“What were you just thinking?”

“Are your thoughts related to your inner desires?”

“Do they reveal who you REALLY are?”

These are the questions Alix Spiegel and Lulu Miller explore in NPR’s new show, Invisibilia (Latin for “all the invisible things”).

With the first episode, The Secret History of Thoughts, we are introduced to a man referred to only as “S” gripped by violent thoughts of killing his wife, and another man trapped inside his body for 12 years; his thoughts being the only thing he could control.

Invisibilia proved to be a prime example of what The Hollywood Medical Reporter aims to examine and discuss. Granted film and television have taken much of the influence once held by radio, the later has not been extinguished by a long shot. Radio and podcasts remain quite popular. As such, so does their influence and power.

This show exemplifies the possibility of that power. Spiegel and Miller take a scientific topic – such as modern psychoanalysis – and shape their presentation with a personal human narrative. The listener gets pulled in – not wholly, but arguably in large part – by the human story of a man consumed with the thought of stabbing his wife, and along the ride learns of the various forms of psychoanalysis the man experienced.

The first episode alone offers such a vast array of topics to discuss that we will be breaking up this coverage into two parts. The first installment we will share our interview with co-hosts Alix Spiegel and Lulu Miller.

How do you pick your interview subjects?

AS & LM: This depends a lot on the subject of the story, but when our focus is someone with an unusual brain condition, we usually talk to a bunch of people with the condition (six to twelve, sometimes more sometimes less) by telephone. We interview them enough to get a decent sense of how they are experiencing the world and what they have to say – then we set up studio interviews with two or three of them. From there we will usually focus on one in particular to visit in person and build into the main subject of the story. That person is picked because there was something they said that seemed particularly interesting, or they are just open to talking about their experience. It’s not really a science, it’s more like a gut reaction to the interview. There are some stories where it’s not possible to talk to a bunch of different people. For example this season we did a story about someone whose brain makes her biologically incapable of fear. That is such a specific condition that it wasn’t possible to talk to a bunch of people about it.

How does this decision factor into the shaping of the tone and general content of the given episode?

AS: I think what’s important is that they seem representative of what it is that you are trying to explore and they seem trustworthy. It’s not possible to know before you sit down for the actual in-person interview what the shape of their story is going to take, what their real experience has been. You just have to talk and see where it goes.

What are your hopes for this program?

AS & LM: We hope it will be received kind of like The Interview was – we’re looking for a statement from President Obama and maybe a formal complaint against us at the UN by North Korea, but we’re kinda doubting that will happen.

Our more realistic hope is that these stories expand listeners’ own thoughts and understanding. We want to be thought-provoking! And we also hope that some people will find a kind of comfort or edification in the stories and that those people will tell their friends about it and then some of those friends will also find a comfort or edification in the stories. We’d be really happy with that.

Do you employ medical experts to assist and advise you on how to go about this project, particularly in regards to any potential caution that may or may not be needed in choosing your interviewees?

AS: I don’t think that we’ve talked to anyone on the show who has been dangerous in any way. Our first program involves someone who initially sounds like they could be dangerous, but the story is about how he is actually one of the most decent, non-violent people you will ever meet. We do talk to lots of scientific experts though – tons of them – and they always give us advice on what we are doing.

How did you come to choose this as NPR’s newest program? What went into this decision?

EN: At NPR, we like to maintain an innovative culture, so we are vetting new ideas all the time. Sometimes it is for a radio show, a special series, a podcast, a blog—lots of ideas percolate all the time. For new shows, like Invisibilia, we follow an iterative development process, which means we work on new ideas a little bit at a time so we can really understand the idea, the work involved, and its potential. So an innovative idea like Invisibilia isn’t unique at NPR; it’s just the only idea (of many) that made it this far in the process.

How do you balance being entertaining with being informative; not to mention being reliably accurate and consumer-friendly so as to produce good ratings?

AS: Well we try very hard to be both! Lulu came from Radiolab and Alix came from This American Life, and so we both were trained in how to tell stories that deliver a lot of information in a way that feels fun.

How much would you say good storytelling plays in the success of this and other radio/podcast programming (NPR and not)? In what way, if at all, does the role, technique and implementation of storytelling differ than in other media such as novel writing, screenwriting?

AG: Storytelling is not a technique for us. Because, if you think about it, we all are living our own stories. Life is a story. At home. At work. So, finding and telling stories seems to us like the most natural way to share information. Serving up information, facts by themselves, takes it out of context.

Sure, a lot of the time reporters don’t present the two together, because they need to be quick. Gathering information and getting it out to people fast is often the most important thing. But we are taking the time (and we hope our listeners will too) to keep story and information together.

As for radio versus other media, radio is the most intimate medium, a human voice connecting with your imagination. It’s probably the oldest too, isn’t it? Really fundamental to our human experience. So we think radio is the right medium for Invisibilia.

