 Okay, looks like we're there. Good evening everybody. I'm Sarah Long. Thank you for joining us tonight. I'm the chairman of the Bedford Playhouse and tonight we're gonna be joined by Dr. Andrew Solomon for a conversation about COVID and the mental health prices and talk to him about what's going on with our situation right now and what's been going on with him since we last saw him at the Bedford Playhouse with his film, Far From the Tree. I just wanted to say a few words about the Bedford Playhouse. Tonight we have over 100 people visiting with us and listening to Andrew's talk. And many of you don't know anything about the Playhouse and found us through our advertising this program. We are a nonprofit in Bedford, New York. We are an arts center that is about trying to bring arts and culture and conversation to our community. And we've been closed now since March and trying to keep the conversation alive via any way we can. And we're starting some outdoor programs. We've been doing drive-ins and we're gonna start some music programs outside. But presently we're doing as much as we can online. And if you visit bedfordplayhouse.org you can see the other programs that we've been doing and we'll continue to do so. And I hope that if you've enjoyed that what you're seeing tonight or if you do enjoy it, you'll think about joining us, become a member or sign up at least for more information about the programs that we have coming up. So tonight, while we are talking to Andrew, if you have any questions you'd like me to ask him, you can use the question and answer feature on the webinar page here. Please don't use the raise the hand function because we won't be looking at that if you put something in the question and answer function. My friend here Emmett will be writing them down and handing this to me and I will be asking Andrew some of the questions. So please do that and I'll be asking them a little later on in the talk. So I think we were just waiting for a group. I think we've got quite a few people in so I think we can probably start. So let me just start. I'm just gonna talk about Andrew Solomon. Andrew is a writer and lecturer who specializes in politics, culture and psychology. He is a National Book Award winner and an activist with LGBTQ and mental health. He is a former president of Penn America Center and he is a professor of clinical psychology at Columbia Medical Center. His book, Far From the Tree, which actually I have right here, is a bestseller and has been translated into 10 languages and is being translated into more every day. It also was turned into a documentary that has been seen around the country and we had at the Bedford Playhouse and Andrew was good enough to visit us twice and do some speaking about it. He also won the National Book Award and got was a Pulitzer Prize finalist for his book on depression, Noonday Demon. That was translated into over 24 languages and as I said, was on the shortlist for Pulitzer and won numerous prizes. He has written novels as a contributor to many, many magazines and is quite well known. So he has podcast. He's got more things than anybody could read. So I hope you enjoy our great conversation tonight. Please welcome Dr. Andrew Solomon. Good evening, Andrew. Welcome. Good evening, Sarah. What a thrill to be here again and for your wonderful playhouse. Thank you so much for joining us. As you may have heard, we have a lot of people tonight who are fans of yours and we have a lot of people who've been fans of the Playhouse who came to see you again and maybe a few who didn't see you the last time but I'm very pleased to see that not only are some of your people who wanna see you again coming but also some people of the Playhouse are gonna learn more about you. So I'm really excited that you could join us. So thank you so much. So the first thing I wanted to say is that it's been fascinating to watch what's been happening with your career doing this COVID because you're so prolific anyway but you've become kind of the COVID go-to for mental health questions. You've seen to be every few days on a new podcast or newscast or article or op-ed, anything. I mean, I see you everywhere and anywhere and I'm curious how that happened and how you're feeling about that now that you're the person who knows the most from the health issue. It's been a kind of slightly shocking process. Of course, when COVID began, there were no experts on COVID in mental health because it was a completely new situation. There was nobody who had experience in really the mental health issues connected to pandemics except on a much smaller scale than the one that we're encountering now. And I felt like a lot of what needed to be expressed wasn't being well expressed. And so I wrote a first piece in which I tried to put forward some of the arguments that I thought were relevant and necessary into the interest. And the aftermath of that was that I started getting hundreds of letters from people who were dealing with mental health issues during COVID. And then I started being asked by other publications whether I would write for them on the subject. And it grew out of nowhere and out of nothing into somewhere and something. But it did draw on my experience with depression both in my own life and in what I've written about. And what came out of the depression book even though I haven't chosen to go back and write another book about depression, I wrote a long extra chapter which is in the new edition of the paperback a couple of years ago. And I've ended up being very engaged in questions of mental health in general. And it looked at mental health issues in connection with immigration or with sexuality or with gender or with the topics that I looked at in far from the tree which ranged from schizophrenia which is obviously a mental health issue to autism which has some elements of mental health concerns attached to it to looking at topics like criminality and so on which are clearly not essentially about what we've defined as mental illness in any case but which bear on questions of mental health. And I just felt from all of the work that I had done on those topics that I was ready to address the questions that are coming up now. So just as an aside, so you added a chapter to Noonday Demon, you're saying? Yes. And did that chapter then get published in all the languages and new copies in every language now as all the new prints are going to have that chapter in addition? Many languages chose to translate it and to add it and some just said it was too expensive to reissue the book. You know, it would have had to be redesigned and it needed a new index and there were all kinds of other issues that were daunting to publishers in some languages but certainly in, I mean the British edition has been, has it in the Brazilian edition? I sell a lot of books in Brazil. The Dutch edition, a number of others, the German edition, the French edition. Interesting. Okay. I didn't realize that it was an edition that people were publishing. I thought it was something that they could go to your site and look at but I didn't realize it was actually getting into books if it was being redone. It was actually my Brazilian publisher of whom I'm very fond who got in touch with me and said we're reissuing the book in Brazil in a new edition. Would you write a brief introduction that sort of comments on what's happened since the book was published? And the brief introduction ended up being 120 pages and he said, I must remember not to ask you that again. Well, you don't write short books. I don't. Well, that's why you take a long time, right? That was a 10 year journey, I think, right? It was and the current one seems to be another 10 year journey. And then after that, I want to go to writing sort of, I don't know, quick graphic novels or something along those lines. Okay. So tell me, during this, the COVID as you've started writing and speaking to people about it, what has been your, what has been the most common theme you found in your discussion? People, what was the thing people are finding most difficult, do you think, during this period? Well, I think part of what people find difficult is that they don't understand how broad these problems are right now. Approximately a third of Americans are currently experiencing symptoms of clinical depression or anxiety for both. And so it's a very widespread problem. And a lot of them are people who haven't experienced those symptoms before and don't know what to do about them. And so there's a feeling of kind of mild chaos. And of course, even for people who are more inclined to access mental health services. And there are many people who for a variety of reasons, political, economic and so on and so forth don't have the same level of access to mental health care. But even among the people who are open to it, accessing mental health care during this time of COVID is very difficult. Particularly if you haven't done it before and you're sort of starting