Discussions about healthy living usually revolve around diet and exercise. Social interaction is often left out of the conversation, even though research shows that it’s critical to our well-being. On this week’s radio replay, we’ll explore research on the extremes of social interaction: from the consequences of constant connection, to the high cost of solitary confinement.
The transcript below may be for an earlier version of this episode. Our transcripts are provided by various partners and may contain errors or deviate slightly from the audio.SHANKAR VEDANTAM, HOST: This is HIDDEN BRAIN. I'm Shankar Vedantam.UNIDENTIFIED EXERCISE INSTRUCTOR: And then see if can begin to deepen your breath here - a nice, long inhale in (inhales) and a nice, long juicy exhale out (exhales).VEDANTAM: There are some commonly accepted ideas about what it means to be healthy. Healthy people eat lots of fruits and vegetables. They don't do drugs. And of course, they exercise.UNIDENTIFIED EXERCISE INSTRUCTOR: Draw your palms together at the heart. Take a deep breath in. Each time we...VEDANTAM: While physical activity and food dominate our discussions about well-being, the importance of social interaction is often overlooked.UNIDENTIFIED WOMAN #1: I think the movie was better than the book.UNIDENTIFIED MAN #1: I'm all right.UNIDENTIFIED WOMAN #2: What's your horoscope?UNIDENTIFIED MAN #2: I'd like a large cappuccino with..UNIDENTIFIED WOMAN #3: Long time, no see.UNIDENTIFIED WOMAN #4: How are you?VEDANTAM: There's a large and growing body of research about how critical social contact is to human survival.UNIDENTIFIED MAN #3: That outfit looks so good on you. Where'd you get those shoes?UNIDENTIFIED WOMAN #5: I'll have a double espresso, please.VEDANTAM: A University of Utah study showed that people with strong relationships have lower blood pressure than lonelier counterparts.UNIDENTIFIED WOMAN #6: I've got to read that book still.UNIDENTIFIED MAN #4: What time is it?UNIDENTIFIED WOMAN #7: It's time for you to get a watch.UNIDENTIFIED WOMAN #8: I'm a huge Carolina fan.UNIDENTIFIED MAN #5: Can you pass the salt?VEDANTAM: Researchers at the University of Chicago found that people who report strong feelings of loneliness are more likely to binge eat.UNIDENTIFIED MAN #6: That place has the best donuts.UNIDENTIFIED WOMAN #9: That place has the worst donuts.UNIDENTIFIED WOMAN #10: I'll take two scoops of mint chocolate chip.VEDANTAM: And at Harvard, one study found that people with good relationships actually live longer and live happier.UNIDENTIFIED WOMAN #11: Happy birthday.UNIDENTIFIED MAN #7: Happy birthday.UNIDENTIFIED WOMAN #12: Happy birthday.UNIDENTIFIED MAN #8: Feliz cumpleanos.VEDANTAM: Our social ties are unquestionably at the core of what it means to be human.UNIDENTIFIED MAN #9: Anything good on Netflix?UNIDENTIFIED WOMAN #13: I just got back from (unintelligible).UNIDENTIFIED MAN #10: Are you going to happy hour tonight?(CROSSTALK)UNIDENTIFIED WOMAN #14: When is the next train coming?UNIDENTIFIED MAN #11: Dinner after work?UNIDENTIFIED WOMAN #15: Long time, no see.UNIDENTIFIED WOMAN #16: Good job.UNIDENTIFIED WOMAN #17: All right, so take a left turn on...UNIDENTIFIED MAN #12: How was your weekend?(CROSSTALK)VEDANTAM: So what happens if you're cut off from human contact?(SOUNDBITE OF MUSIC)VEDANTAM: Later in the show, we talk about the effects of long-term solitary confinement.KERAMET REITER: People talk about not having seen the moon in years or decades and how much they miss that. And then people talk about missing just pure human touch.(SOUNDBITE OF MUSIC)VEDANTAM: First, though, we start by exploring the other end of the spectrum, interaction overload.(SOUNDBITE OF MUSIC)VEDANTAM: In her 20s and 30s, Rachel Leonard lived all over the United States.RACHEL LEONARD: Out in Colorado and upstate New York. And I lived in Vermont for a long time. And then I was living in Asheville, N.C.VEDANTAM: And she traveled - all over the world. She met lots of different people in all these places. To keep in touch with them, she signed up for Facebook.LEONARD: I was traveling in Central America, 2006 and 2007. And I did not have a phone, and I was in pretty remote areas. I signed up then because I kept meeting all these wonderful people. And one of the ways to immediately, you know, connect with them was to friend them on Facebook.VEDANTAM: The site became an important tool for Rachel to keep in touch with people she'd met on her travels, to share her adventures with friends and family back home.LEONARD: That's actually when I started sharing, like, my travels with other friends - my pictures of my trip.VEDANTAM: But as much as Rachel loved traveling and felt good about the choices she'd made in her life, other feelings started to sneak up on her. Having Facebook also allowed her to see what everyone else was up to while she was backpacking in Central America or moving from one city to another.LEONARD: You know, everybody is getting married. Some people have one child. Some people have two children. All my friends have these high-power jobs, and they own houses and all of these things.VEDANTAM: These feelings were at the back of her mind a few years later when she met a guy and decided to start a relationship.LEONARD: I met him, and I had been planning to leave the country and go to Southeast Asia to teach. And I met him in December. And I was supposed to leave in June, and I didn't go.VEDANTAM: Her new boyfriend asked her to stay with him in Asheville, N.C. She wasn't sure it was the right thing to do, but she agreed.LEONARD: It was a turning point in my life in lots of ways because, up until then, I'd kind of been this free spirit and did what I wanted and traveled a lot and still had that wanderlust. But I was also 33 and kind of looking around and realizing that other people were getting married and having kids. And I decided maybe I should try this out.VEDANTAM: Soon, like so many of her friends, she was posting pictures and details about her happy relationship.LEONARD: We got engaged pretty quickly. And, you know, at this time, I'm posting my pictures. I'm posting our hikes. We lived in, you know, the