Hey, everybody, welcome to the podcast. Today, we're gonna laser in on anxiety, and specifically what new science tells us about how we can unwind it, how we can break the cycle of fear and worry, that cripple some, but I think in so many ways, it's fair to say, affects all of us to some degree or another. To do that, I've invited my friend, Dr. Jud Brewer, back on the show. His first appearance was episode 471, back in 2019. For those unfamiliar, Dr. Jud is a psychiatrist and neuroscientist, who specializes in the science of habit change. He's the director of research and innovation at the Mindfulness Center, he's a research affiliate at MIT, and an associate professor in behavioral and social sciences and psychiatry, at the schools of public health and medicine, at Brown University. You might've stumbled upon his TED Talk, it's got something like 10 million views. Maybe you caught him on "60 minutes" with Anderson Cooper, a couple of years back. He's also been featured in "Time Magazine," NPR, "Forbes," and many other places. And this first conversation that we had, focused on addiction, and how mindfulness can help us break bad habits. And today we're gonna extend that exploration to Dr. Jud's latest book, which is called "Unwinding Anxiety." And we're gonna do that, to better understand what causes everything from mild unease to full-blown panic, the relationship between anxiety and addiction, and the many interesting ways, that we can actually train and rewire our minds, to feel, perform and live better. But first, most people that I know, aspire to eat better, but without proper support, very, very few end up sticking with it. So, we decided to try to solve this very common problem. And our solution is the Plantpower Meal Planner. It's our all-in-one affordable digital platform, that sets you up for nutrition excellence, by providing you access, to thousands of customizable, super delicious, easy to prepare, plant-based recipes, that are all integrated with automatic grocery delivery. Plus you get access to our team of nutrition coaches seven days a week, and many other features. Right now we're offering $10 off an annual membership, when you visit meals.richroll.com, and use the special promo code RRHEALTH. This is life-changing stuff, it's just $1.70 a week, when you sign up for a year, literally the price of a cup of coffee. Again, that's meals.richroll.com, promo code our, RRHEALTH, for $10 off an annual membership. Okay, do me a solid, hit that subscribe button, click like, leave a comment, do all the things, leave your thoughts below, and let's get into it with Dr. Jud Brewer. Man, I wish I could see your new studio. Oh man, I wish you were here. It's pretty dope. So, next time you find yourself in Los Angeles, for sure. I will take you up on that, I would love to come visit. And, you know, this also sounds, I don't want to, well, I'll just say it. I'd love to go for a run with you sometime. 100%. Okay. (laughs) I was thinking about you the other day. I was on a long bike ride along the coast, and wrapping my head around what I wanted to talk to you about. And the surf, the lineup was looking pretty good. (laughs) It's calling your name, Jud. Oh, well we can go surfing too. Yeah, I would like that. I could use a little, I'm a very average surfer, so I need all the help I can get in that department. Well, same here, same here. Trying to rewire my brain to master that skill set is no small thing at 54. (laughs) (Jud laughs) Anyway man, let's just roll into it. Yeah, let's do it. How's it going? How has your COVID experience been? Which is kind of relevant to everything that we're gonna get into today. Yeah, well, I could say interesting, but that could mean a gazillion things. So, I'll be a little more specific. You know, I have to say, my wife taught me this term, FGO, I'm sure many folks know what that is, but I had not heard it as of a few years ago, the freaking growth opportunity, you can make that R rated if you want. Yeah.
But man, this has been such a growth opportunity here, in terms of kind of all this adversity coming up, and leaning in rather than running away. You know, you've probably heard this term, this phrase, the only way out is through, have you heard that? Right.
Yeah. Unfortunately, more times than I care to remember. (laughs) Yeah, you've lived it. Yeah. I mean that's a very optimistic spin on it, of course. Well, what are the alternatives? Right.
I mean, we could either go for it, or we could be running our whole life. And I have to say, running's pretty exhausting in my experience.
