August 6, 2024 • 36 mins
What influences our sense of ikigai?
In exploring the concept of ikigai, it’s essential to understand how various factors contribute to its experience.
In this episode of the Ikigai Podcast, Nick speaks with Takaharu Goto about the impact of biopsychosocial factors on one’s experience of ikigai.
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Episode Transcript
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Speaker 1 (00:00):
So, with all this in mind, based on the study, what
can contribute to higher levelsof ikigai?
Speaker 2 (00:08):
Yes, our research shows that, as I said earlier,
it is appropriate to considerthat good affective
psychological status is afundamental condition for having
a higher level of ikigai orikigai.
(00:28):
We believe that by adjustment,one's affective psychological
status, one's physical andsocial status can be improved
and the element of fulfillmentand the sense of mission can be
built upon this to contribute toenhance of ikigai.
Now, japanese companies arecurrently employing a variety of
strategies to address the issueof health management, which can
be defined as the protection ofemployees' health, with a view
(00:52):
to ensuring the long-termviability of the company.
Speaker 1 (01:11):
Find your Ikigai at ikigaitribecom.
My guest today on the Ikigaipodcast is Takaharu Goto.
Takaharu Goto is an assistantprofessor in the Department of
Prosthodontics and OralRehabilitation at Tokushima
University, Japan.
He graduated from the Facultyof Dentistry at Tokushima
(01:32):
University in 2007 and receivedhis PhD in Dentistry from
Tokushima University in 2012.
His areas of expertise includeprosthetic and geriatric
dentistry.
Additionally, he hascontributed to research on
ikigai and social frailty from amedical perspective.
(01:53):
Welcome and thank you forjoining me today, Goto-sensei.
Speaker 2 (01:58):
Thank you, Nick.
I appreciate your referral.
I'm honored to be invited tothis ikigai podcast and look
forward to talking with youabout all things Ikigai.
Speaker 1 (02:09):
So do I.
So we've had a chat and yousaid I could call you Tak,
almost as if we're friends.
So we're friends now.
So thank you again, tak, forbeing here.
I recently stumbled upon yourpaper Biopsychosocial
Consideration of Ikigai in OlderAdults in Japan through a
(02:31):
Cross-Sectional Study, which waspublished in early June this
year.
So congratulations.
I know papers take a lot ofresearch and time.
Thank you very much.
Speaker 2 (02:43):
Thank you for writing it.
Speaker 1 (02:44):
And this paper seemed to be or was a collaborative
effort with six other researchauthors.
So how did this paper comeabout?
Speaker 2 (02:54):
Yes, this paper presents findings from a study
in Koyadaira, mima City,tokushima Prefecture, japan.
It is commonly called the MIMASong Study.
This study examined therelationship between the healthy
life expectancy and oral,cognitive and physical function,
(03:15):
social factors such asparticipation in community
activities and nutritionalintake among older adults in
early and mountainous regions inJapan.
Japan has the highest agingrate in the world.
Its policy is to extendhealth-like expectancy and
measures for the elderly andattracting attention.
(03:36):
Most studies on the elderly inJapan have been urban and
sub-urban areas have been urbanand sub-urban areas.
However, there is a growinginterest in hilly and
mountainous regions, whichaccount for 70% of Japan's land
area, as well as marginalizedcommunities, as research fields.
The MIMASONG study is a fieldstudy conducted in these hilly
(04:01):
and mountainous regions.
May I explain a little aboutthis study, okay?
Speaker 1 (04:07):
Yeah, sure, so I'll just confirm this study.
These are hilly, so hills andmountainous areas, so this is, I
guess, a unique perspective onthe study.
Speaker 2 (04:17):
Yes, the Koyodaira is the east of Tokushima
Prefecture on Shikoku Island insouthwestern Japan.
The area is 95%, surrounded bymountains and with a population
of 582 and an aging rate of 63%,it is considered to have a high
(04:38):
probability of disappearing inthe near future.
The MIMA song study issupervised by Dr Shinji Fujiwara
, director of the KoyadairaClinics.
I was introduced to Dr Fujiwaraby Emeritus Professor Tetsuo
Ichikawa and Professor YasuhikoShirayama of Tokushima
University.
(04:58):
I have been involved in thestudy.
Do you know the Koyadaira area?
Speaker 1 (05:04):
No, but I think this is a common problem.
Many areas, their population isshrinking and they could sort
of disappear.
Speaker 2 (05:15):
I stayed there during my research.
It's a wonderful area, rich innature.
If you are interested in coming, please contact me.
We will show you around.
Speaker 1 (05:25):
Okay, well, let's do that.
I'm going back to Japan thisyear, so I'd love to do that, so
thank you for the invitation.
Yeah, does that concern youpersonally that many beautiful
small towns in Japan willdisappear from this shrinking
(05:46):
population and aging population?
Speaker 2 (05:49):
Yes, it's a very critical problem in Japan For
the disappearing in the nearfuture.
We contact the people in theseliving areas and research to
them.
It's very important for us.
Speaker 1 (06:12):
I agree.
So maybe more research needs togo in and hopefully more people
will move away from the bigcities and return to these
smaller cities and maintaincommunity.
I know recently I was speakingto someone how there's many
abandoned houses but there'salso many abandoned temples,
(06:36):
akidera like empty temples, andthat's quite sad.
These beautiful places ofworship and they have beautiful
architecture and they're beingabandoned and then eventually I
guess, they fall apart.
So I guess Japan in a way issort of losing some of its
(06:58):
culture with these shrinking ordying towns.
Quite sad.
Anyway, let's move on.
So let's touch on the title ofyour paper Biopsychosocial
Consideration of Ikigai in OlderAdults in Japan through a
Cross-Sectional Study.
Speaker 2 (07:18):
I think it might be helpful to define
biopsychosocial yes, thisapproach systematically
considers biological,psychological and social factors
and their complex interactionsin understanding health, illness
and health care delivery.
In recent years, the medicalfield has used this
(07:40):
biopsychosocial model instead oftraditional reductionistic
biomedical model to assess therelationship between the
patient's biological,psychological and social factors
and the degree to which thesefactors influence the patient's
symptoms.
We have found this approach tobe very useful in assessing the
(08:04):
ikigai, as it's related to avariety of factors.
Speaker 1 (08:08):
I think yeah, so that's interesting.
It's a very holistic approachand I guess ikigai is this
holistic approach to life orwhat makes life Exactly yes.