Blue Ridge Mountains, so we'd have these beautiful hikes and this lovely little town, and of course I'm posting all of this.VEDANTAM: Her engagement was chronicled, the new house they moved into, the view from the porch. All of it look beautiful on Facebook.LEONARD: If you looked only from the porch, you could see mountains straight. But if you looked to the left, you could see this huge factory. But of course I didn't take pictures of the factory 'cause why would you do that?VEDANTAM: Because Facebook is not a place for pictures of ugly factories.LEONARD: It was very taboo not to share positivity. No one ever put negative stuff on there. And if they did, people were like - what's going on with blah, blah, blah? So it was always about being positive and showing your best side and your best moments.VEDANTAM: Facebook is also not a place for ambivalence. Celebrating triumph? That's welcome. Mourning a tragedy? That's OK, too. Expressing uncertainty and doubt? Not so much.We all intuitively understand the rules. Posts about engagements and babies will receive ravenous applause. News about a grandparent passing away will elicit virtual hugs. But fears about not making rent, marital tensions, hesitations about becoming a parent? Those are verboten.Rachel started to feel constricted. The more she posted about her happy life on social media, the greater the disconnect she felt with her real life.LEONARD: I know now that at the time, while it looked great and it looked right, it didn't really feel right for me. But I think that putting it out there and having my friends say - oh, this looks so wonderful. You look so happy. This is great - it was kind of my way of convincing myself it was. And I'd say that the more things didn't feel great, the more I posted.(SOUNDBITE OF MUSIC)VEDANTAM: The gulf widened between her real relationship and the Facebook version.LEONARD: What I'm not posting is that we fought a lot. And what seemed to be kind of perfect to other people was not.VEDANTAM: When the new couple took a trip to Charleston, Rachel says her friends on Facebook only saw the beautiful pictures. She posted photos of the two of them sitting on the beach, drinking mimosas, eating good food.LEONARD: And really, we were fighting the entire time. I had actually tried to break up with him, and it was a miserable trip. But I didn't tell anybody that. And I - you know, what I shared was the pictures of us in front of the fountain or at the aquarium or eating something delicious and not that we fought 90 percent of the time. You're kind of curating your life with just these very specific moments, the best of the best that you're putting up there with no context.VEDANTAM: More and more, Rachel found that she was turning to social media for validation. She wanted confirmation from her social media feed that her life was on track. The more she posted photos of her relationship, the more positive feedback she got. Like...LEONARD: I'm so happy for you. You're finally settling down - 'cause I'd been traveling forever. And, you know, you look great. You two look beautiful together.VEDANTAM: So Rachel convinced herself that this was what she wanted. She had constructed a beautiful version of the truth, and now she felt she had to live it. She got married, posted photos of the wedding. She says that she and her husband moved to a new city. They both got jobs. They bought a house, put down roots.LEONARD: You know, on the outside, it looked like we had this beautiful new house. And he had this great new job, and I had this great new job. And still, things were not good.VEDANTAM: The house looked beautiful from the outside but ended up being costly and difficult to fix. Worse than that, Rachel increasingly felt she was with the wrong person.LEONARD: The best way that I can put it is that we were just not suited for each other. And I knew it. I think that part of my psyche was just trying to ignore all of these signs that were just this person and I were not - we were not matched well.VEDANTAM: Rachel quickly got pregnant. She had a difficult pregnancy. But, again, that wasn't something she shared on social media.LEONARD: It was taboo to say that this doesn't feel good, this is really hard - as if you're not grateful that you were pregnant. And instead of being able to say those things out loud, I just posted pictures of my growing belly and, you know, cute things and working on the nursery and, you know, things like that instead of really focusing - or sharing what was going on for me internally.VEDANTAM: The unhappier Rachel felt, the more she posted. And she spent a lot of time looking at other people's posts, too.LEONARD: I would just scour other people's lives. I would just - to compare, you know, their happiness against my happiness, you know. Am I - I felt like I shouldn't be feeling the way I was feeling.VEDANTAM: It seemed like the grass was always greener for everyone else. Everyone else seemed more successful, happier in their marriages, having more fun with their pregnancies and the early days of motherhood.(SOUNDBITE OF MUSIC)VEDANTAM: Eventually, Rachel's marriage fell apart. She says she decided to move back to Cleveland, where her family is from, along with her son. And in that moment, something happened.LEONARD: You know, what was really interesting was when I knew I was moving back to Cleveland, I was trying to kind of put feelers out there because I knew I needed to find a job. And I didn't know how to say it without really saying what was going on.And so I, you know, posted that my son and I were coming back to Cleveland and we'd be there in June and I was looking for some - you know, a new adventure, something like that - put some spin on it. And I got so many private messages from friends of mine who were like, are you guys getting divorced? Blah, blah, blah, and I have been separated for six months or we're getting divorced or I've been divorced for two years.I had no idea. These were people who I looked at their lives. And maybe if I hadn't been so hyperfocused on my life, I would have maybe noticed that their husbands were not in all the pictures anymore. It was eye-opening.VEDANTAM: Once the spell was broken, Rachel realized something.LEONARD: I look at social media differently now. In fact, when people are posting a ton of stuff, I'm always kind of like - I wonder what other story is happening - not that there has to be doom and gloom and negativity. But there's always another story. There's always something else going on. There's context you could never pick up if you didn't know.VEDANTAM: There's always another story. We might know this intellectually, but we still often feel a sense of social comparison when we look at our social media feeds.OHAD BARZILAY: So it's not that you think that others are happier than you are. But you need to prove yourself to yourself over and over again. And this social comparison engagement makes you less happy.VEDANTAM: When we come back, we'll explore how the amount of time you spend on social media can determine how happy you are. Stay with us. This is NPR.