore it. We think it's not worth our doubt. Exactly.

So the first one, like usually when we're in a situation where we want to defy or we think we should, we feel some kind of tension. So our body immediately tells us we don't think this is quite right. So I felt it with a CT scan. I'm sure you've been in situations where you felt like, oh, I don't know about that. Yeah. And so often we just ignore it. We think it's not worth our doubt. Exactly.

Is it worth it? Yes.

Is it worth it? Yes.

And we probably have our own signs, right? People will probably feel it differently. Maybe for some people it's a headache. Maybe for some people it's their throat constricting. Maybe it's feeling butterflies. So we all have a sign that comes up. And then the second stage is to acknowledge that rather than disregard it is to admit it to yourself, right? I'm feeling something.

And we probably have our own signs, right? People will probably feel it differently. Maybe for some people it's a headache. Maybe for some people it's their throat constricting. Maybe it's feeling butterflies. So we all have a sign that comes up. And then the second stage is to acknowledge that rather than disregard it is to admit it to yourself, right? I'm feeling something.

Yeah, avoid it. And that's a shame because it's a warning sign. And if we actually listen to it, it could help us because we just need to like, why am I feeling this way? What does it actually mean? I felt it with a CT scan and I was like, OK, but it actually got worse as I carried on having the CT scan. It didn't go away.

Yeah, avoid it. And that's a shame because it's a warning sign. And if we actually listen to it, it could help us because we just need to like, why am I feeling this way? What does it actually mean? I felt it with a CT scan and I was like, OK, but it actually got worse as I carried on having the CT scan. It didn't go away.

And so I felt it more. And then I felt so much regret afterwards, like how easy would it have been for me to say no? Why couldn't I say no? Actually, it wasn't that easy. But what can I do to make sure I say no next time? And so feeling the tension, acknowledging it to yourself. And then stage three is the real critical stage is just vocalizing it to someone else.

And so I felt it more. And then I felt so much regret afterwards, like how easy would it have been for me to say no? Why couldn't I say no? Actually, it wasn't that easy. But what can I do to make sure I say no next time? And so feeling the tension, acknowledging it to yourself. And then stage three is the real critical stage is just vocalizing it to someone else.

And the reason that stage is so critical is because if you tell someone else you're not comfortable with this, you've stated how you feel. You can't then go back and rationalize to yourself, I was actually okay with it after all, right? You know, it was fine. So once you've said that, all you have to do then is continue saying it. And this was the same in the Milgram experiment.

And the reason that stage is so critical is because if you tell someone else you're not comfortable with this, you've stated how you feel. You can't then go back and rationalize to yourself, I was actually okay with it after all, right? You know, it was fine. So once you've said that, all you have to do then is continue saying it. And this was the same in the Milgram experiment.

So there were people, even though two thirds of the subjects went up to 450 dangerous shocks, And they were called the obedient subjects. Not all of them did this willingly, right? Yes, I'm going to shock that person.

So there were people, even though two thirds of the subjects went up to 450 dangerous shocks, And they were called the obedient subjects. Not all of them did this willingly, right? Yes, I'm going to shock that person.

Milgram called them the moral imbeciles, but they were groaning, nervous laughter. They had these signs of tension, the nervous laughter. Oh, I have that for sure. And then I will smile. I have what a colleague of mine called the crocodile smile, is that as soon as I'm uncomfortable, I'll be like... Yeah. Okay. Oh, that's funny.

Milgram called them the moral imbeciles, but they were groaning, nervous laughter. They had these signs of tension, the nervous laughter. Oh, I have that for sure. And then I will smile. I have what a colleague of mine called the crocodile smile, is that as soon as I'm uncomfortable, I'll be like... Yeah. Okay. Oh, that's funny.

Yeah. It's an appeasement. Okay, I'm not a threat. Exactly. I can't let my face betray me. Yeah.

Yeah. It's an appeasement. Okay, I'm not a threat. Exactly. I can't let my face betray me. Yeah.

That third stage, if you could say, I'm not comfortable with this or the people in the Milgram experiments, is he actually okay? If they had resisted four times, that was the experiment. There was four prompts. then the experiment would have ended. So you just then need to continue. And stage four is that threat of noncompliance. I can't go through with it.

That third stage, if you could say, I'm not comfortable with this or the people in the Milgram experiments, is he actually okay? If they had resisted four times, that was the experiment. There was four prompts. then the experiment would have ended. So you just then need to continue. And stage four is that threat of noncompliance. I can't go through with it.

Yeah. Stage three, you're still in a subservient position.

Yeah. Stage three, you're still in a subservient position.

Yes. And then four is stating that you can't. And then five is your final act of defiance.

Yes. And then four is stating that you can't. And then five is your final act of defiance.

So understanding those stages, it might not be linear. You might skip some stages. There are certain situations that I found that I find it easier to define and you can go from stage two to stage five. And we can all find those places where, oh, this is actually more natural for me to do it.

So understanding those stages, it might not be linear. You might skip some stages. There are certain situations that I found that I find it easier to define and you can go from stage two to stage five. And we can all find those places where, oh, this is actually more natural for me to do it.

Right. So they are. consequences for being defiant, for sure. That's what holds us back a lot of the time. So, you know, when we think about why don't we defy, why do we actively even resist defiance? Number one, immense pressure from other people to do what they want you to do, the insinuation, anxiety aspect of all those psychological processes. And then the

Right. So they are. consequences for being defiant, for sure. That's what holds us back a lot of the time. So, you know, when we think about why don't we defy, why do we actively even resist defiance? Number one, immense pressure from other people to do what they want you to do, the insinuation, anxiety aspect of all those psychological processes. And then the

Number two is actually we don't really understand what consent and dissent actually is. We don't understand what defiance actually is. And I'll come back to that. And then the third one is about once you want to define, you understand that you don't have the skill set to define. So we need to learn it. But the consequences of defiance, people always think about it's going to

Number two is actually we don't really understand what consent and dissent actually is. We don't understand what defiance actually is. And I'll come back to that. And then the third one is about once you want to define, you understand that you don't have the skill set to define. So we need to learn it. But the consequences of defiance, people always think about it's going to

affect this relationship? You know, I'm going to disrupt the harmony. It might even cost me my job or might be some physical danger. So we do need to think about the consequences of defiance. Like what type of situation is this? There's sort of two questions we ask. Is it safe for me to defy and will it be effective?

affect this relationship? You know, I'm going to disrupt the harmony. It might even cost me my job or might be some physical danger. So we do need to think about the consequences of defiance. Like what type of situation is this? There's sort of two questions we ask. Is it safe for me to defy and will it be effective?

But what we don't often think about are the consequences and the costs of complying, because there's a lot of costs for continually complying with other people and putting aside your values. If you're always bowing your head to someone else, disregarding your values, it really has an effect on you.

But what we don't often think about are the consequences and the costs of complying, because there's a lot of costs for continually complying with other people and putting aside your values. If you're always bowing your head to someone else, disregarding your values, it really has an effect on you.

Yeah. if we reflect on what happened in that situation, you in these particular incidents that happened, me with a CT scan, and then think about what factors enable our defiance and what makes it harder for us. Understanding that is really key. But anticipating, even when we think about all the

Yeah. if we reflect on what happened in that situation, you in these particular incidents that happened, me with a CT scan, and then think about what factors enable our defiance and what makes it harder for us. Understanding that is really key. But anticipating, even when we think about all the

the big heroes that defied and had huge moments like Rosa Parks saying, no, I'm not going to move on the bus. There were lots of compliance moments before that moment. And so we shouldn't have so much shame. But that rumination is actually really helpful to think about what is it I wish I had done in that situation.

the big heroes that defied and had huge moments like Rosa Parks saying, no, I'm not going to move on the bus. There were lots of compliance moments before that moment. And so we shouldn't have so much shame. But that rumination is actually really helpful to think about what is it I wish I had done in that situation.

Because if we can then visualize it, if we can anticipate it, then that takes away the surprise, right? So the next time I was asked to go for some more radiation that I didn't need, I wasn't as surprised. I was anticipating it. I had practiced what I wish I would have said, and then I was able to say it.

Because if we can then visualize it, if we can anticipate it, then that takes away the surprise, right? So the next time I was asked to go for some more radiation that I didn't need, I wasn't as surprised. I was anticipating it. I had practiced what I wish I would have said, and then I was able to say it.

Oh, yeah, absolutely. That anticipation is so key. There's this famous saying that's often attributed to Bruce Lee, but it's actually a Greek poet that said like under duress. We don't rise to the level of our expectations. We fall to our level of training. And so that training aspect is so key. And I didn't realize it, right? Because it does change those neural pathways. So anticipating.

Oh, yeah, absolutely. That anticipation is so key. There's this famous saying that's often attributed to Bruce Lee, but it's actually a Greek poet that said like under duress. We don't rise to the level of our expectations. We fall to our level of training. And so that training aspect is so key. And I didn't realize it, right? Because it does change those neural pathways. So anticipating.

And we can anticipate more than we actually think. Sometimes we're caught off. But I know because we've experienced situations before when at the workplace, a particular colleague is going to say something inappropriate or they're going to make a sexist remark. We can kind of predict things that might happen so we can start anticipating.

And we can anticipate more than we actually think. Sometimes we're caught off. But I know because we've experienced situations before when at the workplace, a particular colleague is going to say something inappropriate or they're going to make a sexist remark. We can kind of predict things that might happen so we can start anticipating.

then we can visualize it and practice it. If you don't have like that behavioral training of actually practicing, if it's just the intellectual part, it's not going to make a difference. So you need to actually practice it. And this presentation workshop I went to, I just love the phrase that they use.

then we can visualize it and practice it. If you don't have like that behavioral training of actually practicing, if it's just the intellectual part, it's not going to make a difference. So you need to actually practice it. And this presentation workshop I went to, I just love the phrase that they use.

If you practice, your ears get used to hearing it and your mouth gets used to saying those words. That's really useful to know that that's what makes a difference.

If you practice, your ears get used to hearing it and your mouth gets used to saying those words. That's really useful to know that that's what makes a difference.

Even the insinuation anxiety feeling, I've said it's an aversive state. It's uncomfortable for a reason because your defiance might be causing harm to someone else.

Even the insinuation anxiety feeling, I've said it's an aversive state. It's uncomfortable for a reason because your defiance might be causing harm to someone else.

Yeah. It's there for a reason that somebody is expecting something of you. What does it mean? Right. So I think understanding that too, sort of naming it and knowing that we have two kind of ideal selves, especially in America, we have this ideal independent self. We want to act on our agency. We want to do what we think is right.

Yeah. It's there for a reason that somebody is expecting something of you. What does it mean? Right. So I think understanding that too, sort of naming it and knowing that we have two kind of ideal selves, especially in America, we have this ideal independent self. We want to act on our agency. We want to do what we think is right.

But we also have this interdependent self, which is that we want to remain in harmony with everybody around us. And there are two sort of ideals like Hazel Marcus and Shinobu Kitayama talk about these ideal selves. We can't ever achieve one state or the other state. And they're there for a reason.

But we also have this interdependent self, which is that we want to remain in harmony with everybody around us. And there are two sort of ideals like Hazel Marcus and Shinobu Kitayama talk about these ideal selves. We can't ever achieve one state or the other state. And they're there for a reason.

Exactly. And so we do need to think about that. But we also need to hold dear to ourselves what are our values.

Exactly. And so we do need to think about that. But we also need to hold dear to ourselves what are our values.

It's what I call those defiance hierarchy. Some people are allowed to defy, even rewarded for it. And others, they have more costs. There's more severe consequences. There's more backlash for being defiant.

It's what I call those defiance hierarchy. Some people are allowed to defy, even rewarded for it. And others, they have more costs. There's more severe consequences. There's more backlash for being defiant.

And it's interesting that the people that are in that category, which is anything from the dominant norm, the tall white male, anything that deviates from that group, you actually need to be defiant more often because you're expected to be more compliant.

And it's interesting that the people that are in that category, which is anything from the dominant norm, the tall white male, anything that deviates from that group, you actually need to be defiant more often because you're expected to be more compliant.

Because you've been here for 16 years. Oh, my goodness. Has it been that long?

Because you've been here for 16 years. Oh, my goodness. Has it been that long?

It can be exhausting. You have those extra burdens that you carry.

It can be exhausting. You have those extra burdens that you carry.

I mean, it'd be interesting what people might choose between those things. It's one where I often describe as being on a balance beam for some people. There's only a narrow set of behaviors that are possible for you to do without being punished. But sometimes you can get to firmer ground where you can find this is now safe and effective for me to define and find places where that is accepted.

I mean, it'd be interesting what people might choose between those things. It's one where I often describe as being on a balance beam for some people. There's only a narrow set of behaviors that are possible for you to do without being punished. But sometimes you can get to firmer ground where you can find this is now safe and effective for me to define and find places where that is accepted.

So compliance is something that we just go along with someone else. It's usually externally imposed or default. We're not really thinking about it. We kind of slide into it.

So compliance is something that we just go along with someone else. It's usually externally imposed or default. We're not really thinking about it. We kind of slide into it.

Consent. I take the definition of informed consent in medicine and I apply it to the other decisions that we make in life, which I find really useful. There's five elements that are required for informed consent. So first of all, this capacity that we have the mental capacity to make a decision. So we're not under the influence of drugs or alcohol or we're not sick. And then knowledge.

Consent. I take the definition of informed consent in medicine and I apply it to the other decisions that we make in life, which I find really useful. There's five elements that are required for informed consent. So first of all, this capacity that we have the mental capacity to make a decision. So we're not under the influence of drugs or alcohol or we're not sick. And then knowledge.

So we need to know about the situation, have full information about that situation. And third, understanding of that. Do we understand the risks, the benefits, the alternatives? Then number four, do we have the freedom to say no? In some situations, we don't have the freedom to say no. It might be too risky. Your life might be on the line in some situations.