Yeah, and I think in medicineyou tend to isolate people's
health in certain areas andthat's.
(08:30):
I guess with time we'verealized oh we, we have to look
the whole health, the biologyand the psychology and the
social factors of someone's life.
Yes, so I think this makessense.
And so, in the context of thisstudy, how did you define ikigai
(08:50):
?
Speaker 2 (08:51):
In this study we defined that ikigai can be
explained by physical,psychological or social
components, but we don't knowwhich can be the primary one.
But we believe that there is afundamental state of fulfillment
in which these components arefulfilled, and then the element
(09:11):
of fulfillment and the sense ofmissions are built on the top of
that and ikigai is obtained.
Speaker 1 (09:18):
Yeah, this is really interesting for me.
After studying ikigai for fiveyears now, I knew social, the
social aspect of ikigai you know, very important, yes.
And then obviously thepsychological and I would almost
frame ikigai as positivepsychology, like japan's version
(09:40):
of positive psychology and, andI guess, to have a fulfilling
life we need to be active andhealthy.
So we need this physical aspectof health.
So it's another interestingframework to understand ikigai.
Our physical health, ourpsychological health and our
(10:01):
social health, yes, our socialhealth, yes.
So with your study you did across-sectional study on
sarcopenia, frailty and healthylife expectancy.
Can you share the details ofthe cross-sectional study?
And maybe we should definesarcopenia?
Speaker 2 (10:22):
Yes, as I mentioned earlier, this study is called
the MIMA Song Study.
This cross-sectional studyincluded 105 outpatients and 65
and over who regularly visit theMIMA Municipal Koedana Clinic,
the medical institution only inthis area.
In this paper, we present theresults of our research focusing
(10:46):
on ikigai and in addition tothis ikigai research.
For example, sarcopenia youknow, which means
musculoskeletal disease in whichmuscle mass strength and
performance are significantlycompromised with age was
assessed in this study.
In addition to this, sarcopeniastatus, like a frailty or a
(11:08):
function, could intake anutritional status and the
higher life functions wereassessed and have presented a
relationship between them.
One of our co-researchers, mioKitamura, at Tokushima
University.
This year she published aninteresting study on the
(11:30):
relationship between fieldworkas a daily life task and
physical and cognitive functionamong the elders living in
Koedaira area.
This fieldwork as a daily lifetask means working in
small-scale calibrated land.
In this quadrille area, manyelderly people actually felt
(11:50):
that this working in small-scale, calibrated land was ikigai.
The Mimasong study wasconducted with a baseline survey
in 2018 and the second surveyfive years later, in 2023, last
year.
So data from the long-termstudy is currently being
(12:13):
comprised under the supervisionof the principal investigator,
dr Fujiwara now I understand.
Speaker 1 (12:20):
So quite a lot of people and quite a lot of
research has been conducted forthis study and again, it's quite
unique it's isolated to thishilly, mountainous area of Japan
and included field work, sothat means people going out and
(12:40):
talking to people makingobservations and talking to
people making observations.
Speaker 2 (12:46):
Yes, this 105 patients is almost all the
people living in Koyodara, soit's a very unique study
supervised by Dr Fujiwara.
Speaker 1 (12:57):
So when we're saying old, would that be 60 and above,
70 and above or 80 and above?
What age group?
Speaker 2 (13:06):
Yes, the oldest age is over the 19th, so the average
age is 79.02 is the average age.
Speaker 1 (13:20):
Okay, so 70s and above, yes.
Well, this is interestingbecause it's all done to assess
people's ikigai what makes theirlife worth living.
So how did you measure theparticipants' level of ikigai?
Speaker 2 (13:37):
Yeah.
In the study, ikigai wasassessed through the patient's
response to the questions do youhave any pressure or ikigai?
On the basis of the previousreports.
As an operational definition,the subject scores of 0
indicated having no ikigai and 5indicated having higher ikigai.
(14:00):
The participants were asked torate self-rated ikigai on the
scale of 0 to 5, with higherscores representing higher
ikigai.
Speaker 1 (14:11):
Okay, so quite a simplistic approach.
The question do you have anypleasure?
Or ikigai, and 0 to 5.
So I think this is similar tothe Likert scale, or maybe not.
Speaker 2 (14:26):
Yes, visual scales.
Speaker 1 (14:29):
And obviously five would be highest level and zero
would mean no wiki guy at all.
Speaker 2 (14:37):
To plan this study design.
The simplified question is veryimportant because people must
answer many, many questions, sosimplified question is very
important.
Speaker 1 (14:53):
I understand.
Okay.
So with that, what did thestudy reveal?
Speaker 2 (15:15):
This study reveals that affective psychological
states, such as depressions,have a large impact.
Speaker 1 (15:22):
Yeah, this is interesting.
I guess as we get older, ourphysical abilities become
restricted.
Perhaps because of that wesocialize less and we spend
maybe more time alone, and sothen we have, I guess, more time
(15:43):
to reflect on our life, and itimpacts our psychological health
.
Yes, and so maybe if we're ofgood health, we can reminisce
and think about good memoriesand still have a positive
outlook on life.
But I imagine loneliness alsocomes into this, especially in a
(16:08):
hilly and mountainous areawhere it's harder to access and
visit friends or family.
Yeah, so it's interesting howthe environment in which we live
in as we get older, perhapsrestricts us from finding or
feeling more ikigai.
And you noted that in themedical field, there is a shift
(16:32):
from the conventional yes Ithink we mentioned this earlier
reductionist biomedical model toa biopsychosocial model in
understanding and treatingclinical conditions.
In other words, patients arenow being evaluated holistically
, with an emphasis on therelationship between biological,
psychological and socialfactors and the degree of their
(16:54):
influence on the patient'scondition.
You state that this approach isextremely useful for evaluating
ikigai, which is obviouslythought to be based on the
interconnectedness of physical,psychological and social factors
and leads to a comprehensiveassessment of ikigai.
So, as we touched on, yeah,we're looking at ikigai from
(17:15):
physical, psychological andsocial factors and to this end,
or based on this theory, youcreated a biopsychosocial model
using physical, psychologicaland social perspectives, and
we'll probably add the frameworkyou've created in the show
(17:37):
notes of the podcast.
But would you like to explainthe model you've created?
Speaker 2 (17:41):
Okay, but would you like to explain the model you've
created?
Okay, first, this studyexamined whether ikigai can be
explained in terms of physical,psychological including
affective and cognitive aspects,and social factors.
