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"But since we don't have anything that works well for these individuals — that have a high risk of mortality – it warrants cautious optimism and further study."

doctors implant tiny electrodes next to a region of the brain thought to be dysfunctional. A device, similar to a heart pacemaker, then sends waves of electricity through a wire to the electrodes.

In the latest study, neurosurgeons in Toronto implanted the electrodes in the brains of six women with chronic anorexia. Five of them had been struggling with the disease for over a decade. All of them had experienced serious health problems from it, including heart attacks in some cases.

"My symptoms were so severe. I would wake up in the middle of night and run up and down the stairs for hours or go for a five-hour run," she tells Shots. "I became very isolated. I didn't want to be around anyone because they kept me from exercising."

"It was brain surgery! But I had had a heart attack at 28 and two strokes, " she says. "My mom was in the midst of planning my funeral. If I didn't take this chance, I knew my path would probably lead to death."

Rollins admits that the deep brain stimulation wasn't a magic bullet. She's had to continue her anorexia treatment to get where she is. "I still see a psychiatrist regularly and a dietitian. It [the deep brain stimulation] enables me to do the work that I need to do a lot easy."

Deep brain stimulation can cause serious side effects, Lipsman says, like seizures, and more milder ones, like pain and nausea. "This is a brain surgery – there's no sugarcoating that," he says. "The primary objective of this study was to establish that this a safe procedure for these patients who have been quite ill before the surgery. That's all we can say right now."

When Zeki has put people who have fallen in love inside of fMRI machines and shown them photos of their lovers, he's detected reduced activity in the amygdala — a pair of brain regions that are involved in decision-making. Amygdala activity is typically heightened during fearful or stressful situations, and research suggests that we use it when making social judgements and trying to determine if other people are lying.

Given that we think of love as a positive emotion, it's a bit surprising that she found reduced levels of serotonin in these people, compared to controls. Even more surprising, though, is that they were as low as other study participants who had obsessive compulsive order — so low, she says, that "my biologists came back to me and assumed that the readings were from people who suffered from OCD."

a lack of serotonin may lead to the obsessive, irrationally jealous behavior we see in some people.

"When you're rejected in love, we still find activity in the VTA — you're still madly in love with that person, after all," she says. "But we also find elevated activity in other brain regions linked with craving, and in a part of the brain associated with the distress that goes along with physical pain."

One positive aspect of the study, though, was that the more time that had passed since the participants' rejection, the lower activity was in another brain region associated with attachment.

Activity was elevated in the VTA — just like in new lovers — but also the ventral pallidum, an area associated with maternal attachment in animal studies.

"Romantic love is giddiness, elation, euphoria, energy. When you're feeling a deep sense of attachment, you're much more calm, and contented."

It's still uncertain why people transition from the first phase of love to the second phase of attachment, but Fisher hypothesizes that they're driven by separate evolutionary mechanisms. The initial flood of obsessive love evolved, she thinks, in order to get you to focus on a single person in order to reproduce. The second phase of attachment, by contrast, evolved to link you to another person for an extended period of time, in order to raise a child.

The creators of the D.S.M. in the 1960s and ’70s “were real heroes at the time,” said Dr. Steven E. Hyman, a psychiatrist and neuroscientist at the Broad Institute and a former director at the National Institute of Mental Health. “They chose a model in which all psychiatric illnesses were represented as categories discontinuous with ‘normal.’ But this is totally wrong in a way they couldn’t have imagined. So in fact what they produced was an absolute scientific nightmare. Many people who get one diagnosis get five diagnoses, but they don’t have five diseases — they have one underlying condition.”

Dr. Insel is one of a growing number of scientists who think that the field needs an entirely new paradigm for understanding mental disorders, though neither he nor anyone else knows exactly what it will look like.

Decades of spending on neuroscience have taught scientists mostly what they do not know, undermining some of their most elemental assumptions. Genetic glitches that appear to increase the risk of schizophrenia in one person may predispose others to autism-like symptoms, or bipolar disorder. The mechanisms of the field’s most commonly used drugs — antidepressants like Prozac, and antipsychosis medications like Zyprexa — have revealed nothing about the causes of those disorders. And major drugmakers have scaled back psychiatric drug development, having virtually no new biological “targets” to shoot for.

Dr. Hyman, Dr. Insel and other experts said they hoped that the science of psychiatry would follow the direction of cancer research, which is moving from classifying tumors by where they occur in the body to characterizing them by their genetic and molecular signatures.

Dr. Insel said in the interview that his motivation was not to disparage the D.S.M. as a clinical tool, but to encourage researchers and especially outside reviewers who screen proposals for financing from his agency to disregard its categories and investigate the biological underpinnings of disorders instead.

We want to customize our lives. We want to move in and out of where we are because the thing we value most is control over where we focus our attention. We have gotten used to the idea of being in a tribe of one, loyal to our own party.

We are tempted to think that our little “sips” of online connection add up to a big gulp of real conversation. But they don’t.

“Someday, someday, but certainly not now, I’d like to learn how to have a conversation.”

We can’t get enough of one another if we can use technology to keep one another at distances we can control: not too close, not too far, just right. I think of it as a Goldilocks effect. Texting and e-mail and posting let us present the self we want to be. This means we can edit. And if we wish to, we can delete. Or retouch: the voice, the flesh, the face, the body. Not too much, not too little — just right.

