Vic Strecher: Living with purpose

Vic Strecher: I build apps as part of my living and I know how to create different apps to help people make changes in their lives, so I created Purposeful in an effort to reach millions of people, it'd be nice to reach people because I really believe that overall the world has increasingly lost purpose become what we might call nihilistic, and at the same time more narcissistic, more focused on me, me, me, me, me, and my own problems and my own desires all the time. I think when you start thinking about other people, you build a stronger purpose in your life, and also in doing research on purpose with some of the most amazing impressive colleagues from around the country that I've ever worked with, we found now that people with strong purpose live longer.

Host: Hello and welcome to population healthy, a podcast from the University of Michigan School of Public Health. Join us as we dig into important health topics, stuff that affects the health of all of us at a population level, from the microscopic to the macro-economic, the social, to the environmental, from cities to neighborhoods, states to countries and around the world. Vic Strecher, is a professor of Health Behavior and Health Education at the University of Michigan School of Public Health, renowned for his work in behavior change and digital health, his main research and passion has become helping people to find a greater sense of purpose in their lives. He's authored two books on the subject, which have been used everywhere from Stanford Business School to the largest Texas State Prison to create an online course and to create the purposeful app all aimed at helping people live with purpose. For Strecher, this could not be a more personal mission.

VS: Before my daughter passed away 13 years ago, I hadn't thought about purpose at all, there were a couple of researchers I knew who were doing some research on purpose, but I thought I was such an esoteric and ethereal subject, I thought, How do you measure purpose and is purpose really all that important? And then when my daughter, Julia died very suddenly and unexpectedly of a heart attack when she was 19 years old, I went through a period, as you might guess, of deep grief and then depression, and I found myself in a kayak on Lake Michigan, two miles out at 5:15 in the morning, and I was thinking about continuing the 84 miles more to kayak to Wisconsin, which I probably would not have made of course, but it was a beautiful morning. It was very, very calm, and it was so beautiful and smooth, it was also in the spring time, and it was a very, very cold, and I found myself out there without any life preserver, in fact, I hardly had any clothes on, I felt like I was dieing and I felt like I was completely out of control in my life.

VS: And very suddenly, the sun came up, and when the sun came up, it felt like there are all of these gold flakes around me, sparkling. I don't know how to explain this, but I felt my daughter, Julia, in me, and I felt her talking to me, and she was saying, Dad, you have to get over this, you have to get over your grief, and you have to start transcending and doing something different in your life, you have to lead your life in a new way, I felt that very strongly when I was two miles out on lake Michigan, I could barely see the shore, and I realized that is at a crossroads in my life 13 years ago, where I could continue on to Wisconsin, which of course, I never would have made. Or I could turn around. But if I turned around, went back to shore, I'd have to change my life. It was an interesting experience, even that very choice that I had to make or that I was allowed to make, I could either live or die, and I felt I had that agency, suddenly I had that ability to make a decision because during this period of grief, I felt like I wasn't in control of my life at all, and I was just kinda going through the motions.

VS: I got back, sat at the kitchen table, pulled out a sheet of paper, and I said, What can I do to change myself? And I said, Vic, you're gonna die, you're gonna die if you continue in your ways, you need to fix yourself. And you're in deep, deep trouble. So I started suggesting things to me, and the first thing I suggested was write down the things that matter most in your life, just write them down, and I don't know how I came up with that, but I just started thinking about those things that mattered, and so I wrote down our older daughter, Rachel, my wife Jerry, our friends, my students. I start thinking, okay, how about the different domains in your life. And so I wrote down, of all the things I do at the University of Michigan, I think the most important for me is teaching, of course, my research is important and I love doing research, believe me. But I feel like teaching my students is number one for every one of those, I started writing a little goal, what I call be-goals, I'm here to be this person, I thought to myself, if I'm gonna reshape my life, I'm going to do it by discovering what I wanna be now in the future.

