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Episode Transcript

DUCKWORTH: “Wow, maybe she doesn’t really have it together.” 

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DUCKWORTH: I’m Angela Duckworth.

DUBNER: I’m Stephen Dubner.

DUCKWORTH + DUBNER: And you’re listening to No Stupid Questions.

Today on the show: When is it okay to tell a lie? 

DUBNER: I feel that I get more honest the older I get. Or maybe it’s just “cranky” is the better word. 

Also: is obsessing over your mental health actually bad for your mental health?

DUCKWORTH: You don’t, as they would say in my family growing up, hang your dirty laundry outside. 

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DUBNER: Hello, Angela! 

DUCKWORTH: Stephen. 

DUBNER: I want to talk about something that you recently touched on in your conversation with Laurie Santos when she sat in for me. By the way, I really enjoyed that conversation. 

DUCKWORTH: I just really enjoy Laurie. She’s actually one of my favorite humans. 

DUBNER: You guys talked a little bit about lying. And I hope you don’t mind me asking you a fairly personal question about it, but I want to know: how many times a day do you tell a lie? And when and why is it okay to lie? And maybe the answer to both questions is “never,” but I think that would put you well outside the normal range of humans. 

DUCKWORTH: I would like to say that I go days — if not weeks or months — without a single lie. 

DUBNER: Wow! 

DUCKWORTH: I said, “I would like to say that.”

DUBNER: Oh, you’d like to say that. I would like to be 6’5″. 

DUCKWORTH: Right. Okay. I do think, though, Stephen, that, if we define a lie as intentional deception, then I definitely go days without lying. I’m not saying that, every day, I go without lying. I’m going to just ballpark this and say that my average lying rate is .5 lies per day. 

DUBNER: Okay, so your A.L.R. — average lying rate — is .5 daily. How do you think that compares to the rest of humankind? 

DUCKWORTH: I would imagine — and I’m guessing this, in part, because I’m pretty familiar with Dan Ariely, the psychologist, and his research on lying. And he says that most people lie a little — not many people lie a lot, but most people lie a little — and by the way, when I’m talking about a lie every other day, that includes white lies. 

DUBNER: So, give me an example of your median lie. 

DUCKWORTH: For example, if somebody asks me to review an article for a scientific journal, and I click, “No, I decline.” And then the next screen says, “Why are you not able to review this article?” And the default response is, “I don’t have expertise,” I usually just press “next.” I don’t think, like, “Oh God, I should probably be honest,” which is to say that, “This journal is terrible. Are you kidding? I would never review for this journal.” 

DUBNER: So, this leads to the question of — I guess you’d call them “prompted lies” versus “unprompted lies,” perhaps. Right? 

DUCKWORTH: Like, as in, in response to this conversational cue, or this request, I’m now lying, versus, like, just spontaneously telling an untruth?

DUBNER: Maybe not “spontaneously,” but maybe a little bit more driven by some internal incentive. Like, I want to get something, or I want to avoid something, and therefore, I will proactively create a different version of the truth. 

DUCKWORTH: Let’s call that “first-degree lying.” I can’t call to mind a single instance of first-degree lying, but that doesn’t mean I haven’t done it. I’m sure I have. I’m just saying that seems bad, Stephen, and I hope I don’t do it very often. 

DUBNER: Okay, but let me ask you this. We talked about the Eisenhower Matrix a few weeks ago. And I got to thinking: I wonder if it would be useful to create a lying matrix for ourselves. Here’s my little attempt. There’d be big lies and little lies, and then there’d be lies for self-gain and lies for, let’s say, the benefit of others. 

DUCKWORTH: So, like, prosocial versus personally motivated. 

DUBNER: Or at least neutral. So, you’d have your big lies for self-gain, small lies for self-gain, big lies for the benefit of others or neutral, and small lies for the benefit of others. I think everybody could imagine what’s most desirable and terrible about that matrix. Telling a big lie for self-gain sounds pretty terrible, yeah? 

DUCKWORTH: Oh yes. Absolutely. Like, lying so that you can get the vaccine earlier than other people, or cheating on your taxes. I mean, these are all lies for personal gain.