Human relationships are rich; they’re messy and demanding. We have learned the habit of cleaning them up with technology.

I have often heard the sentiment “No one is listening to me.” I believe this feeling helps explain why it is so appealing to have a Facebook page or a Twitter feed — each provides so many automatic listeners. And it helps explain why — against all reason — so many of us are willing to talk to machines that seem to care about us. Researchers around the world are busy inventing sociable robots, designed to be companions to the elderly, to children, to all of us.

Connecting in sips may work for gathering discrete bits of information or for saying, “I am thinking about you.” Or even for saying, “I love you.” But connecting in sips doesn’t work as well when it comes to understanding and knowing one another. In conversation we tend to one another.

We can attend to tone and nuance. In conversation, we are called upon to see things from another’s point of view.

I’m the one who doesn’t want to be interrupted. I think I should. But I’d rather just do things on my BlackBerry.

And we use conversation with others to learn to converse with ourselves. So our flight from conversation can mean diminished chances to learn skills of self-reflection

we have little motivation to say something truly self-reflective. Self-reflection in conversation requires trust. It’s hard to do anything with 3,000 Facebook friends except connect.

we seem almost willing to dispense with people altogether. Serious people muse about the future of computer programs as psychiatrists. A high school sophomore confides to me that he wishes he could talk to an artificial intelligence program instead of his dad about dating; he says the A.I. would have so much more in its database. Indeed, many people tell me they hope that as Siri, the digital assistant on Apple’s iPhone, becomes more advanced, “she” will be more and more like a best friend — one who will listen when others won’t.

FACE-TO-FACE conversation unfolds slowly. It teaches patience. When we communicate on our digital devices, we learn different habits. As we ramp up the volume and velocity of online connections, we start to expect faster answers. To get these, we ask one another simpler questions; we dumb down our communications, even on the most important matters.

WE expect more from technology and less from one another and seem increasingly drawn to technologies that provide the illusion of companionship without the demands of relationship. Always-on/always-on-you devices provide three powerful fantasies: that we will always be heard; that we can put our attention wherever we want it to be; and that we never have to be alone. Indeed our new devices have turned being alone into a problem that can be solved.

When people are alone, even for a few moments, they fidget and reach for a device. Here connection works like a symptom, not a cure, and our constant, reflexive impulse to connect shapes a new way of being.

Think of it as “I share, therefore I am.” We use technology to define ourselves by sharing our thoughts and feelings as we’re having them. We used to think, “I have a feeling; I want to make a call.” Now our impulse is, “I want to have a feeling; I need to send a text.”

Lacking the capacity for solitude, we turn to other people but don’t experience them as they are. It is as though we use them, need them as spare parts to support our increasingly fragile selves.

If we are unable to be alone, we are far more likely to be lonely. If we don’t teach our children to be alone, they will know only how to be lonely.

I am a partisan for conversation. To make room for it, I see some first, deliberate steps. At home, we can create sacred spaces: the kitchen, the dining room. We can make our cars “device-free zones.”

The brain-development lag has huge implications for how we think about anxiety and how we treat it. It suggests that anxious adolescents may not be very responsive to psychotherapy that attempts to teach them to be unafraid, like cognitive behavior therapy

should also make us think twice — and then some — about the ever rising use of stimulants in young people, because these drugs may worsen anxiety and make it harder for teenagers to do what they are developmentally supposed to do: learn to be unafraid when it is appropriate

up to 20 percent of adolescents in the United States experience a diagnosable anxiety disorder, like generalized anxiety or panic attacks, probably resulting from a mix of genetic factors and environmental influences.

This isn’t to say that cognitive therapy is ineffective for teenagers, but that because of their relative difficulty in learning to be unafraid, it may not be the most effective treatment when used on its own.

Fear learning lies at the heart of anxiety and anxiety disorders. This primitive form of learning allows us to form associations between events and specific cues and environments that may predict danger.

once previously threatening cues or situations become safe, we have to be able to re-evaluate them and suppress our learned fear associations. People with anxiety disorders have trouble doing this and experience persistent fear in the absence of threat — better known as anxiety.

Dr. Casey discovered that adolescents had a much harder time “unlearning” the link between the colored square and the noise than children or adults did.

adolescents had trouble learning that a cue that was previously linked to something aversive was now neutral and “safe.” If you consider that adolescence is a time of exploration when young people develop greater autonomy, an enhanced capacity for fear and a more tenacious memory for threatening situations are adaptive and would confer survival advantage. In fact, the developmental gap between the amygdala and the prefrontal cortex that is described in humans has been found across mammalian species, suggesting that this is an evolutionary advantage.

As a psychiatrist, I’ve treated many adults with various anxiety disorders, nearly all of whom trace the origin of the problem to their teenage years. They typically report an uneventful childhood rudely interrupted by adolescent anxiety. For many, the anxiety was inexplicable and came out of nowhere.

prescription sales for stimulants increased more than fivefold between 2002 and 2012. This is of potential concern because it is well known from both human and animal studies that stimulants enhance learning and, in particular, fear conditioning.

