Huberman Lab - Dr. Alia Crum: Science of Mindsets for Health & Performance
Episode Date: January 24, 2022My guest is Dr. Alia Crum, Associate (tenured) Professor of Psychology at Stanford University and Director of the Stanford Mind & Body Lab. Dr. Crum is a world expert on mindsets and beliefs and how t...hey shape our responses to stress, exercise, and even to the foods we eat. We discuss how our mindset about the nutritional content of food changes whether it is satisfying to us at a physiological (hormonal and metabolic) level. She also tells how mindsets about exercise can dramatically alter the effects of exercise on weight loss, blood pressure, and other health metrics. Dr. Crum teaches us how to think about stress in ways that allow stress to grow us and bring out our best rather than diminish our health and performance. Throughout the episode, Dr. Crum provides descriptions of high-quality peer-reviewed scientific findings that we can all leverage toward better health and performance in our lives. For the full show notes, visit hubermanlab.com. Thank you to our sponsors AG1 (Athletic Greens): https://athleticgreens.com/huberman LMNT: https://drinklmnt.com/huberman Supplements from Momentous https://www.livemomentous.com/huberman Timestamps (00:00:00) Introducing Dr. Alia Crum from Stanford University (00:03:31) Sponsors: AG1, LMNT (00:08:26) What Is a Mindset & What Does It Do? (00:14:45) Mindsets Change Our Biological Responses to Food (00:22:28) Beliefs About Our Food Matter (00:25:57) Placebo vs Beliefs vs Nocebo Effects (00:28:57) Mindset (Dramatically) Impacts the Effects of Exercise (00:33:44) Motivational Messaging & Mindset About Fitness (00:39:30) The Power of a ‘Potency & Indulgence’ Mindset (00:42:03) Mindsets About Sleep, Tracking Sleep (00:45:00) Making Stress Work For (or Against) You (01:01:50) Mindsets Link Our Conscious & Subconscious (01:04:50) 3 Best Ways to Leverage Stress (01:10:40) 4 Things That Shape Mindsets, Influencers & Mindsets (01:19:40) Mindsets About Medicines & Side Effects (01:26:25) How to Teach Mindsets (01:31:47) Dr. Crum’s Research, Clinical & Athletic Backgrounds (01:36:20) The Stanford Mind & Body Lab, Resources for Stress (01:38:30) Synthesis, Participating in Research (01:39:04) Subscribe, Sponsors, Instagram, Twitter, Supplements Title Card Photo Credit: Mike Blabac Disclaimer
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Welcome to the Huberman Lab podcast where we discuss science and science-based tools for everyday life.
I'm Andrew Huberman and I'm a professor of neurobiology and
Ophthalmology at Stanford School of Medicine. Today my guest is Dr. Alia Krum.
Dr. Krum is a tenured professor of psychology at Stanford University and the founder and director of the Stanford Mind and Body Lab.
Stanford University and the founder and director of the Stanford Mind and Body Lab. Her work focuses on mindsets.
How what we think and what we believe shapes the way that our physiology reacts to things
like what we eat, or stress, or exercise.
Indeed, as you will soon learn from my discussion with Dr. Crumb, what you believe about the nutritional
content of your food changes the way that food impacts your brain and body to a remarkable degree.
And the same is true for mindsets about exercise and stress and even medication.
For instance, recent work from Dr. Krum's laboratory shows that what we believe about the
side-effect profiles of different drug treatments, or different behavioral treatments, has a profound
impact on how quickly those treatments work and the effectiveness of those treatments.
I just wanna mention one particular study
that just came out from a graduate student
in Dr. Crumb's laboratory, Lauren Howe, H-O-W-E,
showed that how kids react to a treatment
for peanut allergies can be profoundly shaped
by whether or not those kids were educated
about the side effects of the treatment,
such that if they learned that the side effects were a byproduct of a treatment that would help them, and they learned
a little bit about why those side effects arose and that the side effects might even help
them in root to overcoming their peanut allergy, had an enormous impact on how quickly they
move through the treatment, and indeed how much they suffered, or in this case did not
suffer from those side effects.
And that is but one example that you will learn about today,
as we discuss what mindsets are,
the number of different mindsets that exist,
and how we can adopt mindsets that make us more adaptive,
more effective, allow us to suffer less
and to perform better in all aspects of life.
I personally find the work of Dr. Alia Krum,
to be among the most important work
being done in the fields of biology and psychology, and the interface of Dr. Alia Crom to be among the most important work being done in the fields of biology and psychology and the interface of mind body.
Everything that she's done up until now and published, and indeed the work that she continues
to do, has shaped everything within my daily routines, within my work routines, within my
athletic routines.
And we probably shouldn't be surprised by the fact that Dr. Crom works on all these things.
She was not only an incredibly accomplished tenured research professor,
she's also a clinical psychologist,
and she was also a division one athlete,
and a elite gymnast at one period in her life.
So she really walks the walk in terms of understanding
what mindsets are and applying them
in different aspects of life.
I'm sure you're going to learn a ton
from this conversation as did I,
and come away with many, many actionable items that you
can apply in your own life.
In fact, as we march into today's conversation, you might want to just put in the back of
your mind the question, what is my mindset about blank?
So for instance, ask yourself, what is my mindset about stress?
What is my mindset about food?
What is my mindset about exercise?
What is my mindset about relationships of different kinds?
Because in doing that, you'll be in a great position to extract the best of the information
that Dr. Krum presents, and indeed to adapt those mindsets in the way that is going to be
most beneficial for you.
Before we begin, I'd like to emphasize that this podcast is separate from my teaching and
research roles at Stanford.
It is, however, part of my desire and effort to bring zero cost to consumer information
about science and science-related tools to the general public. In keeping
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And now my conversation with Dr. Aliyah Krum.
Well, great to have you here.
Great to be here.
Yeah.
For the record, it's Aliyah Krum, but you go by Ali, correct?
That is correct.
Dr. Ali Krum, like, so be it.
Or just Ali.
Okay.
Great.
Well, I've been looking forward to talking to you
for a long time.
Just to start off, you know, you've talked a lot
and worked a lot on the science
of mindsets.
Could you define for us what is a mindset and what sort of purpose does it serve?
Of course.
Yeah, mindsets have been described or defined in a lot of ways.
We define mindsets as core beliefs or assumptions that we have about a domain or category of things, that orient us
to a particular set of expectations, explanations,
and goals.
So that's kind of jargon-y, in this little,
I can distill it down for you.
So mindsets are an assumption that you make about a domain.
So take stress, for example, the nature of stress.
What's your sort of core belief about that?
And mindsets that we've studied about stress
are do you view stresses enhancing good for you
or do you view it as debilitating and bad for you?
Those mindsets, those core beliefs
orient our thinking, they change.
What we expect will happen to us when we're stressed.
How we explain the occurrences that happen
are unfold when we're stressed
and also change our motivation
for what we engage in when we're stressed.
So we have mindsets about many things,
mindsets about stress, mindsets about intelligence
as Carol Dweck's work has shown,
mindsets about food, mindsets about medicine, you name it.
It's sort of distilling down those core assumptions that really shape and orient our thinking and action.
I've heard you say before that mindset simplify life in some way by constraining the number of things that we have to consider.
And it sounds to me like we can have mindsets about many things, as you said.
What are some different mindsets? I think many people are familiar with our colleague Carol Dweck's notion of growth mindset that
if we're not proficient at something that we should think about not being proficient
yet, that we are on some path to proficiency. But what are some examples of mindsets and
how early do these get laid down or do we learn them from our parents? Maybe if you could just flesh it out a bit for us
in terms of what you've observed
in your own science or your own life even.
Yeah, sure.
So I think it's important with Carol Dwax work.
A lot of people kind of get focused on
gross motivation and all these things,
but her work really originated from thinking about
what she called as implicit theories or core beliefs about the nature
of intelligence or ability.
So do you believe that your baseline levels of intelligence
or your abilities are fixed, static,
set throughout the rest of your life,
or do you believe that they can grow and change?
Now, those are oversimplified generalizations
about the nature of intelligence.
And the reality is, as it always is,
complex, and it's a bit of both, and it's all these things.
But as humans, we need these simplifying systems
to help us understand a complex reality.
So those assumptions that we jump to,
oh, intelligence is fixed, or intelligence is malleable,
they help us to simplify this complex reality,
but they're not unconsequential, right?
They matter in shaping our motivation.
And as she has shown, if you have the mindset
that intelligence is malleable,
you're motivated to work harder to grow your intelligence.
If you have a setback and you're learning,
you think, okay, there's something there
that I can grow and learn and build from.
If you have the mindset that it's fixed,
why work harder at math if you don't think you're good at it?
So in retrospect, it's pretty clear how these minds
that can affect our motivation.
What our work is aimed to do is to expand the range of mindsets that we are studying,
focused on, and also understand and expand the range of effects that they have.
So by and large, we've focused on mindsets in the domain of health and health behaviors.