from scratch. So I argued that there are essentially four responses to COVID. There are some people who are essentially very naturally resilient. Their response is a very resilient one and they're going on about their lives and doing essentially just fine. There is a large group of people, probably the largest group of people who are experiencing some degree of anxiety and some degree of depression, but who basically need what I would describe as a kind of psychiatric first aid. They need to regularize their sleep. They need to regularize their eating. They need to regularize their exercise. They need to stop watching news quite so obsessively. They need to take a variety of measures that will essentially improve their essential mental health. But they aren't actually dealing with the clinical condition. Then there are many people who have never had a clinical diagnosis before, but who may have had mild subclinical anxiety or depression who are now suddenly finding that they are completely overwhelmed and that they can't cope. And I always say that the opposite of depression is not happiness but vitality. And there are many people who are finding themselves completely drained of vitality during the current crisis. And then finally, there are the people who already had a mental health diagnosis and who have suffered with that diagnosis in the past and who perhaps had an underlying level of dysthymia or who had a depression that was being just held in check by medication. And those people are in many instances now finding circumstances very triggering. And so they're having what some clinicians call a double depression in which they have the basic underlying biological tendency that they've dealt with over a long period of time exacerbated by current circumstances that would make anyone feel more depressed than they mostly have. So, and then you put them all in a house together where they can't leave and you've got a real problem. Well, you've got these two real problems and I think people in each situation are slightly jealous of the ones in the other situation. You know, some relatively large body of people are sheltering alone and the isolation and the desolation and the closeness and the loneliness that are involved in that are enormous. As one friend wrote to me just yesterday, he said, even for someone whose basic tendency is introspective rather than social this is getting to be a bit much. And so there are people who are experiencing that isolation some of them because they're single people who live alone some of them because they're stranded somewhere. I mean, I have one good friend whose husband has a job in LA she has a job in New York they had a commuting marriage they haven't seen each other since March each of them is living in an apartment alone. And then you have the other problem which is that people are sheltering with a group of people from whom they have no respite and no escape usually family, they're not always and so you have a large number of people who are at home with family members and if they have an argument with or a disagreement with those family members they have nowhere else to go and though they may telephone or Zoom other friends they essentially can't escape the context in which the difficulty is occurring and they don't even have the natural breaks that take place. I mean, I have my children with me which is fantastic but in ordinary real life they would go to school they would go to camp they would go to play with friends and in some ways it's been a glorious luxury having all of this time that we can spend together but in many ways the fact that they don't have any external circumstances has forced a kind of frantic intimacy on us that sometimes is difficult to deal with and to negotiate and when I was doing my original work on depression I went to look at depression among the Greenlandic Inuit and my feeling when I went to Greenland I was trying to look at the idea that depression was not a modern Western middle class phenomenon. My assumption when I went to Greenland was that people got depressed there because it's so cold and dork all winter but what I in fact found was that people in Greenland are quite well adapted to the climate and to the sort of cycles of the sun and that it doesn't bother them very much. The problem is that traditionally they lived in igloos which are tiny. I don't know how many of our viewers this evening have ever been in an actual igloo but they are really small and now they live in Danish pre-fab housing because that's what's available to them and there's no natural source of fuel in Greenland there aren't even trees to burn, et cetera, et cetera. So what happens is that people go into these small houses with their whole families and they go in in October or November and they don't leave until April. And so essentially imagine if you were living with everyone you're related to including your mother-in-law and a difficult great aunt and you're all there and none of you can ever get away from any of the others because it is too cold and too dark ever to leave the house except in whatever fashion you do to get food. And I found that it was that enforced intimacy and the emotional repression that went with it and the attempt to sort of accommodate one another that actually had generated such an enormously high rate of depression among the Inuit and I thought at the time it was an exotic and almost unimaginable experience and now it is the reality for most Americans. Amazing, you're talking about that. It's something when I first read that research that you did it rang so true to me because I just, well the first time I was in a country in which it was light all night I thought this I could imagine but I could never imagine when I read that living in a small place with that many people for so long that just seemed crazy to me. That would be mad, I would go mad, I would go mad. So tell me how have we seen the rates of suicide? I mean, I know we have seen so many things not rise because we don't know the numbers because people are not going to get the wellness checks, people are not going to, domestic violence has gone up, we're not getting the right numbers because emergency rooms are not getting people in at the right rates and we're not getting real time data but do we know numbers on suicides and do we know what's happening in that in comparison during the COVID in relationship to the conversation we just had? Suicide statistics always take a long time to amass. They're based on all kinds of population surveys. What we do know is that while a large number of deaths are being recorded that are directly attributable to COVID I mean are a direct consequence of people having the virus and dying from it that the actual change in the rate of death in the United States is much higher than is accounted for by the known cases of COVID. And some of that is because people are dying in COVID who have not been diagnosed with it and some of it is because people are not seeking appropriate treatment for other conditions because they're afraid of going into hospitals and there are a lot of other explanations but one of the explanations is suicide. I had a terrible heartbreaking letter a few days ago from someone who wrote to me and said that she had been in constant touch with her best friend who had already had some history of depression and who was finding the isolation unbelievably intolerable and they had been discussing strategies for it and she had suggested as indeed I suggest to people in that situation that while the risk of COVID is real the risk of dying from mental illness is also real and if the risk of dying from mental illness can be ameliorated by expanding your bubble and interacting face to face with some additional human beings sometimes that is worth the risks that are attached to it terrible that those risks are and important though it is that most of us avoid them. This young woman chose not to do that she did not go and meet other people she just lived by herself and she hanged herself the week before the woman who wrote to me wrote and I think there's much more effect going on than has been published or publicized I think it will be a long time before we have the numbers but I think it's widespread. It's terrible story and I think you're absolutely right. Tell me about, in talking about that it reminds me of, I'm not sure I might have read it on one of your newsletters about the importance of touch and one of the things when people are not living with when they are isolated and living alone not with other family members how the possibility that like that woman just going to see people or entering out even though it might have been dangerous for COVID reasons it was more important for our mental health maybe to explore the world outside even if it might have been dangerous how touch can actually be something that actually can heal you and that your endorphins and your serotonin levels and how that can actually help