If I Understood You, Would I Have This Look on My Face?

by Alan Alda

  Even trained actors can open up in unexpected ways.

  I was invited to run a master class for actors at Ten Chimneys, a museum in Wisconsin that was once the home of the celebrated acting couple Alfred Lunt and Lynn Fontanne. I had already been spending a lot of time working with scientists, and it had been years since I’d taught improvising to actors, so I was eager to get together with them.

  They were maybe a little less eager than I was. They all had twenty or thirty years’ experience on the stage, but when they heard we were going to improvise for a whole week, they showed a slight air of hesitation, in some cases bordering on panic. One especially gifted actress admitted later that she was so determined not to improvise that she was thinking of faking a heart attack.

  I wouldn’t have known this unless she told me, because she made such an amazing leap in her work during one improvisation. The imaginary circumstances were as fraught as they had been with Dr. Furie.

  The actors were reading a scene from the Friedrich Dürrenmatt play The Visit. The actress played an older woman who comes back to her village to confront the man who had impregnated and abandoned her when she was a young woman. The scene calls for her to be full of unexpressed hatred. In the reading, both actors were committed and believable, but the idea was to see if we could go deeper using improv. What if we went back to the primal moment in their lives that prompted this scene, when they were in that place in the woods where he had abandoned her thirty or forty years earlier? This scene is not in the play, but I asked them to improvise the event when she realizes he intends to shrug her off and she begs him to marry her.

  At first, they stood looking at each other, just making up dialogue, as most everyone does to avoid being in the moment. When this happens, the words sound invented, unspontaneous—because when you’re making up dialogue, you’re thinking of what you’ll say next; you’re not focusing on the other person and reacting to them. I needed to get them to focus on something outside their own heads, so, coaching from the side, I asked them to use the imaginary environment, to make contact with the place.

  Within a few seconds, their focus was on where they were and on each other, not on themselves. Suddenly, they noticed it had begun to rain. When she asked him plaintively, “Don’t you want to marry me?” his answer was to wipe a raindrop off her nose. He laughed as if the raindrop were a funny little distraction, which drove her into despair. Real anguish came out of her.

  When the improv was over, they again read the actual scene written in the play. The first reading had been good; this time it was startling. Her tone now was venomous, her hatred far deeper than during the first reading. She wasn’t working from an intellectual understanding of the circumstances; she had actually just lived through a traumatic event from the past and it had changed her. The actress herself was surprised at how far she had been propelled by the improvisation. “I would’ve arrived there eventually,” she said. “But not like this, in ten minutes!”

  At Stony Brook, Dr. Furie had the same experience, and no less so because she wasn’t an actress. Acting wasn’t involved—at least not what people conventionally think of as acting. There’s no pretending in improvising. No deciding to behave differently. Instead, with our attention on the other person, and with a heightened ability to respond, we’re tuned in to the present moment; we’re in intimate contact with each other. It’s as though the raw, vulnerable tissue of our most private self is in contact with the same vulnerable self of the other player.

  We can sense what they’re feeling, and we have a greater awareness of what we ourselves are feeling.

  This is what is usually called empathy.

  I’ve come to see this connection with the other person as the bedrock of communicating. It’s surprising how effective this ability to tune in to others can be.

  CHAPTER 6

  Making It Clear and Vivid

  Bob Conn, the president of the Kavli Foundation, sat me down at breakfast one day and said, “Look, you can’t just work with graduate students. Most of them won’t be communicating with the public for years. There’s a crisis right now in communicating science. You have to start working with senior scientists. They’re out there now.” He was right.

  His foundation had been funding some of our workshops around the country, and his advice paid off when we went to the Kavli Institute for Nanoscience at Cornell and for the first time worked with senior scientists who were already communicating with the public. David Muller was one of them.

  David had recently made an important breakthrough in nanoscience. And while we were there, he made a breakthrough in communication, too.

  A few months earlier, David and a grad student had created the world’s thinnest piece of glass: only one molecule thick. They had achieved something extraordinary—a new way to understand the structure of glass—and their accomplishment was published in a few science journals.

  In our workshop, though, Muller discovered a new way of talking about the glass.

  As he told me later in an email, “The workshop was enormously helpful in helping us craft an effective story and understanding what did and did not resonate with folks.”

  That was probably because we actually gave the scientists real folks to resonate with. We had invited three nonscientists into the classroom, three intelligent people, from average walks of life. David and his fellow nanoscientists had to make clear to them what two-dimensional glass was all about. Before they could do that, they had to make them want to know about it.

  As David reminded me later, “This was something you keyed in on, when we were discussing the abstract. I think you said something like ‘Wait, that’s very unusual for a scientific paper, tell me about it.’ ”

  David and his student had made their discovery by accident. That had caught my ear, and I thought other nonscientists would find it interesting, too. While David and the student were working with a thin layer of graphene, an air leak had produced what they thought was “muck” but turned out to be glass. David realized he could begin his story with that very human moment of accidental discovery.

