Ten Percent Happier with Dan Harris - 530: Your Anxiety Questions, Answered | Judson Brewer

Episode Date: December 5, 2022

The subject of anxiety never seems to lose its relevance. In this special episode we answer listener voicemails with one of the world’s leading experts on anxiety. Dr. Jud Brewer is the Chief Medical Officer at Sharecare and the Director of Research and Innovation at Brown University’s Mindfulness Center. He is also the New York Times best-selling author of Unwinding Anxiety: New Science Shows How to Break the Cycles of Worry and Fear to Heal Your Mind and an expert in the field of habit change and the science of self-mastery. In this episode we talk about:  The current levels of anxiety in our cultureWhy fear and planning can be helpful, but worrying is notThe role of curiosity and kindness in short circuiting anxiety How to differentiate between anxiety and excitementWhether we can try too hard to treat our anxietyAnd why as a society we are moving away from distress tolerance Full Shownotes: https://www.tenpercent.com/podcast-episode/judson-brewer-530See Privacy Policy at https://art19.com/privacy and California Privacy Notice at https://art19.com/privacy#do-not-sell-my-info.

This is the 10% happier podcast. I'm Dan Harris. Hey, gang, sadly, the subject of anxiety never seems to lose its relevance. Anxiety is an epidemic in our culture right now, especially after the pandemic. It's also a major issue in my own life, even after 13 years of meditating. So today, we have one of the world's leading experts on anxiety. Here to answer a bunch of questions from me and also from you in the form of listener voicemails. Dr. Judd Brewer is the chief medical officer at ShareCare and Director of Research and Innovation

at Brown University's Mindfulness Center. He's the creator of several apps, which use mindfulness to help you change habits, including emotional eating, smoking, and also anxiety, which he considers to be a habit. Speaking of anxiety, Judd is also the author of a book called Unwinding Anxiety. New science shows how to break the cycles of worry and fear to heal your mind.

That book just came out in paperback recently. What I really love about Judd, aside from the fact that he's a personal friend, is that he combines clinical practice, in other words, he treats patients, he combines that with cutting-edge neuroscientific research, and deep Buddhist practice. In that way, Judd is kind of like the robo-cop of dealing with human suffering.

In this conversation, we talked about the current levels of anxiety in our culture, post-pandemic, Judd's definition of anxiety and his description of the mental habit loops that feed anxiety, why fear and planning can be helpful, but worrying is not. The steps Judd recommends for working with anxiety. The role curiosity and kindness can play in short circuiting anxiety. Mindfulness as what he calls the bigger, better offer for your brain, his advice for working with panic attacks and stage fright, how to differentiate between anxiety and excitement, whether we can try too hard to treat our anxiety, and why as a society, we are moving away from distress tolerance, which he says is a bad thing.

The moving away, not the distress tolerance. Anyway, we'll get started with Dr. Judd Brewer, right after this. Before we jump into today's show, many of us want to live healthier lives, but keep bumping our heads up against the same obstacles over and over again. But what if there was a different way to relate to this gap between what you want to do and what you actually do? What if you could find intrinsic motivation for habit change that will make you happier instead of sending you into a shame spiral? Learn how to form healthy habits without kicking your own ass unnecessarily by taking our healthy habits course over on the 10% happier app. It's taught by the Stanford psychologist Kelly McGonical and the great meditation teacher Alexis Santos to access the course. Just download the 10% happier app

wherever you get your apps or by visiting 10% calm. All one word spelled out. Okay, on with the show. Hey y'all, it's your girl, Kiki Palmer. I'm an actress, singer, and entrepreneur. On my new podcast, Baby This is Kiki Palmer. I'm asking friends, family, and experts, the questions that are in my head. Like, it's only fans only bad.

Where did memes come from? And where's Tom from, MySpace? Listen to Baby, this is Kiki Palmer on Amazon Music or wherever you get your podcast. Dr. Judson Brewer, otherwise known as Jud. Welcome back to the show. Thanks for having me. It's fun, it's been a long time, I haven't seen you in a minute.

Yeah, it has been a long time. So we've got a lot of listener questions for you. But before we dive into that, I do want to do a refresher for people who either haven't heard you on the show before or who haven't heard you in a while. So let's just start here. What in your view from your perch is the state of the nation or the state of the world as it pertains to anxiety right now?

Well, I would say it's been trending up. We saw big spike at the beginning of the pandemic. And I think if we look overall, whether it's BC before COVID-19 or even as we're moving into whatever this phase is now, a huge amount of anxiety coming from a huge amount of uncertainty. And it's not just health anxiety, which we've seen really spike over the last couple of years, but we're seeing economic uncertainty,

we're seeing political uncertainty, we're seeing environmental uncertainty. And all of those add together, our brains, they don't care what type of uncertainty it is, all uncertainty says, hey, pay attention, this could be a problem. And so they kind of get us revved up and get us in our, is this dangerous mode? And are we seeing levels of anxiety either domestically or globally that we haven't seen before or did things calm down after an initial spike? They haven't really calmed down that much. Yeah. It's unfortunate. I would love to be

focusing on other things than helping people work with anxiety, but I think it is here to stay. I've asked you this question before, but I think it's worth asking again. How do you as a clinician and a scientist and a meditator define anxiety? Well, if you look at some of the dictionary definitions, I think they can be helpful places to start. This feeling of nervousness or unease about an imminent event or something with an uncertain outcome.

So that's pretty broad. Life has an uncertain outcome if we look at it. So that definition, that feeling of nervousness or worry is helpful because that's something we all can relate to. We feel anxiety. And at the same time, I think one thing that we don't focus on enough is that that feeling can lead to worrying, which is a mental behavior on top of the feeling. We feel anxious, start worrying, oh no, you know, what's wrong, what's going to happen, what do I need to do, and that worry

then feeds back and makes us feel more anxious. And yet worry and fear do have some useful purposes. Fear certainly has a useful purpose. So if there's danger that fear says do something about the danger, and that fear can sometimes be triggered by uncertainty. Imagine if you hear a strange noise in your apartment or your house at night when you're sleeping, you know, you don't know what it is, then it's going to be pretty hard to get back to sleep. You can't just roll over and be like, yeah, I don't be fine. Our survival brain state probably should figure that out. So fear is helpful.