So I mentioned, you know mentioned mindsets about stress.
We've also looked at mindsets about food and healthy eating.
So, do you have the mindset that foods that are good for you, healthy foods, are disgusting
and depriving?
Or do you have the mindset that healthy foods are indulgent and delicious?
Now, it could be a variety of different foods. You might have different thoughts about different healthy foods are indulgent and delicious. Now, it could be a variety of different foods.
You might have different thoughts about different
healthy foods, but generally people,
at least in our culture in the West,
have this view that stress is debilitating
healthy foods are disgusting and depriving.
And those mindsets, whether or not
they're true or false, right or wrong,
they have an impact.
And they have an impact not just through the motivational mechanisms that do act and others
have studied, but as our lab has started to reveal, they also shape physiological mechanisms
by changing what our bodies prioritize and prepare to do.
So those are just two examples.
Mindsets about stress, mindsets about food. We've looked at mind sets about exercise.
Do you feel like you're getting enough?
Or do you feel like you're getting an insufficient amount
to get the health benefits you're seeking?
Mind sets about illness.
Do you view cancer as an unmitigated catastrophe?
Or do you view cancer as manageable, or perhaps even an opportunity?
We've looked at mindsets about symptoms and side effects.
Do you view side effects as a sign that the treatment is harmful?
Or do you view side effects as a sign that the treatment is working?
Again, these are core beliefs or assumptions
you have about these domains or categories, but
they matter because they're shaping, they're synthesizing and simplifying the way we're
thinking, but they're also shaping what we're paying attention to, what we're motivated
to do, and potentially even how our bodies respond.
I'd love to talk about this notion of how our mindset shaping how our bodies respond. And maybe as an example of this, if you could share with us this now famous study that
you've done with a milkshake study, you wouldn't mind sharing the major contours of that
study and the results.
Because I think they're extremely impressive and they really speak to this interplay
between mindset and physiology.
Certainly.
Yeah. This was a study that I ran as a graduate student at Yale University. extremely impressive and they really speak to this interplay between mindset and physiology. Certainly.
This was a study that I ran as a graduate student at Yale University.
I was working with Kelly Brownell and Peter Salove, Peter Salove had done a lot of work on
really coining the term emotional intelligence study.
He's not the president of Yale.
He's not the president of Yale.
He's done well for himself and for the university and society.
And Kelly Brownell, who was doing a lot of research on food and obesity.
And I had come in doing some previous work on mindsets about exercise and placebo effects
and exercise and was in this sort of food domain and some motions and food domain.
And it really occurred to me that there was a very simple question that hadn't been
probed yet.
And that was, do our beliefs about what we're eating change our body's physiological response
to that food, holding constant the objective nutrients of that thing.
So that question might sound outrageous at first, but it was, it's really not outrageous
if you're coming from a place
of having studied and depth placebo effects.
So, placebo effects are this row, and medicine at least are this sort of a row bus demonstration
in which simply taking a sugar pill, taking nothing under the impression that it's a real
medication that might relieve your asthma, reduce your blood pressure, boost your immune system,
can lead to those physiological effects,
even though there's no objective nutrients.
And we have more evidence on placebo effects
than we have for any other drug,
because of the clinical trial process
in which all new drugs and medications are required
to outperform a placebo effect.
So we have a lot of data on the placebo effect.
Now, we can get new wants there.
We don't have a lot of data comparing the placebo effect
to doing nothing, which is important for distilling.
Mindset effects or belief effects
from sort of natural occurring changes in the body.
But anyways, going back to this question, it was like, all right, we've moved from medications
solving our health crises to behavioral medicine solving our health crises, increase people's
exercise, get them to eat better, to what degree are these things influenced by our mindsets
or beliefs about them? So to test this question, we ran a seemingly simple study.
This was done at the Yale Center for Clinical and Translational Research, and we brought
people into our lab under the impression that we were designing different milkshakes
with vastly different metabolic concentrations, nutrient concentrations that were designed to meet
different metabolic needs of the patrons of the hospital.
So you're going to come in, you're going to taste these
milkshakes, and we're going to measure your body's
physiological response to them.
This was a within subjects design.
So it was the same people consuming two different milkshakes,
two different time points separated by a week.
And at one time point, they were told
that they were consuming this really high fat,
high caloric, indulgent milkshake.
It was like a 620 calorie, super high fat and sugar.
At the other time point, they were told
that it was a low fat, low calorie, sensible,
sort of diet shake. In reality, low calorie, sensible diet shake.
In reality, it was the exact same shake.
It was right in the middle.
It was like 300 calories, moderate amount of fats and sugars.
And we were measuring their body's peptide response
to this shake.
And in particular, we are looking at the hormone
ghrelin.
So as you know, ghrelin, medical experts
called the hunger hormone rises in ghrelllen, signal, seek out food,
and then theoretically, in proportion, the amount of calories you consume, Grellen levels
drops, signaling to the brain, okay, you don't need to eat so much anymore, you can stop
eating, and also revving up the metabolism to burn the nutrients that were just ingested. What we found in this study was that when people thought
they were consuming the high fat, high calorie
indulgent milkshake, in response to the shake,
their grill and levels dropped at a three-fold rate stronger
than when they thought they were consuming the sensible shake.
So essentially, their bodies responded
as if they had consumed more food,
even though it was the exact same shake at both time points.
So this was really interesting and important
for two reasons.
Really, one was that it was, to my knowledge,
one of the first studies to show any effects
of just believing that you're
eating something different on your physiology.
Lots of studies have shown that believing you're eating different things changes your taste,
you know, and your even your satisfaction and fullness after.
But this shows that it has a metabolic or a physiological component.
But the second piece was really important as well. And especially for me, this was one study that really transformed the way I think about
how I approach eating.
And that was the manner in which it affected our physiology was somewhat counterintuitive.
So I had gone in thinking, the better mindset to be in when you eat is that you're eating
healthy, right?
Like, you know, it just makes sense.
Like, please see, but effects, think you're healthy, you'll be healthy, you know.
But that was a far too simplistic way of thinking about it.
And in fact, it was the exact opposite because thinking that they were eating,
when these participants thought they were eating sensibly,
their bodies left them still feeling physiologically hungry, right, not satiated,
which could potentially be corresponding to slower metabolism and so forth.
So if you're in the interest of maintaining or losing weight, what's the best mindset to be in
it's to be in a mindset that you're eating indulgently, that you're having enough food,
that you're getting enough. And at least in that study, we showed that has a more adaptive effect on grellen responses.
So interesting.
And especially interesting to me as a neuroscientist who has worked on aspects of the nervous system
that are involved in conscious perception, like vision and motion and color perception
and so forth, but also our lab has worked
and is increasingly working on autonomic functions
that are below our conscious detection.
In this case, a lie about how much something
this milkshakes contain affected
a subconscious process because I have to imagine
that the grellen pathway is not one that I can decide,
oh, this particular piece of chocolate is gonna really really reduce my Grelan because it's very nutrient rich, as
opposed to one, if you told me that a different piece of chocolate, for instance, is low
calorie or sugar-free chocolate or something that sort.
The Grelan pathway, however, it seems, based on your data, that the Grelan pathway is susceptible
to thoughts,
which is incredible.
But then again, there must be crossover
between conscious thought and these subconscious
or kind of autonomic pathways.
So it's really remarkable.
It raises a question that I just have to ask
because increasingly so I'm involved in online discussions
and social media and one of the most barbed wire topics
out there, and that's being generous,
is this topic of which diet or nutrients are best.
You've got people who are strictly plant-based,
you've got people who are omnivores,
you've got people who are carnivores,
you have every variation, you have intermittent fasting,
also called time restricted feeding.
And it seems like once a group kind of plugs into
a particular mode of eating that they feel works for them.
For whatever reason, energy-wise, mentally, maybe,
they're looking at their blood profiles, maybe they're not.
But once they feel that it sort of,
it works for them, each camp seems to tout all the health
benefits and how great they feel. It works for them. Each camp seems to tout all the health benefits
and how great they feel.
Could it be that mindset effects are involved there,
that people are finding the nutritional program,
that they feel brings them the most enrichment of life,
but also nutrients, and that their health really
is shifting in a positive direction,
but not necessarily because of the food constituents,
but because of the community and the ideas and the reinforcement.
Yeah, and the belief that this is the right way of doing something.
I think 100 percent, 100 percent, it has something to contribute.
I don't want to, I'm not going to weigh in on the debate.
No, what I will most certainly weigh in on is the notion that,
look, going back to the placebo effect, right,
we have a outdated understanding of what that is,
which is based on this randomized control trial.
You compare a drug to a placebo.
If the drug works better than the placebo,
you say great, the drug works.
If the drug doesn't outperform the placebo,
you say the drug doesn't work.
That's really oversimplified. It's a good test for the specific efficacy of the drug doesn't outperform the placebo, you say the drug doesn't work. That's really oversimplified.
It's a good test for the specific efficacy of the drug.