To some extent, the brain remains a bit of a black box, as puzzling to modern-day psychiatrists as it was to turn-of-the-century charlatans. The difference is, most doctors today have the humility to admit what they don't know.

New research suggests that one possible answer can be found in the brain’s so-called central executive network, which helps regulate emotions, thinking and behavior

used M.R.I. to study the brains of a racially diverse group of 218 people, ages 12 to 14, living in violent neighborhoods in Chicago

the youths who had higher levels of functional connectivity in the central executive network had better cardiac and metabolic health than their peers with lower levels of connectivity

when neighborhood homicide rates went up, the young people’s cardiometabolic risk — as measured by obesity, blood-pressure and insulin levels, among other variables — also increased, but only in youths who showed lower activity in this brain network

“Active resilience happens when people who are vulnerable find resources to cope with stress and bounce back, and do so in a way that leaves them stronger, ready to handle additional stress, in more adaptive ways.”

the more medically hardy young people were no less anxious or depressed than their less fortunate peers, which suggests that while being more resilient makes you less vulnerable to adversity, it doesn’t guarantee happiness — or even an awareness of being resilient.

there is good reason to believe the link may be causal because other studies have found that we can change the activity in the self-control network, and increase healthy behaviors, with simple behavioral interventions

For example, mindfulness training, which involves attention control, emotion regulation and increased self-awareness, can increase connectivity within this network and help people to quit smoking.

n one study, two weeks of mindfulness training produced a 60 percent reduction in smoking, compared with no reduction in a control group that focused on relaxation. An M.R.I. following mindfulness training showed increased activity in the anterior cingulate cortex and prefrontal cortex, key brain areas in the executive self-control network

Clearly self-control is one critical component of resilience that can be easily fostered. But there are others.

One plausible explanation is that greater activity in this network increases self-control, which most likely reduces some unhealthy behaviors people often use to cope with stress, like eating junk food or smoking

she and colleagues studied the brains of depressed patients who died. They found that the most disrupted genes were those for growth factors, proteins that act like a kind of brain fertilizer.

“We came to realize that depressed people have lost their power to remodel their brains. And that is in fact devastating because brain remodeling is something we need to do all the time — we are constantly rewiring our brains based on past experience and the expectation of how we need to use them in the future,

one growth factor that is depleted in depressed brains, called fibroblast growth factor 2, also plays a role in resilience. When they gave it to stressed animals, they bounced back faster and acted less depressed. And when they gave it just once after birth to animals that had been bred for high levels of anxiety and inhibition, they were hardier for the rest of their lives.

The good news is that we have some control over our own brain BDNF levels: Getting more physical exercise and social support, for example, has been shown to increase BDNF.

Perhaps someday we might be able to protect young people exposed to violence and adversity by supplementing them with neuroprotective growth factors. We know enough now to help them by fortifying their brains through exercise, mindfulness training and support systems

Some people have won the genetic sweepstakes and are naturally tough. But there is plenty the rest of us can do to be more resilient and healthier.

“I heard a lot from friends in Miami about people flying in, because they were giving it to everybody,”

, it began to seem like anyone could get a vaccine if they were willing to hunt one down or stretch the truth about their medical history.

“the equivalent of knocking over an old lady for a taxi and feeling good about yourself,” as she put it in an interview.

“It’s broadcasting status, that you got the vaccine ahead of others,”

“We should all consider taking up the Garbo challenge and stay off social media for a spell instead of broadcasting every waking second of the day, including your vax shot.”

Those people seemed just fine when they were splashing in bikinis in Turks and Caicos at Christmas,

Occasionally, those posting on Instagram have said that they were trying to say to others that the vaccine is safe and effective

“On some level, they know it’s tone-deaf for a wide audience but have their group where they feel safe,”

“What’s funny is that many of them just post their vaccination selfies to green circle Close Friends.”

“I mean, come on. You’re not Joe Biden. You’re not the queen,”

Three psychiatrists interviewed for this article said their patients all seemed to understand that attention deficit disorder and mild anxiety do not meet the state definition of an “intellectual” or “developmental” disorder sufficient to place them in the Centers for Disease Control and Prevention’s

“I have patients who brought stacks of medical info when they went to get vaccinated. No one ever asks to see it.”

“I’ve never had so many people happy to be told they’re obese,”

“At this point, the goal is to get as many people vaccinated as possible,”

He sees no issue with giving a note to a patient who had a melanoma five years back. Cancer is cancer. Elevated blood pressure is fine too, even if it’s sometimes less a reason than an excuse.

“Young people are the super-spreaders!

Some young people get around the fauxmorbidity issue by volunteering at a vaccine site.

. “It was basically treated as a given when I got there,”

“I get that people are eager to shame those who are gaming the system,” she said, “but let’s shame the people who set up that system.”

Perinatal Depression

Seasonal Affective Disorder (SAD):

Psychotic Depression:

Depression can occur along with other serious illnesses, such as diabetes, cancer, heart disease, and Parkinson’s disease. Depression can make these conditions worse and vice versa.

Depression affects different people in different ways.

Medications called antidepressants can work well to treat depression.