Yeah. Right, well, you're quite the man for the moment. I think everything that you've been studying for many, many years, is now coming to the forefront of what people are thinking about and grappling with, specifically anxiety, you know? I think it's the rare person who isn't experiencing some kind of anxiety, you know, in this predicament that we find ourselves in. Yeah. And that's what we're gonna talk about today. So, maybe the best way to launch into this, is first to just define our terms. When we're talking about anxiety, what are we talking about specifically? And how does that differ, from other kind of kindred emotions, like fear and worry and the like? Yeah, I think that's a great place to start. So, if you look at, I think the dictionary definition of anxiety, goes something like, you know, "Feeling of worry, nervousness or unease, "about an imminent event, "or something with an uncertain outcome." Mm hmm. It's interesting in that definition, worry is an interesting word, because it can be a noun, like this feeling of unease, but it can also be a verb, where I am worrying. So, I think, let's bookmark that and come back to that, because I think that's a really critical distinction, that in both of those, can actually, the noun can lead to the verb, which can feed back to the noun of worrying. But looking at it from a scientific standpoint, you know, I think a lot of people associate anxiety, with something that's kind of necessary, needed for survival, you know, especially right now. And that's something that I dove into a lot in my book, because I've been really interested with this idea, you know, there's this whole idea of performance anxiety, and I actually haven't found any evidence to support it. So, let's bookmark that as well, and talk about some of these origins here. Mm hmm. So, think of fear as a survival mechanism, okay? We've talked before about habits, and setting up habits for survival, right? To remember where food is, and to remember where danger is. So, these learning mechanisms go way back, you know, evolutionarily conserved all the way to the sea slug. Like this is the oldest learning mechanism known in science, you know, positive and negative reinforcement. So, if you zoom in on fear as a negatively reinforced behavior, fear helps us survive, right? So, think of our ancient ancestors out on the savanna, they are forging for food, right? But they don't know if it's dangerous. So, they're moving from their safe zone, their cave, out into more of an uncertain space, the savanna. So, their brain naturally goes on high alert, to start to learn things, like, "Oh, there's food, go there again. "There's danger, don't go there again," okay? So, fear helps us learn where things are safe and where things aren't safe, so we can avoid the unsafe places. That fear mechanism is this old part of the brain, and then layered on top of it, is a thinking and planning part of the brain, the neocortex, or the prefrontal cortex in particular. And this is interesting, because it helps us survive in a different way. It helps us survive through thinking and planning, yet it needs information, and preferably accurate information, so in this day and age there's a lot of misinformation which gets in the way, but it also is helpful for it to have precedent. So, when it's going into unchartered territory, it's really hard to think and plan, you know? Like, "Oh, let's, let's go explore Saturn." Well, you know, we've never done that before, so you gotta think of a bunch of things, and try to approximate, but it'd be much easier if somebody else had explored Saturn and wrote a book about it, said, "Oh do this, don't do that," okay? So, the prefrontal cortex, think of fear, helps us survive. The prefrontal cortex helps us survive, but if you pair fear with a lack of certainty, right, which is what the prefrontal cortex is trying to help us do, it's trying to help us predict the future, based on past experiences, if there is no precedent, if there's a lack of certainty, that fear, plus uncertainty, leads to anxiety. And people think, "Oh, anxiety it's gonna help me survive." No, it doesn't. (laughs)
Right. There is no evidence for it helping us survive. It makes our thinking and planning brain go offline. And if you think of the extreme form of anxiety, panic, right, which is wildly unthinking behavior, that's that far into the spectrum of anxiety. Right, it's an interesting, but subtle and important distinction, in that it is the uncertainty, that's driving the irrationality, right? You can be afraid, when you have a certain set of predictable parameters to deal with, but when you don't know what you're venturing into, that's what provokes the anxiety. So, to kind of extend that, what's fascinating about that, is it's not the dire consequence that creates the anxiety, it's the lack of certainty, around whether that consequence is going to be dire, or not so dire Yeah, absolutely. And just to be super clear for your listeners, it's not that fear is a problem, right? Fear helps us learn, in new situations in particular. But fear doesn't have the same neurochemical reaction in the brain as anxiety. Like, neurochemically, like how do these two things distinguish themselves? Yeah, I don't think all of the neurochemistry has been worked out, but I think one way to think about this, is on a temporal scale. So, if you look at the timescales, you can actually differentiate them pretty well. Right.
I'll use an example, of let's say stepping out into the street. So, let's say in this day and age, when everybody is distracted by their, what does Cornell Welch say, "Our weapons of mass distraction," you know, everybody's looking at their phone. So, if somebody steps out in the street, and doesn't see the bus coming, you know, bearing down on them, they instinctively jump back onto the safety of the sidewalk. And I say instinctively, because this is much faster than our thinking brain. You know, imagine you look up to the bus, and go, "Hmm, is that really going fast enough, you know? "Is it going to veer," splat. Right.
You know? We don't have time for that.