your mental health. Can you talk about that for a few minutes? There is a field of study of a phenomenon called touch deprivation which has shown that people who are denied the opportunity to have physical contact with other people people who are not embraced, people who are not touched people who are not held and so on and so forth people who are deprived of touch develop a great many pathologies some of them are psychopathologies people are more likely to become depressed but also your immune response is lowered which is not so great in the current epidemic to have a low immune response make your more prone to a variety of other illnesses ranging from diabetes to a heart attack there are all kinds of ways in which human beings require the touch of other human being it helps if you have a cat or a dog because even that kind of touch can make an enormous difference but the kind of touch that really matters is the touch of other human being and there are people who have been described as dying of touch starvation when they really have been deprived of touch for a long time and have had these other conditions come bubbling up in them it's dangerous to your health to go untouched and so we tend to think of, you know it would be very nice to be able to hug grandpa but if I can't I'll just wave actually there is a point at which that becomes a reliability. I remember there are these I mean I've seen documentaries on these people who come over and will lie on top of you and I know there are programs for young people doing OT where you kind of hold your child very tightly to press on their bodies and I've seen documentaries about people that are paid to come over and literally lie on people just to touch them, you put their hands on them just to give them physical touch because they're people who need that and it's fascinating this whole world of study now it's becoming very, very serious medical study area. Yes, it has become a very serious area and it's been demonstrated for example among people with autism that some of them really enjoy having the pressure of another body and that it can make a great deal of difference to how well they're doing. Some people with autism have poorly human touch and some people with autism like the feeling particularly the feeling of pressure and at Temple Grandin famously invented a machine which is a hugging machine that some people with autism use and you sort of get into it and it just presses on your body from all angles and some people find it helps to center them again and it gives them a greater ability to then go out and interact with other people. So that's machine touch which works for a specific population but in general it's really a question of human touch and it's certainly not just for people who have got another diagnosis. I think human touch really, I mean there's a reason why married people tend to share a bed and there's a reason why widowed people often feel not only bereft of the companionship of the person whom they were attached to and so on but of having another person to touch in the night. You know, it's interesting because although you say it's much more important of course the human touch everywhere you read that there's been more animal adoption now than ever because of this and which is wonderful for all the animals in the world and wonderful for people who are lonely getting animals and I'm curious it is also probably good for people who need that regulation you were talking about before because certainly I found that one of the most difficult things for me was the dysregulation. I could not work days were weekends nights were days I could not regulate myself at all but an animal makes you regulate just like a young child does you have to feed them at a certain time you have to walk them a certain time and I'm sure that that having an animal adopting an animal for someone not only does that give them a purpose for someone with depression or mental illness that gives them a purpose they have someone to live for or do something for but they also have to regulate their schedule. Can you have you have you done much researcher heard much about how that is affecting patients with mental illnesses? Well I've seen it actually even in looking particularly at the situation of children there are many children who hated doing online schooling and many children were not crazy about school whether it's online or in person who have talked about how this summer they wish that there were school they wish that they were back in school because irritating though the online schooling may have been in a whole variety of ways it gave them a shape to their days and they knew which days they had French and which days they had math and what was due on Wednesday and there was a lot of structure involved and now many of those children especially if they have parents who are working are essentially they're not going to camp and they're being left to run feral and they're spending hours and hours on their iPads and so on and so forth which is perfectly understandable and may in fact be the best thing that can be arranged for them at this juncture but it's nonetheless very disorienting for them not to feel that different and as you've just said I mean Saturday is not very different from Friday in a lot of households now and you know if the children want to sleep until 11 o'clock you sort of think okay, sleep tight, have a nice time I have some stuff I need to do and so there's a kind of disappearance of any external structure in principle and I think children are sort of as it were the canaries in this coal mine that their inability to deal with all kinds of things and their sort of sense of being overwhelmed by a lack of structure translates into that for many other people so I think it's very difficult right now to be asked to go into a job where you have to show up in an office or a factory or wherever it is that you need to show up and have to go into a job where there is no opportunity to protect yourself as you would wish to do against COVID but I think for the people who are working from home I mean work becomes, as you say, bound-free less you have work you could be doing until late at night you have meetings at strange hours you have people who didn't make a particular call were nicely dressed from the waist up but not from the waist down I mean the whole situation is so bizarre and disorienting and you know I talked to one mother recently who said that of her two children she said one had refused to get out of his pajamas for a month and the other one had ordered a cow suit on Amazon and was wearing it all the time as a sort of demonstration of just kind of I can do whatever I want to now I think that the children and the parents are struggling with this. We have an employee who had a 12 year old and a three year old and I just couldn't think of anything more difficult you know my children are all at least within two or three years of each other and they're all over 16 it's a lot different when you have such age gaps and I think the younger children it's so difficult right now I felt so much for her and everybody with younger children it's so difficult and for these people living in apartment who can't even get outside in cities and places like that it must just be awful. It's also you know a lot of children's maturing processes are tied to human interaction and to their interactions especially with peers and what we have tended to regard as health and social development is contingent on their going between the sort of safety of their family assuming the family is safe which optimistically I think it's at least often the case out into the sort of more vulnerable realm of peer interactions and then coming back to their family and children who are deprived of that alternation and who are only kept at home in a sort of safe area those children don't do very well. So how can people help that? I mean help alleviate or you know keep that from not stunting their children's growth in that area it's kind of like well if your kid's gonna be in a brace they're not gonna learn to crawl. I mean it's almost like saying they're gonna miss those steps that are required. How might you recommend or how can people try and figure out that social for a young child they're not getting on Zoom calls. You know how can you try and do that for a young family who don't have neighbors that they can Zoom with or look through the glass and giggle through their windows. I mean I don't understand how you could do that. You have any recommendations? Well I mean many children actually even relatively young children are doing some form of Zoom calls. They're talking to one another through my playing online games together and so on and so forth. But for really little children I think the question has to be whether you can expand your bubble enough to include a few children outside of your family who are the same age as your child. And there are many ways of structuring that and it