"People who are more socially connected to family, to friends, to community, are happier, they're physically healthier, and they live longer than people who are less well connected," said Harvard psychiatrist Robert Waldinger in his popular TEDx talk. "And the experience of loneliness turns out to be toxic."

The lessons aren't about wealth or fame or working harder and harder," Waldinger said. "The clearest message that we get from this 75-year study is this: Good relationships keep us happier and healthier. Period."

"In fact, the more positive the person, the greater the protection from heart attacks, stroke and any cause of death," said Mt. Sinai's Rozanski, who was the lead author on the study.

A sense of purpose and meaning in your life is a big part of living a longer, happier life, according to psychology professor Lyle Ungar, who has developed what he calls the Well-Being Map. It rates every US county on such psychological factors as openness, trust, agreeableness and neuroticism.

"If your sole duty is to achieve the best for yourself, life becomes just too stressful, too lonely -- you are set up to fail. Instead, you need to feel you exist for something larger, and that very thought takes off some of the pressure."

SpiritualityStudies by the Pew Research Center show that actively religious people are more likely than less- or non-religious people to describe themselves as "very happy." They also share some traits that could improve their chance at a longer, happy life: They are less likely to smoke and drink, and more likely to join clubs and volunteer at charities.

"I'm surprised how good religion is for people," Ungar said. "Religious people are more agreeable, they're happier, they live longer."It doesn't have to be a traditional religion. Layard points out that spiritual practices ranging from meditation to positive psychology to cognitive therapy can also feed an inner life.

“The curriculum covers topics from causal modeling and probability to game theory and cognitive science,” read a website promising teens a summer of Rationalist learning. “How can we understand our own reasoning, behavior, and emotions? How can we think more clearly and better achieve our goals?”

Some lived in group houses. Some practiced polyamory. “They are basically just hippies who talk a lot more about Bayes’ theorem than the original hippies,” said Scott Aaronson, a University of Texas professor who has stayed in one of the group houses.

For Kelsey Piper, who embraced these ideas in high school, around 2010, the movement was about learning “how to do good in a world that changes very rapidly.”

Yes, the community thought about A.I., she said, but it also thought about reducing the price of health care and slowing the spread of disease.

Slate Star Codex, which sprung up in 2013, helped her develop a “calibrated trust” in the medical system. Many people she knew, she said, felt duped by psychiatrists, for example, who they felt weren’t clear about the costs and benefits of certain treatment.

That was not the Rationalist way.

“There is something really appealing about somebody explaining where a lot of those ideas are coming from and what a lot of the questions are,” she said.

Sam Altman, chief executive of OpenAI, an artificial intelligence lab backed by a billion dollars from Microsoft. He was effusive in his praise of the blog.It was, he said, essential reading among “the people inventing the future” in the tech industry.

Mr. Altman, who had risen to prominence as the president of the start-up accelerator Y Combinator, moved on to other subjects before hanging up. But he called back. He wanted to talk about an essay that appeared on the blog in 2014.The essay was a critique of what Mr. Siskind, writing as Scott Alexander, described as “the Blue Tribe.” In his telling, these were the people at the liberal end of the political spectrum whose characteristics included “supporting gay rights” and “getting conspicuously upset about sexists and bigots.”

But as the man behind Slate Star Codex saw it, there was one group the Blue Tribe could not tolerate: anyone who did not agree with the Blue Tribe. “Doesn’t sound quite so noble now, does it?” he wrote.

Mr. Altman thought the essay nailed a big problem: In the face of the “internet mob” that guarded against sexism and racism, entrepreneurs had less room to explore new ideas. Many of their ideas, such as intelligence augmentation and genetic engineering, ran afoul of the Blue Tribe.

Mr. Siskind was not a member of the Blue Tribe. He was not a voice from the conservative Red Tribe (“opposing gay marriage,” “getting conspicuously upset about terrorists and commies”). He identified with something called the Grey Tribe — as did many in Silicon Valley.

The Grey Tribe was characterized by libertarian beliefs, atheism, “vague annoyance that the question of gay rights even comes up,” and “reading lots of blogs,” he wrote. Most significantly, it believed in absolute free speech.

The essay on these tribes, Mr. Altman told me, was an inflection point for Silicon Valley. “It was a moment that people talked about a lot, lot, lot,” he said.

And in some ways, two of the world’s prominent A.I. labs — organizations that are tackling some of the tech industry’s most ambitious and potentially powerful projects — grew out of the Rationalist movement.

In 2005, Peter Thiel, the co-founder of PayPal and an early investor in Facebook, befriended Mr. Yudkowsky and gave money to MIRI. In 2010, at Mr. Thiel’s San Francisco townhouse, Mr. Yudkowsky introduced him to a pair of young researchers named Shane Legg and Demis Hassabis. That fall, with an investment from Mr. Thiel’s firm, the two created an A.I. lab called DeepMind.

Like the Rationalists, they believed that A.I could end up turning against humanity, and because they held this belief, they felt they were among the only ones who were prepared to build it in a safe way.

In 2014, Google bought DeepMind for $650 million. The next year, Elon Musk — who also worried A.I. could destroy the world and met his partner, Grimes, because they shared an interest in a Rationalist thought experiment — founded OpenAI as a DeepMind competitor. Both labs hired from the Rationalist community.

