Dr. Robert Bilder is a remarkable person. Yes, he is remarkable for his resume, which gives one cotton mouth when trying to absorb the depth of his career, but even more remarkable is his dedication to the exceptional health and well-being of young students at UCLA, Louie Schwartzberg’s alma mater and where Dr. Bilder currently serves as Professor-in-Residence. For the last six years, Dr. Bilder and his colleagues at UCLA have been developing a ground-breaking program called the Healthy Campus Initiative. Dr. Bilder leads the Mind Well program within this initiative, to promote well-being, resilience, social connectedness, and creative achievement among UCLA’s students, staff, and faculty. Other campuses around the globe are following UCLA’s lead, and Gratitude Revealed sat down with Dr. Bilder to ask him to share his experiences with helping young men and women address their struggles with isolation, connection and stress.
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Q&A Interview with UCLA's Dr. Bilder
GR: Dr. Bilder, can you tell us about Healthy Campus Initiative? How did it get started at UCLA?
Dr. Bilder: The founding of the Healthy Campus Initiative began about 6 years ago, when Jane and Terry Semel, who are major benefactors for the Semel Institute for Neuroscience and Human Behavior, got together with our director, Peter Whybrow, and others in our group to think about what could be done to advance the model of preventing illness rather than just responding to it. I think that Jane and Terry Semel both realized that the roots of many ills are found in how we cope with stress and manage mental and emotional problems.
The idea of developing programs that would help people develop better coping strategies and build up their overall resilience was something we wanted to work on systematically. In brainstorming with Jane and Terry, we felt that, why not inaugurate such a program for mental and physical well-being right here on our own campus, and use the campus as a model for how to introduce exactly the kinds of preventative programs we wished to see globally. We were able to present these ideas to the chancellor at UCLA, Gene Block, and I think he really liked the idea.
GR: The idea of having a Healthy Campus Initiative was born!
Dr. Bilder: Exactly. A group of us got together to think about how to organize such an initiative. We developed a series of program areas, which we called “pods” for some reason… which always reminds me of the movie Invasion of the Body Snatchers. [laughter]
GR: A classic cult film…
Dr. Bilder: But thankfully, has absolutely nothing to do with the Healthy Campus Initiative [more laughter].
We started with four pods, or program areas. We called these Eat Well, Move Well, for physical activity and exercise, B.E. Well, which stands for “built environment”. B.E. Well focuses on how we can adjust the built environment around us, in order to make it more desirable to move through it in a manner good for your health, as in with your bike, walking up the stairs, etc.
Then, of course the most important of all the pods, is Mind Well, where the focus is on mental and emotional well being and creative achievement.
These were the four principal areas we wanted to focus on. When we were launching, there was a big initiative to make UCLA the first tobacco-free, or smoke-free, campus. We included another pod called Breathe Well, and since then we’ve also added a Research Well pod, to add a measurement component to the Healthy Campus Initiative.
GR: How do you evaluate the success of this program? If UCLA is the model for a larger initiative, by what metrics do you determine its efficacy?
Dr. Bilder: That’s a great question, and certainly one we care a great deal about. It’s still a work in progress for us to develop the metrics that will help us better demonstrate how helpful it has been. In the meantime, there are a number of things that we’re beginning to look at. One strong positive outcome is the emulation of the HCI by other campuses who heard about what we’re doing. They’ve been eager to learn from us and embrace some of the practices that we’ve effected here. We also have learned that students who are applying to UCLA and the parents of students who are applying to UCLA, see our Healthy Campus Initiative as one of the motivating factors that led them to prioritize coming to UCLA. UCLA has long been known for its academic excellence and rigor, but I think now it is increasingly being recognized internationally as a place where we really care about everyone’s well-being, which is really a great thing.
GR: It’s a question that has come up a lot for us here at Moving Art. We know that looking at nature and cultivating gratitude is good for us, but it’s very hard to prove in a controlled and traditionally scientific way.