is not as I said risk free but if you can say okay you know our child needs to have at least three other children with whom he has play dates and those children aren't going to see anyone else and it'll be a group of four and they won't interact with anyone else and we're four families and we feel confident that everyone is cautious. Then I think you expand the bubble enough to include them and I think not only for very young children but for children who are at a variety of developmental stages even if they are old enough to play games on the computer or to make use of Zoom. That's good advice. I think that at the beginning it was so hard to know who was following what. I think at this point it's a little easier to talk about. People are a little more open with and you can tell who's being careful and who's not and people are a little more open about it. I think it's also interesting to see now with some states opening up and some states pulling back how much do you want to risk? And now with schools are they going to open or are they not? People are having to make big decisions which kids are going to go back to college which kids are going to give up that year of college to try and have a better experience to make their four years more exciting by giving it up or which kids want to get it done and we'll just stay at home and it's very, very hard. And which families have to send their children back for various social and economic reasons? I mean, there are a lot of families who, you know both parents work and they have jobs that are not jobs that can be done from home and they don't have enormous financial resources and they may believe that it would be better for their children not to be at school but in order for their children to remain I mean, in order for them to remain functional and to be able to pay the rent and get food on the table they have to send their children to school. That is the risk that's being taken in doing that. You know, I feel like at some point after this is all over assuming that it is all over at some point in the not hugely distant future but it's, you know years from now people are going to say, oh, it's so funny. You know, people did all that took all these ridiculous cautions that turn out to have been totally unnecessary and they didn't realize how risky these other things were that turn out to be incredibly important. And so there's that back and forth that takes place depending of what risks are you willing to take and when you take those risks what are the consequences of them and what constitutes appropriate carefulness and what constitutes obsessive and crazy behavior. And it's all very confusing even if you're just dealing with even if you're just dealing with the questions in relation to family and children and so on and so forth. It's, I mean, we're in a really difficult situation and the primary difficulty I think is not that there are restrictions. It's the confusion about what the appropriate restrictions are and how long they'll last. I think if you could make up a list and say you have to do these 10 things otherwise you're totally safe and we're going to be doing it through January I think people could deal with that admirably. I think it's the sense of not knowing and thinking, well, but I've read this thing and oh, but did you see that thing the other day and oh, I was watching TV. I didn't know if it was an ad or if it was a but I thought after, you know, it's total chaos. And I think also you can't pace yourself because really stringent restrictions that you could deal with for another six months are restrictions you couldn't deal with for another three years and not knowing whether it's six months or three years or two months or five years, you know makes a real difference to how people decide on these things and then not knowing is very, very different. Thinking about your expanding bubble. Can you, what are the needs, you know the social needs of the kids? This is a question from the audience. The social needs of the kids while shifting to the fall term, you think in terms of homeschooling? Well, you know, homeschooling is a complicated question and you know, some parents really have the leisure and the personality to be able to do it well. My experience is the children who are doing online homeschooling that require quite a lot of parental supervision if they're going to really stick with it and if they're really going to learn what they need to learn. I mean, even when they're doing regular schooling our children mostly need to be encouraged to complete their homework. They aren't sort of wildly motivated starting at the age of eight to do that all on their own if they have homework starting at age eight. But I think that when they're doing all of their studying online, we have to be quite involved. And I think it's quite exhausting and I think it can promote a kind of closeness with your child but equally it can promote a kind of frustration and annoyance and put wear and tear on the relationship. It can be very dangerous. And again, in deciding will I send my child to school or won't I? It's not only a question of is it safe? It's not only a question of do I have the economic wherewithal? It's also a question of if I keep my child at home will I deprive that child of peer relationships and also destroy the relationship that I as that child's mother or father have tried to nurture with my child? What are the costs and it's all a cost benefits balance and it's a very difficult one to figure out and there isn't any universal right answer. It depends on a million different factors that are different for each family. And hard to know even next year, two years to know if you made the right choice this fall. I mean, if there's always a what if? Well, you know, you can never do a controlled experiment with your own children. You don't get to sort of divide each child in half and see what happened the way you do it. Speaking about children, do you think that are they equally, are children equally susceptible to the mental health effects of COVID or do you think parents or adults are children equally susceptible to the mental health effects or do you think? Well, children aren't dealing with total isolation. There are no nine year olds, at least there are very few who are living completely by themselves and not seeing anyone else the whole time. Interesting. The children of that age are often enured to the conflicts among adults and the conflicts between children and adults have a different flavor than the ones among adults. Children won't pick up on the emotional repression to hark back to the Greenlandic metaphor. But I think that the effects ultimately on children can be very severe and very serious and the children can really, they can deal with things for a certain length of time and then all of a sudden they fall apart and you think, but nothing has really changed since last week and nonetheless, you find a child who seemed to be completely fine, who suddenly can't deal with any of it and it's difficult to get children to accept mental health care. Children don't like the idea of mental health care by and large. It's very difficult to get them to accept it when they're now going to be treated by a therapist they've never actually met in 3D in person and when the kind of question of how much is this an underlying issue of personality that would have surfaced anyway and how much is this a consequence not only of COVID itself, but of not going to school, of having friends move away, of all of the things that can be going on in the vicinity of COVID, who knows? We have a specific question from somebody who's at home now with a spouse with a 22 year old autistic child and imagining how difficult that must be. She's finding it difficult and finding it increasingly difficult and growing impatient and trying to find a way to find space within her own home and do you have advice on how, I mean, I think everybody would like that, but particularly for this woman who's, you know, the child's completely dependent on her trying to find own space and time in her house for some down time for herself. Do you have a comment? I think many families of children with autism and other challenges and disabilities now have children at home who would otherwise be in supervised housing or at the very least be attending a day program. And so the stress of having children like that at home is tremendous and it's happening on a very broad basis. Having said that, the thing of finding personal space, I think some of the time you essentially have to just prioritize finding your own space. You know, the kind of social imperative that is all around us is I have to take incredibly good notice of what my child needs and I have to put my needs aside so that I can take care of my child. I was always very taken with Myrna Weissman's research and some years ago in which she looked at depressed children and she looked at 10 different interventions for addressing