So we need to know about the situation, have full information about that situation. And third, understanding of that. Do we understand the risks, the benefits, the alternatives? Then number four, do we have the freedom to say no? In some situations, we don't have the freedom to say no. It might be too risky. Your life might be on the line in some situations.

That's no wonder my son says that he's American now. How long has he been? He moved when he was one. We almost went back to the UK in 2020 during the pandemic. So I got offered a position at the University of Cambridge. We were all like, let's go. And then he said, no, I am American. Oh, he really planted a flag, literally.

That's no wonder my son says that he's American now. How long has he been? He moved when he was one. We almost went back to the UK in 2020 during the pandemic. So I got offered a position at the University of Cambridge. We were all like, let's go. And then he said, no, I am American. Oh, he really planted a flag, literally.

Exactly. You might not have the freedom to say no. Another one is if you're a black guy and you're stopped at a traffic stop, right? That's not the place to defy.

Exactly. You might not have the freedom to say no. Another one is if you're a black guy and you're stopped at a traffic stop, right? That's not the place to defy.

So freedom to say no. And then if you have those four things, the fifth element is your considered authorization of an informed consent. And if you want to say no, informed refusal.

So freedom to say no. And then if you have those four things, the fifth element is your considered authorization of an informed consent. And if you want to say no, informed refusal.

And we do have trust in our doctors and it would be a shame if that disappeared, right? That element of public trust. But there's also a lot being written on end of life treatment and how aggressive it can be. But it's really difficult. Again, it's an ideal that can never be fully attained in medicine and elsewhere.

And we do have trust in our doctors and it would be a shame if that disappeared, right? That element of public trust. But there's also a lot being written on end of life treatment and how aggressive it can be. But it's really difficult. Again, it's an ideal that can never be fully attained in medicine and elsewhere.

I think if people want to have that conversation and then even as I told Grande talks about, people prefer different types of care, right? Somebody wants the paternalistic advice. Just tell me what to do and I'll follow it. Other people want more of a guided, informed, shared decision making and the doctor to be more of a coach.

I think if people want to have that conversation and then even as I told Grande talks about, people prefer different types of care, right? Somebody wants the paternalistic advice. Just tell me what to do and I'll follow it. Other people want more of a guided, informed, shared decision making and the doctor to be more of a coach.

Yeah, some people find that really hard.

Yeah, some people find that really hard.

So true yes is consent. So having those five elements there would be your true yes. Or a true no is the same. The informed refusal is just having those five elements. But sometimes you have those five factors there, but you decide to actually do what I call conscious compliance. So you consciously comply because the costs might be too big or this is not the right time to do it.

So true yes is consent. So having those five elements there would be your true yes. Or a true no is the same. The informed refusal is just having those five elements. But sometimes you have those five factors there, but you decide to actually do what I call conscious compliance. So you consciously comply because the costs might be too big or this is not the right time to do it.

And because, as you said, it's exhausting. So you need to choose, is this situation going against my values? Otherwise we'd be defying every day. We wouldn't get anything done. And we need to really choose what situations are going against our values that this is worth me speaking up and saying something about.

And because, as you said, it's exhausting. So you need to choose, is this situation going against my values? Otherwise we'd be defying every day. We wouldn't get anything done. And we need to really choose what situations are going against our values that this is worth me speaking up and saying something about.

I interviewed a few of my students that have been in the military, which was really fascinating to hear their stories. And in fact, one of the first ones, and I remember it really well because we were speaking on Zoom on a Sunday afternoon. I was calling Matthew. He told me about when he went into the military and he did it because he grew up with 9-11 sort of seared into his memory.

I interviewed a few of my students that have been in the military, which was really fascinating to hear their stories. And in fact, one of the first ones, and I remember it really well because we were speaking on Zoom on a Sunday afternoon. I was calling Matthew. He told me about when he went into the military and he did it because he grew up with 9-11 sort of seared into his memory.

And he wanted to prove that he's an American, he's a patriot, and he was deployed to Iraq. And his best friend got killed in the first few months. And there was an incident where they were on some nighttime mission and he's like, nothing usually happens at nighttime. But there was this flash and then a grenade going off that was too close for comfort. And they immediately started opening fire.

And he wanted to prove that he's an American, he's a patriot, and he was deployed to Iraq. And his best friend got killed in the first few months. And there was an incident where they were on some nighttime mission and he's like, nothing usually happens at nighttime. But there was this flash and then a grenade going off that was too close for comfort. And they immediately started opening fire.

We went back when you said 2008. So that last year, I finished my PhD and I was doing my postdoc down at Duke. We were living in Chapel Hill. And then you get one year of this extra, you can stay. And then the second year of my postdoc, my family didn't get visas. So they went back to London and I was going back and forth.

We went back when you said 2008. So that last year, I finished my PhD and I was doing my postdoc down at Duke. We were living in Chapel Hill. And then you get one year of this extra, you can stay. And then the second year of my postdoc, my family didn't get visas. So they went back to London and I was going back and forth.

Some people went off in his squad and they came back with four prisoners. One of them, Matthew, had and had to look after. And this person was just screaming out in Arabic. And his supervisor said to him, he's talking too much. He's screaming, shut him up. And Matthew said, what should I do? And he was like, oh, it's simple. Hit him in the mouth.

Some people went off in his squad and they came back with four prisoners. One of them, Matthew, had and had to look after. And this person was just screaming out in Arabic. And his supervisor said to him, he's talking too much. He's screaming, shut him up. And Matthew said, what should I do? And he was like, oh, it's simple. Hit him in the mouth.

And so he looked at the man and there was blood coming out from his nose into his beard. So he hit him and the man didn't stop talking. And his sergeant said, he's not stopped. Hit him again. Hit him in the stomach. And Matthew just looked at me and he just said, and that's what I did. And then later on, he told me that he found out that these weren't insurgents at all.

And so he looked at the man and there was blood coming out from his nose into his beard. So he hit him and the man didn't stop talking. And his sergeant said, he's not stopped. Hit him again. Hit him in the stomach. And Matthew just looked at me and he just said, and that's what I did. And then later on, he told me that he found out that these weren't insurgents at all.

They were young teenage boys.

They were young teenage boys.

They were 15 or 16 years old. He couldn't understand what they were saying. And he felt really bad about it. And he said in that instant, he just trusted. He had no option. The next time they were on some kind of mission and they stopped and they basically formed like a circle, what they do in war, right? And what he told me is that you're not supposed to get out and just spray and pray.

They were 15 or 16 years old. He couldn't understand what they were saying. And he felt really bad about it. And he said in that instant, he just trusted. He had no option. The next time they were on some kind of mission and they stopped and they basically formed like a circle, what they do in war, right? And what he told me is that you're not supposed to get out and just spray and pray.

You have to have a target. Otherwise you can hurt civilians. And he said, but they just got out and they did spray and pray. And in that moment, he did not do that. he kind of turned around and looked at the desert behind him. And later on, his superior said to him, what were you doing? And he said, oh, I was just providing security. I was looking at providing cover.

You have to have a target. Otherwise you can hurt civilians. And he said, but they just got out and they did spray and pray. And in that moment, he did not do that. he kind of turned around and looked at the desert behind him. And later on, his superior said to him, what were you doing? And he said, oh, I was just providing security. I was looking at providing cover.

And he said that was the only thing he could think of for not doing it. But it actually was because his feelings were getting really complicated about whether he was doing the right thing or not. And he didn't describe his actions as defiant. He even said they were kind of cowardly. If he had actually said what he felt, he would have gone to military prison. And he said, and maybe they'd be right.

And he said that was the only thing he could think of for not doing it. But it actually was because his feelings were getting really complicated about whether he was doing the right thing or not. And he didn't describe his actions as defiant. He even said they were kind of cowardly. If he had actually said what he felt, he would have gone to military prison. And he said, and maybe they'd be right.

But that one incident that he said was half conscious, he did start becoming a little bit more defiant. So I call that quiet defiance where you're not actively saying no to someone else, but you're not going against what you think is the right thing to do.

But that one incident that he said was half conscious, he did start becoming a little bit more defiant. So I call that quiet defiance where you're not actively saying no to someone else, but you're not going against what you think is the right thing to do.

Right. And so later on, then he became less quietly defiant. There was another nighttime mission that he thought was way unsafe. It involved going out at the nighttime with goggles very close to a cliff edge. And he went to see his superior and he just said, I don't think we should do this. It's far too dangerous. And his superior was just like, shut up. Do as I say. Are you disobeying me?

Right. And so later on, then he became less quietly defiant. There was another nighttime mission that he thought was way unsafe. It involved going out at the nighttime with goggles very close to a cliff edge. And he went to see his superior and he just said, I don't think we should do this. It's far too dangerous. And his superior was just like, shut up. Do as I say. Are you disobeying me?

He's like, no, but I'm adamantly against the idea. And of course, the mission went ahead. People came back after half an hour. It didn't work out. It was too unsafe. But he wasn't rewarded for that. He was basically punished. He didn't get his promotion, but he said it was the right thing to do. And he became a little bit more comfortable with sort of saying those things.

He's like, no, but I'm adamantly against the idea. And of course, the mission went ahead. People came back after half an hour. It didn't work out. It was too unsafe. But he wasn't rewarded for that. He was basically punished. He didn't get his promotion, but he said it was the right thing to do. And he became a little bit more comfortable with sort of saying those things.

But yes, in the military, I hear time and time again from my students that have been there, it's yes, yes, yes. And one of them said, you are trained to do, not to think.

But yes, in the military, I hear time and time again from my students that have been there, it's yes, yes, yes. And one of them said, you are trained to do, not to think.

Yeah. So in war, that type of compliance is very helpful on the battlefield, for sure.

Yeah. So in war, that type of compliance is very helpful on the battlefield, for sure.

Yeah, I think there's many situations where it is complicated. That's why we struggle with it, too. If it was that simple, then we would get it right every single time. And we don't.

Yeah, I think there's many situations where it is complicated. That's why we struggle with it, too. If it was that simple, then we would get it right every single time. And we don't.

Utica and Roosevelt Island. Oh, wow.

Utica and Roosevelt Island. Oh, wow.

I think that's definitely worth it. I'm with you.

I think that's definitely worth it. I'm with you.

So when I said earlier on that there's some stories of my parents to find that have really stayed with me, the one of my mom is one that really I think was transformative. So I was about seven or eight and I was walking back from the grocery store with my mom and it was quite a long walk back and we had this rickety shopping cart. And we were rolling that back home.

So when I said earlier on that there's some stories of my parents to find that have really stayed with me, the one of my mom is one that really I think was transformative. So I was about seven or eight and I was walking back from the grocery store with my mom and it was quite a long walk back and we had this rickety shopping cart. And we were rolling that back home.

And we decided to take a shortcut through what you call in Yorkshire a snicket, which is just a narrow alleyway, right? When I went to elementary school, I was not supposed to go through that snicket.

And we decided to take a shortcut through what you call in Yorkshire a snicket, which is just a narrow alleyway, right? When I went to elementary school, I was not supposed to go through that snicket.

It's about four hours between. Oh, gosh. And you're doing that at the same time? Occasionally. It hasn't worked that well. Now, just one semester in one place and one semester in another place because going back and forth is too much. That's a lot.

It's about four hours between. Oh, gosh. And you're doing that at the same time? Occasionally. It hasn't worked that well. Now, just one semester in one place and one semester in another place because going back and forth is too much. That's a lot.

It was there. But anyway, mom and I, we went through the Snicket and we were confronted by about seven or eight teenage boys and they blocked our path. And they started shouting out some stuff to us, like some racist comments, go back home. We're trying to.

It was there. But anyway, mom and I, we went through the Snicket and we were confronted by about seven or eight teenage boys and they blocked our path. And they started shouting out some stuff to us, like some racist comments, go back home. We're trying to.

But my reaction was instant, which is what you had described before, right? Immediately, eyes down, averted. All I wanted to do was not look at them and maneuver my way through and get home as fast as I could. And my mom, she's petite. She's smaller than me now. She was taller than me at the time, but she's like 4'10". She had like her hair very neatly plaited back and single braid at the back.

But my reaction was instant, which is what you had described before, right? Immediately, eyes down, averted. All I wanted to do was not look at them and maneuver my way through and get home as fast as I could. And my mom, she's petite. She's smaller than me now. She was taller than me at the time, but she's like 4'10". She had like her hair very neatly plaited back and single braid at the back.

And I had thought of her as completely compliant person. And she did something that really surprised me that day. She put the shopping cart up vertical and she put one hand on her hip and she looked at them and she said, what do you mean? My fear was going up at this point. So I grabbed her arm even tighter and I started whispering to her. I was like... mama.

And I had thought of her as completely compliant person. And she did something that really surprised me that day. She put the shopping cart up vertical and she put one hand on her hip and she looked at them and she said, what do you mean? My fear was going up at this point. So I grabbed her arm even tighter and I started whispering to her. I was like... mama.

And I wanted to be the compliant person. And she shook me off. She was like, no. And she looked at them again and she said, what do you mean? They stared at her. She stared at them. And then she said, oh, you think you're big, tough boys, right? Big, strong boys. And she started telling them off in broken English. Oh, wow. And they like just looking at each other thinking, What's going on here?

And I wanted to be the compliant person. And she shook me off. She was like, no. And she looked at them again and she said, what do you mean? They stared at her. She stared at them. And then she said, oh, you think you're big, tough boys, right? Big, strong boys. And she started telling them off in broken English. Oh, wow. And they like just looking at each other thinking, What's going on here?

And one of them just said, let's go. Yeah. And they just dispersed. Yeah. And I was like, what happened? My mom grabbed the cart and she walked as fast as she could through that snicket. I never thought the day would come that she would tell off a group of boys on the street in that way.