It's always been helpful, always will be helpful. And then other parts of our brains, regarding that outcome, like the future orientedness are also helpful, like planning. But the worrying itself hasn't been shown to be helpful because it's kind of stuck, it kind of wishes to gather fear and planning. And we're stuck in this gray zone where we can plan all we want. But if that planning flips into worrying, for example, that's not going to change the outcomes because we can't.

We don't know what's what's going to happen, but it certainly can change what's happening right now, which is it makes us more anxious. There are these quotes out there that I love around worrying isn't going to solve tomorrow. There's problems. It's just going to take away today's piece, some flavor of that. And I think that's really dead on where it's like, planning is helpful. It can help us predict and try to plan for the future. Yet when we worry, that's a layer on top of the planning

that is not only doesn't help, but it also makes things worse. And I mean, there's to bring in some basic neuroscience here, I can imagine part of how this becomes a noxious downward spiral is that when you're locked in the fear, which is reinforced by the worry, the part of the brain that is smart, the prefrontal cortex, goes offline while the ancient lizard part of the brain, the amygdala, is in control. The amygdala is much more complicated in that, but that piece aside from a heuristic standpoint. Yes, the prefrontal cortex goes offline and ironically, we go into panic mode, which makes it really hard for us to think and plan. So we can't access that planning part of the brain

when we're anxious, when we're worried, and especially not when we're panicked. I think definition of panic, something like wildly unthinking behavior. So by definition, we're not thinking. But it could be even south of panic, right? Because you could just be in an anxious mode and not have a full fight or flight situation going on, but that anxiety degrades your capacity to actually think clearly if I'm understanding you correctly. Oh, absolutely. And anybody that's had mild moderate or severe ballots or even states or days or weeks of

anxiety can attest to that. Nobody can think more clearly when they're anxious. They're kind of caught up in do something mode as compared to, let's think through this mode. So can you describe before we get to listener questions, can you give us a sort of pre-see summary of your approach than when you lay out in your book, which is just out in paperback on winding anxiety? What your approach is to dealing with this very common phenomena.

I'd be happy to. And so this approach came from me falling on my face trying to help my patients with anxiety prescribing medications, about one in five patients has a significant reduction in symptoms with medication. So I was basically playing the medication lottery one in five didn't know which one didn't know what to do with the other four. And so I started looking at the literature and also looking at my lab's a habit change lab. And so turns out that anxiety is driven like a habit. So those pieces that feeling of anxiety can trigger the mental behavior of

worrying. And that mental behavior of worrying makes us feel like we're in control, or at least like we're doing something, because it feels better to do something than nothing. And that feeds back. And has our brain learn, oh, next time you feel anxious, you should worry. And I say that because that's the first step of my approach, which is to literally just map out these habit loops with my patients. And I've never had a patient come in through the clinic and say, no, I don't have any of these.

It's typically, oh my gosh, I have no idea. And then they come back and they have a list of like 12 other habit loops that they've mapped out. So that's the first step is just mapping out these habit loops. The trigger could just be that feeling of anxiety. The behavior tends to be mental worrying, but it could also be procrastination, stress eating, whatever. And then mapping out what's the result. And then they start to see that cause an effect relationship, which is, oh, when I worry, I actually feel worse, this feeds back, it makes me more anxious. So that's the first step.

The second step is asking this very simple question, what am I getting from this? And that goes way back. You can look at it from a neuroscience lens, you can look at it from an ancient Buddhist psychology lens. And that really comes back to our brains saying, if something's rewarding, I'm going to keep doing it. If it's not rewarding, I'm going to stop doing it. So if somebody pays attention

and they see that worrying isn't serving them, it's not keeping their family members safe. It's not solving the problem. It's just adding to their problems, not helping them plan for the future. Then they start to become disenchanted with it. And when they become disenchanted, it's easier to step out of the cycle. This third step is towards something better and I think of it as anything that helps somebody step out of a habit loop. So here our brains are looking for things that are more rewarding. We must give them to our brains and we actually have several things right within us that are free and accessible and can actually build on themselves as we practice them. So I think of like curiosity and kindness as

two inherent qualities that we have that are really strong and they only get stronger than what we practice them. So for example, if somebody is worrying, I'll have them notice what it feels like to worry, what's the result of that? What am I getting from this? And, I'll have them notice what it feel like to worry. What's the result of that? What am I getting from this? And then I'll have them get curious. What does that worrying or what does the anxiety feel like in your body right now? And as they start to look and describe it, it's tightness, it's tension, it's heat, it's this, it's this, then I ask them, well, what does that quality of exploration feel like?

You know, what does it feel like to be curious, basically? And they can start to see that curiosity itself feels better than worrying. And they can start to get in the habit of being curious when they're worried instead of worrying or when they're anxious instead of getting caught up in an anxiety habit loop, they can start to get curious and bring their awareness to the present moment and use that power of curiosity. So that's really my approach. And we've done clinical studies with our unwitting anxiety app. We've gotten 67% reduction in anxiety and people with generalizing anxiety disorder.

And there that number, I mentioned one in five patients with medications, that number is about one, it's 1.6. So it's better than one in, it's about one in two. So pretty, pretty effective when you utilize your own mind. I love this simplicity of it and I love how effective it can be. And I also love, as an neuroscientist, how it lines up perfectly with how our brains learn and all these reward mechanisms.