depression in children which included medications and various kinds of therapy and mindfulness exercises and so on and so forth. And she found that the best way to cure a child's depression was to treat that child's mother. If mom ain't happy, ain't no one happy is the way that she put it when she was describing the work community before she published it and what she published has been very influential and it was very important work. And I think if you're trying to take care of an autistic child, you feel incredibly guilty when you say, I'm sorry, but I'm going in this room and locking the door and I'm not gonna interact with you for two hours assuming that you have a child who isn't then going to be engaged in very, very destructive behavior. But when you do something like that, you feel guilty, you think, but somebody has to be helping to take care of that child. But if you get stressed out and strung out your child autistic or otherwise will pick up on it and your child will do worse as a consequence of it. And so finding your own space is not simply a matter of what you feel like doing but feel guilty about doing. It's something that you should prioritize and recognize and do. The pragmatics are difficult for me to say in this particular case without knowing what the primary characteristics of this child's autism are or what the circumstances are of these particular people. But if you need to sort of hire someone again and sort of expand for bubble and you are able to do that and get someone who can take care of your child for one afternoon a week even. If you have a friend who could come over and sit with the child while you're in your own room, do it. It's really worth it and it's really worth it not only for you but also for your child. I was wondering if there must be, at this point there must be so many people in the same situation that maybe the other people in the same place that this child may go, maybe they could form a kind of chain of calls, maybe they could each spell each other. I'm just thinking if I were still a mother with young children, I would without even having a child with autism, I would feel the need to spell a friend and say, can you please just watch mine? I'll watch your three. You can watch my three at some point because I got to get out of here. I wonder if there's any way that this woman could reach out to whoever may be watching or maybe there's a school program that her child goes to some other time. I don't know when they're told to if there is one of those programs that they go to. I don't want to trivialize or I mean, I don't want to reduce the acknowledgement of the importance of taking care of your children by protecting them from the possibility of exposure to COVID. And I don't want to trivialize the social distancing requirement. And I'm a big believer in masks and I'm a big believer in distancing. And I think if you're doing something like that you probably want the children to be meeting outside where the risk of infection is lower and you want to know what other children, those children are in contact with and how much of a chain of influence who are opening yourself up to. I mean, it's terribly important that we take precautions against COVID but it's terribly important that we take precautions against going completely to pieces as well. So when we're thinking about another question about, talks about questions about tele-counseling. Certainly tele-medicine is now people are saying that they may never go back the other way because who wants to wait in the waiting room anymore? But now tele-counseling, I mean, I've got my own opinions about it but what do you think about tele-counseling these days? And I think it's, as you mentioned earlier, it's difficult if it's your first time and you're meeting a doctor for the first time. It's particularly difficult for a young person to get a connection. And if they've never talked about their own mental illness and they're struggling with something, that's difficult. But what do you think in general about tele-counseling and if it's a good way, you know, is it possible and is it the form of the future? Is it something that is gonna get better? You know, I think tele-counseling is not ideal. I think that there is an intimacy that you form by being in a room with someone that is different from the intimacy that you form from being on a screen with someone. I just had a kind of telling experience which will sound tangential to this but isn't entirely, is that I'm working on an article for The New Yorker and it's really dealing with two subjects. And the people who are related to half of the subject, I've been interviewing by phone and the people who were, or by Zoom, and the people who were relevant to the other half of the subject, I felt I had to interview in person. And so I went and spent a week in Utah doing these interviews and was masked and outside and all the rest of it to try to make it as safe as possible. But I knew that I wouldn't get these particular people to open up to me if I just saw them online. And what I realized in talking to them was in how many ways, even the people who were quite comfortable with Zoom communication, how many ways they didn't open up in the same way. I mean, the Zoom interviews that I have done have been an hour. The in-person interviews I did were often five hours. Nobody sits for five hours gradually letting you into the workings of their heart on Zoom. It just is not the same. Having said that, it's what we have and it's a lot better than nothing. It's a much better way than nothing for keeping up your friendships. It's a much better way than nothing for interacting with, I don't know, our dog has a problem in the vet and I've been doing telemedicine and it's been terrific. She's been able to figure out a lot and it's been very helpful. And for therapy, it's not as good as being in a room with someone. That's definitely the preferred way but that's really dangerous right now for patients and for therapists and for most people it's impossible. And so we're incredibly lucky that we're having this crisis now and not 20 years ago when we wouldn't have been able to do that. So use whatever is available to you and make the most of it. So tell me a little bit about Utah. The article for the New Yorker, is that something to do with your new book? It is related to my new book. I won't go into too much detail because they prefer that you not do that but I can tell you the sort of rough outline of it which is that when I was in Utah, I was interviewing secular polygamists of whom there are many in Utah. It's a movement. The new book I'm writing is about expanding ideas of family and I see it as a kind of bookend to Far From the Tree. Far From the Tree was about families who perceived themselves to be ordinary, who then had children who seemed quite extraordinary. And this book is about extraordinary families and the children they have who often are children they perceive to be more mainstream than they are themselves. So it includes chapters on divorce and step families, on interracial families, on single parents, on assisted reproduction, on adoption, foster care, gay families, multi-parent families, paid childcare and the so-called child-free family. Really trying to look at the idea that in the valid quest that families who are unusual have made for equality, they have been obliged to make false claims of equivalence. And I argue that each of these kinds of family is different and that in fact, having these different kinds of family, it's not that one is better than another and it's not that you have to conform to or somehow imitate an idealized heteronormative 1950s family in order to be a valid family. There are many ways to be a valid family and they all have their ups and they all have their challenges and we live in a richer, better world if we accept that diversity instead of trying constantly to say, you know, well, gay families are okay because they really, the kids are the same and the families are basically the same and it's all really the same, it's not the same. It's different and I feel like that difference needs to be not only acknowledged but also analyzed and then to some degree celebrated. So interesting. So now it's about identity of the family in some way. Yes. Identity from part of the treat, finding your identity and now it's the identity of the family, the equivalent but not equal but not... So while I was talking to the polygamists in Utah, I looked at the families they have and some of them have families that seem to be very functional and some of them seem to be very happy but boy was their way of life different from my way of life and now as there's some attempt by people in that community to achieve greater validation and acceptance, a lot of the time they have to lie and say, my family is just like your family and I feel like there is that tendency and the family that we're all supposed to be just like doesn't exist very frequently now, didn't