And one of them just said, let's go. Yeah. And they just dispersed. Yeah. And I was like, what happened? My mom grabbed the cart and she walked as fast as she could through that snicket. I never thought the day would come that she would tell off a group of boys on the street in that way.

Yeah.

Yeah.

Protection, responsibility. And people do like I can defy for my son so much easier than I can defy for myself. And isn't that sad?

Protection, responsibility. And people do like I can defy for my son so much easier than I can defy for myself. And isn't that sad?

I was one when I came to England. I grew up my whole life there and also in Scotland. So my dad first came to England from India and did his PhD, then went back to India and then brought the family.

I was one when I came to England. I grew up my whole life there and also in Scotland. So my dad first came to England from India and did his PhD, then went back to India and then brought the family.

I also think there's something beautiful about having responsibility for someone else.

I also think there's something beautiful about having responsibility for someone else.

But you can tap into that.

But you can tap into that.

To a loved one. What would you do in that situation? I say that to my son at times when he gets stressed about things. Like, what advice would you give a loved one? What would you tell someone who's in ninth grade right now how to handle a situation? But what that really taught me was that defiance is a skill set, it's a practice, it's not a personality.

To a loved one. What would you do in that situation? I say that to my son at times when he gets stressed about things. Like, what advice would you give a loved one? What would you tell someone who's in ninth grade right now how to handle a situation? But what that really taught me was that defiance is a skill set, it's a practice, it's not a personality.

And even though compliance might be our default, it's not our destiny. So we can change. I had seen her come home several times and she would be muttering away. So I'm pretty sure she had seen those boys before. Wow. and not said anything. But now I was with her and she showed me that. And even though it might have changed her, because I do think defiance changes your brain, how you react.

And even though compliance might be our default, it's not our destiny. So we can change. I had seen her come home several times and she would be muttering away. So I'm pretty sure she had seen those boys before. Wow. and not said anything. But now I was with her and she showed me that. And even though it might have changed her, because I do think defiance changes your brain, how you react.

It also changes the people that observe it because that had a ripple effect on me and made me feel like we can all be defiant if we want to be. And that does give quite a bit of hope.

It also changes the people that observe it because that had a ripple effect on me and made me feel like we can all be defiant if we want to be. And that does give quite a bit of hope.

Yes. We were in London and we were on our way to see the flame that they hold. And it was like, oh, it's a once in a lifetime experience. He's like not impressed with this at all. Yeah. And he just wouldn't walk there. And he sat down on the pavement. And I was like, no, come on. I was like pulling his arm and trying to pick him up. And I could only get a few steps. He was heavy at that point.

Yes. We were in London and we were on our way to see the flame that they hold. And it was like, oh, it's a once in a lifetime experience. He's like not impressed with this at all. Yeah. And he just wouldn't walk there. And he sat down on the pavement. And I was like, no, come on. I was like pulling his arm and trying to pick him up. And I could only get a few steps. He was heavy at that point.

I was like, no, I can't carry you. And we just completely missed the whole thing. And we went home and he's just not realizing this moment in history that I have now missed forever. And I said to him, why can't you be good?

I was like, no, I can't carry you. And we just completely missed the whole thing. And we went home and he's just not realizing this moment in history that I have now missed forever. And I said to him, why can't you be good?

And that kept me up at night. I was like, why did I say that when that's what I learned, right? This whole obedience equals good and defiance equals bad. And here I was just repeating it. That really took me back to why is it so strong? Even when he was a baby, I would have relatives asking me, is he good? It's a baby. Right. There's no such thing.

And that kept me up at night. I was like, why did I say that when that's what I learned, right? This whole obedience equals good and defiance equals bad. And here I was just repeating it. That really took me back to why is it so strong? Even when he was a baby, I would have relatives asking me, is he good? It's a baby. Right. There's no such thing.

And what they mean is like, does he sleep?

And what they mean is like, does he sleep?

So in our community, medicine is one of the best things you can do, right? So I had the grades. I was a good kid. I asked my dad when I was young, what does my name mean? And he said in Sanskrit, Sunita means good. Oh, wow. And so I mostly lived up to that. I was a good girl in their eyes. So I did exactly what I was told. I did all my homework as expected.

So in our community, medicine is one of the best things you can do, right? So I had the grades. I was a good kid. I asked my dad when I was young, what does my name mean? And he said in Sanskrit, Sunita means good. Oh, wow. And so I mostly lived up to that. I was a good girl in their eyes. So I did exactly what I was told. I did all my homework as expected.

It's amazing what we equate with being good, which is not being a bother to someone else at all.

It's amazing what we equate with being good, which is not being a bother to someone else at all.

And sometimes that's how we feel in organizations, right? When we work, managers love the yes man or the yes woman. Do as I say, don't question it. And we then just sort of narrow our vision to how well we are pleasing the boss rather than the wider. Like, what is it we're actually doing that has a value to the world?

And sometimes that's how we feel in organizations, right? When we work, managers love the yes man or the yes woman. Do as I say, don't question it. And we then just sort of narrow our vision to how well we are pleasing the boss rather than the wider. Like, what is it we're actually doing that has a value to the world?

One of the major things that was really crucial to sort of changing how I thought about defiance is getting rid of some of the myths that defiance has to be aggressive, loud. You have to have a larger than life personality. You got to be me. You got to be you, right?

One of the major things that was really crucial to sort of changing how I thought about defiance is getting rid of some of the myths that defiance has to be aggressive, loud. You have to have a larger than life personality. You got to be me. You got to be you, right?

Monica and I are never going to be here. Don't rule that out.

Monica and I are never going to be here. Don't rule that out.

We can find our own way. We can be defiant in a way that's unique to us. So understanding that defiance isn't just for the brave or the extraordinary, right? It's available and it's necessary for all of us. I think that's one mindset shift that we can really all use and understand. And then the other is what I call the defiance compass, which I think is very useful because

We can find our own way. We can be defiant in a way that's unique to us. So understanding that defiance isn't just for the brave or the extraordinary, right? It's available and it's necessary for all of us. I think that's one mindset shift that we can really all use and understand. And then the other is what I call the defiance compass, which I think is very useful because

which is when we're faced with a situation and we're trying to decide what to do. We have that tension, then we take the pause and we try to understand. These three questions came from James Marsh, who's a sociologist. But I've sort of adapted them to be not just three questions that we ask implicitly for every decision, but to put them in a circle because I think it is a circular thing.

which is when we're faced with a situation and we're trying to decide what to do. We have that tension, then we take the pause and we try to understand. These three questions came from James Marsh, who's a sociologist. But I've sort of adapted them to be not just three questions that we ask implicitly for every decision, but to put them in a circle because I think it is a circular thing.

So the first question is, who am I? And that's really connecting with your values. So if you aspire to be someone who's fair, compassionate, has integrity, that's what you really need to think about. That's who you are, because that's really important. If you've not found that out, spend some time doing that because people that clarify their values are more likely to act in alignment with them.

So the first question is, who am I? And that's really connecting with your values. So if you aspire to be someone who's fair, compassionate, has integrity, that's what you really need to think about. That's who you are, because that's really important. If you've not found that out, spend some time doing that because people that clarify their values are more likely to act in alignment with them.

And also there's research showing that it reduces your stress and cortisol levels if you actually know what your values are.

And also there's research showing that it reduces your stress and cortisol levels if you actually know what your values are.

So really know who am I? You can ask yourself that. And then the second question. So that's internal. Then you go external. What type of situation is this? Is it safe and effective for me to defy? And then the last question is with these particular values, fair, full of integrity, all those things. What does a person like me do in a situation like this?

So really know who am I? You can ask yourself that. And then the second question. So that's internal. Then you go external. What type of situation is this? Is it safe and effective for me to defy? And then the last question is with these particular values, fair, full of integrity, all those things. What does a person like me do in a situation like this?

If you believe you're one type of person, but you're never acting in that way, you want to sort of start thinking about whether that really is who you are or not. And I've found those three questions really powerful in terms of knowing this is what I would like to do. Really tapping into our aspirational selves.

If you believe you're one type of person, but you're never acting in that way, you want to sort of start thinking about whether that really is who you are or not. And I've found those three questions really powerful in terms of knowing this is what I would like to do. Really tapping into our aspirational selves.

I was what in Yorkshire they call SWAT-y, which means you're a SWAT. You work really hard. You do all your homework. Maybe it's equivalent to nerd here.

I was what in Yorkshire they call SWAT-y, which means you're a SWAT. You work really hard. You do all your homework. Maybe it's equivalent to nerd here.

I want to decrease that gap between the intention, what we think we'll do in a situation and how we actually act.

I want to decrease that gap between the intention, what we think we'll do in a situation and how we actually act.

And that's fascinating.

And that's fascinating.

But you wouldn't have felt good about it in the long run.

But you wouldn't have felt good about it in the long run.

And in experiment after experiment, I've seen people say their one thing and then behave in a different way. So anything that helps us reduce that gap.

And in experiment after experiment, I've seen people say their one thing and then behave in a different way. So anything that helps us reduce that gap.

The people that could defy, they're really fascinating. So, I mean, I told you the sort of basic setup of the Milgram experiment, but when you look at all the different deviations that they had, that's where I find the work really fascinating and the people that defied, what was it about them that they defied? And many of them, it was because of responsibility.

The people that could defy, they're really fascinating. So, I mean, I told you the sort of basic setup of the Milgram experiment, but when you look at all the different deviations that they had, that's where I find the work really fascinating and the people that defied, what was it about them that they defied? And many of them, it was because of responsibility.

So one was a professor of the Old Testament. So values were there and very high on that. So even though... He was stuttering and things when they said the experiment requires you to go on. He kind of asked, does it like maybe if we're in Russia, but not here.

So one was a professor of the Old Testament. So values were there and very high on that. So even though... He was stuttering and things when they said the experiment requires you to go on. He kind of asked, does it like maybe if we're in Russia, but not here.

So he was able to stand up to that because he'd done so much thinking about those types of values and humanity and not harming another person. And then the other person that really stands out for me is an engineer that had the knowledge of how powerful these shocks are. Interesting. And he lived through World War II. And so he was fascinated by this afterwards.

So he was able to stand up to that because he'd done so much thinking about those types of values and humanity and not harming another person. And then the other person that really stands out for me is an engineer that had the knowledge of how powerful these shocks are. Interesting. And he lived through World War II. And so he was fascinated by this afterwards.

I don't know. But when you talk about SWOT now, especially at business schools, it means something totally different. Strengths, weaknesses, opportunities, threats. That's not what it means when I was growing up.

I don't know. But when you talk about SWOT now, especially at business schools, it means something totally different. Strengths, weaknesses, opportunities, threats. That's not what it means when I was growing up.

And he said he just felt really bad that he went as far as he did before he stopped. Because it's like if you throw the responsibility onto someone else and just say you were taking orders, that's really quite a cowardly thing to do. You're the one that's causing trouble. the shocks to someone else. And I know what kind of harm those shocks can do.

And he said he just felt really bad that he went as far as he did before he stopped. Because it's like if you throw the responsibility onto someone else and just say you were taking orders, that's really quite a cowardly thing to do. You're the one that's causing trouble. the shocks to someone else. And I know what kind of harm those shocks can do.

And there was another participant, a woman that said the same thing. I don't want to be responsible for causing harm to another person. So I do think that responsibility element is really powerful when we think about what does a person like me do in a situation.

And there was another participant, a woman that said the same thing. I don't want to be responsible for causing harm to another person. So I do think that responsibility element is really powerful when we think about what does a person like me do in a situation.

Really? Yes. I'm just saying that because my son wants to be an engineer.

Really? Yes. I'm just saying that because my son wants to be an engineer.

Yeah, I think sort of the critical thinking element of it is key of knowing actually when to defy or not to defy.

Yeah, I think sort of the critical thinking element of it is key of knowing actually when to defy or not to defy.

No, they weren't actually.

No, they weren't actually.

Yeah, members of the community came in. They had different races and he ran a bunch of experiments. But there was one experiment that was all women. And in that experiment, same rates of compliance as the other ones. There wasn't a gender difference, surprisingly. Right.

Yeah, members of the community came in. They had different races and he ran a bunch of experiments. But there was one experiment that was all women. And in that experiment, same rates of compliance as the other ones. There wasn't a gender difference, surprisingly. Right.

Yeah. Maybe because you have more knowledge, more knowledge.

Yeah. Maybe because you have more knowledge, more knowledge.

So I got the grades and it's like, why wouldn't you want to do medicine? Yeah. And I was like, well, I'm not sure it's really for me. But in the UK, it's a combined undergraduate and graduate degree. So you basically start at the age of 18 medical school and you finished. I was on the wards in my early 20s.

So I got the grades and it's like, why wouldn't you want to do medicine? Yeah. And I was like, well, I'm not sure it's really for me. But in the UK, it's a combined undergraduate and graduate degree. So you basically start at the age of 18 medical school and you finished. I was on the wards in my early 20s.

Yeah.

Yeah.

I think that would be interesting. Those rookie officers, if they had that situation again, wouldn't do it. So how can we learn from the experience of other people? Yeah. And that's really fascinating because I was speaking to another rookie officer and he was trained during the time that the incident with George Floyd took place. And he thought about it a lot.

I think that would be interesting. Those rookie officers, if they had that situation again, wouldn't do it. So how can we learn from the experience of other people? Yeah. And that's really fascinating because I was speaking to another rookie officer and he was trained during the time that the incident with George Floyd took place. And he thought about it a lot.

And so when it came to a situation that he was on this night run with his partner and a few others and they wanted to go and search a garage for stolen bicycles, he said, no, we can't just go in there without permission of the homeowner to go. And they were like, no, we're just going to go in. And he said, no. So he went and knocked on the door and it was about four o'clock in the morning.