VS: So looking out with a future orientation, having a vision of myself in the future, the possible selves that I could be ranging from dead to, I could be this, I started writing down what I call be-goals. And my be-goal for teaching was to teach every one of my students as if they're Julia, I started thinking, What would I want the parents of each of these students to think as I'm teaching them, you know, as if I were their parent, what would I want? What would I hope for through my teaching? If I have a student, for example, who's going through a rough time, if a student is falling behind, if a student has all the pressure from parents to become a doctor since they were a baby, and yet he's getting a D in Organic Chemistry. What are all those students going through and how could I treat them as if they're Julia my own daughter? And once that happened, my whole life changed, I had a purpose in my life, but I found I was repurposing my life to a life that was much more vivid, much more directed. My goals started becoming much more organized, and that's what a purpose is, it's a self-organizing life aim or life aims that you have, so I might have a purpose around my family, which I do, I have purpose around my work, I have purpose around my community, and I have my own personal growth purposes.

VS: And they're all interconnected as well. I don't think about work-life balance because I don't think it's a zero sum game. I think that I'm so happy that the kind of work that I do allows me to try to build myself as well as a human being, to learn more about myself, learn how to control and manage emotions better, learn more and think about philosophy.

Host: Research by Strecher and others has shown that not only does a greater sense of purpose increase people's feelings of emotional well-being, it can even affect how DNA expresses in the body leading to actual physical health improvements.

VS: One of the things that we've discovered, nobody knew this when I was in college or getting my Master of Public Health degree, was that on top of this DNA, which is kind of like our hard drive, is almost a vinyl record that can get worn out and we might call it our epigenome, and it relates to something called methylation, and I don't think we have to get into detail about that, but the idea here is that our experiences in our lives, the type of stressors we have can actually influence how our genes get expressed so while we have this hard drive, we also have this vinyl record on top that can get worn out and our genes can get expressed differently even if we have the same genome, in other words, two identical twins can go through life, one twin may end up having a very stressful life, the other twin may not have a stressful life, and their epigenome is different, and now using artificial intelligence, you can actually look at patterning of that gene expression and create clocks, clocks around specific outcomes, whether there are mortality outcomes, whether there're disease outcomes.

VS: One outcome might be dementia, another outcome might be heart disease or other cardiovascular diseases, there are now 14 epigenetic clocks in what's called the Health and Retirement survey, and so I thought, Wow, these clocks are now out, and we have longitudinal data on people's purposes, let's take a look at purpose in life by the epigenetic clock and sure enough, purpose is predictive of these clocks. I'm fascinated by that. Now, there's a much bigger question, which is, do people live longer? Are they less likely to develop dementia? There are now eight studies that have shown that at retirement, people with a strong purpose are roughly 1.5-2 times less likely to develop Alzheimer's. Imagine if that were a drug, the current drugs that are out there are horrendously expensive, and they produce just a fraction of that impact. If they do at all. Now, here we have something that's essentially free, I could build a stronger purpose in my life.

VS: We find that people with stronger purpose take better care of themselves, they are more likely to get screened for breast cancer or prostate cancer or colorectal cancer, et cetera. They're less likely to spend time in the hospital. And this is controlling for everything imaginable, education, income, race, your health status, your health behaviors, we can't make these effects go away, people with strong purpose, just simply, take better care of themselves, are less likely to smoke, they're more likely to eat better, they're more likely to work out, we've asked people to think more about their purpose, and we find indeed, that they have much better health behaviors afterwards monitoring it by things like accelerometery. We also look at what's going on in the brain, we find that as you're thinking more about your purpose, a part of the brain called the ventromedial prefrontal cortex, which is right in the front of your brain, right behind your eyebrows, we have three times more prefrontal cortex than our closest ancestors, the chimpanzees and other forms of primates, we have three times more. And we have more of this ventromedial prefrontal cortex right in the front than any other animal by far, that part of the brain relates to, for example, future orientation, I think about myself in the future, What are my possible selves, that's where that goes on.