  “That helped me understand where people were and which ideas made good entry points to a discussion,” he said. “The accidental nature of the discovery helped people make an emotional connection, and I think that’s why it was picked up more widely than I would have otherwise expected. It is something we would not have emphasized at all in a straight retelling, but once we told the backstory, people got pretty excited.”

  Not only did he now have the human element of an accident to talk about, he had something else. Between the discovery of the glass and our workshop, his lab had been placed in Guinness World Records as the creators of the world’s first two-dimensional glass, giving him another popular hook on which to hang his story.

  With this new insight into what would capture the attention of laypeople, the next time he spoke to an interviewer about the world’s thinnest glass, the story was picked up by websites and newspapers all over the United States and the United Kingdom. He was able to talk about his discovery not just in terms that interested him as a scientist, but in a way that ordinary people would find interesting.

  He was even contacted by venture capital firms who had seen the media stories and were asking if he wanted to commercialize the glass. It was too early in the research cycle to take advantage of those offers, but, for me, David Muller’s story is an example of how good communication can make the difference between being noticed by a few technical journals and getting the attention of much of the rest of the world.

  David was making use of an increased ability to know what was in the mind of his audience as he told them his story.

  Just as in the mirror games, where the leader is responsible for how well the other person follows, he was taking responsibility for how well his listeners were following him.

  The surprising thing about this is that empathy and Theory of Mind—strengths that make this possible and that most of us seem to have natu
rally—are not called into play as much as they could be.

  Too often, reading minds correctly is just beyond our grasp, when in fact it can be one of our most powerful tools.

  CHAPTER 7

  Reading Minds: Helen Riess and Matt Lerner

  I have a friend who went to a doctor with pains in her foot. The doctor was kind and sympathetic, and when my friend described her symptoms, he dropped his head into his hands and said in an anguished voice, “Oh my God, it sounds like plantar fasciitis!” His tone was so miserable that my friend was afraid she had an incurable disease, rather than a pain in her foot that would probably go away with the right treatment. He had empathy, all right, but he was so swamped by feeling her pain himself that he left her out of the interaction. It wasn’t all that helpful.

  Most people agree that empathy involves putting yourself in the other person’s shoes and understanding in some way how they feel. But why would empathy lead to the doctor’s scaring his patient like that? I needed some help in understanding this and started searching for someone to teach me more about empathy. A TED talk online led me to exactly the right person.

  HELEN RIESS AND DOCTOR-PATIENT EMPATHY

  We sat at my dining room table with a cup of tea, sharing some berries and a bowl of nuts. Helen Riess had agreed to drop by and tell me about her work at Boston’s Massachusetts General Hospital. Helen is a psychiatrist who is helping to revolutionize the way doctors relate to their patients. I told her that I had initially been a little leery about the whole notion of empathy. She looked surprised. She said, “I want to tell you why I got so excited about teaching empathy.”

  Helen was asked to take part in a study of doctors during therapy sessions with their patients. The study was the idea of one of her students who wanted to see if the doctors and patients were really in sync. To test this, both doctor and patient would be videotaped in sessions and they would both be hooked up to skin conductance monitors. These are the devices that measure the minute amounts of sweat your skin gives off during moments of tension, or, as Helen said, autonomic arousal. This is the same technology used in lie detectors—machines that don’t work so well at detecting lies, but are good at showing emotional shifts like the ones Helen and her student were studying.

  At first, Helen was reluctant to get hooked up in tandem with her patient, but when she did, “It turned out to be a career-defining decision.”

  The patient was a young college woman who had a problem with weight loss. She and Helen were hooked up to the skin conductance device while the video camera recorded their session. “Later that afternoon my student called up and said, ‘You’ve got to see this.’ So I went down and I looked at our tracings. I was blown away. This very self-confident–appearing woman turned out to have massive anxiety.”

  She realized that they were generally in sync but their tracings had different signatures. The rise and fall of Helen’s tracings were smooth, whereas the young woman’s had a series of rapid spikes. Helen could see in the patterns of the tracings that although she had sat across from her, she had clearly missed reading the emotions the young woman was going through. She really didn’t know what was going on inside her patient. She showed the tracings to the young woman, who said, “I’m not surprised by this at all. I live with this every day, but no one has ever seen my pain.” Moved by this, Helen studied the video of the session more closely.

  Examining the spikes in the patient’s emotions, she could see the woman was having “these little leaks,” as she described them: leaks of emotion that didn’t necessarily show on her face. “She was very good at concealing them.” So, to see if there had been any physical signs of these emotions that she might have been able to pick up on, Helen checked the video for involuntary gestures. “I’d look to see what she was doing when she had these spikes in the tracings. And I saw these little tics, like throwing her hair back or doing this sudden chortle. I felt like an emotion detective.”

  Now, she was able to see things that had escaped her before. “I didn’t realize how much was going on internally until I saw the tracings. There we were in therapy,” Helen said, “and I had thought I understood her. She seemed very composed, but inside she was a wreck.”