And so when it came to a situation that he was on this night run with his partner and a few others and they wanted to go and search a garage for stolen bicycles, he said, no, we can't just go in there without permission of the homeowner to go. And they were like, no, we're just going to go in. And he said, no. So he went and knocked on the door and it was about four o'clock in the morning.

No answer at all. But the car was there and the neighbor said, oh, I think he's there. He's just asleep. And so he was the only one as this rookie officer that refused to go in. And the reason he did that wasn't because he was brave or anything like that. He said he was motivated by fear because he saw what happened to the rookie officers.

No answer at all. But the car was there and the neighbor said, oh, I think he's there. He's just asleep. And so he was the only one as this rookie officer that refused to go in. And the reason he did that wasn't because he was brave or anything like that. He said he was motivated by fear because he saw what happened to the rookie officers.

And in his mind, he went to the worst case scenario that we're going to go in there and And we don't have any standing to go in there. There's no blood. There's nobody screaming.

And in his mind, he went to the worst case scenario that we're going to go in there and And we don't have any standing to go in there. There's no blood. There's nobody screaming.

And so he knew the law and he'd just been trained. And then he was with police officers 20 years older than him saying, you're telling us what to do. F it. We're going in. He refused to go in because he thought the homeowner is going to come out with a gun. Yeah. Something terrible is going to happen.

And so he knew the law and he'd just been trained. And then he was with police officers 20 years older than him saying, you're telling us what to do. F it. We're going in. He refused to go in because he thought the homeowner is going to come out with a gun. Yeah. Something terrible is going to happen.

So he said no. And homeowner came down and actually thanked them and everything. So everything was fine. And the ride back to the station for him was just awful. And within an hour, he was called in to see his supervisor. And it was a bit like, read this, you got it wrong. And he was like, no, with all due respect, I knew that we didn't have any standing and we shouldn't have gone in.

So he said no. And homeowner came down and actually thanked them and everything. So everything was fine. And the ride back to the station for him was just awful. And within an hour, he was called in to see his supervisor. And it was a bit like, read this, you got it wrong. And he was like, no, with all due respect, I knew that we didn't have any standing and we shouldn't have gone in.

And he said to me, you know, his childhood stutter came back. But he knew in this job, it was going to be difficult and he was going to be asked to do some things that weren't right. And because he'd seen the George Floyd thing. Anticipating. Anticipating. He thought, I'm not going to be that police officer. But he was ostracized for a bit.

And he said to me, you know, his childhood stutter came back. But he knew in this job, it was going to be difficult and he was going to be asked to do some things that weren't right. And because he'd seen the George Floyd thing. Anticipating. Anticipating. He thought, I'm not going to be that police officer. But he was ostracized for a bit.

He said the whole thing went around the station, even though he was right. But he ultimately got transferred to another unit where he said they were younger officers, but they had more understanding of the law. And he's very hopeful and very optimistic about a new era of policing. So that was great to hear. But it also shows that learning from other people, I think, would be wonderful.

He said the whole thing went around the station, even though he was right. But he ultimately got transferred to another unit where he said they were younger officers, but they had more understanding of the law. And he's very hopeful and very optimistic about a new era of policing. So that was great to hear. But it also shows that learning from other people, I think, would be wonderful.

I'm thinking, is there a thing as being too defiant? Because I'm not talking about defiance as a knee-jerk reaction to defiance, but more considered defiance. So maybe that's what you need.

I'm thinking, is there a thing as being too defiant? Because I'm not talking about defiance as a knee-jerk reaction to defiance, but more considered defiance. So maybe that's what you need.

Healthy amount of skepticism, but not too much.

Healthy amount of skepticism, but not too much.

I appreciate that.

I appreciate that.

It's important.

It's important.

Thank you. This is wonderful.

Thank you. This is wonderful.

Biology, we had to do as eight levels before you go in. At that point, it was five years. That's it. But when you say first seen a patient, the first two years are preclinical. So you're learning things. Then the third year, you're on the wards and you're a clinical. By the time you're 22, 23, you're qualified. You're on the wards. Wow.

Biology, we had to do as eight levels before you go in. At that point, it was five years. That's it. But when you say first seen a patient, the first two years are preclinical. So you're learning things. Then the third year, you're on the wards and you're a clinical. By the time you're 22, 23, you're qualified. You're on the wards. Wow.

Here, you have to work so hard. I got all my education for free, which is pretty impressive. There's a small cost now in the UK, but I went through the whole of medical school. I mean, earning peanuts once you start as a junior doctor. But that aspect of working earlier is great. So you can get through. Making the decision so early, questionable.

Here, you have to work so hard. I got all my education for free, which is pretty impressive. There's a small cost now in the UK, but I went through the whole of medical school. I mean, earning peanuts once you start as a junior doctor. But that aspect of working earlier is great. So you can get through. Making the decision so early, questionable.

Oh, wow.

Oh, wow.

Although I say my career is perfectly planned. Yeah. It was perfectly planned how I ended up here. But suddenly there was a lot of pressure and I lived up to those expectations of going to medical school and then finishing medical school and ended up working as a doctor.

Although I say my career is perfectly planned. Yeah. It was perfectly planned how I ended up here. But suddenly there was a lot of pressure and I lived up to those expectations of going to medical school and then finishing medical school and ended up working as a doctor.

I knew it wasn't for me. There were certain aspects I really loved, like the analytical part. I'm always analytical. I was always thinking, always questioning.

I knew it wasn't for me. There were certain aspects I really loved, like the analytical part. I'm always analytical. I was always thinking, always questioning.

I'm really fascinated by people as well. So just talking to people, meeting people, learning about their lives. So that aspect was great. I wasn't actually into the blood and gore aspect. I remember talking to my teachers about that, like, oh, I don't know about medicine. And they were like, it's just two years preclinical. You're going to do that fine.

I'm really fascinated by people as well. So just talking to people, meeting people, learning about their lives. So that aspect was great. I wasn't actually into the blood and gore aspect. I remember talking to my teachers about that, like, oh, I don't know about medicine. And they were like, it's just two years preclinical. You're going to do that fine.

And then just get through the clinical years and then you can end up doing research.

And then just get through the clinical years and then you can end up doing research.

So I was always interested in psychology. So when I was at medical school, I did my two years preclinical and then I took a year out to do what they call an intercalated degree in psychology. So they basically throw you in the fourth year of psychology and you catch up on the four years in that one year. But that was... Such a wonderful year. It was amazing.

So I was always interested in psychology. So when I was at medical school, I did my two years preclinical and then I took a year out to do what they call an intercalated degree in psychology. So they basically throw you in the fourth year of psychology and you catch up on the four years in that one year. But that was... Such a wonderful year. It was amazing.

That's when I started reading about Milgram Stanley's famous experiments, Obedience to Authority. I became fascinated with that, who did what we call the electric shock experiment. Yes, yes, yes. So Stanley Milgram was really fascinated by why the Nazis in World War II always kept saying, I was just following orders afterwards when they were being investigated for war crimes. Yeah.

That's when I started reading about Milgram Stanley's famous experiments, Obedience to Authority. I became fascinated with that, who did what we call the electric shock experiment. Yes, yes, yes. So Stanley Milgram was really fascinated by why the Nazis in World War II always kept saying, I was just following orders afterwards when they were being investigated for war crimes. Yeah.

And so he decided to set up this experiment, which was quite elaborate, where he would bring people in from the community and they would be an actor. It was designed as an experiment on memory. That's what they thought they were coming into. And whether giving someone electric shocks would help them learn better. Wow. So that was the setup.

And so he decided to set up this experiment, which was quite elaborate, where he would bring people in from the community and they would be an actor. It was designed as an experiment on memory. That's what they thought they were coming into. And whether giving someone electric shocks would help them learn better. Wow. So that was the setup.

First experiments were conducted at Yale in their basement, I think. So people would come in, they would meet somebody else that they thought was another participant, but it was actually an actor that they had. And they would rig it so the actor would be what they call the learner.

First experiments were conducted at Yale in their basement, I think. So people would come in, they would meet somebody else that they thought was another participant, but it was actually an actor that they had. And they would rig it so the actor would be what they call the learner.

So then he would go into this room and the participant who was the teacher would see him being rigged up to what looked like an electric chair. And they would feel one of the shocks, 15 volts or something. So it all looks really real And then the teacher would go to another room and they would be sat in front of this box that was sort of labeled from 15 volts to 450 volts. Right.

So then he would go into this room and the participant who was the teacher would see him being rigged up to what looked like an electric chair. And they would feel one of the shocks, 15 volts or something. So it all looks really real And then the teacher would go to another room and they would be sat in front of this box that was sort of labeled from 15 volts to 450 volts. Right.

And it would go up in 15 volt increments and it would be labeled. So right at the end, it was three X's, danger, huge shock.

And it would go up in 15 volt increments and it would be labeled. So right at the end, it was three X's, danger, huge shock.

There can be lethal shocks at that point. Then the teacher had to read out some word pairs and the learner had to memorize and repeat them back. And if they got something wrong, they would get a shock and then it would go up 15 volts.

There can be lethal shocks at that point. Then the teacher had to read out some word pairs and the learner had to memorize and repeat them back. And if they got something wrong, they would get a shock and then it would go up 15 volts.

So they had to read out the word pairs and the experimenter was usually in the room just sort of overseeing. And if the teacher protested, they would tell them, you know, please go on with the experiment. They had like four prompts to tell them, please go on. It's essential that you continue. The experiment requires that you go on.

So they had to read out the word pairs and the experimenter was usually in the room just sort of overseeing. And if the teacher protested, they would tell them, you know, please go on with the experiment. They had like four prompts to tell them, please go on. It's essential that you continue. The experiment requires that you go on.

And when psychiatrists predicted beforehand what would happen, they thought that most people would not go past 150 volts. And in fact, every single participant in the first experiment went past that.

And when psychiatrists predicted beforehand what would happen, they thought that most people would not go past 150 volts. And in fact, every single participant in the first experiment went past that.

ah and the actor is screaming about 150 volts there's thumping on the wall and there's verbal complaints i don't want to go on with this i don't want to go on oh my god get me out of here i refuse to go on with the experiment and it was also told to the participants he had a heart condition oh my god this is like Really horrifying. They predicted only about one in 1,000 would go up to 450 volts.

ah and the actor is screaming about 150 volts there's thumping on the wall and there's verbal complaints i don't want to go on with this i don't want to go on oh my god get me out of here i refuse to go on with the experiment and it was also told to the participants he had a heart condition oh my god this is like Really horrifying. They predicted only about one in 1,000 would go up to 450 volts.

But they found that everyone pulled the lever for 150 volts. Everyone pulled it for 300 volts. And 66% went up to 450 volts. Holy shit. Even Milgram was shocked. Yeah. He was shocked at the results because he didn't think that he would find that. And he was like, I really thought this was something unique about German culture. But everybody is doing this.

But they found that everyone pulled the lever for 150 volts. Everyone pulled it for 300 volts. And 66% went up to 450 volts. Holy shit. Even Milgram was shocked. Yeah. He was shocked at the results because he didn't think that he would find that. And he was like, I really thought this was something unique about German culture. But everybody is doing this.

As I said, I was always known for being an obedient daughter and student. But I was fascinated by people who could defy. And I was good friends with someone at high school. Let's call her Clara. She was able to defy. I started at St. Joseph's College, which is an all-girls Catholic school at the other side of town.

As I said, I was always known for being an obedient daughter and student. But I was fascinated by people who could defy. And I was good friends with someone at high school. Let's call her Clara. She was able to defy. I started at St. Joseph's College, which is an all-girls Catholic school at the other side of town.

My dad thought that I'm going to get a good education there, so I would catch two buses to go to St. Joseph's. It was the roughest school I've been to. Oh, wow. So I don't know what he thought, but it was also a lot of fun.

My dad thought that I'm going to get a good education there, so I would catch two buses to go to St. Joseph's. It was the roughest school I've been to. Oh, wow. So I don't know what he thought, but it was also a lot of fun.

And Clara came in two weeks late. She had moved from Hastings in the south of England to the north. And so she was different a little bit. I was also different. I was just one of a handful of non-white girls at the school. And we became really close friends, even though we were so different from each other.

And Clara came in two weeks late. She had moved from Hastings in the south of England to the north. And so she was different a little bit. I was also different. I was just one of a handful of non-white girls at the school. And we became really close friends, even though we were so different from each other.

Absolutely. I was like, how can she do that? Because she just walked in. We had this sort of checkered blue and white blouse that we'd wear and a red sweater. She walked in without the red sweater. She just stood out so much. And I was like, who is she?

Absolutely. I was like, how can she do that? Because she just walked in. We had this sort of checkered blue and white blouse that we'd wear and a red sweater. She walked in without the red sweater. She just stood out so much. And I was like, who is she?

Especially because the headmistress had said before, I want everybody in their red sweaters because when I look out, I just want to see a sea of red.

Especially because the headmistress had said before, I want everybody in their red sweaters because when I look out, I just want to see a sea of red.

Thank you.

Thank you.

I remember, I think a few years before that, maybe when I was at middle school, my dad got me these bright red, like warmers. When my dad bought them for me, I was like, I just didn't want to wear them. They're too bright. Give me black so I can kind of blend in. And it was like, no, we can't return them now. So I have to wear these things to school. And it was excruciating, right?

I remember, I think a few years before that, maybe when I was at middle school, my dad got me these bright red, like warmers. When my dad bought them for me, I was like, I just didn't want to wear them. They're too bright. Give me black so I can kind of blend in. And it was like, no, we can't return them now. So I have to wear these things to school. And it was excruciating, right?

I was trying to hide them with my coat. I was like, no, no, I don't want to be wearing this. But then I kind of changed when I went to St. Joseph's and when the headmistress said like a sea of red, I was like, hmm, I'm not sure about that. And I had the song of Another Brick in the Wall by Pink Floyd kind of playing, right? So I was getting quite attracted to these kinds of things.