It's not a good test for understanding the total impact of that drug.
Because in the reality of things, if a drug outperforms a placebo, then you start prescribing
it, but the reality is that the total effect of that drug is a combined
product of the specific chemical attributes of that drug and whatever is going on in the
placebo effect, which is, at least from our perspective, it's beliefs, it's social
context, and it's your body's natural ability to respond to something. So, you know, that's
in the placebo effect example. The same is true for everything we do or consume. So when
it comes to what diet you're eating, both are true. It does matter what it is, and it
matters what you think about that diet. And what others around you in an agriculture think about that diet,
because those social contexts inform our mindsets,
our mindsets interact with our physiology
in ways that produce outcomes that are really important.
So let's not get dualistic and say,
you know, it's either all in the mind or not in the mind.
Let's also not be unnecessarily combative and say, oh, it should be all plant-based or, you know,
keto or whatever. It's all of those things are a combined product of what you're actually doing
and what you're thinking about. If you believe in it, if you don't, if you're skeptical or,
you know, in some cases, you think you should be eating a certain way and then you don't, if you're skeptical, or in some cases, you think you should be
eating a certain way, and then you don't live up to that, it might have an adverse effect
because of the stress and the anxiety associated with that.
Very interesting.
Along the lines of belief effects, can we call these belief effects?
Sure.
Your mind says, is there a difference between these, what I'm calling belief effects and placebo effects?
I mean, are placebo effects distinctly different from mindset effects or are they more or less
the same thing?
They're related.
So I think placebo effects, you know, maybe should be reserved for the, you know, conditions
in which you're actually taking a placebo, which is an inactive substance.
When you get out of that sort of placebo versus drug,
realm, and you start looking at placebo effects,
I use quotes with my hands here, in behavioral health,
the term kind of becomes confusing because you're not,
in the milkshake study, we didn't give people
a placebo milkshake, right?
We just changed what they believed about it.
So how I like to think about it is that placebo effects
as they're traditionally construed
are made up of three things.
It's the social context, mindsets or beliefs,
and the natural physiological processes
in the brain embodied that can produce the outcomes.
And so we could just call them belief effects because the beliefs are
triggering the physiological processes and the beliefs are shaped by the social
context. Does that make sense?
It makes sense. Yeah. There was a paper a year or two ago published in Science
Magazine about brain regions involved in
psychogenic fever that if people or you can actually do this in animal models
to think that they are sick, you get a genuine one to three degree increase in
body temperature, three, one to three degrees Fahrenheit increase in body temperature.
Which is pretty, pretty impressive. Yeah. And I guess plays into, you know,
symptomology generally. So I'm a believer in belief effects.
Well, it's also, and I just say that, you know, the term that we use in our field is
no seabull effect for that, which is sort of the placebo's ugly step sister, you know,
it's when negative beliefs cause negative consequences.
So you are told you will have, you know, it's very well demonstrated
that when people are told about certain side effects, they're far more likely to experience
those side effects when people think that they're sick or going to get sick. Sometimes that
can create, you know, the physiological symptoms. And, you know, there's, you know, various debates that it's not only that physiology
changes, it's also that your attention changes. So we're experiencing things like fatigue
and headache and upset stomach all the time. And then when you take a drug and somebody
says, you're going to feel fatigue and headache, you start noticing that you're tired of headaches
and attribute it to the drug. So some of the mechanisms are attention and some of
them are real changes in physiology.
I love for you to tell us about the hotel workers study.
Yeah, sure.
I know you get asked these questions all the time. I find these just these results
also amazing. Yeah, no, I think this is a really good example
of this phenomenon, right,
that the total effect of anything
is a combined product of what you're doing
and what you think about what you're doing.
So this was a study that I ran with Ellen Langer
way back when I was an undergrad,
actually, we started this study.
Ellen Langer's a professor of psychology at Harvard,
and she's done a lot of really fascinating work
on her flavor of mindfulness, which
is distinct from a more eastern Buddhist mindfulness
based work.
And she actually was the one who said to me originally,
you know, I was an athlete at the time,
I was an ice hockey player and I was training constantly.
And one day I'll never forget it.
She said, you know, you know,
the benefit of exercise is just a placebo, right?
And I was like, well, that's outrageous.
Ellen's known for saying very provocative
but also very wise things.
And that statement really got me thinking about that.
So we designed this study together and that was to look at, you know, how would you study?
If the benefits of exercise were a placebo, how would you even test that?
Because, you know, what does it mean to give a placebo exercise?
We sort of flipped it on its head and we found a group of people who were getting a lot of
exercise, but weren't aware of it that they were.
So this we settled on a group of hotel housekeepers.
So these were women working in hotels who were on their feet all day long, pushing carts,
changing linens, climbing stairs, cleaning bathrooms, vacuuming, it was clear
that they were getting above and beyond at least
the surgeon general's requirements at that time,
which were to accumulate 30 minutes of moderate
physical activity per day.
But what was interesting was when we went in
and surveyed them and asked them,
hey, how much exercise do you think you're getting?
A third of them said zero.
Like, I don't get any exercise.
And the average response was like a three on a scale of zero to ten.
So it's clear that even though these women were active, they didn't have that mindset,
right?
They had the mindset that their work was just work.
Hard, maybe thankless work that led them to feel tired
and in pain at the end of the day.
But not that it was good for them, that it was good exercise.
So what we did was we took these women
and we randomized them into two groups
and we told half of them that their work was good exercise.
This, in this case, it was true, factual information.
We oriented them to the Surgeon Gener factual information. We oriented them to the
Surgeon Generals guidelines. We oriented them to the benefits that they should be receiving.
And then we had measured them previously on their physiological metrics like weight and body fat
and blood pressure. And we came back four weeks later and we tested them again. And what we found
was that these women, even though they hadn't changed anything in their behavior, at least that was detectable to
us, they didn't work more rooms, they didn't start doing pull-ups or push-ups in between
cleaning out the rooms as far as I'm concerned. They didn't report any changes in their diet,
but they had benefits to their health, so they lost weight. They decreased their systolic blood pressure by about 10 points on average, and they started
feeling better about themselves, their bodies, and their work, not surprisingly.
That's amazing.
How should we take conceptualize that result in light of all of our efforts to get more out of exercise, right?
Because earlier, you mentioned it from the milkshake study and our perceptions about
nutrient density that, you know, it's a little bit, the right message that actually a
little bit counterintuitive, that if you think, oh, this is very low calorie, nutrient
sparse, then it's good for me in the context of losing weight, for instance.
But it turns out the opposite is true because, as you told us, the body responds differently
when you think something is nutrient dense and can actually suppress hunger more.
So in light of this result, if I were to say, okay, my current understanding of the literature
is that getting somewhere between 150 and 180 minutes per week of cardiovascular exercise, it's probably a good idea for most people.
If I tell myself that it's not just a good idea, but that it's extremely effective in lowering
my blood pressure and maintaining healthy weight, et cetera, et cetera, according to these
results, it will have an enhanced effect on those metrics, is that right?
Definitely.
So, this is a really important point
because what this reveals is that we
have to be more thoughtful in how
we go about motivating people to exercise
or teaching people about the benefits.
Our current approach is to basically tell people large,
here's what you need to get.
Here's what you need to get. Here's what you need to get good for, you know, to get enough benefits to receive the,
enough exercise to receive the health benefits.
The problem with that approach is that most people aren't meeting those benefits yet or
aren't meeting those requirements yet.
And the risk with that is that, well, the intention with that is to motivate them, because,
you know, public health officials think, well, if I just tell people you need to get more
exercise because it's good for you, they'll do it.
We know now that that doesn't work, that these guidelines are not motivational, they don't
change our behavior.
And what our work adds to that is that not only is it not motivational, it also creates
potentially a mindset that makes people worse off than they were without knowing about
the guidelines.
So, again, it's tricky.
I'm not saying that mindset is everything.
Certainly exercise is good for us and useful for us.
It's one of the things we have the best data on.
So I'm not saying, oh, exercise is all placebo.
What I am saying is that we need to be more mindful about
how do we motivate people to exercise?
But how do we help people to actually reap
the benefits of the exercise they are already doing?
Now, Octavia's art, who is a grad student, my lab,
and a number of interesting studies along these lines, one in which she looked at
three nationally representative data sets, which had this interesting question in
them, which was, how much exercise do you get relative to others? Do you get
about the same? A little more, a lot more?
Do you get a little less or a lot less, right?
So, you know, the audience, your listeners,
you could all answer this.
And then in these data sets, what she did was she had,
you know, pulled from data that tracked death rates
over the next 21 years.
And a couple interesting things revealed themselves.
One was that the correlations between
these perceptions of exercise relative to others and people's actual exercise is measured through
accelerometer data as well as more rigorous sort of what did you do today kind of data. Those don't
correlate much at all. People lie. People lie, but also.
Or misperceive.
They misperceive.
And, you know, who's to say it's misperceiving?
There's just everything's relative, right?