(SOUNDBITE OF MUSIC)VEDANTAM: This is HIDDEN BRAIN. I'm Shankar Vedantam.(SOUNDBITE OF FILM, "THE TRUMAN SHOW")UNIDENTIFIED ACTOR #1: (As character) All over the world, in every language and culture, Truman is the ultimate media star, uniting us all in history's greatest entertainment endeavor, "The Truman Show."VEDANTAM: In the 1998 movie "The Truman Show," Jim Carrey is a star of his own reality TV show but he doesn't know it. His entire world is constructed by producers. His wife, his kids, his colleagues, they're all actors. His life is a series of scenes shot to appeal to an audience.(SOUNDBITE OF FILM, "THE TRUMAN SHOW")UNIDENTIFIED ACTOR #2: (As character) Truman's life is as real as anyone else's life. It's merely slightly planned.VEDANTAM: Truman eventually found that living inside a television set kept him from discovering his real life. Like Truman, many of us today find ourselves living inside a carefully curated world. The difference? These worlds are of our own making, on Facebook, Instagram and Twitter. When I first heard Rachel Leonard's story, I kept thinking about a tragic irony. She constructed a fake world to keep up with the happy lives of all her friends on Facebook, but many of her friends were doing exactly the same thing. They were trying to keep up with her. Everyone was posting pictures of that beautiful vacation. No one was saying anything about the fight they'd had during the car trip.LEONARD: What I'm not posting is that we fought a lot.VEDANTAM: You don't need me to tell you that there are many wonderful things about social media. It gives us an easy way to stay in touch with people we care about. But many studies have shown that people who use social media frequently appear to be unhappier than those who don't. Until recently, it was impossible to say whether this was correlation or causation. Do lonely people spend more time on social media in an effort to escape their loneliness, or is social media itself causing people to feel isolated? A recent study at Tel Aviv University has provided what may be the first experiment to sort out correlation from causation.BARZILAY: Yes. So my name is Ohad Barzilay, and I am a faculty member at the Coller School of Management in Tel Aviv University.VEDANTAM: Ohad and his colleagues wanted to test whether spending time on Facebook actually made people feel worse. They happened on what psychologists call a natural experiment. A security firm in Israel decided to restrict the Facebook use of its employees. No one was allowed to use Facebook at all for security reasons. The employees had to delete their accounts if they wanted to continue working for the company.But then after some time, the firm decided to allow some employees to reopen their accounts. They effectively created two groups, one that used Facebook, one that didn't. None of these people were choosing which group to be in so it couldn't be that people who are unhappy were the ones choosing to use Facebook. Ohad and his colleagues collected data about the employees from the time no one was allowed to use Facebook and a few months after some employees were allowed to use the social media website.BARZILAY: We decided to focus on Facebook's effect on social comparison, the perceptions of others' lives and happiness.VEDANTAM: Social comparison, the very thing Rachel struggled with, looking at other people's lives and trying to figure out whether she measured up.LEONARD: I would just scour other people's lives. I would, just to compare, you know, their happiness against my happiness.VEDANTAM: Ohad and his colleagues looked at both groups, and they found a few interesting things.BARZILAY: Our first finding is that using Facebook makes you more comparative. You compare yourself to others more often. You judge yourself, you compare. Am I better or worse than my friends? Am I happier? Are they happier? And so on.VEDANTAM: One surprising thing is that the study did not find that people thought others had better lives. They weren't fooled by all the happy vacation and anniversary pictures posted by their friends.BARZILAY: We know that people post on Facebook mostly positive things and they under-post negative things about their lives. So other studies have argued that users that use Facebook think that their friends have better lives than they have. So we did not find any support for this argument, and we think that maybe people make a correction in their perception and they know that people present a better version of themselves.VEDANTAM: In other words, many people reach the same conclusion that Rachel did.LEONARD: There's always another story.VEDANTAM: In spite of this, the researchers found that the employees who used Facebook became less happy over time compared to those who were prevented from using Facebook.BARZILAY: Being engaged in excessive social comparison decreased one's happiness. So it's not that you think that others are happier than you are, but you need to prove yourself to yourself over and over again, and this social comparison engagement makes you less happy.VEDANTAM: You need to prove yourself to yourself over and over again. In other words, it's not enough for many of us to know we're having a good time. It's not enough to take a