Mr. Aaronson, the University of Texas professor, was turned off by the more rigid and contrarian beliefs of the Rationalists, but he is one of the blog’s biggest champions and deeply admired that it didn’t avoid live-wire topics.

“It must have taken incredible guts for Scott to express his thoughts, misgivings and questions about some major ideological pillars of the modern world so openly, even if protected by a quasi-pseudonym,” he said

In late June of last year, not long after talking to Mr. Altman, the OpenAI chief executive, I approached the writer known as Scott Alexander, hoping to get his views on the Rationalist way and its effect on Silicon Valley. That was when the blog vanished.

The issue, it was clear to me, was that I told him I could not guarantee him the anonymity he’d been writing with. In fact, his real name was easy to find because people had shared it online for years and he had used it on a piece he’d written for a scientific journal. I did a Google search for Scott Alexander and one of the first results I saw in the auto-complete list was Scott Alexander Siskind.

More than 7,500 people signed a petition urging The Times not to publish his name, including many prominent figures in the tech industry. “Putting his full name in The Times,” the petitioners said, “would meaningfully damage public discourse, by discouraging private citizens from sharing their thoughts in blog form.” On the internet, many in Silicon Valley believe, everyone has the right not only to say what they want but to say it anonymously.

I spoke with Manoel Horta Ribeiro, a computer science researcher who explores social networks at the Swiss Federal Institute of Technology in Lausanne. He was worried that Slate Star Codex, like other communities, was allowing extremist views to trickle into the influential tech world. “A community like this gives voice to fringe groups,” he said. “It gives a platform to people who hold more extreme views.”

I assured her my goal was to report on the blog, and the Rationalists, with rigor and fairness. But she felt that discussing both critics and supporters could be unfair. What I needed to do, she said, was somehow prove statistically which side was right.

When I asked Mr. Altman if the conversation on sites like Slate Star Codex could push people toward toxic beliefs, he said he held “some empathy” for these concerns. But, he added, “people need a forum to debate ideas.”

In August, Mr. Siskind restored his old blog posts to the internet. And two weeks ago, he relaunched his blog on Substack, a company with ties to both Andreessen Horowitz and Y Combinator. He gave the blog a new title: Astral Codex Ten. He hinted that Substack paid him $250,000 for a year on the platform. And he indicated the company would give him all the protection he needed.

The inquest heard evidence from a child psychiatrist, Dr Navin Venugopal, who said Molly had been “placed at risk” by the content she had viewed. The headteacher at Molly’s secondary school also gave evidence, describing how it was “almost impossible” to keep track of the risks posed to pupils by social media.

we lack practical knowledge about how to give one another the attention we crave

Some days it seems like we have intentionally built a society that gives people little guidance on how to perform the most important activities of life.

If I can shine positive attention on others, I can help them to blossom. If I see potential in others, they may come to see potential in themselves. True understanding is one of the most generous gifts any of us can give to another.

I see the results, too, in the epidemic of invisibility I encounter as a journalist. I often find myself interviewing people who tell me they feel unseen and disrespected

I’ve been working on a book called “How to Know a Person: The Art of Seeing Others Deeply and Being Deeply Seen.” I wanted it to be a practical book — so that I would learn these skills myself, and also, I hope, teach people how to understand others, how to make them feel respected, valued and understood.

I wanted to learn these skills for utilitarian reasons

If I’m going to work with someone, I don’t just want to see his superficial technical abilities. I want to understand him more deeply — to know whether he is calm in a crisis, comfortable with uncertainty or generous to colleagues.

I wanted to learn these skills for moral reasons

Many of the most productive researchers were in the habit of having breakfast or lunch with an electrical engineer named Harry Nyquist. Nyquist really listened to their challenges, got inside their heads, brought out the best in them. Nyquist, too, was an illuminator.

Finally, I wanted to learn these skills for reasons of national survival

We evolved to live with small bands of people like ourselves. Now we live in wonderfully diverse societies, but our social skills are inadequate for the divisions that exist. We live in a brutalizing time.

In any collection of humans, there are diminishers and there are illuminators. Diminishers are so into themselves, they make others feel insignificant

They stereotype and label. If they learn one thing about you, they proceed to make a series of assumptions about who you must be.

Illuminators, on the other hand, have a persistent curiosity about other people.

hey have been trained or have trained themselves in the craft of understanding others. They know how to ask the right questions at the right times — so that they can see things, at least a bit, from another’s point of view. They shine the brightness of their care on people and make them feel bigger, respected, lit up.

A biographer of the novelist E.M. Forster wrote, “To speak with him was to be seduced by an inverse charisma, a sense of being listened to with such intensity that you had to be your most honest, sharpest, and best self.” Imagine how good it would be to offer people that kind of hospitality.

social clumsiness I encounter too frequently. I’ll be leaving a party or some gathering and I’ll realize: That whole time, nobody asked me a single question. I estimate that only 30 percent of the people in the world are good question askers. The rest are nice people, but they just don’t ask. I think it’s because they haven’t been taught to and so don’t display basic curiosity about others.

Many years ago, patent lawyers at Bell Labs were trying to figure out why some employees were much more productive than others.

Illuminators are a joy to be around

The gift of attention.