If you're, I used to do triathlons very seriously.
So if you were to ask me now, I feel like I'm totally inactive, right?
Because I'm not doing anything near what I used to.
And if that's my focus set, right? I feel like I'm not doing anything near what I used to. And if that's my focus set, I feel like I'm not exercising much.
But if I think about compared to other people,
given what I know about national representative statistics,
then I could feel like, oh, I'm getting a lot, right?
So you can see how these perceptions are decoupled
from objective reality.
And what we found in these studies is that that one question mattered.
In some cases, more than objective activity, but in all cases, controlling for objective
activity and predicting death rates.
And in one of those samples, it was a 71% higher risk of death rate, if people rated themselves
as feeling like they were getting less activity than others.
Wow.
So, yeah.
That's a big deal.
That's a big deal.
And again, that study is cross-sectional longitudinal.
It was not experimental.
But combined, these really sort of coalesced to say,
hey, this is important too.
Like, let's figure out ways to be active and get people active,
but let's also not make people feel
horrible about themselves when they're not getting enough.
And going back to the hotel study, again,
I mentioned that I did that at a time when I was a division one ice hockey player at the time.
We were training all the time.
And I was in an unhealthy mindset about that.
I never felt like I was getting enough.
I would come off a two hour practice
into a weight lifting session.
And then I would get on the elliptical for 30 minutes,
because I thought I had to do that also.
My teammates who were with me at the time could attest to that.
And so that study was really helpful for me to realize that I needed to pay attention
not just to what I was doing, but also take care of my mindset about that.
And I think the essence is how do you get people to feel like they're getting enough?
It's a sense of enoughness that really matters.
I can see the dilemma because you don't want people thinking that exercise and its positive
effects are so potent that they can get away with a three-minute walk each day and that
they're good because most likely they are not. But again, you don't want them to be so back on their heels
psychologically that they don't even do that
or that they never exceed that by very much.
But it seems like the message from the milkshake study
and what we're talking about now in terms of exercise
would be to really communicate to the general public
that food has a potency. about now in terms of exercise would be to really communicate to the general public that
food has a potency, even healthy foods have a potency to give us energy to fuel our immune
system and endocrine system, et cetera, and that exercise has a remarkable potency
and that that potency can be enhanced by believing in or understanding that potency.
Exactly.
Is that an accurate way to state it? by believing in or understanding that potency. Exactly.
Is that an accurate way to state it?
Totally.
That's exactly right.
And that's where I really feel like we need to push
in what I try to do in our research,
just to not just show, oh, mindset matters,
isn't that interesting, but it's both matter, right?
Both exercise and what you think about it matter,
both what you eat and how do you think about what you eat matter.
And so we really as individuals and as a society need to work on, what is the right way to cultivate
both behaviors and mindsets about those behaviors that serve us.
And in the food context, this, again, that milkshake study really changed me on a personal level because
I had been somebody who was constantly trying to restrain my eating, right?
I wanted to maintain her, you know, whose weight looked fit.
And so I was like, well, I should diet, I should have low calorie, low carb, low this, low
that.
But what that was doing was putting me into this constant mindset of restraint.
And what that study suggested was that that mindset was potentially counteracting any benefit, right?
Or any objective effects of the restrained diet.
Because my brain was saying, okay, you're restraining.
Maybe my body was, you know, responding to that, but the brain was was saying, okay, you're restraining. Maybe my body was responding to that,
but the brain was also saying, eat more food.
You know, stay hungry, because you need to survive.
And so the answer isn't, oh, we'll throw everything
into the wind and just drink indulgent milkshakes all day long.
The answer is, eat healthy foods, right?
You know, based on the latest science and what we know
to be true about nutrients and our body's response to them.
But try to do so in a mindset of indulgence, a mindset of satisfaction, a mindset of enjoyment,
right?
That is really the trick.
And that's what I at least try to do in my own life.
I love that.
And as I get more involved in again in public facing health communications, this comes up again
and again.
How should we conceptualize our behavior?
How should we think about all these options that are offered to us?
And I'm excited that the potency of mindsets are coming through again and again.
So I have a question about this.
I don't know if this study has ever been done, but a lot of these mindset effects are something that years ago
I felt I did
These of you sleep because I was
In graduate school and as a postdoc and even as an undergraduate
I had so much work to do that I decided I would sleep when I was dead in quotes not a good idea
From what we know however, I found that
It's not a good idea from what we know. However, I found that a couple nights of minimal sleep
or even an all-nighter, and I could do pretty well.
Eventually, it would catch up with me.
Has there ever been a study exploring
whether or not the effects of sleep deprivation
can be impacted by these mindset effects?
Because over the years, I keep learning more and more
about how much sleep I need, and I've really emphasized sleep,
and I do feel much better when I'm getting it.
But as new parents know or students know or athletes know or anyone that lives a normal
life finds sometimes that they don't get a good night's sleep.
Would believing that we can tolerate that and push through it and function just fine and
then it's not going to kill us or give us Alzheimer's?
Could that help us deal with a poor night sleep,
or even two, or chronic sleep deprivation?
Certainly, I would guess.
There's been one study to my knowledge
that's tested that, Dragonaw and colleagues.
And they looked at, they had people come in
and they gave them sort of, I think it was a sham,
sort of EEG test to sort of figure out
how, you know, this was done a number of years ago now we actually have, you know, devices
to test this, but there's was this sham test and then they gave people fake feedback about
the quality of their sleep and, you know, how it had been the night before. And they also asked the participants how they felt
about their sleep.
And essentially, what they found was
that the sham feedback, if they were told
that they had gotten lower quality sleep
led to deficits in a variety of cognitive tasks,
and that was sort of decoupled from their actual qualities of sleep, at least
as self-reported.
So that's one study that attests to this.
I think certainly, I mean, I would bet a lot of money I haven't run this myself, but
that your mindset can push around your cognitive functioning, physiological effects of sleep. But once again, it's not all or nothing, right?
There are real important benefits of sleep
and how far we can push around that through our mindset
is an open question.
You know, the result that you mentioned
is really interesting because a lot of people
use these sleep trackers now.
They're using rings or wristbands.
In fact, my lab has worked pretty closely
with the company. They supplied us data on how well people are sleeping. And you get a score.
People get the score back. And when they see that score, they might think, based on these
results, my sleep, my recovery score, my sleep score is poor. I shouldn't expect much for myself
today, or I, it makes sense that my memory would be going. For this reason, and I'll probably lose
a few friends for saying this, but hopefully I'll gain a few as well. That's why I like to just do a subjective score for myself.
If I wake up in the morning, I just decide, okay, did I sleep well or not? I don't like seeing a
number. I don't like getting a readout from a device. That's me. I know a lot of people like it,
and they can be very useful. But gosh, it seems that these belief effects are weaving in at all levels.
I'd love for us to talk about stress because your lab has worked extensively on this. And
if you would, could you tell us at some point about the study that you've done about informing
people about the different effects of stress. But also, if there's an opportunity, some takeaways about how we could each conceptualize stress
in ways that would make it serve us better
as opposed to harmless and our mental and physical performance.
Great.
Yeah, so I had come off the heels of doing some research
and exercise and diet and finding these provocative
and also counterintuitive effects of, with respect to how we should try to motivate people.
And I was thinking about this and this grouping of going from medicines to saving us, to
behaviors to saving us and how those behaviors might be influenced
by mindset, the obvious next thing to think about was stress, right? Because it's like,
okay, well, you want to be healthy, fix your diet, fix your exercise, and stress less.
And, you know, so I started doing some digging into the nature of stress, and a couple things were
clear. One was that the public health message was very
clear, right? That stress was bad, right? Unmitigated and harmful on our health, our productivity,
our relationships, our fertility, our cognition, you name it, right? The messages that were
out there by and large oversimplified messages
focused on the damaging consequences of stress. But as you know, if you actually
dive deeper into the literature on stress and the origins of stress, what you
find is that, you know, the literature like most literatures is not so clear cut.
In fact, there's a large amount of evidence to support the fact that the experience of stress,
meaning encountering adversity or challenge in one's goal-related efforts, does not have
to be debilitating.
In many cases, the body's response was designed to enhance our ability to manage at those
moments.
Right?
So, some research showing that stress narrows our focus,
increases our attention, speeds up the rate at which
we're able to process information.
There was some research out there
showing this phenomenon of physiological toughening,
the process by which the release of catabolic hormones
and the stress response recruit or activate
anabolic hormones, which help,
as you know, build our muscles, build our neurons
to help us grow and learn.
And there was a whole body of emerging research
on post-traumatic growth or this phenomenon
in which even the experience of the most traumatic stressors,
the most chronic and enduring stressors,
could lead not to destruction, but in fact,
to the exact opposite, to an enhanced sense of connection
with our values, connection to others,
sense of joy and passion for living.
And so I found that to be interesting.
And my work since then has been not to try to argue that stress
is enhancing and not debilitating, but try to point out that the true nature of stress
is a paradox. The true nature of stress is manifold and complex and lots of things can
happen. But to question, what's the role of our mindset about stress in shaping our response to stress?