We used a method calledstructural cobalancing analysis.
(18:01):
This method uses a numericalvalue called cobalance to model
the relationship and degree ofrelationship among multiple
factors that are related to eachother.
Covalent structure analysisallows us to understand at the
grants, the relationship betweendata that are previously too
(18:22):
complex to understand.
Using this method, we havedeveloped a biopsychosocial
model for ikigai.
In our model, four passes fromphysical, psychological
including affective andcognitive aspects and social
assessment to ikigai, andcorrelations between them were
confirmed, and the path from theaffective psychological
(18:46):
condition to Ikigai wassignificant.
The adaptability of this modelwas good.
In other words, physical,psychological and social factors
are interrelated and influenceIkigai, with the affective
psychological conditions havingthe largest impact to ikigai.
Speaker 1 (19:06):
I see.
So if we're touching onpsychological conditions, does
that really just mean the way wethink about life and our
perception of life?
Speaker 2 (19:20):
Yes, the psychological conditions contain
the affective and cognitiveconditions In this, our model.
The affective psychologicalconditions have a large impact
on ikigai, not the cognitiveconditions, but this social and
physical and psychologicalconditions are interrelated, but
(19:42):
the large impact is only forthe affective.
Psychological conditions areinterrelated, but the large
impact is only for the affectedpsychological conditions.
Speaker 1 (19:48):
We find I see Okay, so this leads us to, I guess,
ikigai and the relationshipbetween depression, and you
mentioned a correlation betweenikigai and depression in the
paper, so would you like toexpand on this?
Speaker 2 (20:05):
Okay.
We explained the method toassessment psychological
conditions In this study.
For the affective psychologicalassessment, the degree of
depression was evaluating theJapanese short version of
geriatric depression 15 scale,gds-ds15, for older adults.
(20:27):
The GDS originally developedversion contains 30 items and is
one of the most widespread andreliable screening scales to
evaluate depressions among olderadults.
Each item is scored yes or novery simple, the total scores
(20:48):
ranging from 0 to 15 points,with higher score representing
more depression symptoms.
The results of multipleregression analysis after age
and gender adjustments show thata significant association was
found only for GDS-15 to ikigai.
In other words, the results ofthis regression analysis and our
(21:12):
ikigai model show that theikigai is more likely to be
obtained in people with lowdepressions.
Speaker 1 (21:21):
I think that makes sense and it's probably I wonder
if it's cyclical.
If you have low depression orlittle depression, you'll feel
or experience ikigai and I guessif you feel ikigai, you're
likely to have low depression.
Speaker 2 (21:38):
Yes, yes, yes, and our model passes from the low
depression to ikigai and ikigaican cycle to biophysical and
psychological and social factors.
The ikigai cycle was alsoexplained in our model in this
(22:02):
whole model.
Speaker 1 (22:02):
Yes, other studies have also noted that ikigai
encourages positive and healthybehaviours, so maybe activities
like walking in nature orspending time with friends or
pursuing a meaningful hobby, andI guess that type of behaviour
would also reduce depression.
(22:23):
Yes, so with all this in mind,based on the study, what can
contribute to higher levels ofikigai?
Speaker 2 (22:32):
Yes, our research shows that, as I said earlier,
it is appropriate to considerthat good affective
psychological status is afundamental condition for having
a higher level of ikigai.
We believe that by adjustmentof one's affective psychological
status, one's physical andsocial status can be improved
(22:55):
and the element of fulfillmentand the sense of mission can be
built upon this to contribute tothe enhancement of ikigai.
Built upon this to contributeto enhance of ikigai.
Now, Japanese companies arecurrently employing a variety of
strategies to address the issueof health management, which can
be defined as the protection ofemployees' health, with a view
(23:16):
to ensuring the long-termviability of the company.
In Mimason's study, weinvestigated the Ikigai of the
elderly.
Our findings suggested that itis important for the energetic
working generation to have aperspective on Ikigai or purpose
in life or work engagement.
(23:38):
From an economic standpoint,focusing on Ikigai can lead to a
financial burden on insuranceand insured individuals, thereby
contributing to reduction ofnational society's social costs,
security costs.
We believe that ikigai is asignificant concept with
(23:59):
considerable potentials.
Speaker 1 (24:02):
All right.
So there's two things here,really, your study revealed.
It starts with psychologicalhealth.
One must have psychologicalhealth, and then from that this
leads to also maintainingphysical and social health.
Speaker 2 (24:18):
Yes.
Speaker 1 (24:18):
And then for the country, this is a positive
thing.
If someone has a sense ofikigai in their old age, it
would suggest that I guessthey're proactive in community,
they can look after themselvesand they're not a burden on the
government and they're not, Iguess, eating up resources where
they need care or they needmedical attention or perhaps
(24:42):
even psychological assistance.
And with Japan's agingpopulation, the more healthy
elderly people outing thecommunity, maybe they're
contributing to the community.
That's obviously a verypositive thing rather than, I
guess, elderly people being verydependent on the government and
(25:04):
funding.
Speaker 2 (25:05):
Yes.
Speaker 1 (25:06):
This is also something you're forecasting.
Yeah, as more and more Japaneseage, there'll be more demand on
government resources, and addedto that is the decreasing
population with more and morereduction in the workforce.
It's going to be very hard totax a reduced workforce to fund
(25:28):
the health of the elderly.
Speaker 2 (25:32):
Exactly yes, I think through the results of this
study, Kigai has verysignificant potential to reduce
the cost of governmentinsurances.
It's potential IKIGA haspotential.
Speaker 1 (25:51):
Yeah, this is fascinating.
So it's not just importantindividually for a person's way
of living and what makes theirlife worth living.
It seems it's quite importantfor, you know, the whole country
of Japan, that if people have astrong sense of ikigai, it has
this compound positive effect onJapanese society and reduces,
(26:16):
yes, insurance and, I guess, theburden of, you know, resources
to treat people who aredepressed or who become weak
because they're not physicallyand socially active.
So ikigai is really crucial forthe well-being of the
(26:36):
individual, but also forprosperity of Japan, and
probably we could say that'strue for all countries.
Speaker 2 (26:47):
Other countries Ikigai research is also reported
, like the Netherlands andEuropean countries.
But Japan has a very importantfear for Ikigai research because
of the highest aging rate inthe world.