DUBNER: Or, like, saying things on your resume that aren’t true, which is apparently a very common lie. 

DUCKWORTH: Mmm. Interesting. Yes. So, we’re all in consensus that lying in a big way for personal gain: bad. 

DUBNER: Now, what about a big lie for the benefit of others?

DUCKWORTH: Like Jean Valjean in Les Misérables

DUBNER: Ooh. Isn’t there something called “The Valjean Effect” in the psych literature about lying? I’m looking at this paper by Williams, Pizarro, Dan Ariely and J.D. Weinberg called “The Valjean Effect: Visceral States and Cheating.” This is from the journal Emotion. That’s a nice name for a journal, it’s like Smokey Robinson.

DUCKWORTH: It’s a good journal.

DUBNER: Is it?  

DUCKWORTH: I would definitely do a review for Emotion

DUBNER: They write that visceral states — like thirst, hunger, and fatigue — can alter our motivations, predictions, and even memory. And they demonstrate that these so-called “hot states” can shift moral standards and increase dishonest behavior. It’s a form of behavior driven by incentives, right? 

DUCKWORTH: That’s right.

DUBNER: Well, Jean Valjean — as many of us may remember from reading or seeing some version of Les Misérables — he stole a loaf of bread because he was starving and had no money. And then spent, I think, 19 years in prison, was released, but was then given a kind of scarlet letter for being a forever-criminal. And so, I guess the Valjean Effect is about the fact that he was in a state — a hot state, a hungry state — where he needed to do something dishonest, which was taking bread that did not belong to him. It would seem to make sense, I think, to just about every human, that cheating, or stealing, or lying when under — if not duress, then under some, you know, pretty strong emotional motivation — we’d be more likely to do it. But you and I aren’t really talking about lying in a hot state. We’re talking about lying in a neutral state. 

DUCKWORTH: At least that’s what I’m thinking about when you say, “Angela, about how many times a day do you tell a lie?” You know, not under duress, not starving, not dying of thirst.

DUBNER: Let me ask you this, my dear friend: do you think you would be interested in, let’s say, an app, or some kind of tracking paraphernalia, where you’d be able to learn exactly how often you tell a lie? 

DUCKWORTH: If I had, like, the equivalent of a pedometer? 

DUBNER: Yeah. A built-in lie detector. But you’re the only one with the data. Do you think you might, perhaps, lie more or less than you think? Because part of it is the lies we tell other people, and then there are the lies we tell ourselves.  

DUCKWORTH: I would love to have an app if I believed that, uh — what’s that word for a lie detector? Isn’t it, like, a polygraph?

DUBNER: I think polygraph is the right word. 

DUCKWORTH: Okay, anyway, if there were a reliable polygraph — and I don’t know whether the science says that those polygraphs are reliable or not. I think they’re based on skin conductance and, like, sweating associated with lying. And then, if it were really possible — yeah, I’d go for it. Totally. I’m all into this kind of, like, self-improvement in all possible ways. 

DUBNER: And what would happen if this polygraph app told you that you were lying a lot more than one-half a day? 

DUCKWORTH: If I believed it — if I thought, “Oh, yeah, there you go. That wasn’t exactly true. I hadn’t thought about all this motivated reasoning that’s happening in the moment,” I think I would begin to lie less. Because I do think lying erodes the trust we have in other people. 

DUBNER: So, that’s the external cost of lying. But what about the internal? How does lying change one’s self-perception as a person of integrity? That’s important to most of us. 

DUCKWORTH: It’s interesting to think about what it means to lie to yourself, and why that’s bad — if it’s bad. And by the way, many psychologists — and I think neuroscience would be in rough consensus with this — that in a real sense, there are multiple selves. There’s, like, tired Angela, and energetic Angela, and there’s Angela with a lot of other people around, and there’s Angela all by herself, and future Angela, and present Angela, and past Angela. And I think the idea that one of the Angelas could be lying to the other Angelas would probably cause some kind of distress — to have that inner dissonance. 

