Good Life Project - How to Unwind Anxiety | Dr. Jud Brewer

Episode Date: March 14, 2024

Neuroscientist and addiction expert Dr. Judson Brewer unveils a practical, evidence-based approach to transforming your relationship with anxiety. Learn how to "unwind" worry and fear by understanding the habit loop of anxiety, applying mindfulness tools, and accessing your brain's innate wisdom. Discover why anxiety persists and how retraining your brain can create more ease and joy, drawing from Jud's research and bestselling book, Unwinding Anxiety: New Science Shows How to Break the Cycles of Worry and Fear to Heal Your Mind.You can find Dr. Jud at: Website | Instagram | Episode TranscriptIf you LOVED this episode: you’ll also love the conversations we had with Ellen Hendriksen, PhD about social anxiety and how to handle it.Check out our offerings & partners: My New Book SparkedMy New Podcast SPARKED. Visit Our Sponsor Page For Great Resources & Discount Codes Hosted on Acast. See acast.com/privacy for more information.

It's like we've hit these multiple rounds of uncertainty to the point where not only has anxiety gone nuts, but I've also seen where people are kind of getting this, I don't know if this is the perfect term, but this is how I think of it is kind of like learned helplessness where, you know, a lot of people they're like, I give up, you know, my brain is fried, just too much anxiety. Anxiety, even saying the word makes me a bit anxious. But what if there was a way to unwind it and come back to calm that was maybe counter-intuitively simple? And what if a lot of the popular thoughts around anxiety and how to deal with it today were wrong, or at least took a lot more work than necessary? Well, that's what we're talking about today with my guest, Dr. Judd Brewer.

He's a New York Times bestselling author, neuroscientist, addiction psychiatrist, and thought leader in the field of habit change. And Judd is also the director of research and innovation at Brown University's Mindfulness Center, where he serves as an associate professor of behavioral and social sciences in the School of Public Health. He's the executive medical director of behavioral health at Sharecare Inc. and a research affiliate at MIT. And he's developed and tested really novel mindfulness programs for habit change, including treatments for smoking and emotional eating, and yes, anxiety. He's the author of Unwinding Anxiety.

New Science shows how to break the cycles of worry and fear to heal your mind and the craving mind from cigarettes to smartphones to love, why we get hooked, and how we can break habits. So excited to share this best of conversation with you. I'm Jonathan Fields, and this is Good Life Project. The Apple Watch Series 10 is here. It has the biggest display ever. It's also the thinnest Apple Watch ever,

making it even more comfortable on your wrist, whether you're running, swimming, or sleeping. And it's the comfortable on your wrist, whether you're running, swimming, or sleeping. And it's the fastest-charging Apple Watch, getting you eight hours of charge in just 15 minutes. The Apple Watch Series X, available for the first time in glossy jet black aluminum. Compared to previous generations, iPhone Xs are later required. Charge time and actual results will vary.

Mayday, mayday. We've been compromised. The pilot's a hitman. I knew you were gonna be fun. January 24th. Tell me is a topic of interest. It has been for a long time. And for anyone that has not been touched by some form of anxiety, I think the last couple of years have made it a relatively universal experience. I'm curious from your lens, how have you seen the depth and the scope of anxiety change over these last two or three years. Yeah. I'm just thinking about the, for anyone who hasn't been touched and I was just thinking, find me that person. Who is that? Yeah. It's, you know, just seeing the rapid increase in anxiety societally is it's just kind of like this unfortunate naturalistic experiment. You know, so me as a neuroscientist, my brain says, oh, wow, I wonder how this is going to go. This was two years ago. And then started thinking about the, you know, well, our brains don't like uncertainty. And boy, there's a lot of uncertainty and, you know, et cetera. And then, you know, the prediction says, well, things are going to spike and then things spiked and then things kept going. And then where these,

with these multiple rounds of uncertainty, just with the pandemic, you know, it's like, you know, first round, then we get Delta, then we get Omicron, you know, and it just keeps coming, you know, in economics schools. And so it's, it's like, we've hit these multiple rounds of uncertainty to the point where not only has anxiety gone nuts, but I've also seen where people are kind of getting this, I don't know if this is the perfect term, but this is how I think of it is, it's kind of like learned helplessness where, you know, there are these experiments that were done decades ago, where animals, you know, when they didn't have, when they were basically, you know, you shock them intermittently. So, and then they, at some point they just give up

and they say, I can't predict this. You know, if they could predict the shock, then they were fine. But if they couldn't predict it, they basically just said, I give up. And we are kind of like that now as humans, you know, a lot of people are just, you know, it's just like, they're like, I give up, you know, my brain is fried, just too much anxiety. Yeah. I mean, and I think before this moment in time, if so many people have experienced it, and I almost wonder, I guess here's what's spinning in my head. If in before times, anxiety was a pretty universal experience, but not entirely universal. And now basically, like you talk to anybody who doesn't say, I'm living with some level of this thing. Does that in any way, shape, or form, does the normalization of an experience that would normally

be really difficult to deal with, does the fact that we're all in it together in any way change the way that we experience anxiety potentially for the better? Yes. Two things come to mind. One is any time we can work together against a common threat or enemy, let's say, it's always better. We really, truly, as humans, are better together. And the other piece that comes of that is just even knowing that we're not alone.

I run a live group for people using our app-based mindfulness training programs. And often, it's like every week we come together. And often one of the first things I say to somebody when we're exploring one of their struggles is, you're not alone. And then with the 200 people on the call or whatever, I say, raise your hand if you could relate to this. And everybody raises their hand. And it's just the normalization. Just you can see that that visible is like a Zoom call. So I can watch the person's expression. It's kind of like this settling in. And the only thing that's changed is that they know that they're not alone. This isn't something unique to them. It's not that

they're messed up or it's their brain or there's something that they're the crazy person. It's that this is, I think of as a psychiatrist, we have these books that say, this diagnosis, this and this and this. To me, more and more, it's just simplifies down to there's a single condition that we all have. It's called the human condition. And, and there are variations on that human condition. And we all share in, you know, stress, we all share in anxiety. And so just knowing that we're all together in this can be the beginning of the healing there. And then also, when we can relate to each other, it's easier to empathize and bring compassion in. When somebody is really struggling with anxiety, and we know that place, it just opens our hearts a little bit, where even non-verbally, it's like, oh yeah, I've been there.