Speaker 1 (27:04):
Yes, it's interesting because many Japanese I speak
to about ikigai, usually they'resurprised oh why do you know
this word, nick?
Like ikigai, and many do notknow that it is an area of
research in Japan.
They just think it's just aJapanese word they occasionally
(27:28):
think about.
So it's a very interesting word.
It's used casually, yet it'salso this area of deep research
in Japan related to, yeah, allthese areas of health.
However, with studies, with allstudies, there are limitations,
and so you noted there wereseveral limitations in your
(27:49):
study.
What were they?
Speaker 2 (27:52):
At first, the participants were a unique group
of older adults living in heliand buntless regions in Japan.
Regions in Japan Compared tourban and rural areas.
There are many restrictions todaily life in this area, such as
mobility and shopping, andsocial situations is not always
(28:12):
changed through the lifetime,because work life and daily life
are comparatively one entity.
This study did not examine theeffect of confounding factors
such as vision and hearingdisorders and educational
background, which are thought toinfluence ikigai, including
these regional characteristics.
(28:33):
This is one of the limitationsof this study and should be
examined in the future.
Another limitation is regardingthe assessment of ikigai.
In this study, ikigai wasassessed through the self-rated
score on the scale of 0 to 5.
Although the question item onikigai was set based on the
(28:55):
previous report, but thereliability and validity of this
method have not been examined.
Ikigai is the integration ofobjects and the feeling
associated with its object,which is difficult to assess
because it has spiritual aspectsin addition to elements such as
the will to live, a sense ofbeing, dreams and a sense of
(29:18):
fulfillment in life.
Today, there is no assessmentthat can be used globally and
across generations, fromadolescent to older age.
As Ikigai is subjective, thevisual analog scale may be
preferable.
The development of anassessment questionnaire for
Ikigai with problem reliabilityand variability is needed for
(29:43):
future studies.
Speaker 1 (29:46):
Yes, that's interesting and I guess with all
studies there are limitations.
You can't do one study thatexplores all facets of ikigai in
all areas of the human you know, our daily living, our mental
health, our physical health, ourhearing, our ability to taste
(30:09):
and see and whatnot.
But it is interesting to seethe integration or the idea or
almost the definition of havingan object of ikigai.
So ikigai, taisho and feelingsikigai.
So ikigai um, taisho andfeelings ikigai kan, which is
obviously a reference to thework of miyako kamiya, who was
(30:32):
japan's research pioneer on thesubject.
I always enjoy seeing her workbeing referenced and then you
point to this idea or this truth.
I guess that Ikigai has allthese elements, it's subjective,
it can be spiritual, veryphilosophical.
So I guess it is hard tomeasure because of these
(30:55):
multifaceted elements to whatmakes life worth living.
So it is a challenge at thesame time.
Speaker 2 (31:05):
Yes, some report assessment ikigai is reported
have been reported, but toalmost to the elderly people,
but adolescents also,adolescents having ikigai, also
adolescents having ikigai.
So the ikigai assessment isaddressing to elderly is very
(31:29):
important, but also thedifferentiation between them can
be reported.
Speaker 1 (31:34):
Yes, I've seen a few studies.
There's a few scales.
There's obviously the ikigai 9.
Yes, ikigai 9.
There's also a four-factorscale that I stumbled upon where
Ikigai was expressed.
For younger people, ikigai isfelt or expressed as passion,
and then for older people,ikigai is this internal, calm,
(31:58):
continuous experience.
So Ikigai also changes overtime, and I guess the way it's
experienced has changed overtime.
Speaker 2 (32:07):
Yes, in this Mima Song study we measure the kind
of ikigai also.
So we have not reported in thearticles but like build a plant,
japanese name bonsai, yes,bonsai on the land, small
(32:30):
calibrated land work life taskis ikigai and many kind of
ikigai can obtain in this KoiValley area, can obtain in this
quadral area.
So in the future we will reportthe kind of wikigai in the
healing and mantras regions.
Speaker 1 (32:49):
Great.
Well, when you've done anotherpaper, we can have you back on
the podcast.
Speaker 2 (32:57):
We have planned.
Speaker 1 (32:58):
Okay, I mean, it's a fascinating question how do you
measure the answer to thequestion of what makes life
worth living?
It's very challenging becauseit is, yeah, so subjective and
individualistic, as I saidbefore, influenced by our age,
(33:20):
where we live, our socialnetwork, whether we're working
or not working.
Do we have a family or do we?
Speaker 2 (33:29):
live alone.
Speaker 1 (33:31):
So do we have hobbies ?
Is religion important in ourlife?
So it's quite a challenge, Ithink.
Taku to measure ikigai.
So with that, let's get alittle bit personal.
What about you, taku to measureikigai?
So with that, let's get alittle bit personal.
What about you, taku?
What is your ikigai?
Speaker 2 (33:49):
Yes, I have several ikigai now.
One is spending time with myfamily, bringing my children
when I get home and going outwith my family on holidays are
very important goals and ikigaifor me, and to communicate new
findings to society as aresearcher, which definitely my
(34:10):
ikigai is as well.
To this end, I would like tolive a better life, taking into
account affective, psychologicalconditions in my daily life.
Speaker 1 (34:20):
I see.
Well, I'm very happy to helpyou with your Ikigai and
communicate your new findings tosociety as a researcher.
So, yeah, when you do anotherpaper on Ikigai, I'd love to
have you back on the podcast.
Thank you very much.
So, thank you for your timetoday, and do you have a website
(34:45):
or a social media account whereyou share your research?
Speaker 2 (34:50):
Oh sure, this is my research map address.
Okay, I have a research mapaddress.
Speaker 1 (34:57):
We'll share that in the podcast notes, so we'll link
to the paper and your researchmap address.
But thank you very much foryour time today.
Speaker 2 (35:09):
Okay, I'm very happy to talk with you about Ikigai.
Speaker 1 (35:15):
Me too, and maybe I'll come and see you and we can
visit this beautiful area thatyou live.
You live in Tokushima, so youlive.
I have to remember the name ofthe area, is it?
Speaker 2 (35:28):
Koya, koya, daera area.
Speaker 1 (35:31):
Yeah, all right, so I'd love to come and meet you in
person.
Speaker 2 (35:36):
Yes, I hope you come to Koya Daera, area with rich
nature.
Speaker 1 (35:41):
Okay, Well, that's a universal source of ikigai.
I think Everyone can find orfeel a sense of ikigai in nature
, so I'd love to do that.