I was trying to hide them with my coat. I was like, no, no, I don't want to be wearing this. But then I kind of changed when I went to St. Joseph's and when the headmistress said like a sea of red, I was like, hmm, I'm not sure about that. And I had the song of Another Brick in the Wall by Pink Floyd kind of playing, right? So I was getting quite attracted to these kinds of things.

I was more questioning. Oh, that's right. Why do they want us to conform so much? Because I was so used to obeying and doing and getting rewards for that. I would see teachers doing things that I thought were unfair. So when I was at middle school, I saw one of my teachers beating up another kid. Oh. And that was horrifying to me.

I was more questioning. Oh, that's right. Why do they want us to conform so much? Because I was so used to obeying and doing and getting rewards for that. I would see teachers doing things that I thought were unfair. So when I was at middle school, I saw one of my teachers beating up another kid. Oh. And that was horrifying to me.

And I remember meeting him in the corner shop that we had just down the road. And I was really scared, but he was so nice and friendly to me. And in my child's mind, I basically thought that was because he thought I was good. Yeah, you were good. He only beats bad people. He only beats bad people. And so I tried like hell never to be bad.

So I wouldn't get treated like the way that boy got treated. But it really unnerved me, right? It left something there as to why are teachers expecting us to behave in this particular way?

And when I realized that people in authority can do things like that, they can be unethical, incompetent, and just plain stupid, then you start to question the people that are in charge maybe don't have our best interests in mind.

In some ways, it's excessive at medical school. All right. Yeah. When I came to the US, it was fascinating when we were trying to find an apartment to rent. As soon as you say I'm a doctor.

Some of the people I know that are completely wild and off track are doctors. Of course. Yeah. There's a lot of stress release. Yes.

Oh, yeah. We had some good nights.

That really haunted me because they were rookie officers. And the guy with the knee on the neck was their training supervisor. So that image of George Floyd is ingrained in lots of people's minds and it's horrific. Also, when I think about the rookie officers, I always think, what would I have done? Because they're obeying. They're in a line of hierarchy. They've been trained to obey.

And even though in the manual, if your officer is asking you to do something unethical and things you should defy or say something, it's impossible. And people are saying, why did they do that? Why did they not say no? It's so impossible to do that in certain situations, especially if you haven't anticipated it, confronted it before, know how to react appropriately.

practiced it rather than just intellectually knowing.

Yeah. And so often our actions just don't align with our values. And we see this time and time again. And this is what I wanted to study in more depth. Why is that? We can sit here in our armchairs, right? And just say, oh, we wouldn't do that. We would act in this particular way. But when you're actually in that situation, it's so difficult.

Yeah.

That day, I had this immense central chest pain and I hadn't felt any pain like this before. So I was worried about it and I thought I need to get this checked out. I was fairly new to having moved to the US. And so I went to the emergency room and immediately there's loads of tests being done. And they did an electrocardiogram, which was the main thing I was concerned about.

Like, am I having a heart attack? Yeah. And everything was normal, thank goodness. And the pain was subsiding. It was going away. So I thought, great, I'm going to be discharged. And then the doctor came in. She was kind of young and confident. And she just said, oh, I'll need you to have a CT scan before you go. And I was like, why?

And she was like, oh, we just want to make sure you don't have a pulmonary embolism. PE is a blood clot in the lungs. And it has a specific type of pain. And I worked for six months in respiratory medicine, which you call pulmonary here. And this type of pain when you have an embolism in the lung is what we call pleuritic chest pain. It's a sharp pain.

It catches your breath when you breathe in and breathe out. And I didn't have that type of pain. I didn't want to have this CT scan she was talking about because it's on average, 70 times the amount of radiation of an X-ray. And even though it's still small, why have ionizing radiation, which can cause cancer many years into the future, why take the risk, right? If it's unnecessary. Yeah.

So I had the knowledge in that situation and I should have said no. And yet I just couldn't say no. And so I was then wheeled into the room with a CT scan and the technician and I couldn't even say no then. I would just ask questions in this polite way like, oh, it's not a lot of radiation, is it?

Even though I knew because I wanted them to pick up on my discomfort and say, oh, do you not want this?

And that didn't happen.

So I ended up having this CT scan. Why couldn't I just say no in that situation? It was safe for me to say no. It would have been effective. And yet something held me back. The only reason I had it was because the doctor told me to. So here's the doctor in a safe situation. She's even smiling. I can't say no. And I'm a doctor myself.

So what would I have done in this situation with George Floyd with a police officer wearing a gun? That's how difficult this is. It's terrifying when you think about it. And there was a survey of 1,700 crew members of commercial airlines. About half of them did not feel comfortable to speak up when they saw an error. Yeah.

So there's this psychological process that I call insinuation anxiety disorder. that I uncovered in my experiments. But the actual experience, I experienced it when I was having the CT scan. I knew this feeling for years and years. The name for it only came after I started doing research in it.

And insinuation anxiety is this aversive emotional state that we have when we believe that not complying with someone else will be a signal of distrust to that person. So it basically insinuates that the other person is incompetent, biased, corrupt and trustworthy in some way. And you don't want to give them that signal. And so the co-pilots telling the pilots, you haven't observed this.

You're doing something wrong here. Like, I don't think we should do that. It's really difficult.

And I see it in experiments in the hospital as well in surveys. Nurses can't speak up when they see a colleague making an error for the same reason. Wow.

How can you? Even with physicians in this particular survey, it was less than 1% whether you had a supervisory role of the physician or not. Less than 1% could actually tell them if it was something about the physician's incompetence. You don't want that. You want your co-pilots to speak up.

You want supervising physicians and nurses working with physicians to speak up if they see something going wrong. Because these life and death situations are huge. But even when it's not life and death, and sometimes you don't know, like as the rookie cops, right, they probably didn't know this was going to turn out to be an unfolding murder or life and death type of situation. Yeah.

But you don't want to end up in those situations because you're so wired to go along with it. You're so socialized to say, OK, I'm going to obey.

The Oxford English Dictionary definition of defiance is to challenge the power of someone else boldly and openly. And I shouldn't really disagree with that having been brought up in English. It's the best. I do. I think it's way too narrow.

And I think a better definition of defiance, considering everything that we've spoken about, is that to defy is simply to act in accordance with your own true values, your core values, when there is pressure to do otherwise.

And also values can involve other people too. Speaking up when you see somebody causing harm to someone else is really a communal act in a way. So redefining, reframing defiance from this negative connotation to being a proactive positive force in society. Because if you think about it, every single act of consent and dissent and compliance, that creates the society that we live in.

So if you're socialized to comply from a young age, if you're rewarded for being compliant, and I know I was, you probably were. I don't know if you were.

That's fascinating. So for many of us... Yeah, yeah.

That was encouraged, right?

One of the things that I really noticed in the people that I've interviewed is if you have seen your parents defy as well, it's so powerful. And I do have one or two moments where my parents did defy, even though they were compliant most of the time. And that stayed with me.

Yes. And it changed my view of compliance and defiance being personality traits. I realized this is a skill. We can choose to use it or not, because even the most compliant person, my mother, she does all the shopping, the groceries, looking after all the family. I had very neatly put her into the box of being compliant. And one day when she was defiant, I just... just blew my mind.

I was like, wow, that's so impressive. She's actually really strong and she can be defiant when she needs to be.

If I can do it with the upbringing I had, I think most people can learn how to defy. It's just you have to learn that skill set. You have to get out. So if you're talking about neurological I was rewarded for being compliant. That's when the neural pathways start to form like obedience. It becomes our default. We start equating obedience with being good, compliance with being good.

Absolutely. So we become what I call wire to comply, right? It becomes the default without thinking. Somebody says to do something, we go along and we do it. And so that's really powerful socialization, the messages that we get to obey, to be polite, you know, don't make a scene, don't question authority, listen to them.

And that makes a difference to the rest of our lives in a way and our default setting. But if we think about situations where we learn how to defy We need to really practice so we can change that default setting. The more that we practice, the more those other pathways start to strengthen. For example, I have these five stages of defiance.

So the first one, like usually when we're in a situation where we want to defy or we think we should, we feel some kind of tension. So our body immediately tells us we don't think this is quite right. So I felt it with a CT scan. I'm sure you've been in situations where you felt like, oh, I don't know about that. Yeah. And so often we just ignore it. We think it's not worth our doubt. Exactly.

Is it worth it? Yes.

And we probably have our own signs, right? People will probably feel it differently. Maybe for some people it's a headache. Maybe for some people it's their throat constricting. Maybe it's feeling butterflies. So we all have a sign that comes up. And then the second stage is to acknowledge that rather than disregard it is to admit it to yourself, right? I'm feeling something.

Yeah, avoid it. And that's a shame because it's a warning sign. And if we actually listen to it, it could help us because we just need to like, why am I feeling this way? What does it actually mean? I felt it with a CT scan and I was like, OK, but it actually got worse as I carried on having the CT scan. It didn't go away.

And so I felt it more. And then I felt so much regret afterwards, like how easy would it have been for me to say no? Why couldn't I say no? Actually, it wasn't that easy. But what can I do to make sure I say no next time? And so feeling the tension, acknowledging it to yourself. And then stage three is the real critical stage is just vocalizing it to someone else.

And the reason that stage is so critical is because if you tell someone else you're not comfortable with this, you've stated how you feel. You can't then go back and rationalize to yourself, I was actually okay with it after all, right? You know, it was fine. So once you've said that, all you have to do then is continue saying it. And this was the same in the Milgram experiment.

So there were people, even though two thirds of the subjects went up to 450 dangerous shocks, And they were called the obedient subjects. Not all of them did this willingly, right? Yes, I'm going to shock that person.

Milgram called them the moral imbeciles, but they were groaning, nervous laughter. They had these signs of tension, the nervous laughter. Oh, I have that for sure. And then I will smile. I have what a colleague of mine called the crocodile smile, is that as soon as I'm uncomfortable, I'll be like... Yeah. Okay. Oh, that's funny.

Yeah. It's an appeasement. Okay, I'm not a threat. Exactly. I can't let my face betray me. Yeah.

That third stage, if you could say, I'm not comfortable with this or the people in the Milgram experiments, is he actually okay? If they had resisted four times, that was the experiment. There was four prompts. then the experiment would have ended. So you just then need to continue. And stage four is that threat of noncompliance. I can't go through with it.

Yeah. Stage three, you're still in a subservient position.

Yes. And then four is stating that you can't. And then five is your final act of defiance.

So understanding those stages, it might not be linear. You might skip some stages. There are certain situations that I found that I find it easier to define and you can go from stage two to stage five. And we can all find those places where, oh, this is actually more natural for me to do it.

Right. So they are. consequences for being defiant, for sure. That's what holds us back a lot of the time. So, you know, when we think about why don't we defy, why do we actively even resist defiance? Number one, immense pressure from other people to do what they want you to do, the insinuation, anxiety aspect of all those psychological processes. And then the

Number two is actually we don't really understand what consent and dissent actually is. We don't understand what defiance actually is. And I'll come back to that. And then the third one is about once you want to define, you understand that you don't have the skill set to define. So we need to learn it. But the consequences of defiance, people always think about it's going to

affect this relationship? You know, I'm going to disrupt the harmony. It might even cost me my job or might be some physical danger. So we do need to think about the consequences of defiance. Like what type of situation is this? There's sort of two questions we ask. Is it safe for me to defy and will it be effective?

But what we don't often think about are the consequences and the costs of complying, because there's a lot of costs for continually complying with other people and putting aside your values. If you're always bowing your head to someone else, disregarding your values, it really has an effect on you.

Yeah. if we reflect on what happened in that situation, you in these particular incidents that happened, me with a CT scan, and then think about what factors enable our defiance and what makes it harder for us. Understanding that is really key. But anticipating, even when we think about all the

the big heroes that defied and had huge moments like Rosa Parks saying, no, I'm not going to move on the bus. There were lots of compliance moments before that moment. And so we shouldn't have so much shame. But that rumination is actually really helpful to think about what is it I wish I had done in that situation.

Because if we can then visualize it, if we can anticipate it, then that takes away the surprise, right? So the next time I was asked to go for some more radiation that I didn't need, I wasn't as surprised. I was anticipating it. I had practiced what I wish I would have said, and then I was able to say it.

Oh, yeah, absolutely. That anticipation is so key. There's this famous saying that's often attributed to Bruce Lee, but it's actually a Greek poet that said like under duress. We don't rise to the level of our expectations. We fall to our level of training. And so that training aspect is so key. And I didn't realize it, right? Because it does change those neural pathways. So anticipating.

And we can anticipate more than we actually think. Sometimes we're caught off. But I know because we've experienced situations before when at the workplace, a particular colleague is going to say something inappropriate or they're going to make a sexist remark. We can kind of predict things that might happen so we can start anticipating.

then we can visualize it and practice it. If you don't have like that behavioral training of actually practicing, if it's just the intellectual part, it's not going to make a difference. So you need to actually practice it. And this presentation workshop I went to, I just love the phrase that they use.

If you practice, your ears get used to hearing it and your mouth gets used to saying those words. That's really useful to know that that's what makes a difference.

Even the insinuation anxiety feeling, I've said it's an aversive state. It's uncomfortable for a reason because your defiance might be causing harm to someone else.

Yeah. It's there for a reason that somebody is expecting something of you. What does it mean? Right. So I think understanding that too, sort of naming it and knowing that we have two kind of ideal selves, especially in America, we have this ideal independent self. We want to act on our agency. We want to do what we think is right.

But we also have this interdependent self, which is that we want to remain in harmony with everybody around us. And there are two sort of ideals like Hazel Marcus and Shinobu Kitayama talk about these ideal selves. We can't ever achieve one state or the other state. And they're there for a reason.

Exactly. And so we do need to think about that. But we also need to hold dear to ourselves what are our values.