I know what you mean. And that too can be part of the process of healing. Yeah, that makes a lot of sense. So we've used the word anxiety a whole bunch, literally in the first like 60 seconds of our conversation. I think it makes sense also to really sort of dive into what are we actually talking about when we're talking about anxiety? Well, there's a definition I think that works relatively well, you know, this feeling of nervousness or unease about an uncertain event or something in the future, basically. I think of it, another way to think of it is fear of the future. And the reason I like that definition is, as I was doing research

for my Unwinding Anxiety book, I was really looking into like, why do we have anxiety? Because it's, you know, our brains are set up for immediate threat. You know, basically our brains are set up to eat and not be eaten. Right. And so we're set up to remember where food is. We're set up to remember where danger is so that we can find the food and go back to it. And we can remember where the danger is and not go back to it. So this big question is like, why, where did anxiety come from? And the best that I can gather is that, you know, think of this survival part of our brain help, you know, fear, very helpful survival mechanism. We learn, you know, don't, don't go back there. But then also more recently, our brains have evolved to plan for the future, you know, don't go back there. But then also more recently, our brains have evolved to

plan for the future, you know, and so we've got the present moment. Is there danger? No. Okay, now I can plan for the future. And planning for the future is also helpful. But when you mix those two together, fear of the future, not so helpful. And so that planning part of our brain actually can start to spin out, especially the more uncertainty there is. Our brain spins out in what-if scenarios. And those what-if scenarios make us more and more freaked out, ironically, making our thinking and planning part of the brain go offline. And so when I think of anxiety as fear of the future, it's these two helpful survival mechanisms, you know, fear and planning that kind of get mixed together. And it's not like peanut butter and jelly, peanut butter and jelly generally good together.

This is like, I don't know what the analogy would be, but mixing something that you would never eat with peanut butter and tasting it and saying, yep, I would never mix that with peanut butter. That's a bad idea. Our brains just haven't figured that out. Yeah. I mean, so when you think about fear and planning coming together in a way where it becomes deleterious, like I wonder, is there a threshold where, you know, like up to a certain point,

this is actually useful. It's like you said, like we have these things in our brain. They've been with us for a really long time. And generally stuff that survives serves some purpose, whether it keeps us alive, whether whatever it may be. So it's almost like, you know, at what point do we cross from, oh, this is maybe not pleasant, but useful. It's valuable.

There's some role that it plays that's constructive in our lives to saying, okay, this is now tipped over to the other side. Now we're now on that side where it's now actually destructive. It's now actually negatively impacting our ability to live. You know, we go from the experience of a state to that state tipping into disorder. Where's the line there? And can you even make a distinction? Well, if we talk about anxiety specifically, you know, there's a lot on the internet. And so you probably know where I'm going based just in that phrase. There's a lot on the internet about how anxiety is helpful. Yet when you look at, you know, so it's where, where do we tip? So for example, I even wrote about this in my book because it is so often quoted and it is just so wrong. That's all I could say. And as a scientist, I tend to be like, well, maybe this, maybe that, but this is really, there's no evidence

for anxiety being helpful. So there is really no tipping point for anxiety. If you look at the research, the more anxious we are, the worse we do on cognitive tasks, whatever, whatever, whatever. Another way to look at it is what's the opposite of anxiety? I think of Mihaly Csikszentmihalyi was this psychologist that coined this term flow. Some people think of this as being in the zone where we're just really singing along in life. And he describes this as selfless, it's effortless, it's joyful. And so the opposite of anxiety, and when somebody is performing at their best, is when they're in flow. And we are so not there, as in we are so not anxious,

that's what flow is. When we are so in the opposite direction of anxiety, we're not even experiencing, getting a sense of us doing anything. It's just stuff happening and where our awareness is there along for the ride. So without going into details about all these, the inverted U-shaped curve of anxiety performance, which is just based on a misconception, people can look it up if they want to, based on a 1908 study of Japanese dancing mice. I'm not kidding. You know, the short story is there is no tipping point for anxiety. It's a linear anti-correlation meaning the more, more anxious you are, the worse you do. So yeah, that's interesting, right? Because you'll sometimes hear like, I kind of need like a baseline level of this feeling to make me, because it almost like

it puts me in an agitated, like a vigilant state that in some way makes me quote, perform better, whether it's in business, whether it's in sport, whether it might be, I'm more hyper. But what you're saying is that's complete mythology. Like it literally serves no purpose. It serves no purpose. And what you're highlighting is something that our brains do really well, which is to make correlations and attribute causation. And by that, I mean, you know, my old PhD mentor, Lou Muglia, used to say, you know, when you're doing experiments, could there be a correlation without causation? Could A be true? Could B be true? And they just happen to be coincident, they're happening at the same time, but is A causing B? That's when it's interesting from a scientific perspective,

you know, if we're trying to study a mechanism. And the same is true here. So the more anxious we are, the more that kind of, you know, we have moments of anxiety, and the more likely that is to be coincident with us performing well, for example, even though it's not true, if you really look at it, anxiety decreases performance in general. But we make this, let's say that we happen to be anxious and we happen to perform well, our brain says, oh, I need this level of anxiety to perform well. True, anxious, true, perform well, but not, you know, it's correlation. It's not causation. Anxiety didn't cause my performance to improve. Yet our brains, without knowing, you know, to look for that, they just assume, oh, I was anxious, I performed well,

it must have been because I was anxious. And so we trip ourselves up thinking, oh, you know, I need that baseline level of anxiety to do something. And it may just be totally correlation. You know, again, if we go back to looking at, well, did you ever perform well when you weren't anxious? Yes. Did you perform better when you weren't anxious? Well, actually, now that you mention it, yes.

Well, there's, there you go. Right. And which one was more Well, there you go. Right. And which one was more enjoyable? Hmm. Yeah. Hmm. For sure. So if anxiety is effectively essentially taking fear, spinning it out into the future.