Each of us has a characteristic way of showing up in the world. A person who radiates warmth will bring out the glowing sides of the people he meets, while a person who conveys formality can meet the same people and find them stiff and detached. “Attention,” the psychiatrist Iain McGilchrist writes, “is a moral act: It creates, brings aspects of things into being.”

When Jimmy sees a person — any person — he is seeing a creature with infinite value and dignity, made in the image of God. He is seeing someone so important that Jesus was willing to die for that person.

Accompaniment.

Accompaniment is an other-centered way of being with people during the normal routines of life.

If we are going to accompany someone well, we need to abandon the efficiency mind-set. We need to take our time and simply delight in another person’s way of being

I know a couple who treasure friends who are what they call “lingerable.” These are the sorts of people who are just great company, who turn conversation into a form of play and encourage you to be yourself. It’s a great talent, to be lingerable.

Other times, a good accompanist does nothing more than practice the art of presence, just being there.

The art of conversation.

If you tell me something important and then I paraphrase it back to you, what psychologists call “looping,” we can correct any misimpressions that may exist between us.

Be a loud listener. When another person is talking, you want to be listening so actively you’re burning calories.

He’s continually responding to my comments with encouraging affirmations, with “amen,” “aha” and “yes!” I love talking to that guy.

I no longer ask people: What do you think about that? Instead, I ask: How did you come to believe that? That gets them talking about the people and experiences that shaped their values.

Storify whenever possible

People are much more revealing and personal when they are telling stories.

Do the looping, especially with adolescents

If you want to know how the people around you see the world, you have to ask them. Here are a few tips I’ve collected from experts on how to become a better conversationalist:

Turn your partner into a narrator

People don’t go into enough detail when they tell you a story. If you ask specific follow-up questions — Was your boss screaming or irritated when she said that to you? What was her tone of voice? — then they will revisit the moment in a more concrete way and tell a richer story

If somebody tells you he is having trouble with his teenager, don’t turn around and say: “I know exactly what you mean. I’m having incredible problems with my own Susan.” You may think you’re trying to build a shared connection, but what you are really doing is shifting attention back to yourself.

Don’t be a topper

Big questions.

The quality of your conversations will depend on the quality of your questions

As adults, we get more inhibited with our questions, if we even ask them at all. I’ve learned we’re generally too cautious. People are dying to tell you their stories. Very often, no one has ever asked about them.

So when I first meet people, I tend to ask them where they grew up. People are at their best when talking about their childhoods. Or I ask where they got their names. That gets them talking about their families and ethnic backgrounds.

After you’ve established trust with a person, it’s great to ask 30,000-foot questions, ones that lift people out of their daily vantage points and help them see themselves from above.

These are questions like: What crossroads are you at? Most people are in the middle of some life transition; this question encourages them to step back and describe theirs

I’ve learned it’s best to resist this temptation. My first job in any conversation across difference or inequality is to stand in other people’s standpoint and fully understand how the world looks to them. I’ve found it’s best to ask other people three separate times and in three different ways about what they have just said. “I want to understand as much as possible. What am I missing here?”

Can you be yourself where you are and still fit in? And: What would you do if you weren’t afraid? Or: If you died today, what would you regret not doing?

“What have you said yes to that you no longer really believe in?

“What is the no, or refusal, you keep postponing?”

“What is the gift you currently hold in exile?,” meaning, what talent are you not using

“Why you?” Why was it you who started that business? Why was it you who ran for school board? She wants to understand why a person felt the call of responsibility. She wants to understand motivation.

“How do your ancestors show up in your life?” But it led to a great conversation in which each of us talked about how we’d been formed by our family heritages and cultures. I’ve come to think of questioning as a moral practice. When you’re asking good questions, you’re adopting a posture of humility, and you’re honoring the other person.

Stand in their standpoint

I used to feel the temptation to get defensive, to say: “You don’t know everything I’m dealing with. You don’t know that I’m one of the good guys here.”

If the next five years is a chapter in your life, what is the chapter about?

every conversation takes place on two levels

The official conversation is represented by the words we are saying on whatever topic we are talking about. The actual conversations occur amid the ebb and flow of emotions that get transmitted as we talk. With every comment I am showing you respect or disrespect, making you feel a little safer or a little more threatened.

If we let fear and a sense of threat build our conversation, then very quickly our motivations will deteriorate

If, on the other hand, I show persistent curiosity about your viewpoint, I show respect. And as the authors of “Crucial Conversations” observe, in any conversation, respect is like air. When it’s present nobody notices it, and when it’s absent it’s all anybody can think about.

the novelist and philosopher Iris Murdoch argued that the essential moral skill is being considerate to others in the complex circumstances of everyday life. Morality is about how we interact with each other minute by minute.

I used to think the wise person was a lofty sage who doled out life-altering advice in the manner of Yoda or Dumbledore or Solomon. But now I think the wise person’s essential gift is tender receptivity.

The illuminators offer the privilege of witness. They take the anecdotes, rationalizations and episodes we tell and see us in a noble struggle. They see the way we’re navigating the dialectics of life — intimacy versus independence, control versus freedom — and understand that our current selves are just where we are right now on our long continuum of growth.

The really good confidants — the people we go to when we are troubled — are more like coaches than philosopher kings.

