Timothy Caulfield Has a Wake-Up Call For Your Health

The University of Alberta prof's new book takes the stress out of decision-making by serving up some science.

University of Alberta professor Timothy Caulfield has been on the front lines of the misinformation wars for years, taking aim at the wellness industrial complex, anti-vaxxers and spreaders of pseudo-science (including, ahem, certain celebrities who suggest pushing certain jade eggs into certain body parts). His latest book brings the fight not just to your front door but inside your kitchen, living room, bedroom — even your bathroom, as you’re deciding, for the 1,346,687th time, if you’re really going to floss.

Relax, Dammit! A User’s Guide to the Age of Anxiety examines all the decisions we make throughout the day and determines how many of them are guided by science versus misinformation. Should you check your phone before getting out of bed? Is it good or bad to weigh yourself? Unloading on your partner about your workday is healthy, right? Caulfield tackles these kinds of questions in the same breezy, accessible style that’s earned him more than 64,000 followers on Twitter, where he’s one of the top policers of the misinformation army.

He acknowledges that at times, it feels like a losing battle. But the guy just loves science. And there’s a distinct note of hope in the dedication of Relax, Dammit!, which reads: “To science. Hang in there.” Does he believe the trend toward pseudo-science may be losing some of its steam?

“You have to be hopeful,” Caulfield, 57, says over the phone. “Some people say, ‘What’s the point in fighting this — you can’t make a difference.’ Well, first of all, the evidence says you can make a difference. But also, just think about what it would be like if we didn’t fight — if the only voice out there was the noise.”

We talked to him about how science can help de-stress modern life, what it’s been like to watch a global pandemic unfold in real time and whether those paper toilet covers in public bathrooms do any good. (In case you can’t stand the suspense: they do not.)

The book walks the reader through a regular day and the multitude of choices we make (Should I have another cup of coffee? Should I let my kid walk to school herself?) which are influenced by a strange brew of science, pop culture and fear. Why did you choose to write it this way?

First, it’s just fun to go through what the science says about these little decisions. But I’ve always been interested in misinformation, fearmongering, the role of ideology and how these forces affect how science and health are represented. We often think about those issues in the context of big things, like climate change or vaccination hesitancy. I thought if we structured the book around these little decisions we all make, it would bring it home, because the same forces are at play. It was a way of exploring and making relevant to people how these social forces impact decision making.

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There’s no debating that breakfast has become the most venerated meal of the day. But the science on its benefits, Caulfield points out, is quite mixed. Most evidence is generally pro breakfast, but experts warn of its importance being “massively oversold.”

I try not to say, “This is the way you must do it.” Instead, I try to paint a picture to show when the facts might be unclear and then show how other social forces shape our thinking — you, me, everyone. Knowing this will perhaps be liberating, in the sense that people won’t be as stressed out about their decision making.

For instance, I’m drinking my third cup of coffee today and am not going to sweat it.

Me too!

You outline three main paradoxes that go into our decision-making process: the knowledge-era paradox (the fact that increased access to better information does not necessarily lead to better-informed decisions), the less-risk paradox (our desire to avoid any kind of harm — enter fearmongering) and the perfection paradox (the compulsion to chase what ultimately is an unachievable ideal). Which one do you think contributes most to anxiety?

I’ll say that the less-risk paradox really speaks to our time. It’s a cheat because it goes hand in hand with the new information environment we have in social media, the speed at which we get information and the degree to which society is an amplifier of risk. Society is becoming increasingly structured in a way that brings together forces that twist what we hear about science —both more broadly and specifically about our health. Yes, there often are entities that are focused on it — they want to market a product to you, or they have some ideology they want to get across — but it’s also a systemic problem. These things work together, and our cognitive biases fit into the way social media feeds us that information.

(Related: This Nutrition Expert Is Encouraging You to Eat the Cookie)

You say perspective is important when talking about risk. That got me thinking about the past year — the way we’ve all been isolating makes it hard to maintain a baseline level of perspective. Do you think the impact of this pandemic will exacerbate the less-risk paradox in the future?