It's what I call those defiance hierarchy. Some people are allowed to defy, even rewarded for it. And others, they have more costs. There's more severe consequences. There's more backlash for being defiant.

And it's interesting that the people that are in that category, which is anything from the dominant norm, the tall white male, anything that deviates from that group, you actually need to be defiant more often because you're expected to be more compliant.

Because you've been here for 16 years. Oh, my goodness. Has it been that long?

It can be exhausting. You have those extra burdens that you carry.

I mean, it'd be interesting what people might choose between those things. It's one where I often describe as being on a balance beam for some people. There's only a narrow set of behaviors that are possible for you to do without being punished. But sometimes you can get to firmer ground where you can find this is now safe and effective for me to define and find places where that is accepted.

So compliance is something that we just go along with someone else. It's usually externally imposed or default. We're not really thinking about it. We kind of slide into it.

Consent. I take the definition of informed consent in medicine and I apply it to the other decisions that we make in life, which I find really useful. There's five elements that are required for informed consent. So first of all, this capacity that we have the mental capacity to make a decision. So we're not under the influence of drugs or alcohol or we're not sick. And then knowledge.

So we need to know about the situation, have full information about that situation. And third, understanding of that. Do we understand the risks, the benefits, the alternatives? Then number four, do we have the freedom to say no? In some situations, we don't have the freedom to say no. It might be too risky. Your life might be on the line in some situations.

That's no wonder my son says that he's American now. How long has he been? He moved when he was one. We almost went back to the UK in 2020 during the pandemic. So I got offered a position at the University of Cambridge. We were all like, let's go. And then he said, no, I am American. Oh, he really planted a flag, literally.

Exactly. You might not have the freedom to say no. Another one is if you're a black guy and you're stopped at a traffic stop, right? That's not the place to defy.

So freedom to say no. And then if you have those four things, the fifth element is your considered authorization of an informed consent. And if you want to say no, informed refusal.

And we do have trust in our doctors and it would be a shame if that disappeared, right? That element of public trust. But there's also a lot being written on end of life treatment and how aggressive it can be. But it's really difficult. Again, it's an ideal that can never be fully attained in medicine and elsewhere.

I think if people want to have that conversation and then even as I told Grande talks about, people prefer different types of care, right? Somebody wants the paternalistic advice. Just tell me what to do and I'll follow it. Other people want more of a guided, informed, shared decision making and the doctor to be more of a coach.

Yeah, some people find that really hard.

So true yes is consent. So having those five elements there would be your true yes. Or a true no is the same. The informed refusal is just having those five elements. But sometimes you have those five factors there, but you decide to actually do what I call conscious compliance. So you consciously comply because the costs might be too big or this is not the right time to do it.

And because, as you said, it's exhausting. So you need to choose, is this situation going against my values? Otherwise we'd be defying every day. We wouldn't get anything done. And we need to really choose what situations are going against our values that this is worth me speaking up and saying something about.

I interviewed a few of my students that have been in the military, which was really fascinating to hear their stories. And in fact, one of the first ones, and I remember it really well because we were speaking on Zoom on a Sunday afternoon. I was calling Matthew. He told me about when he went into the military and he did it because he grew up with 9-11 sort of seared into his memory.

And he wanted to prove that he's an American, he's a patriot, and he was deployed to Iraq. And his best friend got killed in the first few months. And there was an incident where they were on some nighttime mission and he's like, nothing usually happens at nighttime. But there was this flash and then a grenade going off that was too close for comfort. And they immediately started opening fire.

We went back when you said 2008. So that last year, I finished my PhD and I was doing my postdoc down at Duke. We were living in Chapel Hill. And then you get one year of this extra, you can stay. And then the second year of my postdoc, my family didn't get visas. So they went back to London and I was going back and forth.

Some people went off in his squad and they came back with four prisoners. One of them, Matthew, had and had to look after. And this person was just screaming out in Arabic. And his supervisor said to him, he's talking too much. He's screaming, shut him up. And Matthew said, what should I do? And he was like, oh, it's simple. Hit him in the mouth.

And so he looked at the man and there was blood coming out from his nose into his beard. So he hit him and the man didn't stop talking. And his sergeant said, he's not stopped. Hit him again. Hit him in the stomach. And Matthew just looked at me and he just said, and that's what I did. And then later on, he told me that he found out that these weren't insurgents at all.

They were young teenage boys.

They were 15 or 16 years old. He couldn't understand what they were saying. And he felt really bad about it. And he said in that instant, he just trusted. He had no option. The next time they were on some kind of mission and they stopped and they basically formed like a circle, what they do in war, right? And what he told me is that you're not supposed to get out and just spray and pray.

You have to have a target. Otherwise you can hurt civilians. And he said, but they just got out and they did spray and pray. And in that moment, he did not do that. he kind of turned around and looked at the desert behind him. And later on, his superior said to him, what were you doing? And he said, oh, I was just providing security. I was looking at providing cover.

And he said that was the only thing he could think of for not doing it. But it actually was because his feelings were getting really complicated about whether he was doing the right thing or not. And he didn't describe his actions as defiant. He even said they were kind of cowardly. If he had actually said what he felt, he would have gone to military prison. And he said, and maybe they'd be right.

But that one incident that he said was half conscious, he did start becoming a little bit more defiant. So I call that quiet defiance where you're not actively saying no to someone else, but you're not going against what you think is the right thing to do.

Right. And so later on, then he became less quietly defiant. There was another nighttime mission that he thought was way unsafe. It involved going out at the nighttime with goggles very close to a cliff edge. And he went to see his superior and he just said, I don't think we should do this. It's far too dangerous. And his superior was just like, shut up. Do as I say. Are you disobeying me?

He's like, no, but I'm adamantly against the idea. And of course, the mission went ahead. People came back after half an hour. It didn't work out. It was too unsafe. But he wasn't rewarded for that. He was basically punished. He didn't get his promotion, but he said it was the right thing to do. And he became a little bit more comfortable with sort of saying those things.

But yes, in the military, I hear time and time again from my students that have been there, it's yes, yes, yes. And one of them said, you are trained to do, not to think.

Yeah. So in war, that type of compliance is very helpful on the battlefield, for sure.

Yeah, I think there's many situations where it is complicated. That's why we struggle with it, too. If it was that simple, then we would get it right every single time. And we don't.

Utica and Roosevelt Island. Oh, wow.

I think that's definitely worth it. I'm with you.

So when I said earlier on that there's some stories of my parents to find that have really stayed with me, the one of my mom is one that really I think was transformative. So I was about seven or eight and I was walking back from the grocery store with my mom and it was quite a long walk back and we had this rickety shopping cart. And we were rolling that back home.

And we decided to take a shortcut through what you call in Yorkshire a snicket, which is just a narrow alleyway, right? When I went to elementary school, I was not supposed to go through that snicket.

It's about four hours between. Oh, gosh. And you're doing that at the same time? Occasionally. It hasn't worked that well. Now, just one semester in one place and one semester in another place because going back and forth is too much. That's a lot.

It was there. But anyway, mom and I, we went through the Snicket and we were confronted by about seven or eight teenage boys and they blocked our path. And they started shouting out some stuff to us, like some racist comments, go back home. We're trying to.

But my reaction was instant, which is what you had described before, right? Immediately, eyes down, averted. All I wanted to do was not look at them and maneuver my way through and get home as fast as I could. And my mom, she's petite. She's smaller than me now. She was taller than me at the time, but she's like 4'10". She had like her hair very neatly plaited back and single braid at the back.

And I had thought of her as completely compliant person. And she did something that really surprised me that day. She put the shopping cart up vertical and she put one hand on her hip and she looked at them and she said, what do you mean? My fear was going up at this point. So I grabbed her arm even tighter and I started whispering to her. I was like... mama.

And I wanted to be the compliant person. And she shook me off. She was like, no. And she looked at them again and she said, what do you mean? They stared at her. She stared at them. And then she said, oh, you think you're big, tough boys, right? Big, strong boys. And she started telling them off in broken English. Oh, wow. And they like just looking at each other thinking, What's going on here?

And one of them just said, let's go. Yeah. And they just dispersed. Yeah. And I was like, what happened? My mom grabbed the cart and she walked as fast as she could through that snicket. I never thought the day would come that she would tell off a group of boys on the street in that way.

Yeah.

Protection, responsibility. And people do like I can defy for my son so much easier than I can defy for myself. And isn't that sad?

I was one when I came to England. I grew up my whole life there and also in Scotland. So my dad first came to England from India and did his PhD, then went back to India and then brought the family.

I also think there's something beautiful about having responsibility for someone else.

But you can tap into that.

To a loved one. What would you do in that situation? I say that to my son at times when he gets stressed about things. Like, what advice would you give a loved one? What would you tell someone who's in ninth grade right now how to handle a situation? But what that really taught me was that defiance is a skill set, it's a practice, it's not a personality.

And even though compliance might be our default, it's not our destiny. So we can change. I had seen her come home several times and she would be muttering away. So I'm pretty sure she had seen those boys before. Wow. and not said anything. But now I was with her and she showed me that. And even though it might have changed her, because I do think defiance changes your brain, how you react.

It also changes the people that observe it because that had a ripple effect on me and made me feel like we can all be defiant if we want to be. And that does give quite a bit of hope.

Yes. We were in London and we were on our way to see the flame that they hold. And it was like, oh, it's a once in a lifetime experience. He's like not impressed with this at all. Yeah. And he just wouldn't walk there. And he sat down on the pavement. And I was like, no, come on. I was like pulling his arm and trying to pick him up. And I could only get a few steps. He was heavy at that point.

I was like, no, I can't carry you. And we just completely missed the whole thing. And we went home and he's just not realizing this moment in history that I have now missed forever. And I said to him, why can't you be good?

And that kept me up at night. I was like, why did I say that when that's what I learned, right? This whole obedience equals good and defiance equals bad. And here I was just repeating it. That really took me back to why is it so strong? Even when he was a baby, I would have relatives asking me, is he good? It's a baby. Right. There's no such thing.

And what they mean is like, does he sleep?

So in our community, medicine is one of the best things you can do, right? So I had the grades. I was a good kid. I asked my dad when I was young, what does my name mean? And he said in Sanskrit, Sunita means good. Oh, wow. And so I mostly lived up to that. I was a good girl in their eyes. So I did exactly what I was told. I did all my homework as expected.

It's amazing what we equate with being good, which is not being a bother to someone else at all.

And sometimes that's how we feel in organizations, right? When we work, managers love the yes man or the yes woman. Do as I say, don't question it. And we then just sort of narrow our vision to how well we are pleasing the boss rather than the wider. Like, what is it we're actually doing that has a value to the world?

One of the major things that was really crucial to sort of changing how I thought about defiance is getting rid of some of the myths that defiance has to be aggressive, loud. You have to have a larger than life personality. You got to be me. You got to be you, right?

Monica and I are never going to be here. Don't rule that out.

We can find our own way. We can be defiant in a way that's unique to us. So understanding that defiance isn't just for the brave or the extraordinary, right? It's available and it's necessary for all of us. I think that's one mindset shift that we can really all use and understand. And then the other is what I call the defiance compass, which I think is very useful because

which is when we're faced with a situation and we're trying to decide what to do. We have that tension, then we take the pause and we try to understand. These three questions came from James Marsh, who's a sociologist. But I've sort of adapted them to be not just three questions that we ask implicitly for every decision, but to put them in a circle because I think it is a circular thing.

So the first question is, who am I? And that's really connecting with your values. So if you aspire to be someone who's fair, compassionate, has integrity, that's what you really need to think about. That's who you are, because that's really important. If you've not found that out, spend some time doing that because people that clarify their values are more likely to act in alignment with them.

And also there's research showing that it reduces your stress and cortisol levels if you actually know what your values are.

So really know who am I? You can ask yourself that. And then the second question. So that's internal. Then you go external. What type of situation is this? Is it safe and effective for me to defy? And then the last question is with these particular values, fair, full of integrity, all those things. What does a person like me do in a situation like this?

If you believe you're one type of person, but you're never acting in that way, you want to sort of start thinking about whether that really is who you are or not. And I've found those three questions really powerful in terms of knowing this is what I would like to do. Really tapping into our aspirational selves.

I was what in Yorkshire they call SWAT-y, which means you're a SWAT. You work really hard. You do all your homework. Maybe it's equivalent to nerd here.

I want to decrease that gap between the intention, what we think we'll do in a situation and how we actually act.

And that's fascinating.

But you wouldn't have felt good about it in the long run.

And in experiment after experiment, I've seen people say their one thing and then behave in a different way. So anything that helps us reduce that gap.

The people that could defy, they're really fascinating. So, I mean, I told you the sort of basic setup of the Milgram experiment, but when you look at all the different deviations that they had, that's where I find the work really fascinating and the people that defied, what was it about them that they defied? And many of them, it was because of responsibility.

So one was a professor of the Old Testament. So values were there and very high on that. So even though... He was stuttering and things when they said the experiment requires you to go on. He kind of asked, does it like maybe if we're in Russia, but not here.

So he was able to stand up to that because he'd done so much thinking about those types of values and humanity and not harming another person. And then the other person that really stands out for me is an engineer that had the knowledge of how powerful these shocks are. Interesting. And he lived through World War II. And so he was fascinated by this afterwards.

I don't know. But when you talk about SWOT now, especially at business schools, it means something totally different. Strengths, weaknesses, opportunities, threats. That's not what it means when I was growing up.

And he said he just felt really bad that he went as far as he did before he stopped. Because it's like if you throw the responsibility onto someone else and just say you were taking orders, that's really quite a cowardly thing to do. You're the one that's causing trouble. the shocks to someone else. And I know what kind of harm those shocks can do.

And there was another participant, a woman that said the same thing. I don't want to be responsible for causing harm to another person. So I do think that responsibility element is really powerful when we think about what does a person like me do in a situation.

Really? Yes. I'm just saying that because my son wants to be an engineer.