Well, I guess spinning is an interesting word in the context of anxiety, right? Because I would imagine a lot of people experience this thing of anxiety as a spinning sensation. It's almost like there's something that might happen in the future. There's uncertainty. Maybe there's a legitimate high percentage of it. Or maybe it's just like a smidge, but something happens in our brain where we keep telling the story of that being our future reality. And it's not something we want to happen. And we can't let go of it. So it feels like compulsion is a part of the experience of anxiety. Is that accurate or no? Yes. And this is something I wish I'd learned in medical school or residency,

but it happened to, I just kind of learned this because I was studying habit change and we were developing these, you know, app-based mindfulness trainings for smoking and eating. And somebody said to me, you know, my anxiety is driving my eating behavior. And they said, you know, could you create a program for anxiety? And I was thinking, well, I prescribe medications for anxiety as a physician, but it put this bug in my ear. It's just, well, could I, you know, cause medications aren't that great. Could I do, you know, can I look into this? And it turns out that anxiety is driven like any other habit. And so you say spinning, you know, so for any habit to form, we need three elements, a trigger, a behavior, and a result. So just as an example, you know, we talked about survival, right? You see the food, there's a trigger, you eat the food, there's the behavior. And then your stomach sends this

dopamine signal to your brain that says, remember what you ate and where you found it. So that's how, that's the general process for habit formation. With anxiety, the feeling of anxiety can trigger the mental behavior of worrying. And I'm going to say that again, because that, that's hard for some people to, you know, they're like, I never thought about it that way. The physical feeling of anxiety, that feeling of nervousness, or that feeling of worry can actually trigger the mental behavior of worrying. And that worrying is where we start to spin, you know, because we can't predict, you know, we're not very good at predicting the future. And the more we spin, the more we spin

out, because we start to think, you know, oh, this could be really bad. Or here's another thing I didn't think about, you know, and then our brains just get way out of control to the point where we didn't even get into panic, you know, this wildly unthinking behavior, which is that far end of the spectrum of anxiety. So yes, what you're saying is absolutely true. And it's interesting you mentioned the word spinning because that's exactly how these habit loops form. So worry gives us the brain reward of feeling like we're in control, or at

least that we're doing something. You know, I can't do anything about this, but at least I can worry. So, you know, we're occupying our mind and that is rewarding enough that it feeds back so that the next time we're anxious, it says, hey, why don't you worry again? The Apple Watch Series 10 is here. It has the biggest display ever. Flight risk. The Apple Watch Series X. Available for the first time in glossy jet black aluminum. Compared to previous generations, iPhone Xs are later required. Charge time and actual results will vary. So, I guess what I'm trying to understand then is, if this effectively is experienced as a habit, and a habit requires the trigger, the behavior, and the reward,

I get the trigger, like this feeling of anxiety, which leads to the behavior of worrying. What's the reward? Well, I know it seems crazy. And people that, so we have this unwinding anxiety app, people that use the program, one of the questions we have them explore as part of the program is what are you getting from that? You know, like, what is rewarding about worrying? And for a lot of people, when they actually start to map it out and ask themselves that question, like, what am I getting from this? It's absolutely nothing, just like you're pointing out, not getting anything. And then they follow that question up with, why am I worrying? How did this become a habit? And that's what goes back to, at some point, the worrying might have been associated with

solving a problem. Again, could be true, true and unrelated. It might be associated with just the feeling of, you know, I could sit here and feel like my hands are tied or I could sit here and worry. And the worrying feels better, ironically, because worrying doesn't feel very good. But to some people, it feels better than not doing anything. And some of that goes back to just not knowing what it feels like to not do anything in a time when probably the best thing to quote unquote do is to not do. You know, I think of it as being is the new doing where can we learn to be with our thoughts?

Can we learn to be with the anxiety? Can we learn to be with uncertainty? And instead of spinning out into our panic zone, we can be curious about it. We can move into our growth zone instead of our panic zone. But until we learn that, it really, you know, we're just going to keep spinning out in those habit loops around worry. It's a huge, like we talked about it earlier, this is happening all the time to a gazillion people, you know, because there is so much uncertainty out there.

Yeah. And I would imagine, I mean, I'm picturing this as sort of like a series of false peaks. It's like there's one loop on top of another. It's like you get to one and then, oh, there's there's one loop on top of another. It's like, you get, you get to one and then, oh, there's something I'm stacking on top of that. And this, this leads to this, which leads to this, which leads to this. So you have this compound effect. You know, it's interesting. So as you're describing this, the phenomenon where I'm going in my brain is, um, so as we have this conversation, there's a sound in my head. I have tinnitus and I've had it for over

a decade now. So there's a high pitch sound in my head. In the very early days of having that, it was extraordinarily destructive and distressing to me. And what I learned over time was that the sound itself does nothing. The sound is just a stimulus. I lived in New York City at that time. It was one of a bajillion other sounds that were entering my ears all day, every day. And for some reason, this sound was brutalizing to me. And what eventually I learned was it wasn't the sound. It wasn't the actual circumstance. It was the story that I was telling about what the sound would mean for my life. And then it was my brain automatically hitting spin on that and saying, like, what is the worst possible case scenario of this outcome? And then amplifying it and then repeating it over and over

and over and over again. There was something about the repetition that led me to start to feel this is my inevitable future. Like there's no out here. And I would start to spin story on top of story on top of story until I sort of like learned how to basically peel that onion and rewire my brain to be much more okay. And so as I have this conversation with you, I'm completely fine. In fact, the stimulus has never left. At any given moment, if I look for the sound, it's there. But because I've trained my brain to basically not look for it, it functionally doesn't exist unless I look for it now. And there's no anxiety attached to it anymore because of that.

But it was this really interesting cascading, compounding storytelling process that actually wasn't entirely related to the circumstance itself. You know, the way you describe that, and you describe it so beautifully, it brings to mind this image of, you know, like a car where for the car to move forward, say, you know, drive down the road of tinnitus or anxiety, we have to engage the gears, right? We have to put the clutch in, or if it's an automatic, you know, basically put it in drive. And that process of linking is what moves us down that road. And so if we get stuck in the story, like you're talking about, that engages us and gets us caught up in it. And suddenly we get caught up in these gears and we're racing down the road. Whereas if we can notice it and notice the process where, and I don't know if this was the case or the process that you went through as you started to learn to what I'm hearing is unlink these like, oh, there can be sound and i don't have to be reactive to it right it's when we get stuck in the story it's like they're sound and i'm reactive to it so

i'm thinking of my patients it's like i'm an anxious person you know they're so caught up in that story that they can't even see that they are caught up in the story and that we can learn and like you're i think as you said we can learn to retrain our brains. And it's actually relatively straightforward. Not always easy, but relatively straightforward. The process is straightforward. We can learn to retrain our brains through simply bringing awareness. One, noticing the process, noticing when we're caught in a loop.