We might as well leverage the strength of our brain rather than fighting against it. Let me see if I can do a rough recapitulation here. Just to make sure I've got it. And by proxy, everybody listening. When people come in complaining of anxiety, you point out that anxiety is kind of a mental habit and you can have them map how that habit plays out for them. Trigger is feeling of fear, behavior is worrying or stress-eating or whatever, and the reward is maybe a temporary alleviation

of said feeling of fear. But you then get them to investigate further to see that actually that temporary alleviation comes with lots of negative externalities like feeling sick from overeating or completely running down your resilience through over worrying. And you didn't use this term, but I know you use this term generally. You introduced the notion of the BBO, the bigger, better offer for the brain. The brain is, as you've pointed out to me in the past, a pleasure-seeking machine. And you offer mindfulness as the BBO, as a way to tune into our innate capacity to be curious about

what's happening in our mind and body right now, tuning into the physical sensations of the anxiety, any urges or emotions or thoughts that may be accompanying it. And this process, this process is inherently pleasurable and can cut the cycle. Nicely done, yes, absolutely. You said one in two roughly, probably a little bit north of that, it's working for, for the people for whom it's not working, what's their critique? That's a really good question. We've been able to do some research to look at, you know, are there baseline

characteristics of fix that benefit more or less from, for example, we've only studied our own running anxiety app, but the idea that we found is that there's a small group of people that may have some experiential avoidance. That's our working hypothesis. And so if people are afraid to approach their own experience, it can be really hard to work with your experience. The good news is that's not even the majority is not even half, it's not even, it's like a third or less of people that have some strong experiential avoidance.

Just knowing that, it can help move people, an emboldened people, and empower people to move into the process more. So that's the piece that I would say it's really helpful for folks to really check to see, am I avoiding my experience? Is it really hard for me to be with unpleasant things? And I would say in general, as a society, we aren't moving toward distressed tolerance. We're kind of moving away from it with our phones as weapons of mass distraction, because we're basically training ourselves that if some things unpleasant, we can just go on our phone and distract ourselves. And that's problematic overall. Yes, so your biggest opponent in this process may be the culture.

Yes, it certainly doesn't help. A while ago when we were talking about BBOs, bigger, better offers, you said that the mind has within it two BBOs that many of us overlook curiosity slash mindfulness, and you also mentioned kindness. So in this context, I would imagine there are at least two ways one could go with kindness in a moment of fear or anxiety. One would be self-compassion where you send yourself compassion for in the face of whatever fear you're feeling. The other would be doing something nice for somebody else, which is inherently ennobling. Are either of these alternatives part of your pedagogy? Oh, yes.

They are, I think they're front and center, they're essential. And whether it's curiosity, whether it's kindness, self-compassion, acts of kindness, all of these help us move away from that feeling of anxiety, feels closed down, it feels contracted, it feels tight, you feel bald up. And when we're curious, we open to our experience. When we're kind, or when kindness is besowed upon us, we open. When we're connected with others in acts of kindness, we open. And so really it's about anything that helps us open to our experience and really be with our experience. Can you say a little bit more from a nuts and bolts level? How we could apply kindness in a moment when we're feeling fear

and about to go down a habit loop? Sure. So the first thing I would say is somebody's got to recognize that they're about to go down a habit loop. If they don't recognize it, they're, they're just going to go down it. So there's got to be a little bit of awareness there in that moment first. Like, oh, I'm about to go down habit loop. And a lot of folks fall down self-judgmental habit loops, for example. So just starting with that as an example, if somebody starts to notice that they're going to beat themselves up, or they fall down the shooting hole, I should have done that, I shouldn't have done that.

They can then simply ask themselves, what am I getting from this? And then see, oh, this isn't really helping. And then bring in an active self compassion where they're just, it can be as simple as putting their hand on their hearts or just saying, I'm doing the best that I can right now or something to remind them that this human experience doesn't have to include the self-flagelation that comes with self-judgment. That's a habit. And so there's one place for somebody to very simply and in a very short period of time bring in an act of kindness. No, we can also go on that and see what that feels like. Oh, this kindness feels pretty good. And we store up our memory, kind of our memory banks,

of what kindness feels like. And we can go back and reflect on those. And we can go back and reflect on those. And we can reflect on those things. And we can reflect on those things. And we can reflect on those things. And we can reflect on those things. And we can reflect on those things. And we store up our memory, kind of our memory banks of what kindness feels like,

and we can go back and reflect on those. So for feeling anxious, we can reflect on, oh, what was it like when I was kind to myself, or what was it like when that person was kind to me? That can kind of hit the pause button on that anxiety loop, and give us a little space to breathe, bring our pre-prenowned cortex back online, and then say, oh, this might be a good time to do an active kindness for myself,

or even, hey, let me go do something kind for somebody else. And then that virtuous cycle starts to become more and more ingrained as our new habit. I love everything you just said. I just want to highlight one thing. I just recently gave a TED talk about what I call broadly self-love, but what scientists refer to as self-compassion. And I talked about this whole move of putting your hand on your heart or your chest or whatever.

And how, for me, that was a very tough deal to swallow initially. And I think for a lot of guys that's, I'm generalizing here and I know it, but I suspect for a lot of guys that that's really true. So can you just talk about the science here that might get our fellow skeptics over the hump on this one? I'd be happy to. My lab's even done neuroimaging studies of people practicing love and kindness in the FMRI scanner.

And we can watch, we can literally watch those self-referential brain networks that get caught up, they get really activated when we're caught up and worrying, they quiet down, they get really quiet. So there's a fair amount of science behind it, whether you look at the neuroimaging, which is what my lab has largely done. And there are also a number of other labs that have looked at training in self-compassion and seeing all the positive benefits of that. And there's some real benefits for society when we practice. You use some terms of art there for anybody and for anybody who's new to the show,

I just want to just define a few terms there. Loving kindness meditation is a form of meditation. We teach a lot of it over on the 10% happier app. It essentially asks you to envision a series of beings sometimes starting with yourself or an easy person, and then to a mentor, a neutral person, a difficult person, and then all beings. And you systematically send them good vibes, like maybe happy, maybe healthy, maybe safe, maybe live with ease. And this is the practice that Judd was talking about watching people's default mode network, the sort of default mode that we're often in, of thinking about ourselves, worrying about ourselves, planning for ourselves, quiet down. There is a whole field that we've covered quite a bit here on the show of self-compassion,

which can combine compassion itself touch, like putting your hand on your heart, compassion itself, talk, talking to yourself, like you would talk to a good friend, reminding yourself that you're not alone in whatever travails you're enduring. And again, a lot of data behind both of these as just generally good things to do for yourself and specifically very helpful when caught in anxiety. Is all of that an accurate summation there, Jett? Yeah, absolutely. Okay, so having done all of this throat clearing and foundation laying and level setting, let's move to some voicemails. The first one is from Robin who has a question about anxiety as it relates to getting older. First of all, I really want to say that I have found the 10% happier app a game changer