DUBNER: Of all those Angelas that you just named — and there were many, and I’m sure there are many more. I’m sure there’s pizza Angela, and sushi Angela, chopped-liver Angela — which one lies the most, or maybe the least? 

DUCKWORTH: Well, if you believe the Dan Ariely study that you were just talking about, then I think it would be some kind of distressed Angela, desperate Angela, instrumentally lying to get her way. And maybe that’s why — if I am roughly accurate in my belief that I’m not inclined much to lying — maybe it’s because I’m privileged. And maybe because I have not a lot of need. I’m the opposite of Jean Valjean. I don’t need to steal a loaf of bread to feed my family. I don’t need to lie about my credentials. There’s not a lot of duress, honestly, in my life. 

DUBNER: So, I am looking here at some research by Ipsos, the market research firm, surveyed about 1,000 Americans about their views on lying. 64 percent said that lying was sometimes justified, 36 percent said never justified. Now, we don’t know how many of them were lying about that answer. Does that result strike you as believable? Useful? 

DUCKWORTH: It does strike me that there are occasions on which the lie is a price that you’re willing to pay for some greater good. And Barry Schwartz — our common friend and a psychologist now at Berkeley — Barry would very often bring out the example of: your wife wants to show you her new dress. And she says, “How does it look?” And you’re thinking, “It makes your ass look a mile wide.” And the question is: do you tell the truth? Barry probably wouldn’t have been so crass in his description, but Barry would say that’s an example where honesty, which is obviously a virtue, should be trumped by something else like empathy, and that’s also a virtue. So, I think those Americans who say, “Hey, there are occasions on which lying is a good thing,” are probably thinking about the white lies that we tell each other, and maybe even ourselves — in moments where there’s a greater virtue. 

DUBNER: We have that scenario, exactly, in my house all the time. Not “is my ass a mile wide?” scenario, but my wife will put on some thing — it might be an outfit, or shoes, or maybe a piece of jewelry — and say, “This one or that one?” Or, “Do you like this?” And I have learned to be very honest with her, because my wife is very honest in those kind of things. 

DUCKWORTH: And she wants that. 

DUBNER: But what’s interesting is that she will often — in fact, I would say almost always — disagree or overrule me. She’ll come out with, like, black shoe on one foot and a brown shoe on the other, and say, “Which of these do you think goes with this outfit?” And I look at it, and I’ll say, “The black.” She’s like, “Okay, yeah, I’m wearing the brown.” Now, what’s interesting is, I was so conditioned when we first got married, years and years ago, to do the opposite — to do the, the Barry Schwartz, you know, just —. 

DUCKWORTH: Yeah. “You look great!” 

DUBNER: Yeah. Fish around for what she wanted to hear, and then go with that. Or, “They both look fantastic! I couldn’t imagine any third shoe in the world looking better.” So, maybe I’ve been informed by marriage in that way. But I really do — I mean, what I’m about to say is so self-serving, I can’t believe I’m about to say it, because I’m sure everyone would say this — but I really do try to not lie. And I think about why, and I think there are at least two reasons. One is, it feels terrible. It just feels like a small but significant emotional trauma every time you tell a lie. 

DUCKWORTH: It doesn’t feel good. 

DUBNER: The other part is that it becomes costly to lie, in that you have to keep track of your lies, or otherwise you’ll be caught, and then the cover-up is worse than the crime. This gets me back to the question of why we lie. So, I read a really interesting piece of research. It was from almost 20 years ago, by a psychologist at UMass-Amherst named Robert Feldman, that was looking at lying among undergrads. He had 120-some pairs of undergraduate students, and he told them the study was about how people interact when they meet someone new. And these participants would have a 10 minute recorded conversation with a hidden camera. And in one condition, the students were told to try to make themselves seem likable. Another, they were told to try to seem competent. And a third was a control group; they didn’t get any direction like this. Afterward, he told the participants that they had been videotaped. Then he got consent from them. And then he had them watch the videos after and identify where they had told an untruth. And the results, I’m reading here, “60 percent of the people in that 10 minute conversation lied at least once and told an average of two to three lies.” But here’s what I’m getting to — this is a side result that I find really interesting — women were more likely to lie to make the person they were talking to feel good, while men lied most often to make themselves look better. 