And then noticing that the being caught up is the critical link you know i think of it as you know i we functionally use this we actually use a three gears analogy so no wonder i'm talking about gears but think of it as the first step is recognizing that we're caught in that the second step is seeing what we're getting from that, which actually taps into the neuroscience of how our brains work. You know, it's, oh, I'm worrying. I'm seeing, you know, there's the behavior. What's the result of the behavior? Well, I'm getting more anxious.

And when we can see that worrying doesn't actually serve us or using the example of, you know, the story of tinnitus, it doesn't serve you. Again, I don't want to put words in your mouth, but I'm just imagining what this can be like. When we see that that story is not helping, then naturally our brains start to become disenchanted with it. We're less excited to continue the story because the story is not helpful. I'll use a different concrete example.

When we just published a study from my lab where we have this eat right now app that helps people pay attention as they overeat. And when they overeat and pay attention and they see that overeating isn't actually serving them, right? They're stuck in that, you know, that loop within 10 to 15 times that reward value in their brain drops below zero and they shift their behavior. So we can start to see whether whatever the story is, whether it's just an automatic, clean plate club, I overeat, that's just what I do, or am I an anxious person, or here's my story and it's going to last forever and my life is going to be terrible and horrible and we spin

out into the future, whatever that is, whatever the story is, we can start to see, huh, being caught in the story is not helpful. And that gives us the perspective to be able to step back and see, huh, what's it like not to be caught in the story? And that's where change can happen. You know, just as an example, and I'd love to hear your experience, but with our Unwinding Anxiety app, we got a 67% reduction in clinically validated anxiety scores in people with generalized anxiety disorder.

So these are people that wake up and they're anxious. They get more anxious and worried that they're anxious and they're anxious all day. I've had people that, you know, patients that have been like that for 30 years. And we get this huge reduction in anxiety simply by helping them be aware of these habit loops, know that they have them, know that the anxiety is not helping and know that the worry in particular

is just driving more anxiety and then bring in tools like curiosity and kindness, which I think of these as bigger, better offers. They feel better for our brains and our bodies. So if we can start to make the connections and give our brains a choice, you know, choose between worrying and curiosity to our brains, it's a no brainer. Yeah. And that makes so much sense to me. And, and it's, I love that you have sort of technology that sort of builds this into the experience right now. It's funny. I've, I've gone deep down technology that sort of builds this into the experience right now.

It's funny. I've gone deep down the rabbit hole of positive psych over the last probably decade and a half, andreviewed manner practices that have been around in Eastern philosophy and traditions for thousands of years because they were. And I think that's a lot of what we're talking about right here. We're sort of, we're reaching a point where we're sort of looking at these things and saying, huh, you know, people have been doing pieces of this in a lot of different ways for a really, really, really long time. And it's had really interesting cultural effects. And how can we understand what's really happening underneath the hood here? Like what's happening in the systems, in the body, in the brain, and make it more systematic in a really interesting way. And I have no doubts,

it's driven in no small part because there's a lot of suffering happening in the world right now. And the traditional approaches aren't necessarily working as well as we'd like them to. Yeah. It's so interesting you mentioned that. I've been very interested in Buddhist psychology for 25 years now. And I worked with a Pali scholar to look at the parallels between these Buddhist concepts. For know the there was one concept that the buddha was apparently contemplating on the night of his enlightenment you know it's like oh that's probably a good one to look into and it basically long story short is he was describing what we now think of as positive and negative reinforcement in modern day and so here you know before paper

was even invented you know uh somebody had described this process that Eric Kandel gets the Nobel Prize for showing that it's evolutionarily conserved all the way back to the sea slug. And like you're saying, even if you take a Darwinian perspective, the best treatment is going to outcompete the other treatments. So modern day, think of psychoanalysis. And again, I'm a psychiatrist. I'm not anti-ps know, psychiatry or psychology. But if you just take a Darwinian perspective, like which ones have lasted the longest, you know, these principles have not changed in 2500 years.

Whereas the closest that we have in modern day, you know, the oldest one is, you know, based on Freudian psychoanalysis, which is, you know, just over a hundred years old. And that's not on its upswing. You know, it's not out competing this very simple process. So even now we're seeing this surge of people, you know, bringing forward mindfulness practices in the West that have been around, you know, the core, I won't say all of them, because I'm not sure that all of these programs really kind of get the Buddhist psychology. But if you look at the heart of it, it certainly,

I'll just say it's worked well for us. So when we've developed these programs based on these, just, you know, going straight at the Buddhist psychology saying, let's strip away everything else and see if this works. You know, we get five times the quit rates of gold standard treatment in smoking cessation. You know, we got a 40% reduction in craving related eating in our eat right now app. And as I mentioned, we've got this 67% reduction in anxiety with our unwinding anxiety app. And that's basically just bringing these concepts forward in, you know, in a modern day context. And so to me as a scientist, you know, I just want to see what works the best. And if I can find something that works better than everything else, as a physician, I'm going to

prescribe it, you know, if there's a good evidence base for it. So it has certainly increased both my understanding, but also my faith in these very simple principles. Because I see, I've seen it work for me, you know, I used to get panic attacks. I, you know, still panic at times and I can, it's really helpful for me. But more importantly, I see it work for my patients. I see it work for the folks in our programs. And that is tremendously gratifying just to see people's lives, you know, really change a lot for the better. Yeah. I mean, it's so powerful. Effectively, it's sort of like distilling the essence and making it as universally accessible as possible, which is sort of like when you look back at what John