for me in helping me cope with my anxiety. The anxiety, meditations are just fabulous. What I would really like to hear is for somebody to explore the idea of existential anxiety. I find that even though I've had some health anxiety issues because I'm an older person approaching 70, I find that it really is part of an overall existential piece for me. And I've been researching little bits of this and realized that it is a common anxiety for older people. So I would really appreciate if the 10% happier team could pursue that. Thanks a lot. That's a great question. What this person is highlighting how as we age, we don't know what's

going to happen. And often it's not that our bodies get stronger and healthier, but often we can have some health anxiety related to things that don't work as well as they used to. So here, and I would say this can also be a lesson that we all can learn. It's not just about aging or existential anxiety, but really about the process itself, which is if we kind of get in the habit of going, oh no, it's like, oh no, whether it's some health-related issue or anything else, we can recognize it. Oh, there's that, oh no, where I'm kind of closing down to my experience. It might be bracing against it. I might be thinking, oh no, what's going to happen. I'm worried. And there we can kind of flip on the curiosity switch. And even look at the inflection of our mental voice

that, oh no, tends to feel more closed down and feels more heavy, it feels heavier. And we go, oh, I'm in an anxiety, have it loop. And we flip on that curiosity switch and light up the room a little bit that oh in itself Already starts to feel a little bit lighter and help us get out of that old rut And at the same time it can help us kind of approach life and whatever it is More with the growth mindset. So I'm going, oh, no, what's going

to happen? We can go, oh, things are changing. How can I bring some curiosity and some fresh freshness to this? And we can start to see that freshness is a bigger, better offer. It feels lighter than the heaviness that comes when we get in this habit loop of approaching life and life that's always changing, right? That's not something we have any control over. So really seeing, I'm beating my head against this change wall. Can I stop doing that? Because it's not helping not helping anything changes going to still happen. So can I just approach it in a way that's going to be most easeful and ideally even dare I say most joyful.

And I say that because we truly can approach life. And if we get in the habit of being curious, it feels so much better. That just anybody can play with it themselves. How does Oh, no feel versus Oh. But even that, okay, I'm just gonna press you because even that, completely with you, I don't disagree with the thing you've said. And it doesn't stop for me at least the fact

that my ankles, knees and other joints are not functioning as well. Bercytus acts up. The thought of death is not super appetizing. I don't know, the worrying part of my brain just kicks in with that as a rejoinder. Yes. And so I'm sure you've talked about this on your podcast before.

I'm sure somebody has described these in Buddhism, these two arrows. There's the the arrow that comes with pain. You know, it's like you get shot by an arrow, it hurts. And then you start thinking, Oh, am I going to die? Is this who is my shirt going to abstain? Whatever. That's that second arrow that we should ourself with. That is completely optional. And so maybe the Rory and comes in as an rejoiner, then you can ask yourself, is this helping anything? Maybe that's a third arrow and up four arrow. And so if we can recognize what is optional, and we can see that not going, not getting caught up in those optional habit loops actually helps us deal with the joints,

the prosides, or whatever more, then that's ideal. We're not wasting energy getting stuck in these side stories that aren't going to help and actually make things worse. How does that square with your rejoiner? I think what you're saying is aging is non-negotiable. Do you want to be stuck in a toxic eddy of rumination about it? Or do you want to bring a likeness and curiosity to a natural process? Amen, brother. Yes, well said. This is idiosyncratic when I'm about to say, but for me, curiosity is enormously helpful. And the self-compassion stuff, particularly the self-talk

stuff, has really been useful. I'm very influenced by the work of people like Kristen Neff, Chris Girmher, Ethan Cross, all of whom have been on the show and we'll put links in the show notes whom have been on the show and we'll put links in the show notes who have helped me see that in moments where I'm getting stuck, I can do this two part move, maybe even a three part move, but one is put a hand on my chest, even though I find it personally to be pretty strange and maybe cheesy, but again, a lot of science to suggest is really helpful. So that's one, some sort of reassuring self-touch, two, talking to myself the way I would talk to my son or a good friend, the way a really good coach

would talk to you, somebody who's not blind to your flaws, but is on your side and wants you to do your best. So in a moment like worrying about how I look in the mirror because I'm getting older, did you're lucky to be alive still? And this happens naturally and you're doing everything you can to stay as healthy as possible, keep it up. And then the third piece is just to be aware

of what Kristen Neff calls a sort of common humanity that this is universal. What I'm dealing with right now, tens of millions of people are dealing with at this very nanosecond. So all of that as an add-on to the curiosity has been really helpful to me, and I'm just curious what you have to say about that. Absolutely. Going through life alone for most people, some people really enjoy it, but for most of us, that journey is really best done with with friends. And if we think of all other humans and all of their beings even, that doesn't sound

too cheesy, we're kind of going through this journey together. So we might as well link up arms. And one thing that's beautiful about that is that when we learn to work with our own minds, we get inspired to help others. And so we see a little bit on the path and we see, oh, that's kind of slippery, and then we turn around and naturally say to the person behind us, hey, that part of the path is a little slippery. And it benefits two beings at once. It feels good to help and it feels good to be helped. And so that connection, that compassion piece, I think is really essential. Let's go on to the next voicemail here.

It's from Bruce, he is a long time meditator and yet still dealing with anxiety, something I can really relate to. So here we go with Bruce. I'm a meditator for seven plus years and I have fully seen how quietness, stillness, and meditation has lessened my day-to-day experience greatly, and immensely. And yet, when I am in the midst of the intense emotion of anxiety or even sadness, it is difficult for me to experience the softening that I know that noting and self-compassion can foster. My question is, is there something else I can be doing to tap into the benefits of meditation

when you're in the grips of the intense anxiety? Yeah, it's a great question. And so here, I think of meditation as a tool to help us learn how our minds work. And so if we can learn how our minds work, we can then learn to work with our minds in the moment. And so it's not like if we're in the middle of an intense episode of anxiety, oh no, I've got to go find a meditation cushion and sit down. It's that aspect of, oh, what do I know about my mind? Can I step back and map this and then bring in some curiosity to whether whatever the behavior is, if it's worrying, for example. And I would even say one way to start that process is to find something that can really ground us.