So some work had already been done looking at your perception of the stressor, right?
So do you view a stressor like a challenging exam or a health diagnosis as a challenge
or a threat?
And that had shown pretty convincingly that when you view stressors more as a challenge,
less as a threat, that your brain and body responds more adaptively.
What our question was was to take the sort of psychological,
construal one step higher in abstraction. So not just the stressor, but the nature of stress,
right? Do you, you know, at that core level, do you view stress as something
that's bad, is going to kill us, and therefore
should be avoided?
Or do you view some stresses natural and something
that's going to enhance us?
And so we set out to design a series of studies
to test the extent to which these mindsets about stress
mattered.
We first, this again, was with Peter Salove and Sean Acre originally.
We designed a measure to test people's mindsets about stress, simple questions like,
what extent do you believe or agree or disagree with statements like,
stress enhances my performance and productivity stress,
heightens my vital and productivity stress,
heightens my vitality and growth, things like that. And we found in a number of correlational studies
that that more enhancing stress mindset
was linked to better health outcomes,
better well-being and higher performance.
So then we set out to see if we could change people's mindsets.
And in our first test of this, we decided to do so by creating these multimedia films
that showcased research anecdotes, facts about stress, all true,
but oriented towards one mindset or the other.
So you can imagine one set of films showed basically the messages that were out there in the public health
context.
The other showed, hey, you know, stress has, you know,
stress has been linked to these things.
But in fact, the body stress response was designed
to do this.
Did you know it could do that?
And we had empowering images like LeBron James making
the free throw in the final minute versus missing it, right?
So all of these things are true, you know, possibilities, but oriented to two different
mindsets about stress.
So either people saw a video that basically may seem like stress will diminish you, crush
you, reduce you, or a video very similar stress will grow you, bring out your best, and
maybe even take you to heightened levels of performance
that you've never experienced before.
Exactly.
Exactly.
So, yeah, examples in the sports.
We also had, like, true leaders emerge in the moments of greatest stress, you know,
Churchill.
And so, all those examples are out there for both the enhancing nature and the debilitating
nature.
And our question was, does orienting people to different mindsets change how they respond to stress?
So this study was done in the wake of the 2008 financial crisis.
We worked with UBS, a company, a financial service company
that was undergoing pretty massive amounts of layoffs.
So these employees were stressed about being laid off.
They were
taking on more pressure. It was just a tough time. And we randomized them into three conditions.
And this was all pre-work before getting a training on stress. But the three different
conditions, some watched no videos, some watched the stress will crush you videos, and some
watched the stress could enhance you videos.
And what we found was that just, you know, it was a total of nine minutes of videos over the course
of the week led to changes in their mindsets about stress, which led to changes in their physiological
symptoms associated with stress. So people who watched the enhancing films had fewer backaches, muscle tension, insomnia, racing heart, and so forth. And they also reported
performing better at work compared to those who watch the debilitating videos.
Now interestingly, we didn't make anyone worse with the debilitating video, which
was good. We had told that the IRB, we didn't expect that because that message was already out there.
That's what they were already seeing.
That wasn't new to them.
It was more this enhancing perspective
that turned out to be inspiring.
I love that study.
I know we both have friends and ties
in the special operations community
through just sort of happenstance.
And we can maybe we'll get into that a little later, but a good friend from that community always says you know that there are only three ways to go through life at any moment, which is either back on your heels flat footed or forward center of mass.
And I said well well what's the key to forward center of mass and he said it stresses what places you in forward center of mass meaning leaning forward into challenge. And I know that you've actually looked at that community and it does really seem like
that's a mindset that either they have going in or that they cultivate through the course
of their training.
But this notion that stress is what puts us in forward motion is true physiologically,
right?
I mean adrenaline's major role is to place us into a moment of or to buy us
towards action.
That's why we tremble.
It's it.
We're the body trying to initiate action.
But actually, this is probably a good opportunity.
If there's anything interesting to extract from the study on on seal teams, what was it?
Yeah, I know.
I loved working with with the seals.
One of the interesting things we found so at the, found, we've studied this, measured this mindset
in several different populations. And in every single one that we had tested so far,
the average had been on the debilitating side of the scale.
People just saying stress is bad.
Stress is bad, right? And, you know, it's like with measures of growth and fixed mindsets about intelligence,
attends people are in the middle, but oftentimes have a more positive mindsets about intelligence.
That was not the case with stress. It's still not the case of trying to get the message out there.
Except for this group of Navy SEALs, when they were actually recruits,
so people who were going through basic training in order to become Navy SEALs.
And we found that they, on average, had stress as enhancing mindset, perhaps not surprisingly,
right?
If you're going into devote your whole life to being a Navy SEAL, you must have some
inclination that stress is a source of strength for you.
But what we found with them, we measured this at the beginning of their basic training,
of buds training, and then looked at how well they succeeded through that program.
So as you know, this is an extremely rigorous program, you know, at the time it was only
like 10 or 20% of trainees making through.
The numbers have never shifted.
Yes, so.
No matter how hard pressure is on the
community change, the numbers are still on average about 15%.
Yeah, wow. So what we found was that our measure predicted that rate. So people who
even within that range had a more stresses enhancing mindset were more likely to complete
training, become a seal. They also had faster obstacle course times
and they were rated by their peers more positively.
So, you know, again, let's break this down, right?
This doesn't mean, and people get me,
people get this wrong sometimes.
They think that I'm saying that a stress is enhancing mindset
means you should like stress, right?
Well, maybe it seals, too.
But that's not what we're saying.
Having a stress is enhancing mindset
doesn't mean the stressor is a good thing.
It doesn't mean it's a good thing that you have to go into combat
and it's not pretty.
It doesn't mean that a cancer diagnosis is a good thing
or being an abject poverty is a good thing.
These are not good things.
But the experience of the stress associated with that, the challenge, the adversity, that
experience can lead to enhancing outcomes with respect to not just our cognition, but our
health, our performance, and our well-being.
So that mindset, right,. So that mindset, right?
How does that work?
Well, it works through a number of different pathways.
One is that it changes fundamentally
what we're motivated to do.
So if you just imagine we're stressed about something,
maybe a global pandemic for instance.
For instance.
For instance, and you think that stress is bad, then what's your motivation, right?
Your motivation is to, well, first you get worried about the stress, right?
Now, not only do you have the pandemic, you're stressed about the stress of the pandemic,
but second is your reaction is typically to do one of two things.
It's either to freak out and do everything you can to make sure that this doesn't affect you
you know negatively or to check out and say oh it's not a big deal I'm not gonna deal with it
I you know you're basically in denial so people who have a stressors debilitating mindset and we've shown this in our
Research tend to go to one of the other of those extremes they freak out or they check out why because of stress is bad
You need to either get rid of it and deal with it or or it needs to not exist. If you have a stress-enhancing mindset, the motivation changes. Then the
motivation is how do I utilize the stress to realize the enhancing outcomes? What can we do here?
To learn from this experience, to make us stronger, fitter, you know, have better
science and treatments for the future, deepen my relationships with others, improve,
you know, my priorities and so forth. So the motivation changes, the affect around
it changes. It doesn't make it easy to deal with, but what we've shown in our
research is that people who have a stress as enhancing mindset have more positive affect, not necessarily less negative
affect, and it potentially changes physiology. We have a few studies that show
that people who are, you know, inspired to adopt more enhancing mindsets have
more moderate cortisol response, and they have higher levels of DHA levels
in response to stress.
So more work needs to be done on the physiology,
but I'd love your take on the mechanisms
through which that's possible.
Yes, and DHA, of course,
says an anabolic hormone in both men
and women, very interesting because we had a guest
on this podcast.
He actually is a PhD scientist who runs the UFC Performance Training Institute, his name
is Duncan French, and his graduate work at UConn Stores was very interesting.
It was an exercise science and physiology.
What he showed was that if you could spike the adrenaline response, I think they did
this through first time skydive or something like that,
that testosterone went up.
Now, this spits in the face of everything
that we're told about stress and testosterone levels, right?
And this has also been looked at in females with estrogen,
although of course there's estrogen and testosterone
both males and females,
but that's how they designed the study.
So it turns out that at least in the short term,
that a very stressful event can raise anabolic hormones.
And I think that people forget at a mechanistic level
that adrenaline is epinephrine.
And epinephrine is derived biochemically derived
from the molecule dopamine.
If you look at the pathway,
and you even just Google it and go images,
you'll see that adrenaline is made molecule dopamine. If you look at the pathway, you can even just Google it and go images, you'll see that adrenaline
is made from dopamine.
Dopamine and these anabolic hormones have a very close, they're sort of close cousins,
they work together in the pituitary and hypothalamus.
So it makes sense that one could leverage stress toward growth and towards animalism as
opposed to cannibalism, which is not saying cannibalism
is an eating other people, but catabolic processes, as I guess the right way to refer to it.