All right, Thank you Taku.
Thank you Nick.
So, with all this in mind, based on the study, what
can contribute to higher levelsof ikigai?
Speaker 2 (00:08):
Yes, our research shows that, as I said earlier,
it is appropriate to considerthat good affective
psychological status is afundamental condition for having
a higher level of ikigai orikigai.
(00:28):
We believe that by adjustment,one's affective psychological
status, one's physical andsocial status can be improved
and the element of fulfillmentand the sense of mission can be
built upon this to contribute toenhance of ikigai.
Now, japanese companies arecurrently employing a variety of
strategies to address the issueof health management, which can
be defined as the protection ofemployees' health, with a view
(00:52):
to ensuring the long-termviability of the company.
Speaker 1 (01:11):
Find your Ikigai at ikigaitribecom.
My guest today on the Ikigaipodcast is Takaharu Goto.
Takaharu Goto is an assistantprofessor in the Department of
Prosthodontics and OralRehabilitation at Tokushima
University, Japan.
He graduated from the Facultyof Dentistry at Tokushima
(01:32):
University in 2007 and receivedhis PhD in Dentistry from
Tokushima University in 2012.
His areas of expertise includeprosthetic and geriatric
dentistry.
Additionally, he hascontributed to research on
ikigai and social frailty from amedical perspective.
(01:53):
Welcome and thank you forjoining me today, Goto-sensei.
Speaker 2 (01:58):
Thank you, Nick.
I appreciate your referral.
I'm honored to be invited tothis ikigai podcast and look
forward to talking with youabout all things Ikigai.
Speaker 1 (02:09):
So do I.
So we've had a chat and yousaid I could call you Tak,
almost as if we're friends.
So we're friends now.
So thank you again, tak, forbeing here.
I recently stumbled upon yourpaper Biopsychosocial
Consideration of Ikigai in OlderAdults in Japan through a
(02:31):
Cross-Sectional Study, which waspublished in early June this
year.
So congratulations.
I know papers take a lot ofresearch and time.
Thank you very much.
Speaker 2 (02:43):
Thank you for writing it.
Speaker 1 (02:44):
And this paper seemed to be or was a collaborative
effort with six other researchauthors.
So how did this paper comeabout?
Speaker 2 (02:54):
Yes, this paper presents findings from a study
in Koyadaira, mima City,tokushima Prefecture, japan.
It is commonly called the MIMASong Study.
This study examined therelationship between the healthy
life expectancy and oral,cognitive and physical function,
(03:15):
social factors such asparticipation in community
activities and nutritionalintake among older adults in
early and mountainous regions inJapan.
Japan has the highest agingrate in the world.
Its policy is to extendhealth-like expectancy and
measures for the elderly andattracting attention.
(03:36):
Most studies on the elderly inJapan have been urban and
sub-urban areas have been urbanand sub-urban areas.
However, there is a growinginterest in hilly and
mountainous regions, whichaccount for 70% of Japan's land
area, as well as marginalizedcommunities, as research fields.
The MIMASONG study is a fieldstudy conducted in these hilly
(04:01):
and mountainous regions.
May I explain a little aboutthis study, okay?
Speaker 1 (04:07):
Yeah, sure, so I'll just confirm this study.
These are hilly, so hills andmountainous areas, so this is, I
guess, a unique perspective onthe study.
Speaker 2 (04:17):
Yes, the Koyodaira is the east of Tokushima
Prefecture on Shikoku Island insouthwestern Japan.
The area is 95%, surrounded bymountains and with a population
of 582 and an aging rate of 63%,it is considered to have a high
(04:38):
probability of disappearing inthe near future.
The MIMA song study issupervised by Dr Shinji Fujiwara
, director of the KoyadairaClinics.
I was introduced to Dr Fujiwaraby Emeritus Professor Tetsuo
Ichikawa and Professor YasuhikoShirayama of Tokushima
University.
(04:58):
I have been involved in thestudy.
Do you know the Koyadaira area?
Speaker 1 (05:04):
No, but I think this is a common problem.
Many areas, their population isshrinking and they could sort
of disappear.
Speaker 2 (05:15):
I stayed there during my research.
It's a wonderful area, rich innature.
If you are interested in coming, please contact me.
We will show you around.
Speaker 1 (05:25):
Okay, well, let's do that.
I'm going back to Japan thisyear, so I'd love to do that, so
thank you for the invitation.
Yeah, does that concern youpersonally that many beautiful
small towns in Japan willdisappear from this shrinking
(05:46):
population and aging population?
Speaker 2 (05:49):
Yes, it's a very critical problem in Japan For
the disappearing in the nearfuture.
We contact the people in theseliving areas and research to
them.
It's very important for us.
Speaker 1 (06:12):
I agree.
So maybe more research needs togo in and hopefully more people
will move away from the bigcities and return to these
smaller cities and maintaincommunity.
I know recently I was speakingto someone how there's many
abandoned houses but there'salso many abandoned temples,
(06:36):
akidera like empty temples, andthat's quite sad.
These beautiful places ofworship and they have beautiful
architecture and they're beingabandoned and then eventually I
guess, they fall apart.
So I guess Japan in a way issort of losing some of its
(06:58):
culture with these shrinking ordying towns.
Quite sad.
Anyway, let's move on.
So let's touch on the title ofyour paper Biopsychosocial
Consideration of Ikigai in OlderAdults in Japan through a
Cross-Sectional Study.
Speaker 2 (07:18):
I think it might be helpful to define
biopsychosocial yes, thisapproach systematically
considers biological,psychological and social factors
and their complex interactionsin understanding health, illness
and health care delivery.
In recent years, the medicalfield has used this
(07:40):
biopsychosocial model instead oftraditional reductionistic
biomedical model to assess therelationship between the
patient's biological,psychological and social factors
and the degree to which thesefactors influence the patient's
symptoms.
We have found this approach tobe very useful in assessing the
(08:04):
ikigai, as it's related to avariety of factors.
Speaker 1 (08:08):
I think yeah, so that's interesting.
It's a very holistic approachand I guess ikigai is this
holistic approach to life orwhat makes life Exactly yes.
Yeah, and I think in medicineyou tend to isolate people's
health in certain areas andthat's.
(08:30):
I guess with time we'verealized oh we, we have to look
the whole health, the biologyand the psychology and the
social factors of someone's life.
Yes, so I think this makessense.
And so, in the context of thisstudy, how did you define ikigai
(08:50):
?
