Stress has gone down by almost every historical measure. Suffering has gone up. Those turn out to be different things.
In this episode, attachment expert Adam Lane Smith sits down with psychiatrist Dr. Aaron Kheriaty to ask why despair is rising in a culture organized around comfort, what the attempt to eliminate all discomfort has cost, and what ordinary people can do for someone struggling. The conversation covers the research on loneliness and risk, why intervention works more often than people assume, and why small acts of attention matter more than they look like they should.
If you’re struggling, please reach out. In the US and Canada, call or text 988. In the UK and Ireland, call 116 123. Elsewhere, findahelpline.com lists services by country.
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In this episode you will learn:
1- Why reduced external stress has not produced reduced suffering
2- What deaths of despair are, and what has happened to the numbers since 1999
3- Why solitude and loneliness are not the same thing
4- The three reasons religious practice shows up as protective in the research
5- What people who survived a crisis later said about it
6- Why hopelessness predicts risk better than severity of illness does
7- Why more clinicians alone cannot solve a problem rooted in isolation
8- The paradox: how trying to eliminate all discomfort produces more suffering
9- Why addiction is that paradox in its clearest form
10- How joy and suffering can occupy the same moment
11- Three concrete things to do, and a gratitude practice with unusually strong evidence behind it
Dr. Aaron Kheriaty, MD, is a physician specializing in psychiatry and author of five books, including most recently, Making the Cut: How to Heal Modern Medicine (2025). He is a Fellow & Director of the Program in Bioethics, Technology, and Human Flourishing at the Ethics and Public Policy Center
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