But what's again remarkable to me is that all of these brain structures that control dopamine
epinephrine testosterone and estrogen, they're all thought to be in the subconscious, meaning
below our ability to flip a switch and turn them on or off, and yet mindset seemed to impact
them.
So I've all that to say that there's a clear mechanistic basis by which this could all
work.
And so on the one hand, I'm surprised because these are incredible results.
On the other hand, I'm not surprised because there's a physiological substrate there that
could readily explain them. Yeah, and I think figuring out exactly how it works is really, you know.
We should do that.
We should do that.
We should collaborate.
We've got common friends in both departments, so we should do it.
But I didn't want to mention the way I think about mindset.
And again, I think we need to study this.
I'm not a neuroscientist.
I haven't looked at this, but this is something we could do.
But the way I think about mindset is that it's,
mindsets are kind of a portal between conscious
and subconscious processes.
They operate as a default setting of the mind.
So if sort of programmed in there,
you have stress equals bad.
That is going to be something maybe conscious,
but it doesn't have to be conscious.
People don't have to know their minds
that's about stress until they're asked, really.
That's been programmed in through our upbringing,
through public health messages, and through media,
and other things.
And it kind of sits there as an assumption in the brain.
And the brain is then figuring out,
how should it respond to this situation?
And if the assumption, the default, the programming,
is stress is bad, that's going to,
through our subconscious trigger all the things
that's like, okay, well, I need to like, you know, rev up the things that protect me versus
rev up the things that help me grow. And so that's at least how I think about it. And what's cool about
it is that because it operates as a sort of portal that communicates with more, you know, subconscious
physiological processes, but it can also be accessed through our consciousness, right?
So just talking about this, right, for your listeners, they're now invited to bring
their stress mindsets up to the consciousness and say, what is my stress mindset?
How am I thinking about stress?
Can I reprogram that?
Can I start to think about it as more enhancing?
That takes a little bit of a conscious work potentially, but then once you do that, that
can kind of operate in the background, influencing how your body responds and you don't have
to say, okay, I'm stressed, I better tell my, you know, in a molecule or a bone, so that doesn't work that way.
No.
But these mindsets can help with the translational process.
I love the idea that mindsets are at the interface
between the consciousness of conscious.
And I think there's a lot to unpack there.
But it clearly is the case that the mindsets,
they sort of act as heuristics, right?
And as we talked about earlier,
they can limit the number of things to focus on
because one thing that is really stressful
is trying to focus on everything all the time.
I mean, trying to navigate the public health around
anything, the public health information around anything
is kind of overwhelming.
As you mentioned for stress, you see a lot
and the stresses will crush you
and then you can also find evidence that stress will grow you.
How should we, the listeners, think about stress?
What's the most adaptive way to think about stress?
Should we talk about our stress?
Should we not talk about our stress?
Is there a short list of ways that we can cope with stress better?
Or I should be careful with the word cope.
Is there a way that we can leverage stress to our advantage?
Great.
Yeah, and that's an important,
important nuance in your language,
which is people of,
by and large, come from a place of,
how do you manage stress?
How do you cope with it, which implies,
how do you fight against it?
Vacation massage is yoga classes.
Fight against an order check out from it.
Exactly.
And the real challenge is how do we leverage it?
How do we utilize it?
How do we work with it?
And I have a lot of thoughts on this.
The first and most important thing is to clarify our definition of stress.
So I think people often associate, the stress-negative stress mindset is so
insidious that now people define stress with its negative consequences.
So the first step is to decouple that and to realize that stress is a neutral, right, yet to
be determined effect of experiencing or anticipating adversity in your goal-related efforts.
So let me unpack that a little more.
You can be in the midst of it or you could just be worried about something happening.
That's one aspect.
Second is adversity or challenge,
so something that's working against you.
But the third piece is critical,
and that is in your goal-related efforts.
What that means is that we only stress about
things we care about, things that matter to us.
So this is really important, right?
Because stress is linked with, it's the other side of the coin of things we care about,
right?
And so I think that's the first thing to realize, right?
That as humans, we stress because we care, and we don't stress about things we don't
care about.
So the simplified example I like to use is, you know, if Johnny was failing school, that
wouldn't stress you out unless Johnny was your son or you were Johnny or you really cared
about educating the Johnny's of the world, right?
It only becomes stressful to the extent that you care about it.
So why are we trying to fight or run away or hide
or merely cope with our stress or, you know,
overcome it through our massages when the stress
is connected to the things we care about?
So then the question becomes, okay, if that's true,
how can I better utilize or leverage or respond to the inevitable
stresses that we're going to experience? I'm not saying go out and seek out more stress.
What I am saying is that you're going to experience stress if you have any cares or values or
passions and most all of us do. And so then what do you do? And we've developed a three-step approach
to adopting a stress-enhancing mindset.
And briefly, the first step is to just acknowledge
that you're stressed, to own it, see it, be mindful of it.
The second step is to welcome it.
Why would you welcome it?
You welcome it because inherently in that stress
is something you care about.
So you're using it as an opportunity
to reconnect to what is it that I care about here.
And then the third step is to utilize the stress response
to achieve the thing you care about, not spend your time, money,
effort, energy, trying to get rid of the
stress. Does that make sense?
Makes sense.
And I love it.
As somebody who's laboratory studies the physiological effects of stress, the effects
that impress me the most are, for instance, the narrowing of visual attention that then
drives a capacity to parse time more finely, which then drives a capacity to process
information faster.
It's almost like a superpower.
And yes, it can feel uncomfortable often.
But I love the idea that acknowledging it, embracing it, and then understanding its power
and leveraging that power.
I think what I like so much about that framework is that the stress response is very generic.
Unlike the relaxation response, we don't actually have to train up the stress response.
We all kind of get this as a freebie and then it sounds like it's a question of what
we end up doing with that.
Right.
And Han Selya, father of stress said himself, it's a non-specific response. So it occurs. It's what you're doing with that. Right. And Han Selya, father of stress, said himself, it's a non-specific response, right? So it occurs. It's
what you're doing with it. That's how you're channeling it. And
yeah, like we talked about before, what most people do is they
stress about the stress, which then over exacerbates it, or they
check out from the stress, which leads to depression and
anodonia, because by checking out from stress, you're
also checking out from the things we care about.
And substance abuse.
Exactly.
Or Kali Anulemki, who also, we had the good fortune of having as a guest on this podcast,
talked a lot about this, that, you know, so much of substance abuse, because she runs
the addiction clinic over on the med side of campus, it takes over people's lives
because of this increased ability to find a solution
to the stress that then eventually becomes
its own stress or in its own problem.
Well, I love that mindset and framework.
I'd love for you to tell us just a bit
about what you're up to right now
and what's most exciting
to you now.
If you are able or willing to talk about some of the work that's on the way, I saw a brief
mention of something on your publication's website of a paper about influencers, online
influencers and nutrition.
That might not be the main thrust of what you're up to, but if you're able to tell us
about it, sort of interesting, given that a lot of the communication in and around this podcast
takes place through social media, and I've kind of launched into this landscape now where
I'm constantly bombarded with health information and influencers, a term I didn't even know
until a couple of months ago.
You are one.
Well, one could argue one way or the other, but they, so what is the deal with influencers?
Are they doing something good for health information or are they ruining the landscape?
And don't try and protect my feelings.
No.
Because I now know that stress is actually an asset.
Yes.
Well, you know, that work is part of a body of work that we've been sort of venturing into,
which is to understand where do these mindsets come from, right?
And I mentioned sort of public health entities as one source of, say, our mindsets about stress.
But I think that our mindsets are influenced by four different sources.
First is our upbringing, how our parents talked about
things like when we're stressed or food or other things.
Second is culture and media, so movies, podcasts,
and now social media.
Third is influential others.
So what doctors say to us, or close friends, or peers.
And fourth is your conscious choice.
So we talked about that a little.
You do have, as humans,
have the ability to be mindful of
and to change our mindsets.
But the social media and influencer stuff
has been in part an attempt to understand
where do our mindsets about things like healthy foods come from?
And Brad Turnwald, who is a former grad student in my lab,
has done a series of really interesting studies
on this showing that if you rate the nutritional quality
of the top-grossing movies
in the last 20 years.
Are you look at the Instagram accounts
of all the most influential people on Instagram?
What you, and you analyze the nutrition content
of what they're eating, what he's shown is that,
depending on the study, 70% to 90% of those movies
or influencers would fail the legal standards
for advertising in the UK. So they're putting out their nutrition contents that are,
you know, maybe not surprisingly, but undeniably unhealthy. And, you know, to me, that's interesting
and important. It shows that where are we getting this mindset that those unhealthy foods are pleasurable,
desirable.
What's maybe even more interesting than that is some of the work that he and others in
our lab have done to show that the ways people are talking about the foods they're eating
really matter to. So generally what we found is that when
people talk about unhealthy foods, they use language that connotes a sense of excitement, fun,
sexiness, danger, indulgence, basically anything good and desirable. This would be like cookies,
cakes, high sugar, just really unhealthy.