So if we can't, for so freaked out, it can be hard to step back and say, oh, what's this habit? It's hard to be curious in those moments. So here we can bring in practices. I'm sure they're a gazillion that have been put out on your podcast fit where we just look around. And look around the room. If we're in a room, look around,

if we're on the subway looking around at the people in the subway car, if we're in nature looking at the plants and the trees, and just grounding ourselves externally. Like, oh, what am I aware of right now? It's as a way to just really ground awareness outside of that spinning habit in our head. Another way we can ground ourselves is to find an anxiety free zone in our body. One, two that I know that work pretty well are our hands in our feet. They tend not to be places where we hold anxiety so we can ask ourselves

what do my feet feel like right now? And we can even ask, which foot feels warmer than the other just doing this? And it kind of draws that anxiety invites that awareness right into our feet and kind of draws down the anxiety simply because we're not fueling it by being caught up in it. So a grounding exercise can be really helpful. And then we can, once our prefrontal cortex can come back online, we can then start to

notice, oh, what's this anxiety? How about loop? The other thing I would say is if we think, okay, I've been meditating a long time, I'm still caught up in anxiety. It's a good time to look for resistance. So am I resisting my experience? And the typical mental sequence goes something like, I don't know, here's anxiety again, but I meditate.

It shouldn't be here. And that tends to be resistance. Like, I'm not okay with what's happening right now. Otherwise, this mental commentary wouldn't be going on in my head. And so, they are again, we can look for those, oh, oh, and that tends to be a sense of resistance. We can go, oh, am I resisting my experience right now? And suddenly, it can awaken our curiosity,

and we can say, oh, what can I learn about myself right now? What does resistance feel like? And we can flip it on its head from, oh, here's this anxiety. Again, I shouldn't have anxiety anymore. Meditated that proverbial golden seven years to, oh, what can I learn? And we've already started to awaken that curiosity in that moment. I love all of that, Judd. It's brilliant. And Bruce just to add, and at the risk of sounding like a broken record, what's helpful for me at slightly more years of meditation,

and yet still anxious, is the stuff we just talked about the, what I sometimes call without her permission, the Neff three step, these three moves that I sometimes do out of order that Professor Christen Nef, the sort of godmother of self-compassion recommends where some sort of self-compassion to touch if you can get over yourself and do it, talking to yourself counter programming against the negativity bias in your brain slash mind, and then trying to remember that whatever you're dealing with is something that tens of millions of other members of Homo sapiens are also dealing with.

I just would layer that on top of Judd's excellent advice. Coming up, Judd's going to answer listener voice mail and he'll have some practical tips for working with panic attacks and also stage fright after this. Life is short and it's full of a lot of interesting questions. What does happiness really mean? How do I get the most out of my time here on Earth? And what really is the best cereal? These are the questions I seek to resolve on my weekly podcast, Life is short with Justin

Long. If you're looking for the answer to deep philosophical questions like what is the meaning of life, I can't really help you. But I do believe that we really enrich our experience here by learning from others. And that's why in each episode I like to talk with actors, musicians, artists, scientists, and many more types of people about how they get the most out of life. We explore how they felt during the highs. And sometimes more importantly, the most out of life. We explore how they felt during the highs and sometimes more importantly,

the lows of their careers. We discuss how they've been able to stay happy during some of the harder times, but if I'm being honest, it's mostly just fun chats between friends about the important stuff. Like if you had a sandwich named after you, what would be on it?

Follow Life is short wherever you get your podcasts. You can also listen to Add Free on the Amazon music or Wondering app Next voice mail is from Jess Who has another question I can relate to which is about anxiety and when that tips over in to panic Hello there. I'm wondering if you guys might be able to answer a question about what happens when anxiety gets super acute and then it turns to panic like what can we do in those moments? Yeah great question. So speaks from personal experience. I used to get panic attacks during residency and yes note the irony here's a guy training to be a psychiatrist and he's getting his own panic attacks.

I used to wake up from sleep in the middle of the night and out of these full-blown panic attacks and the first one that I had, I had this full-blown panic attack and I was doing a lot of noting practice at the time for my own personal practice, just noting my experience. And so it was kind of strong as a habit.

And so I kind of noted it's like, Oh, tunnel vision, oh, sweating, oh, racing heart, oh, I can't breathe, oh, feeling like I'm going to die. Oh, they really have, we really, these are really true. So the panic of that happened my first one. And then I noted through it. And it ended. Then my brain in psychiatry training mode went through the diagnostic checklist. It was like, check, check, check, check, check. Oh, you just had a panic attack. I also remember thinking, wow,

those thoughts of dying are really true because I really thought I was going to die. Then probably being sleep deprived, but also helped along by my own mindfulness practice. I went back to sleep. And so what I would say is these practices, especially the noting practice, where it helps us observe, but not be caught up in our experience, can be a game changer. And I say especially, it's not about the act of having a panic attack itself that makes somebody especially it's not about the act of having a panic attack itself that makes somebody meet the diagnostic criteria

for panic disorder. It's really about the fear and the worry of having one in the future. And then we start avoiding situations related to, when we had our last panic attack and all these things. So we can learn to have the panic attacks and kind of, I don't want to say embrace them because I wouldn't, I'm not sure anybody

that can embrace a panic attack. Like, woohoo! I want another one of those, but really to hold our arms wide and hold ourselves in this loving kind embrace and it's dead of going, oh no, here it comes again, oh no, I just had one. We can go, oh, it's okay. And we can note through the experience and know that we can be with our experience. And I have to say, when that roller coaster ride ends, certainly just

speaking from my own experience, it feels tremendously empowering and gives me the confidence to be able to work with really tough stuff. Another example, I was a fortune of learning how to surf midlife, and I remember being caught in what they call inside, yet caught inside where the waves are just like pounding on your head. And I remember being underwater, getting pounded yet again, and this started in the panic, because my brain's like, dude, you need some oxygen. And I remember noting, oh, there's panic.

Okay, and if I, and the instinct was to like, flail my arms and try to get to the surface as quickly as I can, but the idea is if I do that, I'm gonna waste all my energy in my oxygen. So I just need to relax and let myself float up to the surface.