beautiful photo, filter it, post it, see how our friends react. We also want our lives to be better, or at least as good as the lives of our friends.Comparing yourself to others doesn't just steal happiness because you discover that other people seem happier than you are. Comparing yourself to others steals happiness because the very act of comparison takes you out of the life you're living. It takes you out of the moment. The fear that others are leading happier lives than you are has a common nickname, FOMO, the fear of missing out.BARBARA KAHN: This particular thing of FOMO for me came from my daughter. My daughter's in her late 20s, and I just observed her friends and she experiencing FOMO and just driving themselves crazy from it.VEDANTAM: Barbara Kahn is a researcher at the University of Pennsylvania who studies perception and decision making. She became interested in studying FOMO after observing a situation with one of her daughter's friends.KAHN: One of her friends chose to go to a wedding in a beautiful locale instead of going to a beach weekend where the other friends were going to be. And instead of enjoying the wedding that she was at, she was looking at Facebook and looking at the activities of her friends at this beach weekend, which was a routine thing. It wasn't a special occasion at all.VEDANTAM: Here's the crucial part. The friend who went to the exotic locale for the wedding didn't think the beach was a better option. She chose to go to the wedding because she felt it was the better choice. Seeing her friends back at the beach didn't make her question her decision, but it did take her mind away from the beautiful spot she was in.KAHN: I think people make decisions and then FOMO undermines their enjoyment of the decisions that they've made.VEDANTAM: Now, as Barbara Kahn points out, FOMO means a lot of different things to different people. It's entirely possible, for example, that the friends who went to the beach vacation were looking at photos from the beautiful destination wedding and feeling like they were the ones who were missing out. But Barbara says the type of FOMO she ended up focusing on through a series of experiments is a very specific feeling.KAHN: What we found out from a lot of experiments that we ran, the thing that was generating the FOMO, the feelings of fear of missing out, it isn't really a fear. It's like a social anxiety, and it's really more about what are your friends doing in building up their social group history that you're missing out on? So it's not really about the experience per se.In all of our experiments, we found that it was really more a function of an anxiety that something might happen in a group experience that will shape the group history in the future that you may not be part of, and that will undermine your group belongingness. And in fact when we went back and said, OK, if you could make this decision again, would you choose to go to the beach weekend or to the wedding - although we didn't use that example in our studies, but that kind of thing - would you choose to go to the clearly better experience, or would you go to the routine thing your friends were doing on a regular basis?Almost every time, people said, no, I'd go to the exotic event. It wasn't that they didn't think that the exotic event was better and the smarter decision. They had no regret about making that decision. What they were anxious about - and we're using the word anxiety - was that maybe something would happen in the group that would forever change the dynamics of the group, and they wouldn't have been there when it happened.VEDANTAM: To be sure, envy and social anxiety were not invented by Facebook and Instagram and Snapchat, but Barbara Kahn says these platforms make us much more aware of all the things that are happening without us. She's run a series of experiments, each with a couple hundred undergraduates, testing the hypothesis that FOMO undermines our happiness with the decisions we've made.KAHN: What I think social media does is it allows you to see these routine things your friends are doing that you really never paid much attention to before, but when you see it on your phone or, you know, if you're looking on a tablet or online and you're just observing that your friends are doing something and you're not there, that's something you didn't get to see before. And suddenly you have this pang. I wonder what they're talking about. Or, what's happening? I'm not there.VEDANTAM: So even if you spent the day ziplining through the Costa Rican rain forest, when you get back to your hotel that night and check Facebook, knowing your friends are having a barbecue in Poughkeepsie diminishes some of the pleasure of the ziplining adventure. After seeing the photos of your friends in Poughkeepsie, Costa Rica now seems a little less magical. FOMO, the fear of missing out, leads to actually missing out.KAHN: Assume you have an opportunity to go to a concert of a musician you love and you never get to see, or you get to go to an exotic vacation, and you choose to do that rather than go to a routine barbecue with your friend. It's exactly set up like that. So we say assume you do that. Then the experiment is, in one condition, we say now assume while you're on vacation, you pick up your phone and you see your friends enjoying themselves at the barbecue.And in the other condition, which is the controlled condition, you pick up your phone and you scroll and you look at something, but it's not pictures of your friends. And then what we do is we - before we ask you to look at those pictures, before that manipulation, we measure how much you're enjoying your Hawaii vacation or the exotic concert or whatever. We have you either look at the pictures of your friends or not, and then we measure again how much are you enjoying where you are now? And what we find is a significant decrease in enjoyment when you've looked at the pictures than when you haven't.VEDANTAM: Barbara Kahn and her team are doing more experiments, but if their findings hold, they say something really sad about our use of social media. The fictional worlds we construct there can make our friends feel their lives are inadequate, and the fictional worlds our friends construct can make our lives feel duller than they actually are. As for Rachel, she's in a new relationship now and she says she's happy. She has a new job, and she and her son are doing well, but she doesn't feel the need to publicize any of this on Facebook.LEONARD: I don't take a lot of pictures anymore. If I'm there in a moment, and I'm having that moment, who's the picture for, you know? Is it for me to remember, or is it - you know, I'm - I am trying to live more presently for myself and for my son and just for my own mental well-being.VEDANTAM: She's asked her new boyfriend not to post about their relationship on social media, either. This time, the good moments and the bad will be theirs alone.