  As I listened to Helen’s story, I was surprised that no one had tracked this kind of emotional gap between doctor and patient before. After all, I thought, the technology had been around for some time. Helen explained how one additional element had made all the difference. “Back in the sixties,” she said, “somebody had the idea of measuring emotions, but they were just measuring the patient.” Measuring the doctor’s emotions and tracking them alongside the patient’s was the critical new idea. When she tried it out, it made a huge impact on Helen.

  Now that she was more aware of her patient’s feelings, Helen could work with her in a way she hadn’t previously been able to. “As I paid attention to the signs and responded to them, our work went to a much deeper level,” she said. Finally, Helen was able to deal with her patient’s weight loss problem. “My patient unburdened herself emotionally—and she started to exercise for the first time in her life. And this woman who had only gained weight and never lost weight before went on to lose almost fifty pounds.” As much of a breakthrough as this was for the patient, it was also a breakthrough for Riess: “I realized that with this careful attention, I had learned to be more empathic,” she told me.

  It launched Helen on an effort to teach other doctors how to be more empathic with their patients, as well.

  SWAMPED WITH EMOTION: “AFFECTIVE QUICKSAND”

  I wondered how Helen taught doctors to avoid some of the pitfalls in empathy. For instance, the doctor who had become so caught up in my friend’s plantar fasciitis was clearly an empathic person, but had managed to scare her. He was feeling what she felt, but he seemed momentarily swamped by it. What did Helen teach doctors that prevented that?

  “First, I introduce them to the idea that we’re wired to read other people’s minds. That we can get under a patient’s skin.” She took a beat. “And that we also have to get back out.” Doctors, she said, can be trained to regulate their own emotional response and avoid what she calls “affective quicksand.”

  This was the quicksand my friend’s doctor sank into when he was so caught up in imagining the pain in her foot (pain he himself had once experienced) that he reacted as if it were happening to him right then. He was not regulating his own emotions and as a result was swamped with empathy.

  Helen’s experience after being hooked up to her patient points to the idea that empathy (without the quicksand) is a step toward a good therapeutic connection. And it seems to me that it’s the kind of connection we need to establish to speak with clarity to an audience. In fact, it seems central to good communication in general.

  MATT LERNER: COGNITIVE AND AFFECTIVE EMPATHY AND THE AUTISTIC SPECTRUM

  There is a group of people notoriously poor at reading the minds of others: children and adults on the autistic spectrum. As I looked through the literature, I came across a researcher who had been working with kids on the spectrum for several years and getting remarkable results, and he was doing it by having them play improvising games. I had to meet him.

  I visited Matt Lerner in his lab at Stony Brook University on a warm spring day that was a relief after a harsh winter, but as soon as we sat down in his office there were no pleasantries about the weather. We plunged immediately into excited talk about communication. I told him how I had come to think of empathy and Theory of Mind as fundamental to communication. “Right,” he said. “Cognitive and affective empathy…which, by the way, is what we’re doing right now. Nodding and smiling as we talk.”

  He told me he did a lot of work with kids on the spectrum who, while they’re fine at empathy, do sometimes have a problem with more complex and subtle aspects of Theory of Mind. “They’re an example of how this fundamental task gets disrupted,” he said. “But the principles really apply to everybody.”

  I asked how h
e got started working with autistic kids, and he told me about a single day that had launched him on a life of discovery when he was only twelve years old.

  Matt and his younger sister visited her friend’s house. Matt noticed that in the other room, a two-year-old was sitting on the floor playing by himself. The boy’s mother could see that Matt was interested and explained that her son, whose name was Ben, had a problem that had something to do with autism. Curious, Matt asked if he could go in to play with the boy. She said he could, but she assured him he would be very bored. And in fact, when Matt sat down next to Ben, the boy never looked up or acknowledged his presence.

  Okay, Matt thought, he can’t really get into my world, so I wonder what’s going on in his world? Ben was playing with a toy car, running it back and forth. Matt decided to mirror what the boy was doing.

  “I started doing the same thing,” Matt said, “running a car back and forth.” He could see that Ben noticed, but still, the boy wasn’t paying much attention to Matt—until Matt deliberately did a slight variation on a motion Ben had made to see if the boy would notice it. And he did. This was the first, slight moment of connection between them.

  Matt was with Ben for the next two hours, following him around the house, mirroring his activity, sometimes varying it slightly to get the boy’s attention. At the end of the day, as Matt left, Ben looked up at him and said, “Matthew.”

  At least, that’s how Ben’s mother remembers it. Matt doesn’t remember if the parting moment was actually that dramatic, but something surely clicked between them that day.

  Matt continued to work with Ben through Matt’s high school and college years, trying to find ways to help him get along in the world. In his early years, Ben’s social skills were impacted, including some very basic ones. For instance, he had trouble with beginning conversations when people said “Hello” to him. He knew a book by heart that began with the word “Hello,” though, and if you said hello to him, he would answer, “Hello, Mickey. It’s me, Donald. It’s nice to see you again.” And if you didn’t stop him, he would recite the whole book.