DUCKWORTH: That resonates so deeply, by the way. I wondered whether, in addition to lying to make the other person feel better, there was going to be a gender difference on claiming, or owning up, to lies. Because, by the way, what one person defines as a lie and what another person defines as a lie could be very different things. 

DUBNER: Ah. Good point. Let me ask you this — you know a little something about children and their brains: at what age does lying start? 

DUCKWORTH: I know from Jerry Kagan’s research that these moral emotions — like, to even feel a sense of what it means to do the right thing, and to also feel guilt and shame when you do a wrong thing — I think he would argue that that starts around the age of two or three. And so, I’m assuming that, if you need some self-awareness about a lie to be a lie, then it would be around then. But, as we all know, young children do say things that are untrue, and I don’t even think they know that it’s bad when they’re really little. 

DUBNER: Wait, I’m a little confused. Is there a period where a child is capable of talking and doesn’t lie? Or does the lying start as soon as they can talk? 

DUCKWORTH: Well, let’s talk about, like, a very young toddler. If they are saying something that’s not true, but they don’t have a metacognitive sense that, like, “Ha-ha-ha, I’m telling this untruth, because I want to get something,” I think Jerry Kagan might have argued that, to tell a lie, you have to know, at some level, that you’re telling a lie. And I think very young children would not have that capacity. 

DUBNER: Does it diminish over time as we get older? Because I’ll be honest, I feel that I get more honest the older I get. Or maybe it’s just “cranky” is the better word. And I don’t like to mince words. 

DUCKWORTH: So, our prefrontal cortex — the stuff behind the forehead, the stuff that is the reason why human beings have foreheads. You know, like —.

DUBNER: Really? 

DUCKWORTH: Yeah. 

DUBNER: That’s the reason I have a forehead? 

DUCKWORTH: Pretty much. I mean, if you look at other primates, of course they have foreheads, but they’re not as big as the human forehead, and that accommodates the prefrontal cortex. And the prefrontal cortex is the seat of executive function in the brain. And executive function is many things, but one of them is to inhibit impulses. And so, there’s an impulse to lie, and then there’s the inhibition of the impulse to lie. And prefrontal function does follow a sort of inverse “U,” where it’s terrible when you’re really, really little, and then it gets better. There’s a little blip in adolescence, by the way, but that’s a slightly more complicated story. But then, your 70s and 80s, for sure — prefrontal function is declining over those later years. And just the other day, Stephen, Jason and I are at the top of a church steeple — we’re on vacation. 

DUBNER: Wait, you’re at the top of a church steeple? 

DUCKWORTH: Well, yeah, it was one of those scenic lookouts that you could pay five bucks and climb the church stairs. 96 stairs. And at the very top, there’s a 90-year-old. 

DUBNER: 90? Nine-zero? 

DUCKWORTH: 90. Nine-zero. 

DUBNER: Wow. Did they get her up there with a crane? 

DUCKWORTH: She goes up and down these really steep, ladder-like stairs every day. 

DUBNER: Ooh. Cause or effect?

DUCKWORTH: I will say this: probably selection bias. It’s certainly not the reason why she’s 90, but, for sure, she’s doing well. And if anybody’s got a good prefrontal cortex, it’s got to be this 90-year-old, at least compared to other 90-year-olds. However, she’s 90. So, we’re leaving, and we’re there with our 18-year-old, Lucy. So, we thank her. We’ve had a lovely conversation. She’s made all these jokes about how as long as she doesn’t do the knitting while she’s walking down the steps she’s fine. And she said, “Oh, are you guys together?” And she points to Lucy and my husband, and says, like, “Are you married?” And we laugh, and we think, “Wow, maybe she doesn’t really have it together.” We, you know, explain that I’m married to Jason and not our daughter, Lucy. And then she just looks at me, and said, “Well, you’re really robbing the cradle.” And the idea was, basically, that I look really old relative to my beautiful, handsome husband. And when we get to the bottom of the stairs, I was like, “Ugh, 90-year-olds, they have no ability to inhibit themselves. She has lost the capacity to tell a white lie.” That was a thought that was probably to protect my ego. The other thought I had is, “Do I really look that old?” 