Speaker 2 (08:51):
In this study we defined that ikigai can be
explained by physical,psychological or social
components, but we don't knowwhich can be the primary one.
But we believe that there is afundamental state of fulfillment
in which these components arefulfilled, and then the element
(09:11):
of fulfillment and the sense ofmissions are built on the top of
that and ikigai is obtained.
Speaker 1 (09:18):
Yeah, this is really interesting for me.
After studying ikigai for fiveyears now, I knew social, the
social aspect of ikigai you know, very important, yes.
And then obviously thepsychological and I would almost
frame ikigai as positivepsychology, like japan's version
(09:40):
of positive psychology and, andI guess, to have a fulfilling
life we need to be active andhealthy.
So we need this physical aspectof health.
So it's another interestingframework to understand ikigai.
Our physical health, ourpsychological health and our
(10:01):
social health, yes, our socialhealth, yes.
So with your study you did across-sectional study on
sarcopenia, frailty and healthylife expectancy.
Can you share the details ofthe cross-sectional study?
And maybe we should definesarcopenia?
Speaker 2 (10:22):
Yes, as I mentioned earlier, this study is called
the MIMA Song Study.
This cross-sectional studyincluded 105 outpatients and 65
and over who regularly visit theMIMA Municipal Koedana Clinic,
the medical institution only inthis area.
In this paper, we present theresults of our research focusing
(10:46):
on ikigai and in addition tothis ikigai research.
For example, sarcopenia youknow, which means
musculoskeletal disease in whichmuscle mass strength and
performance are significantlycompromised with age was
assessed in this study.
In addition to this, sarcopeniastatus, like a frailty or a
(11:08):
function, could intake anutritional status and the
higher life functions wereassessed and have presented a
relationship between them.
One of our co-researchers, mioKitamura, at Tokushima
University.
This year she published aninteresting study on the
(11:30):
relationship between fieldworkas a daily life task and
physical and cognitive functionamong the elders living in
Koedaira area.
This fieldwork as a daily lifetask means working in
small-scale calibrated land.
In this quadrille area, manyelderly people actually felt
(11:50):
that this working in small-scale, calibrated land was ikigai.
The Mimasong study wasconducted with a baseline survey
in 2018 and the second surveyfive years later, in 2023, last
year.
So data from the long-termstudy is currently being
(12:13):
comprised under the supervisionof the principal investigator,
dr Fujiwara now I understand.
Speaker 1 (12:20):
So quite a lot of people and quite a lot of
research has been conducted forthis study and again, it's quite
unique it's isolated to thishilly, mountainous area of Japan
and included field work, sothat means people going out and
(12:40):
talking to people makingobservations and talking to
people making observations.
Speaker 2 (12:46):
Yes, this 105 patients is almost all the
people living in Koyodara, soit's a very unique study
supervised by Dr Fujiwara.
Speaker 1 (12:57):
So when we're saying old, would that be 60 and above,
70 and above or 80 and above?
What age group?
Speaker 2 (13:06):
Yes, the oldest age is over the 19th, so the average
age is 79.02 is the average age.
Speaker 1 (13:20):
Okay, so 70s and above, yes.
Well, this is interestingbecause it's all done to assess
people's ikigai what makes theirlife worth living.
So how did you measure theparticipants' level of ikigai?
Speaker 2 (13:37):
Yeah.
In the study, ikigai wasassessed through the patient's
response to the questions do youhave any pressure or ikigai?
On the basis of the previousreports.
As an operational definition,the subject scores of 0
indicated having no ikigai and 5indicated having higher ikigai.
(14:00):
The participants were asked torate self-rated ikigai on the
scale of 0 to 5, with higherscores representing higher
ikigai.
Speaker 1 (14:11):
Okay, so quite a simplistic approach.
The question do you have anypleasure?
Or ikigai, and 0 to 5.
So I think this is similar tothe Likert scale, or maybe not.
Speaker 2 (14:26):
Yes, visual scales.
Speaker 1 (14:29):
And obviously five would be highest level and zero
would mean no wiki guy at all.
Speaker 2 (14:37):
To plan this study design.
The simplified question is veryimportant because people must
answer many, many questions, sosimplified question is very
important.
Speaker 1 (14:53):
I understand.
Okay.
So with that, what did thestudy reveal?
Speaker 2 (15:15):
This study reveals that affective psychological
states, such as depressions,have a large impact.
Speaker 1 (15:22):
Yeah, this is interesting.
I guess as we get older, ourphysical abilities become
restricted.
Perhaps because of that wesocialize less and we spend
maybe more time alone, and sothen we have, I guess, more time
(15:43):
to reflect on our life, and itimpacts our psychological health
.
Yes, and so maybe if we're ofgood health, we can reminisce
and think about good memoriesand still have a positive
outlook on life.
But I imagine loneliness alsocomes into this, especially in a
(16:08):
hilly and mountainous areawhere it's harder to access and
visit friends or family.
Yeah, so it's interesting howthe environment in which we live
in as we get older, perhapsrestricts us from finding or
feeling more ikigai.
And you noted that in themedical field, there is a shift
(16:32):
from the conventional yes Ithink we mentioned this earlier
reductionist biomedical model toa biopsychosocial model in
understanding and treatingclinical conditions.
In other words, patients arenow being evaluated holistically
, with an emphasis on therelationship between biological,
psychological and socialfactors and the degree of their
(16:54):
influence on the patient'scondition.
You state that this approach isextremely useful for evaluating
ikigai, which is obviouslythought to be based on the
interconnectedness of physical,psychological and social factors
and leads to a comprehensiveassessment of ikigai.
So, as we touched on, yeah,we're looking at ikigai from
(17:15):
physical, psychological andsocial factors and to this end,
or based on this theory, youcreated a biopsychosocial model
using physical, psychologicaland social perspectives, and
we'll probably add the frameworkyou've created in the show
(17:37):
notes of the podcast.
But would you like to explainthe model you've created?
Speaker 2 (17:41):
Okay, but would you like to explain the model you've
created?
Okay, first, this studyexamined whether ikigai can be
explained in terms of physical,psychological including
affective and cognitive aspects,and social factors.
We used a method calledstructural cobalancing analysis.
(18:01):
This method uses a numericalvalue called cobalance to model
the relationship and degree ofrelationship among multiple
factors that are related to eachother.
Covalent structure analysisallows us to understand at the
grants, the relationship betweendata that are previously too
(18:22):
complex to understand.