exist very frequently even in the 1950s. It's essentially something that we have created and formulated for our own purposes. I'm curious, did you ever look, are you looking at families or partners to stay together but are not partners that co-parent that are not lovers or that are not, there's friends that parent or I mean, I don't even know if there are that many of those but I was curious, just reading about Jada Smith and Will Smith that they may be actually, they've been together for many years, they actually may just be co-parenting and great friends but they actually, I don't mean that they have an open marriage. I mean, there are people that I think stay together just for the kids but they actually don't have a relationship in where they just, they just like to be together for the kids and they have different, I don't know, I don't even know what that's called. And then there are sort of two phenomena in what you're talking about, one of which is people who started off having an intense romantic relationship and then in many instances when their romantic relationship ends open up to other people and even if they don't have children they sometimes choose to stay together. I interviewed a woman recently who said that she really adored her husband but they haven't had a sexual relationship for years and she wanted one and he said that was fine and she found somebody else who thinks she has a sexual relationship and at whom she is very fond but she still feels committed to her husband and the three of them live together happily in Brooklyn naturally and that it's worked very well but there are essentially, there are situations in which people who are friends decide to have children together. I have a daughter as you know from the book and other experience that I have a daughter with and my best friend from college and we were never romantically involved with each other it was something that we chose to do. There are also people who sort of grow away from wanting to be attached to each other. There are a lot of structures that can work and I hate the sort of cliche that love makes a family. You know, I feel like love is the necessary precondition to a family but it does not make a family. A family takes a great deal more than love in order to be in any way functional but I think that people can find all kinds of collaborations. I mean, I have a good friend for example who is a gay woman. She and her wife decided they wanted to have children. They approached a friend of one of the women and asked whether he would be a sperm donor. He said, I'm not interested in being a donor but I am interested in being a father. He's a gay man who had a sort of busy and active sexual life that was quite separated from his domestic life. The three of them lived together and brought up their children together. The two women in a romantic relationship. The man has since actually settled down and married another man. But essentially for the children, you know, primary formative years it was those three people. And so I'm very interested in how people balance things and all these possibilities. Interesting, great. So after, I know there's more questions I'll get in a minute, but so this one, how many more years till this one's gonna be done? Ah, yes, what a good question. I think it'll be probably another, I think it'll be another three or four years to get it done. I had thought that I would spend all of my COVID time getting it written and then I started writing about COVID and mental health and many other things. And so I didn't get as much written as I might have hoped to. But I'm dutifully scribbling away and getting it done. Oddly, I've written it, I think a rather nice introduction and a reasonably good conclusion, but I haven't written any of the chapters that go in between. So that's what I'll be working on from here. And I've been interested in writing a conclusion in the ways in which COVID actually reduces you back to being a family and takes away any of the sense of politics that you might have had, that I might have had about being a gay family and a multi-parent family. I feel as though when we are taken away from the gaze of others, we become just a family. Okay, so, Wick, do you think you'll, I mean, I've always wondered if you're gonna get back to doing fiction again. Do you think you'll go for fiction? Do another novel someday? I have the sort of sketch of a novel that I write about two paragraphs of about once every six to eight weeks. So at that rate, it would take me a century or so to complete. I would like when I finish this book to write that book. And also there's a series of stories that I've been telling my children since they were very, very little. And I started to make those into a children's book and then I got derailed onto other projects and I want to go back to that. And so I have sort of two works of fiction that are vaguely in the works, but I keep getting seduced by reality. There's a lot of reality to do that, but I would love to see another fiction book. I'm sure your fans would too. All right, a couple more questions here. I'm in a long distance relationship that has always relied on teleconferencing between the in-person visits. Any tips for maintaining emotional intimacy from far away during such a long time? Well, I mean, as I said earlier, I think it's extremely difficult and I know people who are struggling with it who are in various comparable situations, long distance or commuting relationships. You know, I think frequent use of whatever the means of communication are that are available is helpful. I think it's actually helpful to sort of go backwards and use some of the older means of communication. So assuming that the current president of the United States doesn't bring it into our postal service, I think actually writing letters in some instances can feel more intimate even than having a Zoom call or writing down a quick email. I think there's a certain beauty in that and a certain beauty in the delay that's involved in it. I think that, you know, lots of people I know have done things like they are watching a movie together in two different cities, but they're watching it at the same time, possibly one that's being shown by the Bedford Playhouse. But they can enjoy it in different places at the same time and really get drawn into it and then just sit there, each of them sort of saying, oh my God, I can't believe what she's wearing or that scene just made me cry or whatever it is that you say during a movie for the person that you love, trying to have dinner at the same time, even if it's inconvenient given a sort of different time zone that you may be in, trying to do all of the things together that you can do together is a big help. But I also am a fan of writing letters and of sending photographs and of doing all kinds of other things using every means of communication we have available to us, not only the newest ones, but all of them. That's nice, very nice. I like the idea of watching the movie. I know my daughter has been doing that a couple nights a week. She watches movies with one friend and then another couple of friends and they watch it on some, I think it's called cast in some streaming situation where they can actually all comment and they talk and it's been very nice. But I like that idea. I certainly know that the way we're talking here is a webinar and I know there are 70 or 80 people now watching and it would be wonderful if we could have all their faces here. But one of the reasons it's not possible is because we can't see them all and they'd be popping in and out and although it would be great if everybody could, I wish we could all look like we were all together. I know we're all together but and I like that we're having conversations so it feels like we're together and it's nicer than just having you be a talking head and so we're having a conversation and I'm able to ask these questions but it's one of the things that I miss so much about being in the play house that we get to bring 160 people into that space and we all get to talk about a subject matter or watch a movie together and then talk about it or listen to an artist speak about their work and then discuss it or it's such an important thing. These things are how we learn about humanity and how we learn about ourselves and it's so important. I mean, I get different if you go to a movie theater or indeed to live theater, laughing with a whole roomful of people who are laughing is so different from laughing by yourself and you laugh much less if you're by yourself. I mean, I find even in doing public lectures in which I try some of the time but at least to be mildly amusing that if people are packed in together and you tell them something funny, they will all laugh and if you're speaking in some ways where people are actually at a distance from one another, they really don't and I once gave a talk in the General Assembly of the UN which I was incredibly psyched about doing