(SOUNDBITE OF MUSIC)VEDANTAM: While many of us spend too much time on social media interacting with friends and acquaintances, some of us have too little contact with fellow human beings.(SOUNDBITE OF RADIO SHOW)UNIDENTIFIED RADIO HOST: All right. And next up, we have Diana (ph) shouting out to the Polunsky Unit.DIANA: Hito (ph), it's Mama D. I know I sound kind of different. I'm very sick right now, got diagnosed with pneumonia. Been sick already for quite some time now.VEDANTAM: This is the voice of a woman calling into a radio show on the Texas station KPFA. She has a personal message for a prison inmate.(SOUNDBITE OF RADIO SHOW)DIANA: Anyway, I want to tell you, Hito, that Mama D loves you. I always think of you. And it's just getting harder and harder. I know I'm not supposed to cry 'cause you're going to get mad at me. But I can't help but feel so much love for you.VEDANTAM: Calling into a program like this is one of the few ways for spouses and parents and children to communicate with prisoners, especially inmates in solitary confinement. In recent years, both liberals and conservatives worried about the psychological and financial costs of long-term solitary confinement have raised questions about the practice.In the second half of our show, we explore what happens inside the prison cells that few people ever see and the psychological effects of being alone for long periods of time. That's coming up in just a moment. I'm Shankar Vedantam. And you're listening to HIDDEN BRAIN from NPR.(SOUNDBITE OF MUSIC)VEDANTAM: This is HIDDEN BRAIN. I'm Shankar Vedantam. Social contact is a fundamental aspect of human life. So what's it like to spend vast stretches of time in solitary confinement, to live without the hundreds of interactions that most of us have with people around us every day?Keramet Reiter has spent more than a decade researching the effects of loneliness on these inmates. She's a professor of criminology at the University of California Irvine and the author of the book "23/7: Pelican Bay Prison And The Rise Of Long-Term Solitary Confinement." Besides being a researcher, she's also been a prisoner's rights activist at Human Rights Watch. Keramet, welcome to HIDDEN BRAIN.REITER: Thanks for having me, Shankar.VEDANTAM: You can't tell the story of solitary confinement without understanding the story of a man named George Jackson. He was sent to prison in the early 1960s after pleading guilty to armed robbery. And he was sentenced to a term of one year to life. What was the thinking behind this kind of indeterminate sentence?REITER: So the idea for someone like George Jackson was that he would go to prison, and he'd have to prove that he'd been rehabilitated before he could get out of prison. Around the time Jackson went to prison, however, people started to look at these indeterminate sentences and realize that they were having truly disproportionate impacts depending on the race of the person with the sentence. So white people had a much easier time convincing prison officials that they had been reformed and should be let out of prison than African-American men like George Jackson happened to be.So George Jackson found himself, essentially, stuck in prison. Years went by when he was denied parole, and he became radicalized in this process. He wrote a book of best-selling letters that achieved national and international acclaim - letters to his family and to his lawyers - articulating his revolutionary politics and the problems with things like this indeterminate sentence.This brought him to the attention of prison officials, and he was accused of murdering a prison guard in the early 1970s. And he was preemptively sent to death row at San Quentin while he awaited a death penalty trial for that murder he was accused of. And while on death row at San Quentin - in an isolation unit, interestingly - one day, his lawyer came in to visit him.And this story that prison officials tell - and it's been repeated many times - is that his lawyers snuck a 9-millimeter gun into him inside of a tape recorder and that Jackson then used that gun to try to escape from this isolation unit. All we actually know is that he was shot to death on the San Quentin prison yard as he ran out of that isolation unit.And when staff ran into the unit to see what had happened, they found three officers and two more prisoners who'd been stabbed to death. So this was the most violent day in California's prison history ever - six deaths total on August 21, 1971. And this moment is a moment that people point to in California as incredibly important in understanding why the state needed long-term solitary confinement units.And similar things happened across the U.S. And prison officials in other states point to those moments. So two weeks after George Jackson died, the revolt at Attica happened. Similarly, following that, prisoners were locked into their cells. And that became a moment people pointed to as a justification for really long-term solitary confinement.VEDANTAM: You also tell a story of a prison administrator Carl Larson, who began his career the same year that George Jackson went to prison. I understand you interviewed Carl Larson. And his view gives us a glimpse into the other side of the story, how prison guards and prison officials see the need for solitary confinement.REITER: So Carl Larson was one of the earlier people I