Like truly unhealthy foods, or yeah, that's actually
the objective of what health means is challenging,
but yeah, high fat, high sugar.
I think there's pretty good agreement now
that excessive sugar is in go.
And highly processed.
Yeah, highly processed excessive sugar.
I think there's general consensus.
I'm sure someone, if you're gonna come after anyone,
come after me, I'll stand behind you.
But on the other hand, when people are talking about if they do, which, you know, healthy foods aren't portrayed in media, they aren't portrayed by influencers rarely ever.
And when they are, they're often talked about with language that conveys a sense of deprivation. It's, you know, it's nutritious, but it's sort of boring, it's bland,
it's lusty.
Recovery from the holidays.
Sort of the post-holiday.
Exactly.
Exactly.
And this is really important because you're doing all this work trying, and others are doing
all this work trying to inform people about what actually is good for them. And meanwhile, there's this hurricane of other force
that's telling people that's seeping into our minds
that sure those might be good for you,
but those foods are not fun or sexy
or indulgent or desirable in any way, shape or form.
And it's also paid advertising for fast foods
and sugared beverages and other things.
So it's not surprising that we have this mindset that healthy foods are the less desirable
thing to eat because of those cultural and social forces.
What our work has just tried to do is to reveal that, you know, quantify it as a way to say,
all right, let's maybe be a little bit more mindful
about how we talk about healthy foods.
And could, you know, if you're a movie producer,
can you be a little bit more mindful to showcase
healthy and delicious foods and have the characters talk
about them in ways that are more appealing?
There's a lot of room for people who produce this content
to have an impact not just on what people do,
but what they think about the foods they're eating.
It's really interesting.
I hadn't thought about it until now,
but it makes sense that any food that's packaged
and can be sold can be woven into a film
or promoted by a celebrity influencer,
not a health influencer per se, but a celebrity
influencer because they'll get paid, right?
It's part of the ecosystem that allows them an income and it feeds back on sales to the
company.
And whereas things that can't be commoditized, it's more difficult, right?
It's hard to, whoever makes oranges and sells oranges is unlikely to promote oranges in
a celebrity post or in a movie because oranges can be purchased from many, many sources.
There's no identifiable source of oranges as there is with a packaged food, for instance.
Yeah, but the interesting thing we found in those studies is that it wasn't driven by promoted content or branded content.
There was some of that, certainly, and all of the promoted and branded content is usually for processed high-sugar foods.
But 90% or more of these foods that they were showing were not promoted or branded. And so there's a lot of flexibility in what,
these producers or influencers could show
on their media.
Although it goes both ways, right?
It's not just the producers and the influencers
responsibility the public is reacting to this.
And we showed too that people respond more positively.
They're more likes on posts about unhealthy foods.
So it's a, yeah, it's a sort of distasteful,
and in neck, it's a distasteful culture around healthy eating,
and we really have a lot to do to change it.
Yeah, it's dopamine circuits through and through,
just the site of some very calorie
dense, extremely tasty food, which drives those dopamine circuits.
And I realize that there are people out there who derive the same sort of, or similar,
levels of pleasure from healthy foods.
And that's a wonderful thing if one can accomplish that.
So we just need more of that is what it sounds like.
Yeah, exactly.
And that's what's really inspiring to me, at least,
is that it is possible.
I mean, people think, oh, well, vegetables
are just inherently less tasty than ice cream.
And it's like, well, that's not necessarily true.
Also, it doesn't have to be a competition.
I don't have to get my three-year-old to hate ice cream
in order for it to like broccoli. There's a lot more I can't have to get my three-year-old to hate ice cream in order for it to like broccoli.
There's a lot more I can be doing to help shape a more positive
approach-oriented, indulgent mindset around
healthy, nutritious
vegetables and fruits and other foods, right? In addition to having her like ice cream, right?
And that's totally fine. Sounds like a really interesting study. When it's published, we let me know.
Yeah, I think it was actually released this week.
Oh great.
I will be sure to.
And Jammin, Turner Medicine.
Jammin, Turner, okay.
Great journal.
I will definitely talk about it on social media and elsewhere.
Sounds very interesting.
What else are you up to lately that's?
My favorite question to ask any scientist or colleague,
by the way, is, what are you most excited about lately?
What do you up late thinking about
and getting up early thinking about?
Yeah, so hands down the thing I most excited,
well, I guess there's so many things.
The thing that I'm most into right now,
we're doing the most work in is,
I started by getting inspired by placebo effects in medicine. I did a long stint in placebo or belief-like effects in behavioral health,
and now we're moving back into medicine. So I'm really interested in looking at how we
can work with active drugs and treatments to make them better and make the experience
of them better by instilling different
mindsets. So one study we did along those lines, we worked with kids or undergoing treatment
for food allergies. So allergies to peanuts, for example, this was with Kari Nedo, who's
the head of the Stanford Allergy Center here. She has a great treatment for food allergies. Basically, kids take gradually increasing doses
of the thing they're allergic to, like peanuts.
And over the course of six or seven months,
these kids become less reactive to peanuts.
And the problem with that treatment
is it's really difficult because they're having all sorts of negative
symptoms and side effects.
These kids are getting itchy mouths and upset stomach, they're puking, and it's scary because
they're literally eating the thing that they've been told might kill them, right?
And what we did in the study was we attempted to improve the experience and outcomes of that by reframing mindsets about the symptoms and the side effects.
So as it was being conducted before, the kids were told, look, these side effects are just
an unfortunate byproduct of this treatment.
And you have to sort of endure them to get through it.
But what we found in our conversation with Kari was that
the reality of those side effects was not so negative.
In fact, they were mechanistically linked
to the body learning how to tolerate peanuts
or the allergen.
And so what we did was we worked within a trial,
they were all getting the treatment.
But half of them were helped
to see this more positive mindsets. That symptoms and side effects from this treatment were
a positive signal that the treatment was working and their bodies were getting stronger.
And what we found was that that mindset led to reductions in anxiety, fewer symptoms when at the highest doses
and most interestingly of all, they had better outcomes.
So based on immune markers that were a sign
of the allergic tolerance, those who had this mindset
throughout had better outcomes to the treatment.
So that's just one example.
I think my goal is really to move us
beyond the placebo versus drug,
mindset versus behavior,
to get to a place where we can blend them together
and maximize the benefit of these treatments.
So we're doing a lot of studies like that.
How can we improve treatment for cancer
with different mindsets?
We've done some work recently with the COVID-19 vaccine
and symptoms since side effects, so that's what I'm really passionate about right now.
Incredible. I can't wait to read that study. Is that one out or on the way? Okay, well then I will
also read and communicate with you and then about that study. Who knows, maybe you would come on Instagram and do a little Instagram live to make sure
that I don't screw up the delivery
and that we can hear it direct
from the person who ran the study.
I find this issue of side effects really interesting.
I don't take a lot of prescription drugs,
but recently I was prescribed a few
and the list of side effects is, you know,
it's incredible. And it just goes on and on and on. I realized some of that is legal protections
I it's hard for me to believe that they're actually
Expecting anyone to read those because you need a you know a high-powered microscope to read this print is truly fine print
but I did realize that in reading over the side effects that you you
Prime one prime is themselves to experience those side effects and so now I just rip up the side effects, one prime is themselves to experience the side effects.
And so now I just rip up the side effects thing
and or the sheet and just throw it away.
I just take it as recommended.
Do you think it works in the other direction too?
Where if an effective medication is supposed
to have result A, B or C and you are told again and again how effective it is
for that treatment that it could amplify the effect.
So in other words, it's not a strictly a placebo.
It's not no placebo as you described before,
but that perhaps at a lower dose,
a given medication could have a amplified effect
or at an appropriate dose, if you will,
it could have a super physiological effect.
Has that ever been demonstrated?
To some degree, I think where it gets tricky
is for a long time people thought the effects of placebo
were expectancy-based, so you expect to get a benefit
and that benefit occurs.
There's certainly some truth to that,
but I think the mindset approach is more powerful because it helps us understand the mechanisms.
So if you just expect that your blood pressure will go down, what are the mechanisms through
which that expectation would lead to your blood pressure going down?
It's hard to even understand that, right?
But if you have the mindset that you're in good hands,
that this is being taken care of,
that illness is not going to kill you, right?
That you're being treated well.
Then you can start to unpack, you know,
the mechanisms through which blood pressure could
be relieved.
Maybe it's anxiety, reduction, maybe it's changing the, you know, the sort of anticipation of
what the prioritization of what the body needs to focus on.
And so I really think that, you know, the work of the future needs to be on getting more
sophisticated about what is the mindset
that we're instilling when we say something will work or it won't work?
And how do we understand the mechanisms through which that changes physiology?
So to answer your question, I think that that could be true, but it depends on what actually
is the mindset you're evoking.