Dr. Bilder: That’s right, so we are gathering data, some of which has always been gathered. When I say always, I mean over the last 10 or 20 years. There have been many surveys conducted of the UCLA population and we know a number of things about the overall campus climate and how student ratings of stress and distress have fluctuated over the years. We do have some measurements and we have been increasingly interested in enhancing the kinds of measures that we’re able to get from the campus. We have quite a few additional surveys and questionnaires and qualitative research probes that have been deployed to try to understand how students are feeling, what their experience is, what coping resources they utilize.
Indeed, we did a little project supported by the American Association of Colleges and universities using a newly devised instrument called the SARA, or Stress And Resilience Assessment, which examined the various kinds of stressors that people might be experiencing, and their current levels of depression and anxiety, and determined how aware students were of the campus resources that are available to combat stress and to promote resilience. Then, we engaged them in a series of eight weekly email blasts to focus on the kinds of things that one could do to promote resilience and combat stress. Sure enough, we did increase awareness of those resources and had some minor improvements in the overall levels of stress, anxiety and mood problems, despite the fact that the students were going into finals.
What’s really needed to document the kinds of changes we hope for, are some randomized controlled trials of the methods that we’re deploying. No matter how we enhance measurement, if we don’t do randomized trials, we will always wonder if perhaps other factors were involved in causing an overall change in the campus mood, or increase in the amount of resource utilization. We need to conduct more carefully controlled trials of specific kinds of interventions that promote resilience and we hope will decrease the levels of various kinds of adverse illnesses, mental illnesses and so on, and other stress-related disorders.
GR: I love that you’re using the word resilience. Louie [Schwartzberg] is always discussing the power of this word. Research conducted by the Greater Good Science Center has shown that exercises designed to cultivate gratitude result in greater resilience. I would think resilience would be a great attribute to cultivate in college students struggling with isolation, as well.
Dr. Bilder: I agree, and indeed the Mind Well program’s vision statement highlights the enhancement of social connectedness across the campus. It’s one of the most challenging problems that we face because the college is extremely demanding academically. Most of the academic curriculum is not focused explicitly on social connectedness, so finding ways that will enable students to prioritize that kind of connection is something that requires a lot of creativity and innovation. We’re trying to highlight the importance of those kinds of connections as key goals during the college experience, and that those pursuits, for example, having a good social life, may be as or more important than other academic pursuits and other teachings that one may acquire in the course of one’s college education.
Yet, there remain very few courses that focus on how to make friends or how to sustain relationships. One course we have revived here on campus is widely known as Life Skills for College Students, and among other topics it really focuses on a combination of personal identity development and relationship development in ways that we think is a fantastic first course for everyone to take. We’ve been working on developing curricula for a proposed Semel Academy that will ultimately offer a degree in courses related to mind and body. In the pursuit of having an integrated mind/body studies curriculum, we see having a basic life skills course that includes a heavy emphasis on the development of social connectedness as a cornerstone of that curriculum.
GR: That sounds invaluable to young students who are traditionally so results-driven, focused primarily on getting the degree more than by the quality of the process that leads up to the degree.
Dr. Bilder: Exactly. Here we focus not only on how valuable relationship are to life and finding meaning and purpose in life, but also to other aspects of emotional and physical well-being. In the academic environment we’re able to focus on what are the basic scientific and biological mechanisms that underlie that kind of impact? Why is it that having better friendships enhances your immune system function and makes it less likely that you’ll get sick, less likely that you’ll develop any one of a series of stress-related disorders?
GR: It’s encouraging to hear of such a program that would counter-balance the negative influences of technology. When cell phones are creating more and more isolation in younger people, UCLA is creating more and more opportunities to connect with one another. Is that true?