interviewed in doing this work. And to my surprise, we got to be friends. I came at this work from a perspective of a prisoner's rights advocate very critical of the system. But as I got to know Carl Larson, I saw that he had a really interesting perspective on the system.And he was one of the first people to point me to the story of George Jackson and to explain how scary it was to be a guard working in the California prisons in the 1970s when these deaths were happening and to make that fear real for me in a way that helped me to understand why he thought a long-term-solitary-confinement facility made sense.So Carl Larson is particularly interesting because, as you said, he started out as a - as an officer in the 1970s in California prisons, actually even earlier. And then he worked his way up through the system, becoming a warden and then becoming head of the prison construction projects that California engaged in in the 1980s when the state built one of these long-term-solitary-confinement supermax facilities.And he takes credit for designing one of the first of these institutions. And that's really interesting because he's a prison administrator. He's not an architect. He's not an expert in exactly what kinds of punishments work. He didn't have a law degree. He had just worked in prisons. And he designed this completely new facility.VEDANTAM: I understand that there was some interesting architectural features with this facility, Pelican Bay. The cement for the facility was poured in one large block and - so that the cells were not built in individual units.REITER: So one of the things that's striking about the place is it's made of these poured concrete cells. So they're incredibly easy to hose down, which is - the fact that they can stay clean is important because courts earlier had criticized isolation units for being really dirty. And they're grouped together into these pods of eight.And then the pods of eight are grouped together again into these tessellated T-structures so that one officer can look out over six pods of cells at a time. So it's a modern panopticon. And that also - that allows - the fact that there are no windows makes it really easy to just fit all these blocks together, if you can imagine that structure.VEDANTAM: I'm wondering, Keramet, if you can actually just describe what one of these cells looks like? Give me a sense of what's in the cell, how big it is. What does it actually feel like to be in one of these units?REITER: So the cells in these units are generally about 8 by 10 feet. So imagine a wheelchair-accessible bathroom stall or a generous parking space - pretty small. You can, you know, almost reach from one end of the cell to the other. And they're fairly self-contained.So they contain a poured concrete ledge with a very thin piece of foam over it, and that's the bed. And then there's another sort of concrete bit protruding that is a desk-and-seat combination. So it's just like a concrete block that a prisoner could sit on and write there. And then there's - in another corner there's a steel, usually toilet-sink combination. So it's just, you know, one smooth steel object that has running water and plumbing for the prisoner. Sometimes there are showers in these cells, but generally, it's just a sink and a toilet.And, again, if the prisoner is lucky and they can afford it and the system they're in allows it, they might have a TV or a radio. And usually they're allowed maybe a few books at a time and a little bit of paper for writing letters or doing legal paperwork.(SOUNDBITE OF MUSIC)VEDANTAM: To be clear, many prisoners in solitary have been found guilty of heinous crimes including murder, rape and terrorism. But here's something you might not know. Some are there because they're difficult to manage or because of bureaucratic inertia. While judges and juries decide whether someone should go to prison, a decision that can be appealed in court, typically it's prison officials who decide whether someone should be in solitary confinement. I asked Keramet to describe the kind of prisoner who ends up in solitary.REITER: There's been shockingly little research over time on who ends up in solitary confinement and how. And it's very hard to track across states. But as people have paid more attention to this and through the work I've done, I've started to see some patterns that there's a disproportionate racial impact of solitary confinement. So we know that in our prisons in general, African-Americans and Latinos are more likely to be in prison than - in the general prison population.They're doubly likely, again, to be in solitary confinement than even the general prison population. And that's often because gang members are being targeted for long-term isolation, especially in states like California. Prison systems are not putting people there based on some act or rule that they broke but based on their status as dangerous. So prisoners get labeled dangerous gang members and they get sent to isolation indefinitely.In general, I think one way to think about people who end up in isolation is that it's often the people who are really difficult for the system to manage. So that might include seriously mentally-ill prisoners. There's recent research showing that transgender prisoners are really likely to end up in isolation, that pregnant women end up there. So people who the system just isn't equipped to provide resources to can end up there also.VEDANTAM: Keramet Reiter is a professor of criminology at the University of California, Irvine and the author of "23/7: Pelican Bay Prison And The Rise Of Long-Term Solitary Confinement." So the rise of these institutions coincided in some ways with a decline or closing down of various institutions for the mentally ill, which speaks, of course, to the point that you were just making. But I also understand that this is reflected in the number of suicides we see in solitary confinement compared to the general prison population.REITER: There is a very close relationship between solitary confinement and mental illness. One way to understand that is that in the 1970s and early '80s when mental institutions closed was the