DUBNER: Now, if we could take a chainsaw and cut off one leg of you and Jason, how many rings would we see on each of you? In other words, is he younger than you? 

DUCKWORTH: That’s a lovely image. Thank you. 

DUBNER: Yeah. Sorry, that’s not the easiest way to tell age, I guess. 

DUCKWORTH: But next time I want to know somebody’s age, I’m just going to say, “If I could take a chainsaw and chop off one of your legs —.” 

DUBNER: If that seems too violent, you could use a handsaw of some kind. But is Jason significantly younger than you, however? 

DUCKWORTH: He’s two years younger than me! He’s 49, and I’m 51. And I don’t know, maybe I was having a bad day. But I really couldn’t believe it. This woman thought that I looked old enough to be my husband’s mother. And she felt no desire to lie. 

DUBNER: Okay. Question: how did that incident change your view of 90-year-old women, generally? 

DUCKWORTH: I hate them. 

DUBNER: Yeah, that sounds about right. 

DUCKWORTH: Damn you all! No, I thought it was actually kind of charming. And, honestly, if it’s true at all that the older you get, the less you lie — whether it’s because your prefrontal cortex isn’t what it used to be, or you have learned that honesty is the best policy — I kind of like it, honestly. 

DUBNER: Well, I’m not going to lie; I enjoyed this conversation, every word of it. 

DUCKWORTH: Yeah. How do you like this dress? 

Still to come on No Stupid Questions: Stephen and Angela debate whether there’s a downside to destigmatizing mental illness. 

DUCKWORTH: Oh, I would like everyone to think I’m depressed. I would like everyone to think I have generalized anxiety disorder. 

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DUBNER: Angela, here’s an email from a listener who wishes to remain anonymous. He writes to say, “I have served as an officer in the British army for the past 15 years, including two tours of Afghanistan. As a young officer, I can barely remember mental health being discussed, except during a mandatory period of post-operational decompression at the end of deployments. It certainly didn’t pervade the everyday management of my soldiers, as it can do at the moment. Putting my professional experience to one side,” he continues, “it does seem like over the last decade, society writ-large has become more mental-health conscious. I don’t dispute that for the most part, this seems like a really positive progression.” You can feel the “but” coming here. “People are now far more comfortable verbalizing their struggles and accessing the treatment they need,” he writes. “But,” he goes on, “cold-heartedly, I can’t help but wonder if the focus on mental health has caused widespread hypersensitivity and/or hypochondria. Could our modern-day obsession with mental health be bad for our mental health?” “At this point,” he concludes, “I would add the massive caveat that, of course, I am not advocating cutting people adrift. Clearly, there is a threshold at which mental health becomes a medical issue, and I really believe in helping anyone who is suffering.” So, Angela, I find this a really interesting question, which is essentially: can paying a certain sort of attention to a problem turn into a problem itself, or at least magnify the problem? You know, there’s the old saying, “When you’re holding a hammer, everything looks like a nail.” So, I’m really curious what you have to say about that in the context of mental health. 

DUCKWORTH: Well, I am going to argue that understanding that mental health and mental illness — “they’re a thing,” as the teenagers say. You know, they’re real issues. I’m going to argue that that is a good thing and a big advance, actually. I think that we now live in a time where most people would say that depression and anxiety are diseases and that they can be understood in the same way that we would understand any other disease. I think that is a major advance for humanity. But before I argue that side of things, I do think that what this question gets at is the fact that we’re shining a light on our anxiety or our insecurity — could that create the self-fulfilling prophecy that now we are anxious? And I think that’s a legitimate concern, even if, net, it’s clearly better to understand these things for what they are, which is real conditions. 

DUBNER: So, it is true that it’s common to hear someone say, you know, “I have O.C.D.,” when they’re simply bothered by a sloppy area. 