Dr. Bilder: Actually, I want to do a study on PUMP, or Problematic Use of Mobile Phones. I had the honor of being the co-author on a paper published recently that looked at PUMP in Sweden, in a big population study. Anyone can observe immediately, looking around in any public space, but particularly on a college campus, how many people are walking through a beautiful landscape and scenery on a gorgeous Los Angeles day, and the majority of them are staring into a mobile device. Not smelling any roses, that’s for sure.
I’m really excited about this, because this is something that we can measure quite easily, as we can observe people walking past a particular point in one of our big quads and see what proportion of students are looking at the environment or another person, on the one hand, and how many are looking into their phone on the other hand. I would estimate about 60 percent of them are looking at their phones.
GR: I might think it’d be higher than that? We’d all be eager to hear those results, I’m sure…
Dr. Bilder: The prevailing theory behind this habit of looking at one’s mobile phone so frequently ties directly to our conversation about isolation because it is seen largely as an anxiety-driven response. There’s some element of FOMO, or fear of missing out, but basically in the presence of situations that may provoke social anxiety, it’s very easy to just retreat into one’s phone as it makes it look like you’re doing something when the reality is that you don’t need to be checking your phone.
There are apps now that, of course, will reward you for not using your phone. That’s an interesting approach. In terms of gathering the data, we have a group working as part of our work on the Depression Grand Challenge at UCLA.
GR: What is the Depression Grand Challenge?
Dr. Bilder: It dovetails really well with the Healthy Campus Initiative. UCLA, in connection with their centennial campaign, has organized several grand challenges, one of which is a Sustainability Grand Challenge that aims to make L.A. a sustainable city by 2050, if you can believe that. Then, even more ambitious, is the Depression Grand Challenge which aims to eliminate half the burden of depression, globally, by 2050.
Dr. Bilder: To do that we are planning to do large-scale research on depression including scientific techniques including whole genome sequencing, and gathering lots of behavioral data in about 100,000 people right here at UCLA.
Along with typical questionnaires, interviews, cognitive tests and MRI scans, we have a team working on developing mobile apps which aim to collect data of high relevance to understanding your mood and anxiety, and predicting your future mood and anxiety states. Among the kinds of techniques that can be easily deployed on the phone include where you are and the degree to which you’re exploring a novel environment. For example, people tend to be pretty predictable, but when they go off the range and start going into territory they don’t usually explore, that may be a sign of an emergent manic episode.
We can also monitor mood, without even looking at the exact words that are being used, just from the tone of voice and the degree to which we pause before responding to someone else’s comments in a conversation. Usually there’s no pause between two speakers in a conversation, in fact, speakers usually interrupt each other slightly. In depression, there may be a lag and that inter-speaker interval may increase. That may be a marker of incipient depressive mood before other overt signs of depression emerge.
GR: Wow, now I’m going to be really sensitive about how much time I wait before speaking with you in this conversation … I’m going to make sure to interrupt you a lot now.
Dr. Bilder: There you go, you’re sounding perkier already.
GR: With all of this wonderful work you are doing, creating such abundant resources for students to improve their well-being, how do you get the word out to these students so they know about it? Is that a problem for you?
Dr. Bilder: Yes, it’s absolutely a challenge. One of the things we’ve discovered through our work in Healthy Campus Initiative is that if we do a fantastic job of blasting to the entire student body or our staff or our faculty, using every media channel we’ve got, we are going to definitely get the attention of 500-1,000 people… out of our 80,000-person campus. [laughter]
The question is how to promote really broad and sustained engagement. That is a significant challenge. We’ve been focusing on more niche marketing strategies to try to understand how do we engage in a meaningful and sustained way, the different, unique sectors of our campus population.
The same pitch is not going to have the same impact if you’re talking to an NCAA athlete as it is to somebody else who’s doing a Ph.D. in electrical engineering. Our hope is more to understand what are the natural things that different sub-groups are likely to engage in, rather than finding the one shot in the dark that goes viral, like the Ice Bucket Challenge … Well, even the Ice Bucket Challenge wasn’t full-proof. I never did an ice bucket challenge.
GR: I didn’t either.