So I can catch my breath. And if another wave's about to come on on my head, it's going to happen. And so there, it's really about like being able to have those practices being grained enough that we can learn to be with even the rough stuff with panic itself. And trust that we can rely on them when we need them. I know this podcast is designed to let Judd and our listeners talk, but I'm just gonna hog the mic for a second and tell a story because I've been going through a research

of panic attacks recently triggered by long standing claustrophobia. And so I've been having trouble on airplanes and elevators. I think it's multi-factorial. One of the contributors is that in the pandemic, I wasn't in elevators or on airplanes that much. So I sort of deconditioned. And one of the treatments that I've really have had a lot of positive experience with for panic is exposure therapy, where you expose yourself systematically and carefully to the things that are scaring you and the point of the story I'm about to tell is that you don't want to push yourself too hard in this.

I just got back from a week in L.A. that I planned with me and my seven-year-old son, and I planned it before I was having this recent quite acute spike in panic. And so the plane ride was tough, but I got through it. And as my therapist, the therapist I work with, specifically on panic issues, as I said, he's never seen anybody actually totally lose it in front of their child.

But there's something about being with your child that can keep you together. But anyway, so the flight was okay, but I had planned before the panic to take him to both Disneyland on one day and Universal Studios on a subsequent day. And if anybody has ever been to amusement park, the thing about rides is they lock you in. has ever been to a amusement park. The thing about rides is they lock you in. And I went through a day at Disneyland where actually it was like most of the days are a positive exposure therapy. I would be locked into these rides and I was actually doing all the things that Judd was talking about and doing all the things that I've been trained to do in my exposure therapy of getting

curious about the sensations and then having some positive self talk about, yeah, I've experienced these sensations a million times, I've always survived. There is no real danger here. The brain is lying to you right now. And it was really working. By the end of the day, though, I was really exhausted. And there was one final ride my son wanted to go on.

And I knew not to go on it. And he was really not happy with me, but I didn't do it. However, that night for one reason or another, I didn't sleep well. And we got up the next morning to go to Universal Studios. I was very depleted and was skipping most of the rides all day long, but then decided at the end of the day to go on a 45 minute studio tour where you're in an open air, like trolley type thing, because I had done that ride with my parents when I was a kid, so I was thinking, okay, this one I can do,

it's not really even a ride, it's a tour, but they've changed the tour now, so that actually, actually, at three points in the ride, you have to go into these hangars where they do these 3D fights between King Kong and a dinosaur and the tram is shaking. And then another one is a simulated earthquake where you're stuck in there or the thing is shaking and everything's falling apart around you. So I've made it through two of these on this 45 minute ride. And're entering the third and I'm just completely dead. And the third is called the Fast and the Furious. It's after the Fast and the Furious movies where

you're going to get locked into a hanger and they're going to do a reenactment of racing in a car. And I pulled the rip cord. I had to get off the ride and my son was really embarrassed. I was really embarrassed. But I knew I was at my limit. So we're giving you all these tools, folks, especially as it pertains to panic. I just want to point out that with anxiety, I think that's a little bit more workable. But panic when you're in full fight or flight, there are times when you need to know that you got to pull yourself out of the situation. And as embarrassing as that was, and I was on the phone the next day with my shrink,

and I started crying because I thought I had totally traumatized my child. As embarrassing as that was, I think I was right to know when I was at my limit. So what say you, doctor? Oh, yeah, 100%. So I'm glad you bring that forward. The none of these practices can be done in a forest manner. You and I've probably talked about this before, but you know, I spent 10 years beating my head against the meditation wall and anything that we do to try to force ourselves with these

practices are actually antithetical to the practices themselves. Curiosity can't be forced, kindness can't be forced. And so what you're talking about is this self-care aspect where we're asking ourselves, what do I need right now as compared to what I want? I might want to grit my teeth and make it through this last ride, but you know, we can ask, what do I need? And this is what I need. And we take care of ourselves, and that's the most compassionate response. That's the practice, is compassion.

So I'm so glad you bring that forward because that's so critical. So many people, myself included, have approached meditation with the, just grit your teeth and force it. I remember some meditation retreat, teacher telling me on the retreat one time saying, she was so exasperated with me that,

Judd, your path to enlightenment can be through striving. Because I was striving so much. I was like, but that's not it. And then I was like, oh, later. I don't even remember how many years later, I was like, oh, later, I don't even remember how many years later, I was like, oh, that's what you're talking about. Yeah, not about striving. It's about curiosity.

Curiosity is not striving. Kindness is not striving. And the beauty of those things, they take us by the hand and show us the way in such a gentle way that it just seems like it was obvious all along when we see it. Just hanging a lantern on something you said there. Chris Germer, who's a long time collaborator of Christen Neff, Chris is at Harvard, Christen Neff is at the University of Texas, Austin, and Chris, when he was on the show a while ago,

said that the preeminent self-compassion question, you should ask yourself, is the one that you articulated just moments ago, Judd, what do I need right now? And let that be your guide in many things in your life. Let's go on to the next call. It's from Laura, and it's yet another one I can relate to deeply. It has to do with stage fright. Whenever I give a presentation to people I get horrendous stage fright. It's awful. It's heart beating out of my chest, waves of burning heat all over my body and I just can't think. Unless I have my presentation completely written out

and take proprytinalol, which is a beta blocker, that slows my heart rate down. So any advice for a stage fright, I would be grateful, thanks so much. So I think if I remember the research correctly, people fear public speaking more than death if you remember the research correctly, people fear the public speaking more than death if you take the polls, so sure a lot of folks can relate to that question.

And here, so the question is, what can we do? I think this person's already highlighting some beneficial aspects. If we really get stuck in that stage fright loop, it can be hard to get unstuck. And so finding ways to give us those handholds, those railings, like writing out our presentation, et cetera, can be a really helpful way to stay grounded in the present moment instead of having our mind fly off in the Oh no, Oh no, people are looking at me.

And then there can be many ways to bring in some of the things that we've been talking about today, even, where it's just like practicing slowly, it's like a exposure therapy, slowly standing up on an empty stage and grounding ourselves. What's it feel like here? What's it feel like here? Noticing thoughts that have literally come up.