DUCKWORTH: Mm. Oh yes, by the way, I remember taking psychopathology my first year in my doctoral program. And my professor said that it really bothered her as a therapist who treats people with actual obsessive-compulsive disorder, that people who are like, really don’t want to miss their workout would say that they were O.C.D. And she was just like, “No. O.C.D. is when you go back to your house 50 times in a morning to check the stove. That’s O.C.D.” 

DUBNER: I think what this British army officer is writing about is something a little bit beyond that, which is the idea that hypochondria is maybe on the rise. According to the Cleveland Clinic — do you have any idea what share of Americans are affected by it? It’s also called “illness-anxiety disorder.” Just take a guess. 

DUCKWORTH: Gosh, I would guess maybe — what, 5 percent?. 

DUBNER: That’s what I would have guessed too. Point-one percent. On the other hand, it could be wildly underdiagnosed. But what this writer is implying is that there’s been a rise in attention paid to mental illness, and then some people are selecting into that group. So, can you tell us what’s known about the incidence of mental illness over time and the incidence of diagnosing mental illness over time? 

DUCKWORTH: Most of the reports suggest that issues like anxiety and depression are on the rise. Those are two of the biggest categories, and actually the ones that create the most suffering — particularly among young adults. 

DUBNER: Right. So, I’ve seen a report that says that 25 percent of all college students in the U.S. have a diagnosable psychological disorder. So, that suggests that either there is more mental illness or more mental-health issues in younger people, or there’s a lot more diagnosis than there used to be. Or both, theoretically. 

DUCKWORTH: When they say “diagnosable,” it may be that they are diagnosed, but my suspicion is that somebody is extrapolating from data, because it would be hard for me to believe that one in four college students have been diagnosed. That would mean that colleges around the country had big mental-health divisions that could even do all that testing. 

DUBNER: So, to go to the big issue that he’s raising: what’s a bigger problem? Undiagnosed and untreated mental illness, or the opposite? 

DUCKWORTH: And that’s why I think this is a net problem. In other words, I think there could be pros and cons of increased awareness of mental illness. But to me, the pros outweigh the cons. I mean, the cons are, like: does it create a self-fulfilling prophecy? Maybe. You know, medical students, famously, in their first year of medical school are, like, diagnosing themselves with everything that we just learned about in class. Like, “Oh, my gosh, I must be having appendicitis!” No, you don’t. But I do think that when I was a kid, my dad and mom were given the advice that they should take one or all of us to a counselor for various problems that we were having when we were growing up. And my dad rejected it wholly out of hand. Like, “over my dead body” was, essentially, his attitude toward that. And I think it was because there was such a stigma. I guess for my dad, it wasn’t that he didn’t believe that people could have mental health problems. It was just, “God forbid our family had any of them.” So, I think that’s why this awareness is, like, net so much better. 

DUBNER: If you could transplant your father, the same person from when he came to the U.S. to — let’s say he’s coming to the U.S. now: do you think the environment is now different enough that he that he would have a totally different view of the wisdom of seeking out therapy? Or do you think that was his character? 

DUCKWORTH: I think it would be better now, because even within his own lifetime, I could see my dad’s attitude shift along with culture — you know, questions of sexuality, et cetera, race. But I will say this, you know, my dad was raised in 1930s China, where not only do you not talk about mental health issues— I don’t even know if they would know what the phrase “mental health” means — but also, you don’t, as they would say in my family growing up, “hang your dirty laundry outside.” I was like, “Wouldn’t you definitely want to hang it outside?” Like, why would you want to keep it in the house? 

DUBNER: So, let me ask you this: how is America an outlier in thinking about mental illness? I’ve seen a World Health Organization study looking at the number of mental disorders in 28 countries. The lowest rate of reported mental disorders with Nigeria, and the highest was the U.S. So, is this about existence and incidence, or diagnosing, or what? 

DUCKWORTH: You know, it will be impossible, I think, in cross-cultural data, to tease apart how much of this is having the language and the awareness and how much of this is just true — like, we are more depressed or we have more anxiety. I don’t think we can ever definitively do that. I have to say that it’s got to at least be some element of, like, we have the words for it and we think it’s okay. 