Yes. We’re all spending more time online. There’s interesting research that looks at social media and how being online all the time, and being bombarded in a chaotic information environment, can stress us out. It makes it more difficult for us to tease out what’s real and what’s not. There’s also some research that suggests it causes us to share misinformation more. So we’re just getting this worst-case scenario — this cycle of fear. We’re getting all this information about the pandemic while being stuck at home, which creates a tough situation with respect to not just fear and risk perception but also the spread of misinformation.

Another interesting thing about the pandemic is that you get anti-maskers and anti-vaxxers saying, “Oh, it’s not risky to me.” Risk to the community is another perspective that’s being lost, and increasingly so. So it is going to be very interesting to see how this plays out.

On a more “glass half full” note: There’s a study that just came out that shows people are taking the pandemic more seriously, even in the United States. More people are wearing masks. Given the politics in the U.S. over the last while, that’s a remarkable achievement. In Canada, we’re seeing trust in the vaccine tick up. And I think that’s partly because of the efficacy and good research behind it but also because of the increase in science communication.

What’s the most useful tip you have for someone who’s faced with a bunch of unequivocal information and doesn’t have you on speed-dial? How do they navigate that knowledge paradox on their own?

Over the past couple of months, people have been saying we need to improve our critical-thinking skills and our media literacy, and it creates the impression that there are really difficult tools people have to learn…but it’s not difficult. There are fundamental, straightforward things people can do that don’t take that much time. One of them is checking the evidence that exists to support a claim. If it’s a testimonial, be suspicious. If it’s just one study, be suspicious. If it’s an animal study, be suspicious. If they’re trying to sell you something, be suspicious. These are all things you can look for that will give you a sense of the quality and credibility of the evidence being used to support a claim.

The good news is, there’s evidence that if you teach these straightforward things to people, they are more critical and better at discerning what’s real and what’s not. In fact, even just pausing to consider the truth of something and doing a brief check increases the likelihood of not sharing bad information.

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Does anyone actually (really?) floss? And does it matter? More data is needed for a definitive answer, but brushing appears to be the superior practice. Still, if it makes you feel good, Caulfield writes, go ahead. Just make sure to do it before you brush.

After doing all the research for this book, is there anything you feel 100 percent okay about saying, “You can stop worrying about this”?

Sitting on a public toilet seat. The worry people have about that is very real.

Anything else we can stop debating?

The uselessness of meetings at work is pretty well documented. The other one, and I love this topic and could have written a whole book on it — is how ranting isn’t good for you. I know these might seem esoteric, but they are good examples of little things in our lives we get wrong, sometimes just because we listen to intuition. I mean, who wants to sit on a common toilet seat? And ranting does feel like it should work.

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And was there anything that, prior to writing the book, you felt pretty relaxed about but then started taking more seriously?

How I handle my email. I joke that if you’re downtown in a big city and you see a crowd of people, then you’re looking at a crowd of email answerers — that’s how dominant it is in our lives. I learned how to manage my email and not get too stressed out about it, and it seems like a little thing, but it made a big difference in my life. I could wake up in the morning and do nothing but answer email for 10 hours.

Yes, I think that’s a common feeling.

Exactly. And if you realize you’re never going to get on top of it, you’re never going to get to “inbox zero” — that’s the type of thing that lets me manage my life a little bit better.

On a related note, you also call out the illusion of “time panic” — the idea that there’s just never enough time. Saying that it just doesn’t exist completely blew my mind. How is it possible that it’s all in our heads?

Honestly, I thought more people would be angry about that part of the book and say, “But I am busy!” I think that’s because, in some ways, we all recognize life is just structured to make us feel very busy. We carry our office around in our pocket. We always could be doing something else. The other day I was sitting with my son and watching a football game, and my phone was with me, and I felt guilty that I could be answering an email. We live in this chaotic information environment, where we’re always capable of working all the time, and that creates the feeling of being busy even if we’re not necessarily so. Of course, there are people who are incredibly busy, but when you look at the global data, it shows we really aren’t as busy as we think we are.