And then really doubling down on our mindfulness practices, for example, to help us be able to be present when things come up. And then even working in situations where that anxiety comes up when we're not on stage to give us the confidence and trust that we can work with anxiety. Like, okay, I can work with it here. I can work with it here and then then start practicing working with it on stage, even with all of the props that I speak that we have, those things that prop us up, like the written out speech. And then eventually building toward that being able to be on stage and wing it.

And I have to say, this is not for everyone. For some of us, there's nothing wrong with just doing what this person highlighted, and it might be just as good as it gets, because it is, that can be such a really challenging thing for folks to do. So the other piece there is, how can I build my practices to be able to stand up on stage, but also not have the expectation that I'm going to do this in order to, if we get in that mindset of, I've got to do this, then we have a destination in mind, and that destination invariably trips us up. I really like the approach of cliche as it is life as a journey. Like, can we, well, can we explore, oh, maybe it'll work, maybe it won't, as compared to this has

to work this time. Very different approaches that this has to work is very closed down, contracted forest. Whereas, oh, let me explore with this. Let me try this. And then we learn no matter what. Just to say to Laura as somebody who has been a public speaker, his whole adult life, I rely on two of the things you mentioned there. One of them is propanolol. I take a beta blocker every time I'm going to do public speaking. And the second, and by the way, for those who don't know what a beta blocker is and Judd, you'll correct

me if I'm wrong about this. But it's a non-narcotic medication. So in other words, you're not loopy or high or anything like that. It just puts a ceiling on how fast your heart can beat. So it really precludes to a great extent the amount of panic symptoms you're going to feel. So that's really helpful as just a net. And the second thing is preparation. I just prepare so much that it looks like I'm winging it. And if that means I have to have my notes on the stage, whether I use them or not, then I keep them with me, even if it's just in my pocket. The final thing to say is more of a question,

really, for Judd, is I believe there are forms of therapy, either clinical therapy or more informal stuff, like toast masters, where people can really get a workout in public speaking, the CBT cognitive behavioral therapy or other forms of therapy where people can train. Yeah, so I mean, this is such a common phenomenon that there are ways where people can practice giving speeches in public, and that's a great way to do it. I'll also highlight one thing that you're pointing out,

whereas if we pharmacologically limit the rapidity with which our heart can beat, if we give a ceiling to that, that highlights how interconnected our mind and body is, where just the heart-racing, contrigger panic in certain situations, because we've learned to associate racing heart with panic.

There's even a term for this called, I think it's called somatic memory, where we form memories in our body related to certain emotions. And so when we kind of fit those body postures or those physiologic parameters and then they turn on, our brain can suddenly think, oh, am I supposed to be anxious right now? Because my heart's racing, this, this, this, this, and this. So I think it really highlights this mind-body connection and how the two, there can be this reciprocal feeding on each other. We can have a thought that triggers these physiologic reactions.

We can have physiologic reactions that happen for whatever reason. They can trigger the thoughts, and that's where some of these pharmacologic interventions can help to kind of break that link between the two. It's a temporizing measure. Quick note here before we get to the next voicemail. A great hack that was given to me by a professor from Columbia, Madupa, Akanoa. She's actually a business school professor, but it's studied stress a lot. And she often recommends people do a little bit of cognitive reframing,

which is if you start to notice your heart beating, palms sweating, to just tell yourself, this is the body preparing you to act. Thank you. There's nothing wrong here. As long as you don't tip over to full on fight or flight, I think it's a really, really useful reframing. Coming up, Judd answers more listener voice mails, including a question about whether there is such a thing as throwing too much at anxiety and how to differentiate between anxiety and excitement.

After this, this next voicemail has to do with how we manage anxiety and excitement, which is an interesting and tricky balance. So here we go. Hi there. My question is on anxiety and tricky balance? So here we go. Hi there, my question is on anxiety and excitement. For me, I've been a type A person who has a lot of excitement around my work, but it has led to some burnout, trouble sleeping,

and excess tension in my body. Recently, I read Bernie Brown's new book, Atlas of the Heart, and in there, there's a line where she says, excitement and anxiety show up the exact same way in the body, which I have definitely experienced in my meditation practice. So knowing this, my question is, do you have any recommendation on how to work with the excitement, slash anxiety?

So it's a really important observation that's been made here, which is the feeling of anxiety can share a lot of characteristics with the feeling of excitement. There's this restless quality to it. And if you look at it from a survival or an evolutionary standpoint, excitement says go do something. An anxiety also says go do something because there's uncertainty here. Make that uncertainty go away.

So, what's the difference between anxiety and excitement? Often because the physiologic response feels very much the same. It tends to be simply the thoughts that are associated with the feeling. And so, somebody could have anxiety and have the restlessness, the tightness, that urgency that says, do something. And it's got that oh no loop playing in their head. Somebody with excitement could have the very same physiologic response. And they're going, oh, I can't wait for whatever they're excited about. And both of those, as the caller point and I can burn us out because it's really using up a lot of

energy. It's like driving our car in first gear all the time. The engine is very inefficient. The engine overheats all these things. So we can get burnt out. And the good news here is the simplicity of the practices. So we can work with these the very same way. Whether it's thoughts and emotions associated with anxiety, or thoughts and emotions associated with excitement, we just bring in that curiosity, like, oh, what thought, I know the thought. What's my body feel like right now?

Know the sensations. Am I having this urge to do something? Because that's my survival brain saying, do something. That's what dopamine's all about. It says go do something. And so we can note that. And we can bring that practice in no matter whether it's anxiety or excitement.

I'll add one other thing because I think in today's this item, Dan, I'd love to hear your thoughts on this. Today's society, we've kind of been trained that excitement equals happiness, because it gets us to buy stuff, go on this ride, go to this, you know, go to the theme park, go buy this, go on this date, whatever. And there's a, I think it was I'll butcher the quote, but I'll try it. Sido Upandita wrote in his book, In This Very Life, something about people mistake the excitement of mind for happiness

and they don't notice the greater joy that comes from calm and peace or whatever. And what he's highlighting is that when you really look at it, especially if you compare and look at the similarities between anxiety and excitement, excitement is exciting, but it gives us that exciting rush and then we crash and that restless quality that comes with excitement, which says to go do Excitement is exciting, but it gives us that exciting rush and then we crash and that restless quality that comes with excitement, which says, go do something, restlessness itself doesn't actually feel that good.