Using this method, we havedeveloped a biopsychosocial
model for ikigai.
In our model, four passes fromphysical, psychological
including affective andcognitive aspects and social
assessment to ikigai, andcorrelations between them were
confirmed, and the path from theaffective psychological
(18:46):
condition to Ikigai wassignificant.
The adaptability of this modelwas good.
In other words, physical,psychological and social factors
are interrelated and influenceIkigai, with the affective
psychological conditions havingthe largest impact to ikigai.
Speaker 1 (19:06):
I see.
So if we're touching onpsychological conditions, does
that really just mean the way wethink about life and our
perception of life?
Speaker 2 (19:20):
Yes, the psychological conditions contain
the affective and cognitiveconditions In this, our model.
The affective psychologicalconditions have a large impact
on ikigai, not the cognitiveconditions, but this social and
physical and psychologicalconditions are interrelated, but
(19:42):
the large impact is only forthe affective.
Psychological conditions areinterrelated, but the large
impact is only for the affectedpsychological conditions.
Speaker 1 (19:48):
We find I see Okay, so this leads us to, I guess,
ikigai and the relationshipbetween depression, and you
mentioned a correlation betweenikigai and depression in the
paper, so would you like toexpand on this?
Speaker 2 (20:05):
Okay.
We explained the method toassessment psychological
conditions In this study.
For the affective psychologicalassessment, the degree of
depression was evaluating theJapanese short version of
geriatric depression 15 scale,gds-ds15, for older adults.
(20:27):
The GDS originally developedversion contains 30 items and is
one of the most widespread andreliable screening scales to
evaluate depressions among olderadults.
Each item is scored yes or novery simple, the total scores
(20:48):
ranging from 0 to 15 points,with higher score representing
more depression symptoms.
The results of multipleregression analysis after age
and gender adjustments show thata significant association was
found only for GDS-15 to ikigai.
In other words, the results ofthis regression analysis and our
(21:12):
ikigai model show that theikigai is more likely to be
obtained in people with lowdepressions.
Speaker 1 (21:21):
I think that makes sense and it's probably I wonder
if it's cyclical.
If you have low depression orlittle depression, you'll feel
or experience ikigai and I guessif you feel ikigai, you're
likely to have low depression.
Speaker 2 (21:38):
Yes, yes, yes, and our model passes from the low
depression to ikigai and ikigaican cycle to biophysical and
psychological and social factors.
The ikigai cycle was alsoexplained in our model in this
(22:02):
whole model.
Speaker 1 (22:02):
Yes, other studies have also noted that ikigai
encourages positive and healthybehaviours, so maybe activities
like walking in nature orspending time with friends or
pursuing a meaningful hobby, andI guess that type of behaviour
would also reduce depression.
(22:23):
Yes, so with all this in mind,based on the study, what can
contribute to higher levels ofikigai?
Speaker 2 (22:32):
Yes, our research shows that, as I said earlier,
it is appropriate to considerthat good affective
psychological status is afundamental condition for having
a higher level of ikigai.
We believe that by adjustmentof one's affective psychological
status, one's physical andsocial status can be improved
(22:55):
and the element of fulfillmentand the sense of mission can be
built upon this to contribute tothe enhancement of ikigai.
Built upon this to contributeto enhance of ikigai.
Now, Japanese companies arecurrently employing a variety of
strategies to address the issueof health management, which can
be defined as the protection ofemployees' health, with a view
(23:16):
to ensuring the long-termviability of the company.
In Mimason's study, weinvestigated the Ikigai of the
elderly.
Our findings suggested that itis important for the energetic
working generation to have aperspective on Ikigai or purpose
in life or work engagement.
(23:38):
From an economic standpoint,focusing on Ikigai can lead to a
financial burden on insuranceand insured individuals, thereby
contributing to reduction ofnational society's social costs,
security costs.
We believe that ikigai is asignificant concept with
(23:59):
considerable potentials.
Speaker 1 (24:02):
All right.
So there's two things here,really, your study revealed.
It starts with psychologicalhealth.
One must have psychologicalhealth, and then from that this
leads to also maintainingphysical and social health.
Speaker 2 (24:18):
Yes.
Speaker 1 (24:18):
And then for the country, this is a positive
thing.
If someone has a sense ofikigai in their old age, it
would suggest that I guessthey're proactive in community,
they can look after themselvesand they're not a burden on the
government and they're not, Iguess, eating up resources where
they need care or they needmedical attention or perhaps
(24:42):
even psychological assistance.
And with Japan's agingpopulation, the more healthy
elderly people outing thecommunity, maybe they're
contributing to the community.
That's obviously a verypositive thing rather than, I
guess, elderly people being verydependent on the government and
(25:04):
funding.
Speaker 2 (25:05):
Yes.
Speaker 1 (25:06):
This is also something you're forecasting.
Yeah, as more and more Japaneseage, there'll be more demand on
government resources, and addedto that is the decreasing
population with more and morereduction in the workforce.
It's going to be very hard totax a reduced workforce to fund
(25:28):
the health of the elderly.
Speaker 2 (25:32):
Exactly yes, I think through the results of this
study, Kigai has verysignificant potential to reduce
the cost of governmentinsurances.
It's potential IKIGA haspotential.
Speaker 1 (25:51):
Yeah, this is fascinating.
So it's not just importantindividually for a person's way
of living and what makes theirlife worth living.
It seems it's quite importantfor, you know, the whole country
of Japan, that if people have astrong sense of ikigai, it has
this compound positive effect onJapanese society and reduces,
(26:16):
yes, insurance and, I guess, theburden of, you know, resources
to treat people who aredepressed or who become weak
because they're not physicallyand socially active.
So ikigai is really crucial forthe well-being of the
(26:36):
individual, but also forprosperity of Japan, and
probably we could say that'strue for all countries.
Speaker 2 (26:47):
Other countries Ikigai research is also reported
, like the Netherlands andEuropean countries.
But Japan has a very importantfear for Ikigai research because
of the highest aging rate inthe world.
Speaker 1 (27:04):
Yes, it's interesting because many Japanese I speak
to about ikigai, usually they'resurprised oh why do you know
this word, nick?
Like ikigai, and many do notknow that it is an area of
research in Japan.
They just think it's just aJapanese word they occasionally
(27:28):
think about.
So it's a very interesting word.
It's used casually, yet it'salso this area of deep research
in Japan related to, yeah, allthese areas of health.