Yeah, I think sort of the critical thinking element of it is key of knowing actually when to defy or not to defy.

No, they weren't actually.

Yeah, members of the community came in. They had different races and he ran a bunch of experiments. But there was one experiment that was all women. And in that experiment, same rates of compliance as the other ones. There wasn't a gender difference, surprisingly. Right.

Yeah. Maybe because you have more knowledge, more knowledge.

So I got the grades and it's like, why wouldn't you want to do medicine? Yeah. And I was like, well, I'm not sure it's really for me. But in the UK, it's a combined undergraduate and graduate degree. So you basically start at the age of 18 medical school and you finished. I was on the wards in my early 20s.

Yeah.

I think that would be interesting. Those rookie officers, if they had that situation again, wouldn't do it. So how can we learn from the experience of other people? Yeah. And that's really fascinating because I was speaking to another rookie officer and he was trained during the time that the incident with George Floyd took place. And he thought about it a lot.

And so when it came to a situation that he was on this night run with his partner and a few others and they wanted to go and search a garage for stolen bicycles, he said, no, we can't just go in there without permission of the homeowner to go. And they were like, no, we're just going to go in. And he said, no. So he went and knocked on the door and it was about four o'clock in the morning.

No answer at all. But the car was there and the neighbor said, oh, I think he's there. He's just asleep. And so he was the only one as this rookie officer that refused to go in. And the reason he did that wasn't because he was brave or anything like that. He said he was motivated by fear because he saw what happened to the rookie officers.

And in his mind, he went to the worst case scenario that we're going to go in there and And we don't have any standing to go in there. There's no blood. There's nobody screaming.

And so he knew the law and he'd just been trained. And then he was with police officers 20 years older than him saying, you're telling us what to do. F it. We're going in. He refused to go in because he thought the homeowner is going to come out with a gun. Yeah. Something terrible is going to happen.

So he said no. And homeowner came down and actually thanked them and everything. So everything was fine. And the ride back to the station for him was just awful. And within an hour, he was called in to see his supervisor. And it was a bit like, read this, you got it wrong. And he was like, no, with all due respect, I knew that we didn't have any standing and we shouldn't have gone in.

And he said to me, you know, his childhood stutter came back. But he knew in this job, it was going to be difficult and he was going to be asked to do some things that weren't right. And because he'd seen the George Floyd thing. Anticipating. Anticipating. He thought, I'm not going to be that police officer. But he was ostracized for a bit.

He said the whole thing went around the station, even though he was right. But he ultimately got transferred to another unit where he said they were younger officers, but they had more understanding of the law. And he's very hopeful and very optimistic about a new era of policing. So that was great to hear. But it also shows that learning from other people, I think, would be wonderful.

I'm thinking, is there a thing as being too defiant? Because I'm not talking about defiance as a knee-jerk reaction to defiance, but more considered defiance. So maybe that's what you need.

Healthy amount of skepticism, but not too much.

I appreciate that.

It's important.

Thank you. This is wonderful.

Biology, we had to do as eight levels before you go in. At that point, it was five years. That's it. But when you say first seen a patient, the first two years are preclinical. So you're learning things. Then the third year, you're on the wards and you're a clinical. By the time you're 22, 23, you're qualified. You're on the wards. Wow.

Here, you have to work so hard. I got all my education for free, which is pretty impressive. There's a small cost now in the UK, but I went through the whole of medical school. I mean, earning peanuts once you start as a junior doctor. But that aspect of working earlier is great. So you can get through. Making the decision so early, questionable.

Oh, wow.

Although I say my career is perfectly planned. Yeah. It was perfectly planned how I ended up here. But suddenly there was a lot of pressure and I lived up to those expectations of going to medical school and then finishing medical school and ended up working as a doctor.

I knew it wasn't for me. There were certain aspects I really loved, like the analytical part. I'm always analytical. I was always thinking, always questioning.

I'm really fascinated by people as well. So just talking to people, meeting people, learning about their lives. So that aspect was great. I wasn't actually into the blood and gore aspect. I remember talking to my teachers about that, like, oh, I don't know about medicine. And they were like, it's just two years preclinical. You're going to do that fine.

And then just get through the clinical years and then you can end up doing research.

So I was always interested in psychology. So when I was at medical school, I did my two years preclinical and then I took a year out to do what they call an intercalated degree in psychology. So they basically throw you in the fourth year of psychology and you catch up on the four years in that one year. But that was... Such a wonderful year. It was amazing.

That's when I started reading about Milgram Stanley's famous experiments, Obedience to Authority. I became fascinated with that, who did what we call the electric shock experiment. Yes, yes, yes. So Stanley Milgram was really fascinated by why the Nazis in World War II always kept saying, I was just following orders afterwards when they were being investigated for war crimes. Yeah.

And so he decided to set up this experiment, which was quite elaborate, where he would bring people in from the community and they would be an actor. It was designed as an experiment on memory. That's what they thought they were coming into. And whether giving someone electric shocks would help them learn better. Wow. So that was the setup.

First experiments were conducted at Yale in their basement, I think. So people would come in, they would meet somebody else that they thought was another participant, but it was actually an actor that they had. And they would rig it so the actor would be what they call the learner.

So then he would go into this room and the participant who was the teacher would see him being rigged up to what looked like an electric chair. And they would feel one of the shocks, 15 volts or something. So it all looks really real And then the teacher would go to another room and they would be sat in front of this box that was sort of labeled from 15 volts to 450 volts. Right.

And it would go up in 15 volt increments and it would be labeled. So right at the end, it was three X's, danger, huge shock.

There can be lethal shocks at that point. Then the teacher had to read out some word pairs and the learner had to memorize and repeat them back. And if they got something wrong, they would get a shock and then it would go up 15 volts.

So they had to read out the word pairs and the experimenter was usually in the room just sort of overseeing. And if the teacher protested, they would tell them, you know, please go on with the experiment. They had like four prompts to tell them, please go on. It's essential that you continue. The experiment requires that you go on.

And when psychiatrists predicted beforehand what would happen, they thought that most people would not go past 150 volts. And in fact, every single participant in the first experiment went past that.

ah and the actor is screaming about 150 volts there's thumping on the wall and there's verbal complaints i don't want to go on with this i don't want to go on oh my god get me out of here i refuse to go on with the experiment and it was also told to the participants he had a heart condition oh my god this is like Really horrifying. They predicted only about one in 1,000 would go up to 450 volts.

But they found that everyone pulled the lever for 150 volts. Everyone pulled it for 300 volts. And 66% went up to 450 volts. Holy shit. Even Milgram was shocked. Yeah. He was shocked at the results because he didn't think that he would find that. And he was like, I really thought this was something unique about German culture. But everybody is doing this.

As I said, I was always known for being an obedient daughter and student. But I was fascinated by people who could defy. And I was good friends with someone at high school. Let's call her Clara. She was able to defy. I started at St. Joseph's College, which is an all-girls Catholic school at the other side of town.

My dad thought that I'm going to get a good education there, so I would catch two buses to go to St. Joseph's. It was the roughest school I've been to. Oh, wow. So I don't know what he thought, but it was also a lot of fun.

And Clara came in two weeks late. She had moved from Hastings in the south of England to the north. And so she was different a little bit. I was also different. I was just one of a handful of non-white girls at the school. And we became really close friends, even though we were so different from each other.

Absolutely. I was like, how can she do that? Because she just walked in. We had this sort of checkered blue and white blouse that we'd wear and a red sweater. She walked in without the red sweater. She just stood out so much. And I was like, who is she?

Especially because the headmistress had said before, I want everybody in their red sweaters because when I look out, I just want to see a sea of red.

Thank you.

I remember, I think a few years before that, maybe when I was at middle school, my dad got me these bright red, like warmers. When my dad bought them for me, I was like, I just didn't want to wear them. They're too bright. Give me black so I can kind of blend in. And it was like, no, we can't return them now. So I have to wear these things to school. And it was excruciating, right?

I was trying to hide them with my coat. I was like, no, no, I don't want to be wearing this. But then I kind of changed when I went to St. Joseph's and when the headmistress said like a sea of red, I was like, hmm, I'm not sure about that. And I had the song of Another Brick in the Wall by Pink Floyd kind of playing, right? So I was getting quite attracted to these kinds of things.

I was more questioning. Oh, that's right. Why do they want us to conform so much? Because I was so used to obeying and doing and getting rewards for that. I would see teachers doing things that I thought were unfair. So when I was at middle school, I saw one of my teachers beating up another kid. Oh. And that was horrifying to me.

So she asks Jason Bradley, who's a 27-year-old cook, to take over. So Jason comes. He takes over the phone. And Officer Scott demands that Louise drops her apron so she can see whether she's hiding any evidence.

So she asks Jason Bradley, who's a 27-year-old cook, to take over. So Jason comes. He takes over the phone. And Officer Scott demands that Louise drops her apron so she can see whether she's hiding any evidence.

So at this point, Donna Summers says that she can't spare any more staff because it's getting really busy in the McDonald's. And Officer Scott asks whether she is married. And she said, she's engaged. And he asks her, do you trust him? And she says, yes. And he tells her to call him, call your fiancé.

So at this point, Donna Summers says that she can't spare any more staff because it's getting really busy in the McDonald's. And Officer Scott asks whether she is married. And she said, she's engaged. And he asks her, do you trust him? And she says, yes. And he tells her to call him, call your fiancé.

He rings his friend and he immediately says, I've done something terrible. So it's only when he leaves that he recognizes that this was wrong. And after he's left, Officer Scott continues. He asks Donna Summers, who else is there? Is there another man that can monitor Louise? So at that point, Donna Summers goes back into the restaurant to look for someone.

He rings his friend and he immediately says, I've done something terrible. So it's only when he leaves that he recognizes that this was wrong. And after he's left, Officer Scott continues. He asks Donna Summers, who else is there? Is there another man that can monitor Louise? So at that point, Donna Summers goes back into the restaurant to look for someone.

And the only person that she thinks of is Thomas Sims, who's actually a 58-year-old maintenance man who is there just on his day off. He's having dessert and coffee. So she asks him to come with her to the back room. And then she hands the phone to him and Officer Scott asks the same thing again.

And the only person that she thinks of is Thomas Sims, who's actually a 58-year-old maintenance man who is there just on his day off. He's having dessert and coffee. So she asks him to come with her to the back room. And then she hands the phone to him and Officer Scott asks the same thing again.

He asks Thomas Sims to tell Louise to drop her apron so that Thomas can see whether she's concealing any evidence. And Thomas now immediately feels alarmed. And he says, looks directly at Louise and he says, you keep that apron wrapped around you. And he hands the phone straight away back to Donna Summers and he says, something's not right about this. This is wrong.

He asks Thomas Sims to tell Louise to drop her apron so that Thomas can see whether she's concealing any evidence. And Thomas now immediately feels alarmed. And he says, looks directly at Louise and he says, you keep that apron wrapped around you. And he hands the phone straight away back to Donna Summers and he says, something's not right about this. This is wrong.

Yes, that's right. But it took Thomas Sims to come in and puncture this compliant atmosphere and say this is wrong for Thomas Sims to really take a step back and think about this. And when Thomas Sims said these words, she decided, like, what's going on? And she picked up her cell phone to call her manager, Lisa Siddons, who Officer Scott said was on the other line.

Yes, that's right. But it took Thomas Sims to come in and puncture this compliant atmosphere and say this is wrong for Thomas Sims to really take a step back and think about this. And when Thomas Sims said these words, she decided, like, what's going on? And she picked up her cell phone to call her manager, Lisa Siddons, who Officer Scott said was on the other line.

And Lisa says, what are you talking about? And only then does she realise that this is a hoax. She puts the other phone to her ear and the line is dead.

And Lisa says, what are you talking about? And only then does she realise that this is a hoax. She puts the other phone to her ear and the line is dead.

That's right. Once you start complying, you do a little bit more and a little bit more. And then at what point do you start saying no? It's harder to say no to end the compliance now if you didn't do so early on. You know, what is the line that you draw that this has gone too far now?

That's right. Once you start complying, you do a little bit more and a little bit more. And then at what point do you start saying no? It's harder to say no to end the compliance now if you didn't do so early on. You know, what is the line that you draw that this has gone too far now?

I was working as a junior doctor in the UK and I received an invite to meet with a financial advisor for free at work. So I agreed to meet with this financial advisor and I remember that meeting very well. So it was in the hospital's posh meeting room, a room that I didn't even know existed. And I walked in and there was this blue plush bed

I was working as a junior doctor in the UK and I received an invite to meet with a financial advisor for free at work. So I agreed to meet with this financial advisor and I remember that meeting very well. So it was in the hospital's posh meeting room, a room that I didn't even know existed. And I walked in and there was this blue plush bed

In contrast to the stone-cold tiles of the floor, this was a nice change.

In contrast to the stone-cold tiles of the floor, this was a nice change.

He was very tall, big smile, handsome, very sharp suit. And he shook my hand and he spoke to me for a very long time, about an hour, mostly about my finances, which was surprising because I had a very limited disposable income at the time working as a junior doctor. He built up this fantastic rapport with me.

He was very tall, big smile, handsome, very sharp suit. And he shook my hand and he spoke to me for a very long time, about an hour, mostly about my finances, which was surprising because I had a very limited disposable income at the time working as a junior doctor. He built up this fantastic rapport with me.

And at the end of an hour, he said that I should invest in a couple of funds and that he would write a report for me about my finances and all this would be for free. So I was impressed. It sounds great. And since I was tired, I did blurt out, what's in it for you? Well, he responded with, there's no such thing as a free lunch.

And at the end of an hour, he said that I should invest in a couple of funds and that he would write a report for me about my finances and all this would be for free. So I was impressed. It sounds great. And since I was tired, I did blurt out, what's in it for you? Well, he responded with, there's no such thing as a free lunch.