DUBNER: So, now you’re talking about the change in stigma associated with mental illness. By the way, I learned this recently: in ancient Greece, stigma referred to a brand to mark a slave or a criminal. So, when we destigmatize, it’s a fairly heavy meaning. But when we’re talking about the destigmatization of mental illness, plainly the upsides are large. It makes me think back to P.T.S.D. — post-traumatic stress disorder. That is a relatively newly-identified condition, correct? Newly recognized. What can you tell us about the origin of that classification? 

DUCKWORTH: Post-traumatic stress disorder, which is the psychological consequences of having been through something traumatic, like war, or rape, or witnessing a murder. This phenomenon, I think, actually came about in the wake of World War II and Vietnam, as well. There was federal funding and federal recognition of a problem, and that actually spawned, in some ways, the whole mental health industry, because now there were federal dollars going to therapy, diagnosis, et cetera. But P.T.S.D. is when you experience something which is truly traumatic, that you have this over-sensitization of your vigilant system. And so, you respond in an exaggerated way to stimuli that are mildly threatening or even, like, neutral. There are now formal treatments. There’s lots of argument about what the best treatment is. Is it cognitive therapy, is it exposure, et cetera. But I do think that P.T.S.D. is a good focus for this conversation, because I think that would be the sort of thing where some would say like, “Oh, we used to say ‘keep calm and carry on,’ and now, you know, everybody wants to be diagnosed.” And again, I can understand that sentiment, but isn’t it worse for people who are, like, genuinely suffering to feel like it’s all made up? 

DUBNER: Right. So, on balance, it’s a gain. 

DUCKWORTH: In my view, it really is. And I, by the way, don’t think we have to worry about people running out and falsely getting stickers that say they have mental health disorders who don’t, because even if we’re trying to remove the stigma, I don’t think a lot of people are like, “Oh, I would like everyone to think I’m depressed. I would like everyone to think I have generalized anxiety disorder.” So, I think it’s more like, hey, people sprain their ankles, and some people need to work on their hamstrings because they’re too tight, and you can break your femur, and your brain can have some problems that you have to get help with. That said, I do see on social media people spending just a lot of time talking about their issues and problems. And you do wonder whether it starts to even verge on exhibitionism, which I think is also a formal diagnosis. So, it’s not like there’s an either/or, like, “Oh, this is always good.” 

DUBNER: The anonymous listener who wrote in, I have to say — I don’t think he sounds unsympathetic, but it does make me want to know how hard is it for someone without mental illness, or experience with mental illness, to empathize with someone who does have a mental illness. And for anyone listening, how can they improve that? 

DUCKWORTH: You know, my uncle by marriage, Ken Duckworth, is a psychiatrist. He is the chief medical officer for N.A.M.I., which is the National Alliance on Mental Illness. So, I always like to think of him as “the nation’s psychiatrist.” And he would say — both as a lifelong clinician and as the chief psychiatrist for N.A.M.I. for years, and also as the son of somebody who had florid, manic depression — that one of the most important things you can do is just say that these things are real and they are more like diseases than they are not like diseases. But I think Ken would say that understanding these things as being more common than people think, and more treatable than people think, is a very important advance. 

DUBNER: I understand there is an effort underway to change how mental illness is diagnosed from the National Institute for Mental Health. There’s something called the Research Domain Criteria Project, which is, from what I understand, an effort to make these disorders less black and white and more on a spectrum, which sounds like common sense.

DUCKWORTH: Well, the Diagnostic and Statistical Manual, which everyone else calls it, the D.S.M., in the latest revision — I think the major sea change is to to understand that the majority of mental-health issues are more like continua than they are like categories. So, rather than saying, “you are A.D.H.D.” or “you are not A.D.H.D.,” it’s more like, “How A.D.H.D. are you, and does it pass a threshold of dysfunction?” 

DUBNER: And we should say the D.S.M., is famous for including, until I believe 1972, homosexuality as a mental disease, yes? 

DUCKWORTH: Yes, that’s true. it’s almost like a history of cultural change, right? Even just how it is written about. 