and I had a nice photo of me doing it that I used on Facebook for a while but the reality is if you look at photos of the UN everyone is sitting at a slight distance from everyone else and it isn't an intimate setting in any way and I felt like I would make some fun little jokes and there would be a kind of silent staring at me as I then went on to the next thing that I was going to say and I would say something very moving and instead of having people sort of rubbing their eyes I felt like everyone was just sort of staring, I mean, there is a joy in being with people and as I say, when I went to Utah, I mean, I was not really with people I wouldn't go socially, there were not the kind of people I mostly would be spending time. I loved being in those rooms full of people after three and a half months of not being in a room full of people it was masks not withstanding, open windows and stuff it was still to be with people, talking to an inner room full of people was a moving experience. That brings up a good question. This was about how should seniors living alone who are completely immunocompromised, how could they attend their mental health and specific advice? I mean, I think some of what you just said trying to figure out how they can, I don't know if this is a senior who's asking or someone who's asking about a senior in their life but it certainly would be great if they could find a way to share movies and things together and things like that but any other ideas for people like that? I mean, I certainly wish that they would come to the Bedford Playhouse and do some of these things with us online because there are classic movies we do things like this and have talk backs and we do a lot of things like this that I hope doing this tonight makes somebody feel a part of a community but go ahead. There are seniors who are isolated by COVID because they're immunocompromised and can't go out and can't do anything and only have some groceries delivered and there are seniors who are isolated in the first place and who don't have a lot of family and many of whose friends may no longer be alive or may no longer be able to communicate well and who were very isolated even before this began and isolation that's been exaggerated and strengthened through the COVID process. I think in general that it's important for people to have yes, just that kind of connection and communication. I mean, a lot of people I think have got what they what are seen as very attentive children and they are very attentive children who call maybe they even call every day. They call every day, they talk for 10 minutes and they say, okay, well, I'm glad you're doing okay. And then that leaves you 23 hours and 50 minutes and they fill in in the various ways that you can fill it in. And a lot of people end up spending the day sitting and watching television and feeling lucky that they have a family that still cares about them and makes contact. And I think it's often a terribly lonely situation and I think if there are ways for those senior people to connect with one another as you were just saying that your daughter does, then I think that would be spectacular and would make an enormous amount of difference. And I think if you're taking care of someone who is a senior citizen, there are a lot of things you can do that make people feel a little bit more seen. I mean, you can send flowers, okay? The flowers will have to be delivered by someone and there may be issues about letting the delivery person in, but the flowers themselves are unlikely to give the person COVID and maybe receiving them will make a difference. You can call them up and say, I just heard an amazing performance of X, my favorite pop song, the opera that I've always loved. I'm sending you a link and if you can get on a computer, you can listen to it and then we can talk about it. I mean, often the problem is that the children say to the parents when they call them and say, are you okay? And the parents say, yes. And then the children say, so what have you been doing lately? And the parents have nothing to say because they haven't been doing anything lately. And then the parents say to the children, but what about you? What have you been doing lately? And the children say, well, I had some teleconferences and the kids were kind of acting up before, but nothing much has happened in the lives of the children either because that's part of the COVID strangeness. And so I think if there are instances in which you can develop more common ground and introduce things to talk about, I don't know, read the same book and talk about that, all of those things. That's a great idea. It's a great idea. A book should be able to talk, have a book club with a senior. That's a great idea actually because that's something a lot of the seniors who I know don't do well with the Zooms and aren't able to do that. So that's a great idea. We should think about doing that with the Playhouse, try and get a group of seniors to talk, maybe a book, that's a good idea. That would be tremendous, yeah. All right, I have a few more questions. It's already been, it's already nine o'clock, so let me go through a couple of these great questions. All right, so Charles writes, is there a way to recognize the line between the ubiquitous lack of motivation so many of us are experiencing and the slip into a dangerous state of lacking vitality which characterizes depression? Yes, Charles, whoever you are, that's a great question. I think that there is, I think it's difficult to do, but that it can be done. I think that there is a general sense of nonclinical demotivation in which you just don't feel a burning urge to accomplish all kinds of things which might otherwise be interested in. But I think there's also a point when you begin feeling like I don't wanna make myself any dinner because who cares? And I'm not gonna bother to take a shower because I'm just here on my own anyway or I'm here with my family and I don't care if I'm smelly and where you begin giving up on all of the stuff that constitutes the basics of daily life. There was an annoying meme going around on Facebook pointing out that Shakespeare wrote most of King Lear while he was in quarantine and it seemed to place quite a high standard for what the rest of us should be doing in this time. I don't think you need to write King Lear and I think if you feel professionally unmotivated so long as that isn't going to leave you destitute, that's okay, people are struggling. But I think when you begin giving up on hygiene and eating when your sleep becomes irregular when you no longer feel the inclination to do any form of exercise, all of that stuff, those are signs that you're actually slipping into a depression because in fact, even under these circumstances, I mean, okay, you don't wanna get dressed up necessarily in exquisite clothing every day to just sit around your own house but you have to have a sense of being engaged in some aspects of your life and in the basic domestic ones. And Andrew, do you think that, I mean, I'm saying this because I think it maybe helped in my life. Do you think that sometimes just putting yourself back on a schedule or making yourself do some of those things actually can actually stave it off or alleviate some of these issues, some of the issues from slipping further into it? I mean- That's a terrific insight, yes. I hadn't thought of that as a sort of formal part of what was happening to address kind of the COVID blues or whatever you wanna call them but yes, I think absolutely. I think setting yourself a schedule and having things that you do do on certain days and don't do on other days or that you do every day or whatever it is but having something that structures your life is very helpful and letting all of the structure go and just thinking I can't be bothered is an indication of slipping into a kind of latitude that is a symptom of depression. So if you see it going, try and grab a few things and get them back on track. Even if it's one, like try to get the bedtime on or like last night, like didn't sleep much. Like, okay, that's a bad one. Try and get, you know, then get up in the morning. Even if you didn't sleep, get up in the morning at the right time and then try and get something back on track. Okay, wow. Everyone's still with us, we have a lot more. Okay, all right, so this is an interesting one because I thought a lot about it because I was so taken with the first chapter of Noon Day Demon all those years ago when you talked about the difference between depression, why in Cambodia when people are at war, they have a purpose. And so there's a different feeling why it wasn't depression. It was when people are, I can't even paraphrase it but you had amazing conversation about how when people feel like they're all there for a purpose they can get together and feel even in the most terrible circumstances they feel like they have, there's power and purpose in their tragedy. But in certain situations