same time that mass incarceration and rates of incarceration are increasing across the United States. And that meant that some mentally ill people unsurprisingly ended up in prisons.And one of the arguments I make is that as those people ended up in prison, they tended to be put into solitary confinement. And that's one explanation for the fact that rates of suicide in solitary confinement can be twice as high as in the general prison population or even higher and that rates of mental illness and isolation can be high. And often there's a real chicken-and-egg problem of, you know, did a person get sent to isolation because they were mentally ill and states have tried to limit that, or do people in isolation develop mental illnesses?VEDANTAM: Most of us are never going to see the inside of a supermax. But we often do see scenes of solitary confinement described in pop culture. One of those examples is the TV show "Orange Is The New Black." We have a bit of tape. The character Piper is put into a security housing unit and starts speaking to a voice she hears through the grate of her cell.(SOUNDBITE OF TV SHOW, "ORANGE IS THE NEW BLACK")TAYLOR SCHILLING: (As Piper Chapman) How long have you been down here?LAVERNE COX: (As Sophia Burset) I lost track. I don't know - nine months, a year.SCHILLING: (As Piper Chapman) A year - that's insane.COX: (As Sophia Burset) They keep the lights on, so you lose all sense of time. It's not living. I mean, yeah, you're breathing. But you ain't a real person no more. It's bad. You start to see [expletive] that ain't there. You start to hear voices.SCHILLING: (As Piper Chapman) Oh, my God.COX: (As Sophia Burset) They keep you here until they break you.SCHILLING: (As Piper Burset) I feel like I'm going to throw up.VEDANTAM: Keramet, I'm wondering how accurate that description is of what life's actually like in solitary confinement.REITER: I do think that the disembodied voice that you hear talking to Piper is accurate on a number of levels. The voice is kind of flattened in effect. And the prisoner was describing hearing voices, hallucinations. That's a very common side effect of isolation.And people talk about time - the way they perceive time changing because there is no way to mark time. People talk about it exactly as that prisoner said. It's not that it even feels long. It's just that it's almost endless, that days can kind of, in a weird, counterintuitive way, fly by because there's nothing marking anything about a day or week. So in that sense, it's accurate.(SOUNDBITE OF MUSIC)VEDANTAM: I want to spend a moment talking about your own role in looking at this. On the one hand, you are a researcher who has spent time studying the question. But as you yourself have said, you know, you're also a prison rights advocate. You've been an activist at Human Rights Watch and other organizations. How do you preserve your ability to be analytical about the subject while you also have what are very clearly strong views about solitary confinement?REITER: You know, when I went to interview Carl Larson, he said, well, you're a Berkeley liberal (laughter). So he asked me to do some background reading and prove that I was serious. And I would listen to him. And so I actually think in the process of doing this work, I have become more open-minded and been criticized by advocates for talking so directly and so extensively to prison officials.And so I've had the interesting experience of trying to keep the conversation open across a really broad spectrum of perspectives on this process. And I think in that way, I've been able to try to at least incorporate these different perspectives and tease apart the arguments and the positions people are coming from.And I do think that in reform, prison officials have to walk into these institutions and engage with these prisoners day in and day out. And they also need to be part of the reform conversation. And through this process, you know, surprisingly, even though I came basically from the other side, if you want to think of it in terms of sides, I've come to see that perspective.VEDANTAM: Keramet, what sorts of things do people in solitary confinement say they miss? What are the kind of things that you miss that the rest of us might not think about?REITER: So people talk about not having seen the moon in years or decades and how much they miss that. And then people talk about missing just pure human touch. And you know, I tell a story in the book about a prisoner who - his cell door and the cell door of the prisoner next to him were accidentally opened at the same time. And they were rival gang members. But they had been talking to each other, shouting through the cell walls. And when the cell doors opened, they just reached around and grabbed each other's hands and held on because it had been so long since either of them had had a gentle human touch like that.VEDANTAM: Prisoners often stay alone in their cells for 22 or 23 hours a day. And you found that perhaps the only way to actually manage this psychologically is to stick to a series of very, very rigid routines. Tell me about those routines.REITER: The prisoners who I was able to interview in this research to understand their experiences tended to be the prisoners who survived. And so they did develop all kinds of coping mechanisms. And one of the ones I heard about again and again was that they would wake up, you know, first thing in the morning, 5 a.m. And they would do thousands of repetitive exercises, often what prisoners called burpees - so a combination of jumping jacks, push-ups and sit-ups - and, you know, literally a few thousand in the morning to start out their day and then clean their cells, write letters, work on legal cases.And in general in these units, if prisoners are following the rules and they have money being sent in from family, they can buy either a TV or a radio. And prisoners who develop these routines talk about really limiting the time they spend listening to media, so maybe only an hour a day or two hours a day or a special show they like to watch so that they were keeping both their bodies and their minds really busy really consciously over