VS: I think more about my values and way different core values in my life that goes on in the ventromedial prefrontal cortex. I make better decisions, that goes on right there. And at the same time, more activation there is associated with less activation in the amygdala, which is associated with fear and aggression, think about COVID, it comes out, suddenly everyone's freaked out and some people are running to the stores, going into bunker mode, and there are other people though amazingly, who say, You know, our neighbor is 75 years old and she's by herself and she's scared, now what are we gonna do for her, or could we bring food over to the hospital because hospital employees are just going crazy right now. So could we support them? There are really different pathways people can take in their lives, I do believe that people have choices, and I think that if we can improve people's sense of purpose in their lives, that they tend to start making less fear-activated choices. They make choices that are actually much healthier for them, in being healthier for their community, for their society, for their families, for others. And so in that sense, I've found through my research and through many other people's research that may be a root cause of a lot of the changes we make in our lives, which is what we're trying to do in public health, we want people to get immunized, we want people to quit smoking, we want people to eat well, work out more.

VS: We want them to transcend, we want them to be kinder to other people, we want them to view others in a more equal way, et cetera. All of those are related to purpose, and you can have people think about purpose and you see changes in those things. So it becomes a root cause going upstream further and further and further, rather than these surface level models that I was so used to teaching about and using in my research, if I could start going upstream and helping people find greater purpose and direction, I thought maybe I could make a bigger impact. And by the way, a lot of people tell me, Well, this is just for people at the top of Maslow's hierarchy, for people who have everything else... It's almost the opposite. Purpose gives people hope. Purpose and having a vision give people hope for the future, and that's absolutely essential. And we see people who are impoverished doing anything they can to have a purpose in their life and find purpose and direction in their lives, so helping facilitate that can become a starting point for a more positive life.

Host: Although purpose is related to goal setting, there are some very important differences...

VS: Well, I think that purpose is aspirational, I mean to teach all of my students as if they're my daughter, Julia, is aspirational. It can't be real. I mean, I have hundreds of students and I have lots of people who have graduated, and I just can't be that person, but I can aspire to be that person, I can prepare in the morning to be that person, I can be more intentional in my life rather than letting life just jostled me around, I can try to wake up in the morning just as I wore a rain coat this morning because it was raining, I do so many different things we all do. So how do we prepare for those things on a regular basis? Those are aspirations.

VS: Let's take athletes, for example, I work a lot with both college and pro athletes, and one of the things I find, especially among college athletes, is that the majority of them who were aspiring to be in the NBA or Major League Baseball, NFL don't make it. And what happens to them when they spent their entire lives with the purpose of getting into that Pro Sport, and then suddenly they don't make it. Severe depression can happen after that, even those who do make it, then they've made it, they've made millions of dollars, and then they retire and they go, Wow, what do I do now? I love working with people like that. They totally understand that the achievement suddenly is hollow, that making the money turns out to be hollow, they're still very unhappy, in fact, sometimes they're less happy than they were while they were striving for that goal.

Host: If having a strong sense of purpose can do so much towards achieving healthier life with better self-care, better habits, less stress and less risk, how can we all begin to find and implement that purpose into our own lives? 

VS: So if you're thinking about re-purposing your life or trying to build a stronger sense of purpose in your life, you might start in the way that I did with a sheet of paper and a pencil or pen, and you start by writing down what matters most. You might think about different domains in your life, do you have a family domain that matters to you, do you have a work domain that matters to you, a community domain, community can be the world or it could be your very local neighborhood. Do you have personal growth goals as well, or that domain within those, write down what matters most. At work it could be your co-workers that you care about, it could be the customers that you work with, it could be the product that you're building, I would suggest that just about anybody can find purpose, through any kind of job in terms of your family, can you look at your family and those people who are familiar to you in new ways? I think that's important. And in your community, can you think about what you might be able to do in your community? If you have a family, are there things that you could build as a purposeful family that relate to your community, could you volunteer on a regular basis as a family, so that your family says, We are a unit. We have a purpose. Imagine growing up in a family like that. Wouldn't that be awesome? Those people coming out are going to want their families to have a stronger purpose as well.

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