About that office in your pocket… The number of times a day we decide to check our smartphones is staggering. You raise the idea of how our phones increase our capacity for “absent presence” — I admit that put a chill directly into my heart. It’s a terrible truth to realize about how you’re living your life.

Yeah. There’s that story I tell, where my son came in, all excited about his report card, and I pulled out my damn phone. We all do it. And even if you don’t pull out your phone, you’re thinking about it.

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I think people are familiar with the detrimental effect smartphone addiction has on health, but it feels like too big a problem to tackle. We are connected to our phones all the time. What is one change people can make that would have the biggest payoff?

There are two things I try to do. First, I put my phone away in my office when I’m done work. So if I want to check it, I have to get up and go into my office. And then I try not to check it at all after 9 p.m. It’s not that my phone stresses me out, necessarily, but it does keep my mind active.

And I’d add, definitely don’t take your phone into your bedroom. A colleague I work with in the U.S. actually has a little bed she puts her phone in, and she puts a little blanket over it. I love it. It may be a bit of an obvious thing, but it makes such a huge difference, especially in the quality of my sleep.

And the other thing I try to do is create some blackout times throughout the day. When I first started doing this, I aimed for only a half an hour — 30 minutes with no email, no social media. It’s hard to do.

Relax Dammit CoverCourtesy of Penguin Random House

Let’s talk a little bit about stress. There are some pervasive beliefs that chronic stress —and I’m talking about the garden-variety kind, that’s not brought on by poverty or conflict — can make you sick. So then we stress about not practising enough self-care. Then the wellness industrial complex reinforces that anxiety. What’s your take on how stressed we should be about stress itself?

First of all, I just want to be clear that we’re not talking about stress in terms of a mental health issue. If people are feeling high levels of anxiety, they need to reach out to a doctor. But in general, being anxious and being stressed out, especially about something like a pandemic, is a natural reaction. So how can we respond to it? One of the themes in my work is that we should, as much as possible, focus on evidence-based fundamentals, and this is relevant when we talk about living a healthy lifestyle and how to deal with anxiety: Exercise. Get a good night’s sleep. Eat a healthy diet.

Another thing to layer on top of those fundamentals is to step away from the noise when you can. There was a great piece in the New England Journal of Medicine recently about mental health issues stemming from the pandemic, and one of the recommendations was to take a break from all the chaotic and conflicting information we’re bombarded with all the time. I think taking those steps will not only help with your stress but also allow you to increase your critical thinking. There’s actually a little bit of evidence to back that up as well — that if you can just take a pause and reflect, you’re less likely to share misinformation, and you’ll be better at critically assessing the content circulating on social media.

Timothy Caulfield Headshot Courtesy of Penguin Random House

It must be a bit of a trip to be releasing this book now. What’s it been like to be Tim Caulfield — a guy ruled by science and reason — over the past 10 months, as the world’s been trying to figure out how to deal with a global pandemic in real time?

It really has been bonkers. There have been some days when it’s been incredibly frustrating, and others when I’ve sympathized with the public health authorities trying to struggle with the uncertainty of the science. It’s a unique time, because people are watching the science unfold and maybe don’t like what they’re seeing as the sausage gets made.

There’s been a lot of confusion about the science, but the spread and the embrace of misinformation — I’ve never seen anything like this.

The silver lining, if I can use that phrase, given the time, is that there are people who are taking misinformation more seriously now than I’ve ever seen before — in health organizations, and governments, at provincial levels and around the world. Hopefully that will have long-term implications for how we deal with it in the future.

It’s been interesting to see so many doctors and scientists also step up and become much more active, raising their voices on Twitter and other platforms to help explain the science, and use it to challenge policy decisions.

You’re right — we’re seeing the creation of this wonderful community of scientists, clinicians, science communicators, students, nurses, pharmacists, physical therapists, teachers and just people who are passionate about battling misinformation. I really hope it becomes a bit of a social movement that carries on — a legacy of the pandemic.

This interview has been condensed and edited for clarity.

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Originally Published in Best Health Canada