Kabat-Zinn did in the early days of mindfulness-based stress reduction, he was kind of doing the same thing. It's like, let's pull the pieces that anyone can say yes to and offer it in an accessible way. You write about and you speak about, and this is baked into your technology, this sort of like the notion of three elements of awareness, curiosity, and compassion. I want to talk about each one of those. And we've kind of been dancing around each one of them, but let's go into them in a little bit more detail. Awareness, sort of like the starting point of what? Great question. So I would say certainly awareness is an endowed characteristic that we all have. We can be aware or we could not be aware if we're lost in a story. So I would say awareness of everything, right? The more aware we are of our experience,

the more helpful it can be for helping us live a healthy, happy life. So let's drill down on that because that sounds kind of vague. In particular, when it comes to things like anxiety or things that are causing our suffering, like you were saying, there's a lot of suffering in the world today. If you look at the Buddhist psychology, they talk about cause and effect. You know, that's kind of the essence of karma, basically, is cause and effect. If you frame that in terms of modern psychology, it's, you know, positive and negative reinforcement are another way that they're described as reward-based learning. And it's described that way for a reason.

If a behavior is rewarding, we're going to keep doing it. If it's not rewarding, we're going to keep doing it. If it's not rewarding, we're going to stop doing it. And so here with awareness, what I would say is it's helpful to drill down on awareness of the results of our behaviors. If we can see what the result of worrying is, then it helps us become disenchanted with it. If we can see, if we're a jerk to somebody, if we can see what the result of that is, instead of just yelling at somebody on the internet and then turning our computer off or our phone off and ignoring it. But really, if, you know, if we, if we did that face to face, you know, we get to see the results of that and just

the results can help us start to change our behavior and become disenchanted with being a jerk. If we can see the result, and I'll stop with the example shortly, if we can see the results of being kind or having kindness bestowed upon us, we can start to see the joy that comes with that. So I would say awareness of cause and effect or basically awareness of the results of our behavior if we're looking specifically at behavior change, habit change, or anxiety. But in general, awareness is good. You know, looking both ways before crossing the street, very helpful. Yeah, it's interesting. I'm also wondering about in the context of awareness is what about awareness of our current sensation, even before we get to sort of like the result of a behavior that we say yes to in the

first place? Because what I'm thinking is so few of us, I think, are tapped in like at any given moment in time. I mean, if somebody's spinning something in their head or somebody's in an anxiety state in their head. And it's because like there's a projected storyline or projected outcome and doom and gloom scenario that they're kind of like spinning. Do they actually know that they're telling this story in the first place? Or is it this autopilot thing that's happening? And before we can even get to like the reward-based learning side of it, what about the awareness of simply like meta-awareness, awareness of where our

attention actually is at any given moment in time? Yes. So I think that can be very helpful. And I also think it can be very confusing for people because it conceptually can be easy to get caught in the concept, but the idea of being aware that, you know, that meta-awareness, being aware that we're not aware or aware, you know, that we are thinking, for example, can be challenging for people. And so I often start with, you know, what are the simplest ways for somebody to get the idea of this, you know, this concept? And so behaviors are generally a little more straightforward and less conceptual. You know, it's like, oh, did I overeat or not? You know, did I worry? You know, so those are

concrete things that we can pay attention to. And then we can pay attention concretely to the results of those. So I often find that that is a good doorway in to then asking the question like, huh, okay, so you notice that you are worrying. Now can you notice that thought, you know, or that there is thinking? And then that's a doorway into that meta-awareness. Oh, I am somebody who is thinking, you know, or as one person put it in our program, I'm a person with anxious thoughts. am not an anxious person right that but that conceptually saying oh just notice you know that can be really challenging but starting with something super concrete typically not involving thinking or our minds because it's so easy to get lost in the story especially when we've never had enough distance to be able to see that there's thinking that then the second step can be, you know, Oh, you know, can you notice a thought, you know, like a cloud in the sky or like a leaf in a

river, you're drifting by as compared to, you know, you being that leaf. Does that make sense? Yeah, no, it totally does. I mean, it's interesting that you asked me like what my process was around tennis and a lot of it actually was mindfulness-based. And for me, the reason that I was drawn to mindfulness and still it is my daily practice, like 12 years later, is that it trained me to just sort of like dedicate a small amount of time every day to continuously inquire into where my mind was.

And it's not easy and it's not fun. And to this day, I feel like, you know, if I was going to rate on a scale of one to 10, like how good my sit was, I'm going to probably tell you two to four, you know, it's like, and we're not supposed to do that. Of course, like, it's not about that, you know, can't gamify like the whole practice itself. But you know, what's interesting is that a big part of that practice, it teaches you to dedicate a regular amount of time on a daily basis or regular basis to just sitting there and noticing where your brain is and then making an intentional choice about like if you notice it, if there's a thought, whatever it is, let it go. And it's

not about clearing your mind. It's not about trying to get all thoughts out of your mind. It's just, it's a practicing, noticing and dropping. It's like a daily training in noticing and dropping and noticing and dropping and returning. Notice, drop, return. And I agree with you. I think it is stunningly valuable, but the practice itself is hard to describe sort of like what comes out of it. And we tend to experience it as being so unsuccessful at it by sort of like Western terms for so long that nobody wants to stick with it. Yeah. You know, it's,

it's funny you mentioned that because in one of our first studies, this is the study of smoking cessation. I was at Yale at the time and I'd been meditating for about 10 years. So we wanted to see if mindfulness training could help. And what we did was we looked at both formal meditation practices like you're describing, sitting, walking, things like that. But we also looked at informal mindfulness practices where in the moment that somebody had a craving for a cigarette, you know, we give them tools to work with and could they use those tools.

And we found that both the formal, like the sitting meditations and the informal, you know, in the moment that I have a craving, both helped, both were correlated with reductions in cigarette smoking. Yet, we found that the informal practices formally moderated a decoupling of craving and smoking, which is just fancy terms for there was a greater effect for the informal practices, which made me totally rethink how I approached mindfulness practice. And part of it is what you're describing. It can feel like a slog. I'm not saying that's what you're describing, but a lot of people describe it as like, oh, I have, you know, and for, you know, even people getting in the habit, it's kind of like, you know, oh, I should exercise because it's good for my body. I should meditate because it's

good for my brain. And that sometimes can get in the way of the practice itself. And so here, I think of it as, you know, there's people talk about psychedelics and, you know, as a emerging field of treatment in psychiatry. And they're also exploring doing a lot of research. We don't know how good this will be yet. But with a term called micro dosing, where they'll give a tiny dose of LSD or psilocybin every day and see if that can help people in different ways. Again, research is out, don't know. But the term microdosing and looking at our own research made me start to rethink, huh, well, how are habits formed through repetition?