They take in your story, accept it, but prod you to clarify what it is you really want, or to name the baggage you left out of your clean tale.

They’re not here to fix you; they are here simply to help you edit your story so that it’s more honest and accurate. They’re here to call you by name, as beloved

They see who you are becoming before you do and provide you with a reputation you can then go live into.

there has been a comprehensive shift in my posture. I think I’m more approachable, vulnerable. I know more about human psychology than I used to. I have a long way to go, but I’m evidence that people can change, sometimes dramatically, even in middle and older age.

Since the 1960s, advances in resuscitation had helped to revive thousands of people who might otherwise have died. About 10% or 20% of those people brought with them stories of near-death experiences in which they felt their souls or selves departing from their bodies

According to several international surveys and studies, one in 10 people claims to have had a near-death experience involving cardiac arrest, or a similar experience in circumstances where they may have come close to death. That’s roughly 800 million souls worldwide who may have dipped a toe in the afterlife.

In the 1970s, a small network of cardiologists, psychiatrists, medical sociologists and social psychologists in North America and Europe began investigating whether near-death experiences proved that dying is not the end of being, and that consciousness can exist independently of the brain. The field of near-death studies was born.

in 1975, an American medical student named Raymond Moody published a book called Life After Life.

Meanwhile, new technologies and techniques were helping doctors revive more and more people who, in earlier periods of history, would have almost certainly been permanently deceased.

“We are now at the point where we have both the tools and the means to scientifically answer the age-old question: What happens when we die?” wrote Sam Parnia, an accomplished resuscitation specialist and one of the world’s leading experts on near-death experiences, in 2006. Parnia himself was devising an international study to test whether patients could have conscious awareness even after they were found clinically dead.

Borjigin, together with several colleagues, took the first close look at the record of electrical activity in the brain of Patient One after she was taken off life support. What they discovered – in results reported for the first time last year – was almost entirely unexpected, and has the potential to rewrite our understanding of death.

“I believe what we found is only the tip of a vast iceberg,” Borjigin told me. “What’s still beneath the surface is a full account of how dying actually takes place. Because there’s something happening in there, in the brain, that makes no sense.”

Over the next 30 years, researchers collected thousands of case reports of people who had had near-death experiences

Moody was their most important spokesman; he eventually claimed to have had multiple past lives and built a “psychomanteum” in rural Alabama where people could attempt to summon the spirits of the dead by gazing into a dimly lit mirror.

near-death studies was already splitting into several schools of belief, whose tensions continue to this day. One influential camp was made up of spiritualists, some of them evangelical Christians, who were convinced that near-death experiences were genuine sojourns in the land of the dead and divine

It is no longer unheard of for people to be revived even six hours after being declared clinically dead. In 2011, Japanese doctors reported the case of a young woman who was found in a forest one morning after an overdose stopped her heart the previous night; using advanced technology to circulate blood and oxygen through her body, the doctors were able to revive her more than six hours later, and she was able to walk out of the hospital after three weeks of care

The second, and largest, faction of near-death researchers were the parapsychologists, those interested in phenomena that seemed to undermine the scientific orthodoxy that the mind could not exist independently of the brain. These researchers, who were by and large trained scientists following well established research methods, tended to believe that near-death experiences offered evidence that consciousness could persist after the death of the individua

Their aim was to find ways to test their theories of consciousness empirically, and to turn near-death studies into a legitimate scientific endeavour.

Finally, there emerged the smallest contingent of near-death researchers, who could be labelled the physicalists. These were scientists, many of whom studied the brain, who were committed to a strictly biological account of near-death experiences. Like dreams, the physicalists argued, near-death experiences might reveal psychological truths, but they did so through hallucinatory fictions that emerged from the workings of the body and the brain.

Between 1975, when Moody published Life After Life, and 1984, only 17 articles in the PubMed database of scientific publications mentioned near-death experiences. In the following decade, there were 62. In the most recent 10-year span, there were 221.

Today, there is a widespread sense throughout the community of near-death researchers that we are on the verge of great discoveries

“We really are in a crucial moment where we have to disentangle consciousness from responsiveness, and maybe question every state that we consider unconscious,”

“I think in 50 or 100 years time we will have discovered the entity that is consciousness,” he told me. “It will be taken for granted that it wasn’t produced by the brain, and it doesn’t die when you die.”

it is in large part because of a revolution in our ability to resuscitate people who have suffered cardiac arrest

In his book, Moody distilled the reports of 150 people who had had intense, life-altering experiences in the moments surrounding a cardiac arrest. Although the reports varied, he found that they often shared one or more common features or themes. The narrative arc of the most detailed of those reports – departing the body and travelling through a long tunnel, having an out-of-body experience, encountering spirits and a being of light, one’s whole life flashing before one’s eyes, and returning to the body from some outer limit – became so canonical that the art critic Robert Hughes could refer to it years later as “the familiar kitsch of near-death experience”.

Loss of oxygen to the brain and other organs generally follows within seconds or minutes, although the complete cessation of activity in the heart and brain – which is often called “flatlining” or, in the case of the latter, “brain death” – may not occur for many minutes or even hours.