Right. So, we jump back onto the safety of the sidewalk, and then we have a fear response. (air whooshing) All of our, you know, basically our fight or flight response kicks in, and says, "Wow, that was crazy." And I, to be more precise, that fight or flight response, is where we get these catecholamines, we get all these, basically the adrenaline surge, that says, "Hey, you gotta run if you need to, "if you're not safe at this point, okay?" Right. But that also helps us have this fear response, that says, "Wow, you could have almost gotten killed. "You should learn from this, look both ways," you know, "Relearn what you learned as a kid." The problem is, so think of that as super rapid, is that instinctual response, the rapid response is that fear response, but then ideally that drains out of our system, you know, and we move on when we've learned. Right. So, this is what differentiates that from anxiety, is with the anxiety, maybe we keep replaying it in our head, "Oh, I could have gotten killed, I'm an idiot. "I shouldn't have done that." That is just kind of keeping that fear response going, chronically.
Wow. And that could happen for hours, days, weeks, years, you know, and this is where people, you know, it's not like we need a lifetime of psychotherapy for a fear response. Right, right.
But what we do need, is the ability to see the difference between a helpful fear response, and us literally getting spun out of control, because our mind's going out of control, making us continue to think about it. Right. And I think we're all experiencing, you know, some variation on those two things, over the past year, whether it's fear or unhealthy anxiety, you know, amidst a global pandemic, and our weapons of mass distraction, that are feeding us conflicting information, about X, Y and Z. I would suspect that this has created an unbelievably robust Petri dish, for you to really immerse yourself in the subject matter, in which you are an expert. And I know that early in the pandemic, like last May, you were writing pretty extensively about anxiety, and how we were grappling with how to manage this crazy shift in all of our lifestyles. But here we are almost a year later. It would seem to follow that there's less uncertainty now, perhaps the same amount of fear, but have you seen any kind of differentiation in how your patients or or the population at large, is kind of coping with COVID? So, I would say there are two main things that I'm noticing both in my clinic and then just at large. One is that there is that big spike of, "Wow, this is crazy. "This is really gonna be a pandemic. "Is it, wow, this really is a pandemic," you know? And then "How dangerous is this?" You know, "How infectious is this?" All of that, that uncertainty has gone down a little bit. And the death rate has gone down, when people figured out things like using steroids to help severely ill patients. So, that part has helped, yet we've seen the continual spikes, and these are intermittent ones, we don't know when they're gonna happen, with other forms of uncertainty, like the variants, "Oh," of "this variant popped up." And then those things feed a whole nother level of uncertainty. We've also seen things that really haven't changed that much in terms of the uncertainty. You know, small businesses, for example, the economy, for example, this is totally unprecedented. So, everybody is kind of feeling their way through this, whether it's a poor, small business owner, I've seen so many who've just like put their life savings, and they're like "Just one more month, just one more month." Right. And then they crash and burn. Or the feds, who are trying to figure out how to prop up the economy, without throwing us into whatever wild inflation or whatever. That's not my lane, so I don't know. (laughs) But the other piece that I've seen on top of this, is how people are coping. And I say, "Coping" with air quotes, because you've probably heard of the quarantine 15, and you know, where people have gained weight, and people are turning to these short-term coping strategies because are immediate and feel good in the moment. Whether it's drinking, you know, drinking has gone up, actually it's interesting, drinking has gone up in a significant part of the population, and some people have just basically cut out their drinking, probably due to lack of social resources, and the the usual places that they do. So, drinking's gone up, Netflix has had a quite a run. Yeah. You know, social media, all these things have gone up as coping mechanisms, that are probably gonna get laid down even harder as negative habits that people that are gonna have, that's gonna give this pandemic a long tail. And then, you know, I think the anxiety piece is gonna have an even longer tail. Some are describing this as the coming epidemic of anxiety. Right, right. What's interesting about what you just said, is this nexus between anxiety and addictive behavior patterns, right? I mean, it's logical if you really think about it, but this is something that your new book really gets into in depth, the extent to which addictive behaviors, really are, you know, a close cousin to chronic anxiety, and how that works neurochemically. Can you talk a little bit about what that connection is? Yeah, I'd be happy to. This was actually a big aha moment that I had several years ago now. So, just to set the stage as a budding addiction psychiatrist, I had a lot of patients, not only with addictions, but a lot of folks with anxiety. Anxiety and depression are the bread and butter of the psychiatric profession. Right. And I learned in medical school, to basically give people medications for anxiety. And the best medications out there, are actually in a class of antidepressants, ironically, because there aren't, you know, the anxiolytics, the benzodiazepines, are now no longer recommended as a first-line treatment for anxiety. So, the best evidence for these, shows that you need to treat about five people, before one person benefits. This is called the number needed to treat. And so as a psychiatrist, you can imagine it's not very satisfying for me to treat five people, and one person shows a significant benefit. So, I was struggling in my outpatient clinic, helping my patients with anxiety. And, you know, I was even trained in cognitive behavioral therapy. The response rate to cognitive behavioral therapy is about 50%, if you can get a good therapist, you know? So, there are a lot of barriers to good treatment for anxiety, so I was really struggling. And we were studying one of these apps that we developed for eating, it's called Eat Right Now. And somebody said, you know, "My habit pattern around eating goes like this. "I'm anxious and I eat," (laughs) you know, "Repeat."