And is there a way, this is actually borrowing from Tibetan Buddhism, where they talk about short moments many times, you know, it's just can you be aware right now, don't worry about sitting for 30 minutes. Don't worry about sitting for three minutes, just can you be aware right now, let's start there. And those results from our study suggested, huh, that could actually be a powerful way to start. So we've actually, we actually tooled all of our digital therapeutics based on that, on that finding was, can we start with these short moments many times? And actually, can we start before that? Can we help people understand how their minds work? So we teach people about these habit loops first. So they, they know why they're

practicing. And part of this was my own ignorance of like, why am I supposed to pay attention to my breath? I don't get it. You know? So we're like, this is, this is, this is how your brains work. You know, habitually all of our brains work this way. Let's start there. Okay, great. Now in the moment that you're caught up in a habit loop, can you just notice that?

Great. What's it like to notice it as compared to not having noticed it and being lost? That is, I think of it as a quick win because it feels better to know than not. I mean, you know, we'd rather know that we're stuck in a habit loop than keep being stuck in it for longer, you know, because it's just building up. And so here I think of this as, can we bring awareness in any moment and be curious, right? Curiosity is that attitudinal quality of mindfulness where, you know, it's like, instead of going, oh, I was lost or my mind wandered again, oh, where we kind of judge ourselves, we go, oh, I was lost. And now I see

that, right? And so there can actually be some joy and some reward that comes just from the noticing. And that can happen off the cushion, you know, through our daily lives. And it can even happen when we're on the cushion, when we're meditating. It's like, oh, my mind wandered. Oh, my mind wandered. And it gives us an opportunity to inject some curiosity. And curiosity itself, I think of it as a superpower because curiosity feels great. Yeah, no, I agree. And just that it's so funny you described this sort of like that. Oh, like just noticing, it's almost like you get like a little credit for actually picking

up on the fact that you've noticed like when your mind is somewhere, it's like, oh, score. Like I get like a little checkbox right there. It's like, where's my gold star? I would say a lot of credit because all we have is any one moment. And so it's kind of on or off. Are we aware? Are we not aware? So if we're aware, you know, it's like jackpot, multiple gold stars, because that's all we can be doing anyway. Yeah, no, I love that. Mayday, mayday. We've been compromised. The pilot's a hitman. I knew you were going to be fun.

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Compared to previous generations, iPhone XS or later required, charge time and actual results will vary. And that drops us into this space of, as you described, curiosity, where now we can kind of inquire into it a little bit. Under that context, you also, you write about, and I know it's part of your work, this acronym that I, again, was familiar with originally from a Buddhist teacher,

Tara Brach, and it's a shorthand, you know, the acronym is RAIN, R-A-I-N. So it was interesting to see you bringing it in, in the context in a very sort of like specific way in the work you're doing. Walk us through sort of like what those letters stand for and how it actually really plays into the curiosity and reinterpreting process. Yes. So first off, a shout out to Tara because she makes these practices so accessible for so many people. So, you know, she is certainly adding light into the world in a much needed way. So this RAIN practice is this acronym. I think it was actually Michelle McDonald who had first come up with it.

And then Tara has done a great job of helping people learn about it. Our stance for recognize, you know, if we're lost, we can't, we're not aware. So the first step is that moment of recognition, like we've been talking about. Gold star, boom, I'm aware. Oh, okay. And it could be a craving. It could be worry. It could be anything, right? Whatever we're lost in, we're aware. The second step that a stands for allowing or accepting where, you know, if we notice something and we're like, Oh, my mind wandered, we kind of want to push it away. We don't want to face it. You know, we run away or we push it away. What we resist persists, right? So here, instead of pushing something away, we invite it in. Oh, well, here it is.

Can I just allow it to be here as compared to pushing it away? Already there's less energy needed, right? Because it's like, we're not resisting. That I stands for investigate. And this is where curiosity comes in. So if we recognize, let's use a craving as an example of craving for food, recognize that craving allow, okay, here's this craving instead of saying, I want to ignore it, get rid of this. Oh, what does this craving feel like in my body, right? That I stands for that investigation where we're starting to get curious about what that craving feels like in our body. And then N, Sattar originally talked about non-identification,

where we're seeing that it is not me. You know, like a thought, I have a thought, it's not me. That can be challenging for people who are first learning these practices. So I brought this together with a practice from a Burmese teacher, Masi Said, I was the first one that popularized this noting practice, where you basically note physical sensations, thoughts, you know, sounds, smells, tastes, you just basically note whatever's in your experience. And that noting practice is a really helpful way to help us gain perspective. You know, it's in physics, they call this observer effect. When you're observing something, you're likely to affect the result.

And in psychology, I think the same is true. When we observe a thought, we're less likely to be identified with that thought. So the N happened to be the same end. So I was like, okay, great. Let's use noting instead of non-identification. So we can really get, keep it on the pragmatic level. And so somebody has a craving, they can note, what does that craving feel like? Is it tightness? Is it tension? Is it burning? Is it heat? And, you know, note, note, note, note, note.

And as somebody notes and they're having that perspective, they're less identified with it. And they can notice, oh, this can come and go. and I don't have to act on it because it is not me. It is just physical sensations. And the more they inject the curiosity that I'm part of the practice, the more you can be like, huh, what's going to come next? You know, oh, what's next? It's compared to, oh, no, this craving, you know, when's it going to go away? So that's what the RAIN practice is for. And again, we use it as a core practice in all of our digital therapeutics.