However, with studies, with allstudies, there are limitations,
and so you noted there wereseveral limitations in your
(27:49):
study.
What were they?
Speaker 2 (27:52):
At first, the participants were a unique group
of older adults living in heliand buntless regions in Japan.
Regions in Japan Compared tourban and rural areas.
There are many restrictions todaily life in this area, such as
mobility and shopping, andsocial situations is not always
(28:12):
changed through the lifetime,because work life and daily life
are comparatively one entity.
This study did not examine theeffect of confounding factors
such as vision and hearingdisorders and educational
background, which are thought toinfluence ikigai, including
these regional characteristics.
(28:33):
This is one of the limitationsof this study and should be
examined in the future.
Another limitation is regardingthe assessment of ikigai.
In this study, ikigai wasassessed through the self-rated
score on the scale of 0 to 5.
Although the question item onikigai was set based on the
(28:55):
previous report, but thereliability and validity of this
method have not been examined.
Ikigai is the integration ofobjects and the feeling
associated with its object,which is difficult to assess
because it has spiritual aspectsin addition to elements such as
the will to live, a sense ofbeing, dreams and a sense of
(29:18):
fulfillment in life.
Today, there is no assessmentthat can be used globally and
across generations, fromadolescent to older age.
As Ikigai is subjective, thevisual analog scale may be
preferable.
The development of anassessment questionnaire for
Ikigai with problem reliabilityand variability is needed for
(29:43):
future studies.
Speaker 1 (29:46):
Yes, that's interesting and I guess with all
studies there are limitations.
You can't do one study thatexplores all facets of ikigai in
all areas of the human you know, our daily living, our mental
health, our physical health, ourhearing, our ability to taste
(30:09):
and see and whatnot.
But it is interesting to seethe integration or the idea or
almost the definition of havingan object of ikigai.
So ikigai, taisho and feelingsikigai.
So ikigai um, taisho andfeelings ikigai kan, which is
obviously a reference to thework of miyako kamiya, who was
(30:32):
japan's research pioneer on thesubject.
I always enjoy seeing her workbeing referenced and then you
point to this idea or this truth.
I guess that Ikigai has allthese elements, it's subjective,
it can be spiritual, veryphilosophical.
So I guess it is hard tomeasure because of these
(30:55):
multifaceted elements to whatmakes life worth living.
So it is a challenge at thesame time.
Speaker 2 (31:05):
Yes, some report assessment ikigai is reported
have been reported, but toalmost to the elderly people,
but adolescents also,adolescents having ikigai, also
adolescents having ikigai.
So the ikigai assessment isaddressing to elderly is very
(31:29):
important, but also thedifferentiation between them can
be reported.
Speaker 1 (31:34):
Yes, I've seen a few studies.
There's a few scales.
There's obviously the ikigai 9.
Yes, ikigai 9.
There's also a four-factorscale that I stumbled upon where
Ikigai was expressed.
For younger people, ikigai isfelt or expressed as passion,
and then for older people,ikigai is this internal, calm,
(31:58):
continuous experience.
So Ikigai also changes overtime, and I guess the way it's
experienced has changed overtime.
Speaker 2 (32:07):
Yes, in this Mima Song study we measure the kind
of ikigai also.
So we have not reported in thearticles but like build a plant,
japanese name bonsai, yes,bonsai on the land, small
(32:30):
calibrated land work life taskis ikigai and many kind of
ikigai can obtain in this KoiValley area, can obtain in this
quadral area.
So in the future we will reportthe kind of wikigai in the
healing and mantras regions.
Speaker 1 (32:49):
Great.
Well, when you've done anotherpaper, we can have you back on
the podcast.
Speaker 2 (32:57):
We have planned.
Speaker 1 (32:58):
Okay, I mean, it's a fascinating question how do you
measure the answer to thequestion of what makes life
worth living?
It's very challenging becauseit is, yeah, so subjective and
individualistic, as I saidbefore, influenced by our age,
(33:20):
where we live, our socialnetwork, whether we're working
or not working.
Do we have a family or do we?
Speaker 2 (33:29):
live alone.
Speaker 1 (33:31):
So do we have hobbies ?
Is religion important in ourlife?
So it's quite a challenge, Ithink.
Taku to measure ikigai.
So with that, let's get alittle bit personal.
What about you, taku to measureikigai?
So with that, let's get alittle bit personal.
What about you, taku?
What is your ikigai?
Speaker 2 (33:49):
Yes, I have several ikigai now.
One is spending time with myfamily, bringing my children
when I get home and going outwith my family on holidays are
very important goals and ikigaifor me, and to communicate new
findings to society as aresearcher, which definitely my
(34:10):
ikigai is as well.
To this end, I would like tolive a better life, taking into
account affective, psychologicalconditions in my daily life.
Speaker 1 (34:20):
I see.
Well, I'm very happy to helpyou with your Ikigai and
communicate your new findings tosociety as a researcher.
So, yeah, when you do anotherpaper on Ikigai, I'd love to
have you back on the podcast.
Thank you very much.
So, thank you for your timetoday, and do you have a website
(34:45):
or a social media account whereyou share your research?
Speaker 2 (34:50):
Oh sure, this is my research map address.
Okay, I have a research mapaddress.
Speaker 1 (34:57):
We'll share that in the podcast notes, so we'll link
to the paper and your researchmap address.
But thank you very much foryour time today.
Speaker 2 (35:09):
Okay, I'm very happy to talk with you about Ikigai.
Speaker 1 (35:15):
Me too, and maybe I'll come and see you and we can
visit this beautiful area thatyou live.
You live in Tokushima, so youlive.
I have to remember the name ofthe area, is it?
Speaker 2 (35:28):
Koya, koya, daera area.
Speaker 1 (35:31):
Yeah, all right, so I'd love to come and meet you in
person.
Speaker 2 (35:36):
Yes, I hope you come to Koya Daera, area with rich
nature.
Speaker 1 (35:41):
Okay, Well, that's a universal source of ikigai.
I think Everyone can find orfeel a sense of ikigai in nature
, so I'd love to do that.
All right, Thank you Taku.
Thank you Nick.
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Current and classic episodes, featuring compelling true-crime mysteries, powerful documentaries and in-depth investigations. Follow now to get the latest episodes of Dateline NBC completely free, or subscribe to Dateline Premium for ad-free listening and exclusive bonus content: DatelinePremium.com