the course of the day.And interestingly, prisoners talk about having trouble letting go of these routines once they got out of prison, that they would still do those thousands of burpees every morning at 5 a.m. when they got up and that their ability to control everything in their space in that 8-by-10 cell they live in is also hard to let go of, that they could keep - you know, a prisoner described to me how he could keep the cap of his toothpaste perfectly clean. And it was really hard when he had a roommate when he got out of prison - the fact that he couldn't control the cap of the toothpaste anymore - so kind of gives you a sense of how intense it is to survive and then how long those coping mechanisms linger afterwards.VEDANTAM: You talk in the book, Keramet, about inmates trying a number of different things to not just be physically active and mentally active but emotionally expressive, to try and find ways to do artistic things. Can you talk about that for a moment?REITER: Prisoners do struggle to find ways to express themselves. And sometimes that's becoming really good at the law and litigating cases. But very often it's teaching themselves to draw, sometimes teaching themselves to speak a new language, sometimes teaching themselves to sew.One of my favorite stories was a prisoner who told me that he was in isolation for a number of months. And I'm not even sure how he made himself a needle. I know that he pulled threads out of the jumpsuits they're given in order to make thread. And then he started tailoring his clothes so that they fit better. They're often given these very loose jumpsuits. And so he would add cuffs or shorten the sleeves.And I think other prisoners found out about him doing this. And in some cases, a friendly officer would pass a uniform back and forth. And he started tailoring other people's uniforms. It's kind of - and not that anyone is even seeing them. But it's this amazing kind of self-expression and community that they're managing to create in this place.VEDANTAM: I'm sure they're going to be people who say, look; there are lots of people in these units who really are the worst of the worst. Maybe not all of them are, but some of them probably are. Some of them probably are really violent and really dangerous and ought to be there. And I'm wondering, do you ever feel that they might be people who need to be in solitary confinement?REITER: So there are certainly people in isolation who are dangerous. One of the really important points of analysis is the length of time people are spending in isolation, the fact that people - we're not talking about weeks or months. We're talking about years and decades often and that even people who might have been fairly scary or dangerous in their 20s are unlikely to be that way into their 40s and 50s.And as we look at decades of these policies, we see that even some of the people who have been held up as the scariest, the system didn't control them very well while they were in it. And they're doing surprisingly well outside of isolation. So it really does call the practice into question on all different levels.VEDANTAM: So your book comes at a time when many liberals and conservatives have joined hands to call for prison reform. For one thing, keeping people in prison and keeping someone in solitary confinement is very, very expensive. Give us a sense of how expensive it is and whether these ideological pairings are triggering any change in the system.REITER: So solitary confinement is astronomically expensive. In states like California, it costs about $45,000 per prisoner per year to keep someone in the general prison population. And it costs about $90,000 per prisoner per year to keep someone in isolation.So the cost of running the facilities is really expensive because these prisoners in isolation, you know - every need has to be met by someone working in the prison, whether it's delivering mail or or delivering legal documents or getting them a meal. So that's how the costs go up. And the costs of the facilities are also expensive to build these kinds of technologically advanced facilities. And that's not even wrapped into that per-prisoner per-year cost. So I think that has been part of the reform conversation, as you suggest, that perhaps there might be a less-expensive way to do this.One other cost of isolation is that the vast majority of people, even from long-term solitary confinement, ultimately get out of prison. It's a - it's - 95 to 98 percent of all prisoners get out eventually, and that's surprisingly true of people in isolation, too. And so there's the question of, what are the social impacts of letting people out?And I think in combination those economic costs and the social costs, people are beginning to think about alternatives. And that is a conversation that is - crosses political lines. And prison, as I suggested, in many states - legislators are initiating reforms. Some litigation has happened. But in many states, prison officials within the system are looking at the norms changing and the critics of this practice and initiating their own reform, saying what can we do to reduce our reliance on this practice?(SOUNDBITE OF MUSIC)VEDANTAM: Keramet Reiter is a professor at the University of California at Irvine. She's the author of the book "23/7: Pelican Bay Prison And The Rise Of Long-Term Solitary Confinement." Keramet, thank you for joining me on HIDDEN BRAIN today.REITER: Thanks for having me.(SOUNDBITE OF MUSIC)VEDANTAM: This week's show was produced by Maggie Penman and Parth Shah. It was edited by Tara Boyle. Our team includes Rhaina Cohen, Jenny Schmidt and Renee Klahr. Our engineers are Andy Huether and Jay Sciz (ph). NPR's vice president for programming and audience development is Anya Grundmann.If you liked the show, check out our weekly podcast. Search for HIDDEN BRAIN in NPR One, iTunes or wherever you find your podcasts. You can also follow the show on Facebook, Twitter and Instagram and listen to my stories on Morning Edition each week on your local public radio station. I'm Shankar Vedantam. See you next week.(SOUNDBITE OF MUSIC) Transcript provided by NPR, Copyright NPR.