That began to change in 1960, when the combination of mouth-to-mouth ventilation, chest compressions and external defibrillation known as cardiopulmonary resuscitation, or CPR, was formalised. Shortly thereafter, a massive campaign was launched to educate clinicians and the public on CPR’s basic techniques, and soon people were being revived in previously unthinkable, if still modest, numbers.

scientists learned that, even in its acute final stages, death is not a point, but a process. After cardiac arrest, blood and oxygen stop circulating through the body, cells begin to break down, and normal electrical activity in the brain gets disrupted. But the organs don’t fail irreversibly right away, and the brain doesn’t necessarily cease functioning altogether. There is often still the possibility of a return to life. In some cases, cell death can be stopped or significantly slowed, the heart can be restarted, and brain function can be restored. In other words, the process of death can be reversed.

In a medical setting, “clinical death” is said to occur at the moment the heart stops pumping blood, and the pulse stops. This is widely known as cardiac arrest

In 2019, a British woman named Audrey Schoeman who was caught in a snowstorm spent six hours in cardiac arrest before doctors brought her back to life with no evident brain damage.

That is a key tenet of the parapsychologists’ arguments: if there is consciousness without brain activity, then consciousness must dwell somewhere beyond the brain

Some of the parapsychologists speculate that it is a “non-local” force that pervades the universe, like electromagnetism. This force is received by the brain, but is not generated by it, the way a television receives a broadcast.

In order for this argument to hold, something else has to be true: near-death experiences have to happen during death, after the brain shuts down

To prove this, parapsychologists point to a number of rare but astounding cases known as “veridical” near-death experiences, in which patients seem to report details from the operating room that they might have known only if they had conscious awareness during the time that they were clinically dead.

At the very least, Parnia and his colleagues have written, such phenomena are “inexplicable through current neuroscientific models”. Unfortunately for the parapsychologists, however, none of the reports of post-death awareness holds up to strict scientific scrutiny. “There are many claims of this kind, but in my long decades of research into out-of-body and near-death experiences I never met any convincing evidence that this is true,”

In other cases, there’s not enough evidence to prove that the experiences reported by cardiac arrest survivors happened when their brains were shut down, as opposed to in the period before or after they supposedly “flatlined”. “So far, there is no sufficiently rigorous, convincing empirical evidence that people can observe their surroundings during a near-death experience,”

The parapsychologists tend to push back by arguing that even if each of the cases of veridical near-death experiences leaves room for scientific doubt, surely the accumulation of dozens of these reports must count for something. But that argument can be turned on its head: if there are so many genuine instances of consciousness surviving death, then why should it have so far proven impossible to catch one empirically?

The spiritualists and parapsychologists are right to insist that something deeply weird is happening to people when they die, but they are wrong to assume it is happening in the next life rather than this one. At least, that is the implication of what Jimo Borjigin found when she investigated the case of Patient One.

Given the levels of activity and connectivity in particular regions of her dying brain, Borjigin believes it’s likely that Patient One had a profound near-death experience with many of its major features: out-of-body sensations, visions of light, feelings of joy or serenity, and moral re-evaluations of one’s life. Of course,

“As she died, Patient One’s brain was functioning in a kind of hyperdrive,” Borjigin told me. For about two minutes after her oxygen was cut off, there was an intense synchronisation of her brain waves, a state associated with many cognitive functions, including heightened attention and memory. The synchronisation dampened for about 18 seconds, then intensified again for more than four minutes. It faded for a minute, then came back for a third time.

n those same periods of dying, different parts of Patient One’s brain were suddenly in close communication with each other. The most intense connections started immediately after her oxygen stopped, and lasted for nearly four minutes. There was another burst of connectivity more than five minutes and 20 seconds after she was taken off life support. In particular, areas of her brain associated with processing conscious experience – areas that are active when we move through the waking world, and when we have vivid dreams – were communicating with those involved in memory formation. So were parts of the brain associated with empathy. Even as she slipped irre

something that looked astonishingly like life was taking place over several minutes in Patient One’s brain.

Although a few earlier instances of brain waves had been reported in dying human brains, nothing as detailed and complex as what occurred in Patient One had ever been detected.

In the moments after Patient One was taken off oxygen, there was a surge of activity in her dying brain. Areas that had been nearly silent while she was on life support suddenly thrummed with high-frequency electrical signals called gamma waves. In particular, the parts of the brain that scientists consider a “hot zone” for consciousness became dramatically alive. In one section, the signals remained detectable for more than six minutes. In another, they were 11 to 12 times higher than they had been before Patient One’s ventilator was removed.

“The brain, contrary to everybody’s belief, is actually super active during cardiac arrest,” Borjigin said. Death may be far more alive than we ever thought possible.

“The brain is so resilient, the heart is so resilient, that it takes years of abuse to kill them,” she pointed out. “Why then, without oxygen, can a perfectly healthy person die within 30 minutes, irreversibly?”

Evidence is already emerging that even total brain death may someday be reversible. In 2019, scientists at Yale University harvested the brains of pigs that had been decapitated in a commercial slaughterhouse four hours earlier. Then they perfused the brains for six hours with a special cocktail of drugs and synthetic blood. Astoundingly, some of the cells in the brains began to show metabolic activity again, and some of the synapses even began firing.