How common is “Harm OCD,” [the condition which caused “S” to be consumed with thoughts of killing his wife]? Does the intangible nature of its symptoms impact the ability to diagnosis it?

AS & LM: Turns out Obsessive Compulsive Disorder with harming obsessions, or Harm OCD, is a well-recognized condition that is regularly diagnosed. I (this is Alix) had never heard of it before I got an email from someone who had it, but once I started looking into it, I was surprised by how many people had it. To find out more about it you can look here.

Indeed, I have to say (now this is Lulu), once I starting talking to people about this piece we were working on — in which an otherwise normal man is plagued by violent thoughts everywhere he looks — the amount of people that privately confessed they had such thoughts really shocked me. I think maybe it is not as rare as you might think. I think there is huge stigma around it, and thus people are often left alone with these thoughts, worrying about them, which is exactly the perfect way to make them worse.

Also – and this is important – mental health professionals who work with people who have violent thoughts have various ways of diagnosing whether the thoughts are signs of OCD. It’s not as though everyone off the street who is complaining of murderous thoughts is told the thoughts should be ignored; it takes a therapist or psychiatrist time and investigation to get to that point.

And of course, as with any condition, medical or psychological, the diagnosis is always (at least in some very small sense) a bet. Which is sort of the point of the show. Frustrating as it may be, it’s very hard to get to an absolutely scientifically perfectly perfect absolutely certain answer to the question of “how are your thoughts related to your inner wishes?” But in the case of the mental health professionals we were talking to, some of them have been working on this condition for 20 years and never once been wrong on their “bet.”

When attempting to reach large audiences, how do you overcome the distance between the two types of knowledge involved: scientific knowledge and common knowledge?

AG: We let each one inform the other.

How would you define the genre of entertainment INVISIBILIA fits into? Is it a simplified scientific message or perhaps, does it belong to a different category? To that end, how does NPR effectively use mass media to popularize science and medical subjects?

AG: Invisibilia looks at things that have a profound and yet mostly unrecognized impact on us. Intangible things like thoughts, expectations, fears. And sometimes tangible things, like computers, that affect us in unseen ways. As scientific research reveals how these things shape our behavior and our lives, we will try to share what has been found. So Invisibilia is stories about what we don’t usually see about ourselves.

Regarding NPR and science and medical subjects, our feeling is that we don’t need to popularize them. We just need to make them accessible. We all want to know about ourselves and our world. Sharing this kind of information in stories can make it clear and meaningful.

Can you share a particular story and/or moment you heard or experienced during production that stuck with you on a deep level and why?

AS: There have been so many: for me (Alix) one of the most powerful was when we went to interview this woman who physically feels the things that the people around her physically feel. It made me think really differently about empathy. Lulu?

LM: Can I have two? I have two. 1) “BOTHER.” When I was interviewing a woman from India for a piece about an all-Indian retirement community in Florida, she mentioned that where she grew up (in a small Indian village), there was no word for “bother.” “Why would you say that word?” she asked me. Her point was that, when she came to the States, everybody was always afraid of ‘bothering’ each other, of showing up unannounced on a neighbor’s doorstep, or calling to talk on the phone. I completely knew what she meant. I spend a large portion of my life being TERRIFIED of ‘bothering’ people. I will look at a telephone and literally sweat… before dialing. And here she was pointing out – that where she came from ‘bothering’ wasn’t even a thing. It started to make me realize just how much my private interior life (like the pounding worry that can be produced by fear of bothering) is in fact created by exterior forces like culture and society. Alix has known this for a very long time, but I’ve been a little late to the party. 2) THERE IS A FOOLPROOF ANTIDOTE FOR FEAR. It is not a controlled substance. It requires no prescription. It is just a very simple equation that this man, Jason Comely, an IT guy in Canada, discovered and told us about. But I suppose I shouldn’t tell you what it is, because it’s kind of the treat we dangle at the end of the “FEARLESS” episode. So. You will just have to listen.

Can you share a bit on what we can expect for future episodes?

AS: We’ve done a whole show about fear (that’s the one with the person who is biologically incapable of fear) and another about expectations. In the future we want to do a whole show that looks at the concept of personality.

LM: Well, there is the show about fear we just mentioned (Jan 16). There is also a totally cool and spooky episode about entanglements, and all the ways we are connected to each other in ways that REALLLLLLLLY surprised me (and in ways that aren’t theoretical but quite earthly, and real, and being capitalized on by the US gov’t). That episode comes out Feb 6. There may or may not be a partly sung segment in our show about how computers are changing how we behave (Feb 13). And, if they let us keep making this stuff, we’ve talked about wanting to do the show on personality (how consistent it is over a lifetime, what forms it, does it come from the outside or in?), teen pregnancy, and a town in Belgium where being psychologically abnormal is the norm.