like now in COVID depression seems, we don't have any purpose. We don't know when it's ending. There's all the unknown. It feels such a perfect time for it. And so John is asking about during this current time of social activism and the movements doesn't exacerbate some of the mental health issues cause some are struggling with or does the importance of the movement supersede that? And social media is increasing, not so is it something to avoid? Like how does that work? Cause to me it's like everything is now it's COVID now it's the social justice. Everything feels like it's nothing good is happening. Yes. Well, I mean, something good is happening. I think in that social justice movement and in the expansion of resistance to the, you know, to what at the risk of being too political for Westchester, but what I think has been the kind of disastrous rule of our current president. And so I think part of the energy that has come to this movement for social justice above the one that happened with, you know, Michael Brown or other people, Trayvon Martin previous incidents where there's been a sort of upsurge of engagement and then it's all faded away. Is that I think people do have a sense that they want something to live for and something that's meaningful and something that's purposeful. And so while I think part of the movement has to do with a genuine commitment to social justice and a sense that many people in the United States are fed up with seeing the police brutalize African Americans and other people who are in marginalized populations. I think also that a lot of people have had very little sense of purpose through this time. And suddenly they have something that seems worthwhile and important and bigger than themselves. And that's been galvanizing. So that gives them a, that's a good reason to pull out of a depression. Yes. I think that it helps people to pull out of a depression. If you feel like you can't fix the thing that's wrong with your life, which is perhaps COVID, but that you might play a role in fixing what's wrong with our society. Boy, that's an energizing thing that then allows you to think there are things to do. And yes, in Cambodia, what happened was that there was a lot of depression after the war that hadn't been so visible during the war because during the war people who were fighting to survive had a great sense of purpose either about the larger issues brought up by the Khmer Rouge or just about managing to keep themselves and their children alive. And now for many people who are relatively well-able to keep their families alive, there was a sense of sort of that doesn't take that much doing and it entails all the frustrations we talked about earlier in our conversation. And now I think the sense that there are these terrible social problems and that are uprising of a large enough number of people might actually bring about change. The connotation of that is optimistic at a time when there's been nothing but pessimism for a terribly long time. Interesting, okay, good. Thank you for pointing out the perspective. Okay, I'm gonna do two really quick class ones because I wanna end by 9.15 because you've been so great to stay with us long. All right, one is about coping mechanisms. Cogum mechanisms for managing anxiety and fear that many of us feel for loved ones. And I'm gonna say the other one now, so you have them both. And one is how can employers be sensitive to employees' needs when they come back to work about their potential mental health issues? Those are very different questions, sorry. But those are our last two. And then I'll say a few words. I'm always, when I try to answer two questions, answer one and then completely forget what the other one was. I'll come back. I'll start with the one about employment. I think it's important for employers to be responsive to the genuine and the well-reasoned feeling that their employees may have that they are taking their lives in their hands by returning to work. I think it's important to be sensitive to the vulnerabilities that exist. The talk about schools has been about what's right for kids. What, on the other hand, is right for teachers. I mean, there are many teachers who are not in the sort of first flush of youth and who are now going to be exposed to a large number of children, especially if they're little children who may be running around all over the place. There's a debate about whether little children who are non-symptomatic or often vectors for the illness and it appears that they may not be. But in any case, I think we have to be sympathetic to the vulnerabilities of everybody involved. And we have to respond to those vulnerabilities. And those include the fact that while it was very difficult to transition into lockdown, it is also very difficult to transition out of lockdown. Even if the disease were well under control, even if there were a vaccine, if you have not interacted with other people face-to-face for a period of months and now all of a sudden you're thrown back into the expectations that characterized your former life of constant interaction of one kind or another, that's an enormous stressor. Ultimately, it may be what you want and it may be a locus of joy, but it's a terrible stressor and terrible stressors are difficult. And employers who have employees coming back to work should recognize that even the employees who are really glad to have the structuring shape of work to lend coherent form to their lives, even they are struggling and are likely to struggle and are likely not only to bring the mental health problems that accrued during COVID, but also the new ones that are occasioned by reentry. And I think your other question was about coping mechanisms. And I feel like this whole conversation has effectively been about coping mechanisms. There are many, many different things and different things work for different people. But if I had to reduce it to a single phrase, I would say as Ian Foster did so long ago, only connect. I think the primary coping mechanism is to not be lonely. And I think the moment when you know you're shifting into depression is when you feel lonely and can't be bothered to reach out to anyone because it just doesn't seem worth the trouble. And if there's one thing you can do to maintain your mental health more or less during this period, it's to remain attached to and in touch with and connected to the people who really matter to you and to find people whom you can characterize in that way. Very well said. And anyone who's ever suffered from depression knows exactly what you mean by that feeling of not, you know, knowing that that's the right thing to do, but having no ability to do so and no interest because no energy, no ability to do so. So that is really, really well said. And hopefully if you're not in isolation, somebody nearby you sees that you're not able to do so and will get you connected to somebody if you don't for yourself. Certainly that's something you need to be aware of. Keep an eye on the people around you to see if they are not on a schedule, if they're not sleeping, if they're not taking care of themselves, you're close. You know, keep an eye on the people around you because and check in with those older people who are not with you because it's harder to know if they're on a schedule and they're doing what they need to be doing. So Andrew, I just wanna say thank you so much for enlightening us and spending this time with us. And again, it's always a pleasure to have you. And I hope that you will come and visit us when we're back up in the playhouse again. Nothing to please me more. This was a wonderful interview and I thank you so much for your insightful question and the audience who also had a lot of really wonderful and insightful questions. So everybody, please follow Andrew. You can follow him on his, Andrew Solomon at Andrew Solomon. Well, you just Andrew Solomon at AndrewSolomon.com I think, are you? Andrew at AndrewSolomon.com is the way to reach me but my website is AndrewSolomon.com. And he's got newsletter. He's got an Audible. You can read, listen to his podcast. You can read his newsletters every, I don't know, you do one every week, don't you? Pretty much? Well, not quite as often as that. But they're all on there and all of the articles and everything else and all of his books and depending on how many languages you wanna learn. And so everybody please, if you've enjoyed tonight's program, please think about signing up for emails from the Bedford Playhouse. We have a lot of interesting stuff. All the money from tonight goes to the Mental Health Wellness series that we do here. We have five or six different evenings sponsored during the year with experts in this area and they've all been wonderful. And I just wanna thank you and please think about joining us and becoming a member. And so thank you all, the audience and Andrew and everyone, thank you Emmett and thank you Dan for helping us host. Everybody, good night.