And I remember being surprised then because I was working as a junior doctor and we got free lunches all the time from the pharmaceutical reps.

And I remember being surprised then because I was working as a junior doctor and we got free lunches all the time from the pharmaceutical reps.

I'm going to receive a commission if you invest in the funds that I'm recommending today.

I'm going to receive a commission if you invest in the funds that I'm recommending today.

Yeah, I mean, that disclosure of the conflict of interest changed the dynamics of the situation for me. So I did feel less trust in the advice that he was giving me to invest in these funds. But at the same time, I didn't want Dan to know that I no longer trusted him.

Yeah, I mean, that disclosure of the conflict of interest changed the dynamics of the situation for me. So I did feel less trust in the advice that he was giving me to invest in these funds. But at the same time, I didn't want Dan to know that I no longer trusted him.

I didn't want him to know that his disclosure had corrupted the good rapport that we'd built up and this relationship that we now had over the last hour. And so I started to feel more uncomfortable. I actually felt more pressure to sign and say that I will take the fund's advice, I will invest in the funds that he is recommending.

I didn't want him to know that his disclosure had corrupted the good rapport that we'd built up and this relationship that we now had over the last hour. And so I started to feel more uncomfortable. I actually felt more pressure to sign and say that I will take the fund's advice, I will invest in the funds that he is recommending.

It's wonderful to be here. Thank you.

It's wonderful to be here. Thank you.

Because if I don't take his advice now, I'm essentially depriving him of his commission. So both I felt that pressure to be helpful, but I also felt a lot of pressure not to signal distrust.

Because if I don't take his advice now, I'm essentially depriving him of his commission. So both I felt that pressure to be helpful, but I also felt a lot of pressure not to signal distrust.

So insinuation anxiety is a distinct type of anxiety that arises when people worry that their noncompliance with another person's wishes may be interpreted as a signal of distrust. insinuating that the person is not whom they appear to be or should be.

So insinuation anxiety is a distinct type of anxiety that arises when people worry that their noncompliance with another person's wishes may be interpreted as a signal of distrust. insinuating that the person is not whom they appear to be or should be.

So we don't want to insinuate that, for example, our advisors, our co-workers, or even our friends and our family are not trustworthy, that they're incompetent or they're biased or even corrupt. And this anxiety increases the pressure to comply with another person.

So we don't want to insinuate that, for example, our advisors, our co-workers, or even our friends and our family are not trustworthy, that they're incompetent or they're biased or even corrupt. And this anxiety increases the pressure to comply with another person.

We had a middle-aged white man go up to passengers, just over 250 passengers, to ask them to fill out a very short survey. So it was an innocuous survey just asking them, was the ferry running on time? How clean is the ferry? How many people are you traveling with? And for filling out this survey, they would get $5 in cash. So people agreed to fill out this survey.

We had a middle-aged white man go up to passengers, just over 250 passengers, to ask them to fill out a very short survey. So it was an innocuous survey just asking them, was the ferry running on time? How clean is the ferry? How many people are you traveling with? And for filling out this survey, they would get $5 in cash. So people agreed to fill out this survey.

And once they had finished the survey, the man asked them, well, you know, I can give you the $5 as promised, or I can enter you into this lottery, which pays out somewhere between $0 and $10, but the average payment is usually less than $5.

And once they had finished the survey, the man asked them, well, you know, I can give you the $5 as promised, or I can enter you into this lottery, which pays out somewhere between $0 and $10, but the average payment is usually less than $5.

Yes. I had this immense chest pain. And it was a pain that I had not felt before. And so I thought I should do something about this. And I ended up going to the emergency room in Pittsburgh, which is one of my first experiences of the health care service in the U.S., having moved from the U.K., And it was very efficient.

Yes. I had this immense chest pain. And it was a pain that I had not felt before. And so I thought I should do something about this. And I ended up going to the emergency room in Pittsburgh, which is one of my first experiences of the health care service in the U.S., having moved from the U.K., And it was very efficient.

pretty much everyone went for the cash. Only 8% chose the lottery.

pretty much everyone went for the cash. Only 8% chose the lottery.

Exactly, yeah. So it really shows that the preference for nearly everyone was the $5 cash, you know, the certain $5 bill. But when the man gave advice, I think you should go for the lottery, that went up to 20%.

Exactly, yeah. So it really shows that the preference for nearly everyone was the $5 cash, you know, the certain $5 bill. But when the man gave advice, I think you should go for the lottery, that went up to 20%.

But even more surprising, there was one condition where the man had to reveal his ulterior motive for recommending the lottery, that he would receive a bonus, a commission, if you took the lottery. And so in that way, he was disclosing his conflict of interest, much like Dan, my financial advisor, had disclosed to me.

But even more surprising, there was one condition where the man had to reveal his ulterior motive for recommending the lottery, that he would receive a bonus, a commission, if you took the lottery. And so in that way, he was disclosing his conflict of interest, much like Dan, my financial advisor, had disclosed to me.

In that condition, compliance with the lottery advice went up to 42%. It more than doubled the advice alone.

In that condition, compliance with the lottery advice went up to 42%. It more than doubled the advice alone.

That's right. And people are suspicious. They trust the advice less. And some even said that they like the man less because of that. But they still went along with it. And the reason is insinuation anxiety. They didn't want the man to know that they trusted his advice less.

That's right. And people are suspicious. They trust the advice less. And some even said that they like the man less because of that. But they still went along with it. And the reason is insinuation anxiety. They didn't want the man to know that they trusted his advice less.

So in this particular experiment with insinuation anxiety and the man giving advice, this insinuation anxiety on compliance occurred only in the women participants. We didn't see it in the men. And we were surprised because other experiments that we had run in different contexts showed no gender difference. But in this one, there was a clear gender difference. Women felt insinuation anxiety

So in this particular experiment with insinuation anxiety and the man giving advice, this insinuation anxiety on compliance occurred only in the women participants. We didn't see it in the men. And we were surprised because other experiments that we had run in different contexts showed no gender difference. But in this one, there was a clear gender difference. Women felt insinuation anxiety

much more than men did. And that increased their compliance.

much more than men did. And that increased their compliance.

I found some really shocking statistics. So one survey found that nine out of 10 healthcare workers, most of them nurses, don't feel comfortable speaking up when they see a colleague making an error or taking a shortcut. And crew members in commercial airlines, nearly 50% of them don't want to speak up when they see their superior making a mistake.

I found some really shocking statistics. So one survey found that nine out of 10 healthcare workers, most of them nurses, don't feel comfortable speaking up when they see a colleague making an error or taking a shortcut. And crew members in commercial airlines, nearly 50% of them don't want to speak up when they see their superior making a mistake.

These can be life and death decisions and insinuation anxiety can account for some of the reasons why they don't feel comfortable speaking up.

These can be life and death decisions and insinuation anxiety can account for some of the reasons why they don't feel comfortable speaking up.

So things were not great at all. He was in the middle of a war zone. His friends were getting blown up by various different explosive devices. In fact, his best friend was killed.

So things were not great at all. He was in the middle of a war zone. His friends were getting blown up by various different explosive devices. In fact, his best friend was killed.

Within minutes, I was actually through triage and a nurse had whisked me into an examination room and they did a lot of tests, including an electrocardiogram to make sure there was nothing wrong with my heart, which was my primary concern. And everything was fine. So I was relieved and my pain was going down a little bit.

Within minutes, I was actually through triage and a nurse had whisked me into an examination room and they did a lot of tests, including an electrocardiogram to make sure there was nothing wrong with my heart, which was my primary concern. And everything was fine. So I was relieved and my pain was going down a little bit.

Yeah, so when this grenade went off, sort of too close for comfort, immediately they hear orders to dismount and to engage. So some of his squad, they run towards the mosque. Matthew, along with others, stay back to provide cover. And when his men came back, They had four young men as prisoners that were dusty, bloody, blindfolded and in handcuffs.

Yeah, so when this grenade went off, sort of too close for comfort, immediately they hear orders to dismount and to engage. So some of his squad, they run towards the mosque. Matthew, along with others, stay back to provide cover. And when his men came back, They had four young men as prisoners that were dusty, bloody, blindfolded and in handcuffs.

So Matthew was given one of the prisoners to basically look after. And his prisoner was yelling at the top of his voice in Arabic and he couldn't understand him and neither could his superior. So his superior tells him to shut him up. And Matthew asks, what do you mean? What do you want me to do? And his superior says, it's not complicated. Hit him in the mouth.

So Matthew was given one of the prisoners to basically look after. And his prisoner was yelling at the top of his voice in Arabic and he couldn't understand him and neither could his superior. So his superior tells him to shut him up. And Matthew asks, what do you mean? What do you want me to do? And his superior says, it's not complicated. Hit him in the mouth.

And so Matthew looks at the prisoner and he sees blood streaming from his nose into his beard. And he doesn't want to hit this man. He really doesn't. But it's a direct order. His best friend is dead. He doesn't want to be seen as a coward. So he raises his hand and he hits him in the mouth. And then his superior says, he's still talking. Hit him again. Hit him in the stomach.

And so Matthew looks at the prisoner and he sees blood streaming from his nose into his beard. And he doesn't want to hit this man. He really doesn't. But it's a direct order. His best friend is dead. He doesn't want to be seen as a coward. So he raises his hand and he hits him in the mouth. And then his superior says, he's still talking. Hit him again. Hit him in the stomach.

And I remember Matthew looking at me while he's telling the story. And he said, so I raised my hand and that's what I did.

And I remember Matthew looking at me while he's telling the story. And he said, so I raised my hand and that's what I did.

That's really fascinating to hear. And it aligns with some of my research as well. If you don't admit to yourself or to someone else that you feel something is wrong in this particular situation, if you don't say that you're uncomfortable with it, it's easy to convince yourself that you felt a different way at some point. I mean, cognitive dissonance is very strong, as we can see.

That's really fascinating to hear. And it aligns with some of my research as well. If you don't admit to yourself or to someone else that you feel something is wrong in this particular situation, if you don't say that you're uncomfortable with it, it's easy to convince yourself that you felt a different way at some point. I mean, cognitive dissonance is very strong, as we can see.

And I told the doctor and I thought I was about to get released from the emergency room. And she said, well, actually, just before you go, I would like you to have a CT scan. And so I was like, oh, I wonder why? Why is that? And she said, just to make sure that you don't have a pulmonary embolism.

And I told the doctor and I thought I was about to get released from the emergency room. And she said, well, actually, just before you go, I would like you to have a CT scan. And so I was like, oh, I wonder why? Why is that? And she said, just to make sure that you don't have a pulmonary embolism.

They felt tension, something that I call resistance against resistance, the resistance to resist, which is that they felt this tension between what they thought was the right thing to do and the tension to go along with what others expected of them.

They felt tension, something that I call resistance against resistance, the resistance to resist, which is that they felt this tension between what they thought was the right thing to do and the tension to go along with what others expected of them.

Well, if we think about that tension, it can actually be a warning sign to us that something is wrong and that we should pay attention to that. It could be the first signal that you should defy before you even consciously know that you want to defy.

Well, if we think about that tension, it can actually be a warning sign to us that something is wrong and that we should pay attention to that. It could be the first signal that you should defy before you even consciously know that you want to defy.

And I recognize that tension in them because that's the kind of tension I have felt when I want to defy but feel strong pressure to comply with what somebody else is telling me. And it can show up in different ways for different people, but we often experience that kind of tension when we want to go against something.

And I recognize that tension in them because that's the kind of tension I have felt when I want to defy but feel strong pressure to comply with what somebody else is telling me. And it can show up in different ways for different people, but we often experience that kind of tension when we want to go against something.

So instead of ignoring it or sweeping it away or thinking it's not worth our doubt, we should really think about what that tension means and whether this really means this is the time to act. This is the time to speak up.

So instead of ignoring it or sweeping it away or thinking it's not worth our doubt, we should really think about what that tension means and whether this really means this is the time to act. This is the time to speak up.

Well, I felt immense pressure to just sign in front of him. But as soon as things started getting really awkward, my pager actually started beeping. So I had to tell him there's an emergency, a medical emergency, I have to go. And he was fine. He looked a bit deflated to begin with, but then he was, that's okay. I will send you everything and you can sign the paperwork later on.

Well, I felt immense pressure to just sign in front of him. But as soon as things started getting really awkward, my pager actually started beeping. So I had to tell him there's an emergency, a medical emergency, I have to go. And he was fine. He looked a bit deflated to begin with, but then he was, that's okay. I will send you everything and you can sign the paperwork later on.

And that allowed me to exit the situation, I now call the power of the pause because it allowed me to not have to send a signal of distress back to him. When I got the papers a week later and I didn't have to sign on the dotted line in front of them, I could much more easily assess my very low income. And so I threw the papers away.

And that allowed me to exit the situation, I now call the power of the pause because it allowed me to not have to send a signal of distress back to him. When I got the papers a week later and I didn't have to sign on the dotted line in front of them, I could much more easily assess my very low income. And so I threw the papers away.

Exactly. Ask for some time to think about it. Step away from the situation. Physically, if you can, would be great. Psychologically, if you can't.

Exactly. Ask for some time to think about it. Step away from the situation. Physically, if you can, would be great. Psychologically, if you can't.

That's right. Especially if something is seen as an emergency, it becomes very difficult to say no. A lot of times we can take more time to think about a decision. We don't need to make decisions in the heat of the moment. So we can step away. We can take the power of the pause.

That's right. Especially if something is seen as an emergency, it becomes very difficult to say no. A lot of times we can take more time to think about a decision. We don't need to make decisions in the heat of the moment. So we can step away. We can take the power of the pause.

And one thing that I've learned about defiance that is really helpful is that if you can take the power of the pause, it is great. But surprise often disables defiance. And anticipation enables defiance. So preparing for situations like that in advance is particularly helpful before the moment of crisis.