So when we compare that to what it feels like when we're joyful, we can check with our brains to see which is the bigger, better offer. We can see for ourselves that excitement might be more than it's cracked up to be, so to speak. If you want my thought on it, I would say what is often said in Buddhist circles when somebody says something wise, they say, Sado, well said.

And yes, you and the aforementioned Saido, Pandita, the late Burmese meditation master, I believe are completely correct that we mistake, we conflate excitement with happiness. You just get curious as Judd's been telling us to do throughout this whole conversation. What does it feel like when you buy a lottery ticket or prepare to bite into a piece of candy as opposed to what it feels like? I'll just put this in personally. From me, the excitement of eating some slice of pizza or getting somebody famous to retweet something that I want them to retweet or whatever that buzzy headlong rush feeling is totally different from the feeling I get when I hug my son

where my whole nervous system relaxes. Or the very few moments I've had on meditation retreats where the discursive mind, the chattering mind goes way down and I'm just filled with this inexplicable sense of everything's okay. Those are not the same species. Clear branch point in the evolutionary chain. Yeah, for sure. Yes, emotional evolutionary chain. Let me do one last voicemail here. And it's from Sarah. And it has to do with COVID. Take it away Sarah.

I work in the music business as a songwriter and performer and I've dealt with anxiety in different forms throughout my life. I've had a little bit of social anxiety and I've also had some performance anxiety related to when I have big performances on stages in front of lots and lots and lots of people. Those kinds of things I've gotten used to sort of relaxing down after I get into the flow of things on stage. But the place where I'm really struggling seems to be with my day-to-day general anxiety levels. After my husband and I got sick with COVID five weeks ago. We didn't have terrible cases.

Our symptoms were mild, but around day five or six, I felt like I was starting to get my energy back and tried to go back to normal life. That apparently was a mistake because after about 24 hours of putting out my regular productivity, I shut down. And all of the sudden had horrible, unresolvable heartburn, headache, and really, really bad high level of baseline general anxiety.

It's been a few weeks since those symptoms presented and while the heartburn and headache are reoccurring, they're quite small compared to how they used to be. Whereas the feeling of general anxiety has sort of remained. I'm a meditator, I'm a breather, I'm an extraciser. I do all of these things, but I'm having a really, really, really, really hard time with anxiety at this point. I guess my question for you is, how do I break through with anxiety when nothing that I'm used to doing to managing at works and I feel completely overwhelmed?

And also, is there such a thing as throwing too much at anxiety? Is there such a thing as focusing too much energy and intention on trying to handle anxiety. What a really great and important question. So the short answer is whenever we're throwing stuff at anxiety, that's saying what we resist persists, that can be an indicator that we're not okay with what's happening. And we're going to do all this stuff to make the anxiety go away. When we do stuff, that is us trying to brick ourselves up and create that wall so the anxiety doesn't get to us. The paradox here is that the only way out is through. And so when we learn to open to allow, to accept as much as we can, our thoughts and our emotions and our sensations, that's how we don't feed them. And that's how

that resistance can go away. So we can certainly throw too much at anxiety, but I would say we can't open too much to anxiety and hear with all the caveats, taking care of ourselves, respecting our limits, all of these things. But really, it's about that openness, that acceptance that helps us be able to see the feelings and the thoughts as simply feelings and thoughts as compared to something that is terrible and horrible that we have to make go away. It's not pleasant yet by trying to make these things go away or trying to do something to make whatever our experiences change or go away, that trying tends to feed that resistance.

And so here, to bring another cliche, if we can really open to it and realize, okay, the only way out is through, we open to it. We can even learn to open to the obstacle becoming the way. And so, oh no, here's anxiety. Oh, oh, here's anxiety. How can this help me learn? How can this help me grow stronger to be with difficulty? And that in itself becomes a gift. This sounds crazy.

The gift of anxiety, probably not a book that would sell very well. But the gift of anxiety, we approach it through like this lens of openness and bow to it as a teacher and say, what can I learn from this? That's where it opens our curiosity and it opens our kindness and compassion to ourselves because we're really using everything at our disposal to help ourselves. You can throw too much at anxiety in a type A effort to get rid of it, but you can't open too much to it. Yes. With the caveat that you want to be careful not to push yourself too hard in the opening. Right. We can't force ourselves to open. Yes. Yes. But in the end, learning to work with this natural phenomenon is nothing wrong with you.

If you have anxiety, it's very common. In the end, learning to work with this obstacle can become the way in which we have an overall better life. Yeah, I actually have somebody who is a former patient because he doesn't need my help anymore that I write about in my underwriting anxiety book named Dave. And he full-blown panic disorder, full-blown generalizing anxiety disorder for 30 years. And he now talks about his anxiety as this gift that's helped him learn so much about himself. And at the same time, has helped him work through it. That obstacle literally became the way for him. Judd really appreciate your time.

I wanna remind everybody, the paperback edition of Unwinding Anxiety, subtitled, New Science, shows how to break the cycles of worry and fear to heal your mind. I wanna remind you all that it's now available, said book. In paperback, go check it out, and also don't forget, Jets got an app, one of many, actually, Jets remind everybody about your various apps,

so they can go check those out as well. Oh, sure. We have one for smoking called Craving to Quit, one to help people with their relationship to eating, whether it's emotionally eating, overeating, et cetera, called eat right now. And then the unwinding anxiety app that is also the same total as the book, they can just go to my website, drjud.com, drjud.com, drjud.com, and it's got information on all those things.

Dr. Judd, thank you again, really appreciate it, great to see you. Thanks for having me. Thanks again to Judd, always great to have him on We'll see you all on Wednesday for a freshy, brand new episode. producer is Jen Poient, scoring and mixing by Peter Bonaventure of Ultraviolet Audio. We'll see you all on Wednesday for a freshy, brand new episode. Hey, hey, prime members. You can listen to 10% happier early and ad-free on Amazon Music. Download the Amazon Music app today.

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