I know you're a parent and to the other parents out there, but also the kids and people who
don't have kids, what is the best way to learn and teach mindsets?
I mean, clearly a conversation like this informs me and many other people out there about mindsets
and how we can adopt them.
But it also seems to me that if we have the opportunity to teach mindsets and really cultivate certain mindsets,
that the world would be a much better place.
Yes.
How does one go about that?
Given that there were kids and we are all
being bombarded with conflicting information all the time,
how do we anchor to a mindset?
Yeah, and you're getting at my other major passion
right now, which is what we're calling our lab, meta mindset
working on this with Chris Evans and others.
And that is how do we consciously and deliberately change our mindsets.
And the first step is really simple, and that's just to be aware that you have them, that
the world, your beliefs aren't sort of an unmitigated
reflection of reality as it objectively is.
They are filtered through our interpretations, our expectations, our frameworks, and simplifications
of that reality.
And as you know, your work, and then your, as you know so well, there are all of most
of what goes on in our brain is an interpretation of reality.
Mindsets are just the simplified core assumptions
about things.
And the first step is to realize that we have them.
The second step is to start to think about what
the effects of those mindsets are on your life,
to sort of play out the story.
OK, I have this mindset that stress is debilitating.
How is that making me feel?
What is that leading me to do?
Is this mindset helpful or harmful?
The question isn't, is the mindset right or wrong?
Because you can find evidence for against it, you know,
and we can fight about it till we're, you know, exhausted.
The question is, is it helpful or harmful? And then you can go about
seeking out ways to adopt more useful mindsets. So, you know, we've been doing a lot of work on
how to actually do that, how do you consciously change it? Sometimes it's really simple,
I think, in cases where we don't have a lot of prior experience, like the
kids with allergies who are getting treatment, they didn't have any other mindsets about
symptoms. So we just got the luxury of setting it, right? When it comes to healthy food,
I think we have a, it's harder to change people's mindsets because we have a lot of baggage
weighing us down. As a parent, for me, I get my
number one piece of advice is to lighten up trying to get your kids to do certain things
and focus more on helping them to adopt more adaptive mindsets. So, you know, by no
means and expert at this, but I'm testing it with my own
child. Real time. But it's real kind of experiment. Yeah. It's how do I, you know, how do I resist
the urge to force my child to eat her dinner so that she can have her dessert? Right? Because
that's the real urge. No, you need to do that. Because when you start thinking about it in terms of mindset, you realize,
oh, that's just reinforcing to her that the dessert is the exciting, fun thing to have.
And this thing that I have to do must be horrible, so horrible that my, you know,
my parent is forcing me to do it, right?
So it's letting go a little bit of the behavior, the objective reality, and really thinking
about the subjective reality and focusing on adaptive mindsets.
So my goal as a parent has been to try to help her in still a healthy mindset about eating,
that healthy foods are indulgent and delicious, that the experience of stress is inevitable, that it's natural,
and that it can help going through stressful experience, can help her learn, grow, and become
a more connected and happier individual.
And you know, with exercise and physical activity, we haven't really gotten to that yet,
but we will with time.
Yeah, it's great.
I wrote down, and I'm going to keep this in the front of my mind going forward to continually
ask what is the effect of my mindset about X and just to evaluate that, about exercise,
about food, about school, about stress, about relationships, about relationship to self,
et cetera, and to really think about that in a series of layers.
So you think that would be a useful exercise.
Definitely, and you know, and your work speaks to the system. I mean, the mindful, it's not...
I would, yeah, really urge against
people getting dogmatic about their mindset also. Right? Like, oh, I need to have the right mindset.
And if I don't have the right mind, you know, it's like, okay, mindset is a piece of the puzzle.
It's a piece of the puzzle that's
really empowering because we
have access to it and we can change it. But it is just one piece of the puzzle. So treat yourself
like a scientist. Look at your life, look at your mindsets, see what's serving you, see what isn't,
find more useful, adaptive, and empowering mindsets and live by those.
and empowering mindsets and live by those. I love it.
Now, in one version of this kind of discussion, I would have asked the question I'm going to ask
next at the beginning, but I'm going to ask it now close to the end, which is, you're
a unique constellation of accomplishments and attributes, and I only know a subset of
them, of course, because today's the first time that we've met in person even though I've known
your work for a long time and work colleagues across campus. So you run your
laboratory where you do research. You were also an athlete in the University, a
serious athlete, and then you're also a clinical psychologist, is that right?
I was trained as a clinical psychologist. So my PhD is in clinical psychology, and I did all my pre and post internships with stress
and trauma.
Do you see patients or did you see patients at the time?
Yes, I don't anymore.
Okay.
That's a very unique constellation of practitioner and researcher. So, what are the mindsets that you try and adopt on a regular basis as a consequence or
in relation to those things, sort of athlete researcher clinician?
You know, for yourself, as you move through life, do you have an overarching mindset that
all challenge is good, or do you have any kind of central mindsets
that help you navigate through,
it has to be a pretty complex set of daily routines
given everything that you juggle.
But I think that people like you are unique in that,
you have the inside knowledge of how this stuff works,
and you've also existed in these different domains.
And I know a lot of listeners have a more athletic slant to their life for a more cognitive
or some are raising kids or some people are just, you know, are doing any number of things.
So this is where I think it would be useful for people to hear.
What do you do?
This is what I'm asking.
Yeah, well, it's certainly true in my case that research is me search. Everything that I study as an intellectual has come from my own experience or my own
failings right.
When I was really intensely exercising and training, those were the questions I asked
when I was dealing with eating and concerns about my weight.
Those were the questions I asked when I was stressed about my dissertation.
I decided to do my dissertation on stress.
Right? Now I think we're in the midst of a global pandemic.
It's, you know, how can our mindsets be useful here?
You know, so I don't think there's an obvious answer to your question other than the guiding
light for me has been an undercurrent of understanding that our minds that's matter. I think I got
that very clearly and deeply as a child, both through my experiences as an athlete. I know
many of your listeners are athletes.
Any athlete knows that you can be the same physical being
from one day to the next, one moment to the next,
and perform completely differently,
just depending on what you're thinking.
I was a gymnast growing up, and if you can't visualize,
if you can't see something in your mind,
you have no chance when you get up there on the balance beam. And I also, my father was a martial artist, a teacher of meditation, so
this kind of mind-body work was baked into me from an early age.
And I think what I've done recently is to try to understand it scientifically and
more importantly to figure out how can we, how can we do better with this? How can we, you know, we're all
talking about AI taking over the world and technology this and all personalized medicine
that and it's like we have done so little, relatively so little with the human resource,
our human brains, that the potential for which is so great.
And we've done almost nothing.
Take the placebo effect.
We know a lot about what it is.
We've done almost nothing to leverage that in medicine, consciously and deliberately.
So what keeps me going, what gets me through the hard times,
is just that burning question of what is going on here
and what more can I do with the power of my mind?
Well, I and millions of other people
are so grateful that you do this work.
It's so important and it's truly unique.
Tell us where people can learn more about your research,
where they can find you online.
I'm gonna try and persuade you to take more of a social media presence going forward, but whether or not I succeed
in that effort or not. Where can people find you? Ask questions, find your papers, learn more.
I'd love to have you back for a conversation in the future, but in the meantime.
Yeah, no, it's really, it's been such an honor getting to chat with you. And just you, you have such an impact on the world.
And I look forward, I hope we can do some science together.
Absolutely.
Yeah, with all our papers and materials and interventions are housed on our website.
MBL.Stanford.edu.
We also have a link there to, that takes you to Stanford Spark,
which stands for Social Psychological to real-world questions.
We have a lot of toolkits on that website, including a toolkit for this rethink stress approach of acknowledging, welcoming and utilizing your stress.
And then, I guess I'm on Twitter, Alia Kron.
I don't do much there, but maybe I will start too.
Well, those are all great resources.
We will provide links to all of those
for our listeners and viewers.
And I also hope to convince you to write a book
or many books in the future.
The world needs to know about this.
But thank you so much for taking time out
of your exceedingly busy schedule to talk to us about these ideas.
I learned so much. I'm going to definitely think about what is the effect of my mindset about blank
every category of life and really just on behalf of everybody and myself. Thank you so much.
Yeah, thank you. And I guess I just want to end by saying, I think this work is really the tip of the iceberg of what can
and should be done.
And so I really invite your you, your listeners, and all, you know, anybody who's inspired by
this work, if they want to share stories or want a partner on a collaboration to please
reach out.
Great.
Well, and the comment section on YouTube is a great place to do that as well.
You will hear from them.
Great. Great.
Thank you so much, Allie. Thank you.
Thank you for joining me for my conversation with Dr. Alia Crumb.
I'm guessing by now you can appreciate the enormous impact that mindsets have on our biology
and our psychology and how those interact at the level of mind and body.
If you'd like to learn more about Dr. Crumb's work,
and perhaps even be a research subject
in one of their upcoming studies on mine sets,
you can go to mbl.stanford.edu.
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