Dr. Bilder: Aha. So, 100 percent of those of us in this conversation actually didn’t do the ice bucket challenge, so it didn’t really work for us.
GR: That’s true. [laughter]
Dr. Bilder: At the same time, there are some things that just have such universal appeals, like Louie’s work, which has among the broadest appeal of anything I’ve ever seen in engaging people of all stripes. I think those kinds of methods that focus on enlisting the arts is one path. I think that’s among the kinds of global messaging that we think is important. This idea led us to a concept that we’re going to be introducing more broadly this year, which is eudaimonia.
GR: What is eudaimonia?
Dr. Bilder: One of the beautiful things about eudaimonia is that no one knows what it is, so it gives you the opportunity to explain it. It turns out that in ancient Greece, going back at least to the time of Socrates, there was a distinction made between different kinds of happiness. There was hedonia, or hedonic well being as it would now be called, which is the kind of happiness that comes from satisfying or gratifying an immediate need, like for food or sex. In contrast, you can identify eudaimonia, which is true happiness or well-being, and this is a more sustained form of well-being that goes along with finding meaning and purpose in life.
We believe a key part of the UCLA experience that we hope to promote is seeking eudaimonia and helping our students, our staff, and our faculty all realize their eudaimonic well-being goals, and focus on those things that give them sustained happiness through finding meaning and purpose in their lives.
GR: I am going to wish everyone a Eudaimonic New Year! What a wonderful word.
Dr. Bilder: It really is. A critical part of this overarching concept of eudaimonia and finding meaning and purpose in life, and the pursuit of promoting meaningful interpersonal interactions, is the process of gratitude and the expression of compassion.
As a neuroscientist, I’m prone to thinking about why is that such a good thing and what is it that the brain is doing to help that be such a positive element that connects it to well-being? It’s very interesting how the expression of gratitude to others helps to connect us to them in a meaningful way. That, I believe, promotes social recognition and the meaningfulness of our connections to each other that promotes our success as a species and, thus, resonates with the entire purpose of why we’re here evolutionarily.
I think it’s promoting our bonding as a species and, yes, promoting the degree to which we experience directly the support of others mirrored in our support of them.
GR: I can’t think of a better environment than a college campus where we’re preparing these young men and women to be good citizens, to go out and do good things in the world with their degrees, but also to stop and to take a moment to appreciate the process and be filled with gratitude. It seems like the most valuable gift we can give them.
Dr. Bilder: There is one other component that I think is worth recognizing, and that is if you think about what’s involved in becoming a great academic and breaking new ground in various academic pursuits, one key is the critical appraisal and evaluation of existing knowledge. In some ways, that’s what you would call a breaking down or analytic mode of thinking. If you think about gratitude, in contrast, the recognition of what’s going well, what’s good about the world, and good about one’s own experience could be thought of as a complementary practice that focuses not on what’s wrong with things and how they can be improved or corrected, but rather on what’s going well and what’s working, and on the positive.
I think that having a good balance of weighing pros and cons, positives and negatives, the good, the bad, and looking at these in a more holistic way is a key to having balance in life, and would certainly produce an even greater academic, in my opinion… and would in the process be promoting eudaimonia.
Dr. Robert Bilder is a Michael E. Tennenbaum Family Professor of Psychiatry & Biobehavioral Sciences at UCLA David Geffen School of Medicine. He is also Chief of Medical Psychology – Neuropsychology at the Semel Institute for Neuroscience at UCLA and Resnick Neuropsychiatric Hospital. Dr. Bilder’s current research focuses on transdisciplinary and translational research on brain and behavior. Dr. Bilder also directs the Tennenbaum Center for the Biology of Creativity, the Translational Reesarch Center for Neuropsychiatry at UCLA, and the Medical Psychology Assessment Center (a training clinic for neuropsychological and psychodiagnostic assessment) and the UCLA-Semel Institute Postdoctoral Training Program in Neuropsychology.