DUBNER: So, let me just bring you back to a portion of the listener’s question. He writes, “Cold-heartedly, I can’t help but wonder if the focus on mental health has caused widespread hypersensitivity and/or hypochondria. Could our modern-day obsession with mental health be bad for our mental health?” Let’s just focus on that very last part. Could the “obsession,” he calls it, be bad for mental health? Your answer on balance, then, is what? 

DUCKWORTH: No. If I were only allowed one syllable, I would say on balance, “No.”

DUBNER: The potential overflow costs are well worth the benefits, you’re saying? 

DUCKWORTH: Correct. I consider it net unequivocally positive.

DUBNER: Angela, I thought this was a great conversation. I thank you, and I really thank this listener who not only raised an interesting point, but I think what he did for us, in a public sphere, is set a really good example for how to struggle with an interesting and difficult topic. And so kudos to you, Mr. Anonymous British Army Officer. Thank you. 

*      *      *

No Stupid Questions is part of the Freakonomics Radio Network, which also includes Freakonomics Radio, People I (Mostly) Admire, and Freakonomics, M.D. This episode was produced by me, Rebecca Lee Douglas. And now, here is a fact-check of today’s conversations. 

In the first half of the episode, Stephen and Angela discuss the work of Israeli-American psychologist and Duke University professor Dan Ariely. After this recording, the blog Data Colada published research revealing that a 2012 Ariely field study about dishonesty was based on fabricated data. Ariely denies making up the figures, and it is possible that the fabricated data came from the company where the study took place. So while nobody disagrees that there is a smoking gun here, it’s not clear who pulled the trigger. 

Later, Angela said that she doesn’t know whether polygraph tests are an effective tool to detect lies. Research has confirmed that polygraphs can detect physiological reactions associated with stress, fear, guilt, anger, excitement and anxiety. These reactions include elevation of pulse, respiration, blood pressure and electrodermal activity due to sweat. But according to the National Academy of Sciences, quote, “the absolute magnitude of an individual’s physiological response to a relevant question cannot be a valid indicator of the truthfulness of a response.” 

Also, Stephen remembers reading that 25 percent of all college students in the United States have a diagnosable psychological disorder. I wasn’t able to locate that exact statistic. However, according to survey results published by the National Institute of Mental Health, 20.6 percent of all Americans have some form of mental illness. And for young adults aged 18 to 25, that figure is 29.4 percent. 

Finally, Stephen says that homosexuality was listed as a psychopathology in the Diagnostic and Statistical Manual of Mental Disorders until 1972. He was actually one year off. In 1973, the American Psychiatric Association removed the diagnosis from the D.S.M. 

That’s it for the fact-check.

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No Stupid Questions is produced by Freakonomics Radio and Stitcher; our staff includes Alison Craiglow, Greg Rippin, Eleanor Osborne, Joel Meyer, Tricia Bobeda, Emma Tyrrell, Lyric Bowdich and Jacob Clemente. We had additional help this week from Anya Dubner. Our theme song is “And She Was” by Talking Heads — special thanks to David Byrne and Warner Chappell Music. If you’d like to listen to the show ad-free, subscribe to Stitcher Premium. You can also follow us on Twitter at NSQ_Show and on Facebook @NSQShow. If you have a question for a future episode, please email it to nsq@freakonomics.com. And if you heard Stephen or Angela reference a study, an expert, or a book that you’d like to learn more about, you can check out Freakonomics.com/NSQ, where we link to all of the major references that you heard about here today. Thanks for listening! 

DUCKWORTH: Can you remember the last time you lied? 

DUBNER: Well, remember at the beginning of this conversation? I said it was so great to speak with you. 

DUCKWORTH: Total, flat-out untruth.

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Sources

  • Laurie Santos, professor of psychology at Yale University.
  • Dan Ariely, professor of psychology at Duke University.
  • Barry Schwartz, visiting professor of management at University of California, Berkeley.
  • Robert Feldman, professor of psychological and brain sciences at University of Massachusetts, Amherst.
  • Jerome Kagan (deceased), professor of psychology at Harvard University.
  • Ken Duckworth, Chief Medical Officer at the National Alliance on Mental Illness.

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