In our Eat Right Now program, we got these gangbuster results, 40% reduction in craving-related eating. And that RAIN practice is really a critical piece of that. Yeah, that makes a lot of sense to me. And it's interesting to reframe the non-attachment versus noting. It's almost like, again, it's creating this kind of similar goal, but or similar sort of like state, but maybe more accessible language to different people. You know, the last piece, the third element is for you, and you referenced it earlier as kindness. I've seen you describe it as compassion or self-compassion. You know, we're not talking about being kind to other people when you're anxious. Not necessarily a bad thing, of course, but it's really bad. It's about ourselves. And that was interesting to me because I recently had a conversation with Bessel van der Kolk about

trauma and what it does to us. And he said, one of the things that's so difficult to deal with is actually not the trauma itself. It's actually the shame that people have around the trauma. Not necessarily around feeling there's any responsibility for the events that led to it, but their inability. Their inability to integrate it, to move through it, to find a way back to life. And if you can't find a place to let that go, if you can't step into a place of self-compassion, it becomes this persistently brutalizing experience. And it sounds like there's a similar context for anxiety here. Absolutely. Yes, absolutely. So think of a habit loop around anxiety. Anxiety triggers, you know, makes us feel like we're doing something in control of its back to anxiety, shame, for example, or self judgment, you know, something we have a thought that could trigger us to judge ourselves or feel

bad about ourselves. Shame is about, you know, I'm a bad person. And then that shame can often the reward there, because it's not very rewarding. If you just look at it, you know, it doesn't look very pleasant to be in the shame spiral. But it, again, makes us feel like we're in control. I can beat myself up over who I am or what I did. You know, guilt is about what I did. Shame is about who I am. We can beat ourselves up over those things. And it makes us, you know, that self-flagellation ironically can feel better because we're doing something active as compared to not doing anything. And that's because we just don't know anything better. We don't know what else we could do. So here, those all share the characteristic of this contracted quality.

You know, you think of we're feeling shame. We feel this closed down contractedness as whether we're beating ourselves up or not. Same is true for anxiety. We feel closed and down, contractedness is where whether we're beating ourselves up or not. Same is true for anxiety. We feel closed and contracted. Same is true for a craving. We feel, you know, contracted. And that restlessness that underlies all of them drives us to do something, whether it's

to, you know, worry more or beat ourselves up or feel, you know, feel shame. So here we can just compare what is it? What is shame or self-judgment feel like compared to being kind to ourselves? And this isn't about, you know, roses and scented candles and unicorns. This is simply about like thinking about the last time somebody was kind to us. You know, what did that feel like? Oh, well, for me, it feels a lot better than somebody yelling at me. And then we can think about times when we've been kind to ourselves. When have I truly, think of a time, we've all had moments where we've been

kind to ourselves. For a lot of people, it's foreign because they're so used to being in these other loops. But then we can just compare, what does it feel like to feel shame or to be stuck in a shame spiral as compared to being kind to ourselves. Yeah, that makes a lot of sense to me. I want to zoom the lens out a little bit and talk about these ideas. Maybe let's do a walkthrough of sort of like the process in a very specific context. We've been talking a lot about generalized anxiety, which we're all experiencing for a lot of different reasons. One of the other sources of anxiety for a lot of people is moment or event based. And the thing that I think, whether it's test anxiety, interview anxiety, it's around a

very particular thing where they're anticipating how it's going to go and they're freaking out. Maybe let's take like a, just as an example, test anxiety. Test anxiety. Sure. Walk me through like a process of like how this unfolds in the context of trying to sort of like step into a better place around that. Yes.

So with test anxiety, for example, and I'll just say, you know, if it's been a while since somebody's taken a test, it could be, you know, they have to give a presentation at work or they, you know, there's some event that's about to come up. So we use test anxiety as an example. So what can happen is that we have this thought, you know, there's some event that's about to come up. So we use test anxiety as an example. So what can happen is that we have this thought, you know, it's about the future. Oh, I have to take this test in the future. How am I going to do? Did I study well enough? Is there going to, are there going to be trick questions? Am I going to be up for it? So those thoughts, there's the trigger, they trigger us to worry, right? And we start worrying, oh no, how am I

going to do? Ironically, worrying doesn't help us study for our tests because we close down. We're not open, you know, and you think of fixed versus growth mindset, you know, where growth mindset is where we can, we can learn. So, so when we're worrying about the test, we're not actually in a good place to be studying for the test, ironically. So that worrying can be that habitual behavior that then, you know, our brain has somehow, you know, lodged in there or habituated to and said, yeah, worry about the test, you know. And it could be a number of reasons, whether it's that correlation that we talked about earlier, where, you know, I worried and then I did okay on the test. So I assume that I need to worry for the test or whatnot. So the first step here is

just map that habit loop out. We actually have a habit mapper that's free. Anybody can download and print it out. It's mapmyhabit.com. But basically what I do with my patients in my clinic or anybody that just wants to learn how their mind works is I say, start by mapping it out. So if you have test anxiety, map it out. What's the trigger? What's the behavior, mental or physical? And what's the result of that? The second step, very simple, also includes awareness, right? Because you have to be aware to map it out. You also have to be aware of the result of the behavior, right? We talked about cause and effect. We talk about reward-based learning. So what is my brain thinking is rewarding for this? So if it's worrying about a test, I would ask somebody not to think about it,

but to really feel into their body because our feeling bodies are much stronger than our thinking brains. That's really where behavior is driven. So it's like, what do you get from worrying? Is it helping you study for the test? Is it helping you retain information? Generally, the answer is no, no, no. Right. But just seeing that it's not rewarding is that critical step for helping us to become disenchanted with the behavior. And so instead of telling ourselves that we shouldn't worry and then beating ourselves up over the fact that we can't stop ourselves from worrying, we can actually go to the source where our brain is. And our brain, if it sees very clearly that something is not rewarding, it's going to become less likely to do it in the future. And that's where the process of change happens. Now we can accelerate that process when in this third step, I think of it as finding that bigger, better offer. So our brains are relative organs. So they'll look for relative rewards. Like is this rewarding, more rewarding than something else? And so if we can start to see that worry

is not rewarding, that reward value drops, it opens up the space to find something that's more rewarding, that bigger, better offer. And here we can ask ourselves, well, what happens if I just bring curiosity in instead of worrying? Like, oh, let me get curious about those thoughts, those worry thoughts. And does it help me notice the thoughts and not get stuck in them? And does it also help condition me to be curious and learn the material for the test? Instead of going, oh, no, I have to study for this test. Like, oh, what's this material? You know, oh, is it, you know, and see where we can find the

natural curiosity to, you know, it's not that we're going to be curious about every single subject matter that we're ever going to be tested on, but it can certainly go a long way in helping us start to at least have that mindset, that curious mindset. So that's the three-step process. Map out the habit loop. Awareness requires awareness. Ask ourselves, what am I getting from this? Also requires awareness. And then ask ourselves, is that awareness, that curious awareness itself, even more rewarding than getting stuck in a habit loop of worry? I guess part of my curiosity is, can we actually do this to ourselves for ourselves?

Or is it much more, I get how if somebody's working with somebody else who's really skilled at walking you through this, that can be an incredibly powerful thing. I'm envisioning somebody who's frantic before a big meeting or presentation or a test or whether it may be, and they're in this state and you just walk through a process that sounds linear and rational and cool and the data shows that it works. Do you find that people are really capable of doing this to and for themselves or do you need someone else to help you through? Or some other technology, which I guess is part of what you've been building?

Yes. So if somebody just listened to this conversation, and said, and then they're freaking out before a big presentation, and they've not employed any of this stuff, it's not like they can just flip a switch and suddenly, well, he said to be curious, okay, you go, because their brain's gonna be freaking out. And they they're they're not going to be in a place where they can practice it so here you know this is i mean i'm as a you know practitioner of medicine i want to figure out what are the systematic ways that we can help as many people as possible to learn how to be aware basically because this is all about awareness and curiosity and kindness so that's why we developed, you know, it's interesting. I started, my first studies were with once weekly groups to help people with addictions. We were doing work with alcohol and cocaine use disorder. And then I, I, I started saying, okay,

we need more than once a week. Okay. Let's do twice a week groups. And then I threw the whole thing out the window when the apps started coming around, you know, we developed our first digital therapeutic back in 2012 or 13, like right when smartphones were, everybody was just playing games on these things and nobody really thought about like, could we actually deliver treatment through them? But I was thinking, well, you know, people learn in context, can I deliver treatment instead of in my, in my clinic, you know, and make them come to my clinic, can I deliver it right to their context? And so we started developing these digital therapeutics. And what we found so far is that again, it goes back to these short moments many times. Can we give people bite-sized training,

you know, like 10 minutes a day systematically, you know, for over the course. And we've, you know, we've the core trainings for each of these apps is about 30 days, but then we have these theme weeks where they can build them over and over and they go back and, you know, so we've set up the context for people to do the learning in a self-paced manner. And I find, you know, our data are gangbusters. I never thought they would work this well. So if you look at the studies, it works, they work pretty darn well. If you look at the process, you know, I, if I'm trying to learn something, I want to be able to do it at my own pace, little bits at a time, and be able to practice it over and over and

over. So we've tried to set that framework up so people can do that. Now, that's just one way to do it. Also, I think that, like you're talking about, having somebody help you with it can be very helpful. So for example, we have online communities in our programs. Other people, you know, I'm just saying like as an example, there are online communities. So I moderate a section in there called Ask the Experts.

So somebody has a question they can ask me. And we also run a weekly group via Zoom for anybody with any of our apps where they can ask me any question related to the practices or the programs. And I have to say it's a highlight of my week because it's, it's so rewarding to work with people even for five minutes, you know, where they say, I'm struggling with this habit loop. You know, we just had a group today when somebody talked about procrastination, you know, it's like the 230 people or whatever on the group. And one person asked about procrastination. I know that's going to be 100 people that are going to be able to follow along.

And so in five minutes, we can work through an example like you and I did about test anxiety with procrastination, give somebody a tangible tool to play with as they go through the program. And so they're, I think, getting help from a person that's, you know, I've a fair amount of experience with this now. So helping guide somebody actually mostly through just asking questions and being curious. So drawing out their own inner wisdom is not only rewarding for me, but can give them a handhold where, you know, just an app or just this or that may not be enough. So we try to provide whatever level of support people actually need in a way that's scalable. I can't be available to everybody all the time, but we can do things in ways that seem to help. Yeah, and what you're describing also really takes us back to the beginning of our conversation

around the normalizing effect. It's sort of like if you're experiencing something that's causing some level of suffering or distress, and then you start to realize that, oh, like, A, I'm not alone. Actually, in this context, B, I'm sort of like in the vast majority. I'm not the weirdo. I'm not broken. This is a part of the human condition that we're all experiencing together. And that alone has got to just be like, change the nature and the quality of what you're going through. And that alone has got to just be like change the nature and the quality of what you're going through. And then you add to it process and tools and ways to actually collectively integrate the experience differently. Yeah, super powerful and sensible. And I love the

fact that fundamentally, we're talking about these interesting ideas, and we're talking about peer-reviewed research, and we're talking about technology, and we're also talking about things that people have been doing for thousands and thousands of years that have worked and made them feel better. And it's just about making them accessible to a broader audience. And for the rationally brained people who need to know, well, prove to me that this works, here you go. Yeah, here it is. It's like these ideas actually work. Yeah.

Super cool. Feels like a good place for us to come full circle as well. I always wrap these conversations with the same question, so I'll pose it to you. Sitting here in this container of a good life project, if I offer up the phrase to live a good life, what comes up? Yeah. Curiosity, kindness, rinse and repeat. That's what comes up.

Love it. Thank you. Hey, before you leave, if you love this conversation, safe bet you'll also love the conversation that we had with Dr. Ellen Hendrickson about social anxiety and how to handle it. You'll find a link to Ellen's episode in the show notes. This episode of Good Life Project was produced by executive producers, Lindsay Fox and me, Jonathan Fields, editing help by Alejandro Ramirez, Christopher Carter crafted our theme music and special thanks to Shelley Adele for her research on this episode. And of course, if you haven't already done so, please go ahead and follow Good Life Project in your favorite listening app. And if you found this conversation interesting or inspiring or valuable, and chances are you did since you're still listening here, would you do me a personal favor, a seven second favor and share it? Maybe on social or by text or by email, even just with one person. Just copy the link from the app you're using and tell those you know, those you love,

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