(Rich laughs) And she said, you know, could you develop a program for anxiety? And I was thinking, "Well, you know, I'm a psychiatrist, "I generally prescribe medications." But as a researcher, you know, I knew a little something about habits. We'd been studying this for a long time. So, I went back and looked at the literature, and back in the '80s, right? This is when the Stones, this is how popular benzodiazepines were. Do you remember the song, "Mother Little's Helper"? Of course. Yes. Do you wanna sing a few bars for us? (laughs) No, I'm not going to subject anybody to my singing voice, but go ahead, feel free, Jud.
Yes. Well, I won't sing, but it goes something like, "She goes running to the shelter "of mother's little helper, "and it helps her through her day, "do, do, do, do, do, do." Yeah, so the Stones were singing about benzos, because they were so wildly popular in the '70s and '80s, and the psychiatric field was looking for new medications, so they came up with the SSRIs, you know? Prozac was, I think it was invented in '85 or something like that. So, everybody's heralding the miracle of Prozac, while the Stones are singing about the benzos. And there was this guy at Penn State who was quietly studying anxiety, his name is Thomas Borkovec. And he said, "You know, I," and he was very interested in the psychological aspects. And he said, "You know, I think anxiety "could actually be perpetuated, "in the same way as any other habit, "through negative reinforcement." And that's when all the bells went off for me, when I read that. You know, I went back, 'cause I never learned this in residency or medical school, when I saw this literature, it was pretty solid. And I was thinking, "Wow, I never thought about that. "Could anxiety actually be driven habitually?" And so I started looking at that, and lo and behold, it can be negatively reinforced, just like any other bad habit. And that's where things really took off for me, and I started exploring that both in my research, and also in my clinic. Right, in the way that an addict experiences some level of emotional discomfort, and reaches for the substance to self-medicate that anxiety, is extremely similar in that you're feeling agitated, and you then try to ameliorate that, through any number of different behaviors, right? And this is something you talk about in the book. It's less about the anxiety, and it's more about the behavior that you're reaching out to, to self-medicate. Yeah, absolutely. So I've had a number of patients, and I think I write about one of them in the book, who were referred to me for alcohol use disorder. And in fact, their primary disorder, quote, unquote, I don't like that word, their primary issue, let's say, is anxiety. And so anxiety prompts them to drink, and then that gives them this brief relief, and then rinse and repeat every day. Right. But the other thing, and this comes back to the definition of anxiety, what Borkovec talked about, was that anxiety as a noun, so that negative feeling, that unpleasant feeling or emotion, can trigger worry as a mental behavior. And I wanna highlight that, because a lot of people think of behaviors as, you know, eating, smoking, drinking, whatever. Worry is a mental behavior, 'cause we're doing something, it's just not obvious to everybody else. And that worry gives people a couple of things. One is a feeling of control, because at least they're doing something, and/or it can also distract them from that worst feeling, feeling of fear or anxiety. And so worry, as that mental behavior, can actually feed back and drive anxiety habit loops, that then, you know, when people realize they're not really in control, then they go over that event horizon into the black hole of anxiety, 'cause they get worried, and then they get more anxious and they get more worried, and you know, and it just spirals out of control. Right. I grew up with a parent who is a chronic worrier, and, you know, in the way that a virus like COVID-19 can get passed from person to person, these are emotions that travel virally, in a way that's perhaps worse than a virus, because of our social media apps, et cetera, and I know you've talked about this. But it took me a long time to deprogram, the amount of anxiety that was layered upon me throughout my youth, that made me a very afraid person. But I've come to recognize the extent to which this parent relied upon worry as basically, you know, a behavior that had some reward for her, my mother, in that it made it did make her feel like she was doing something, and it was all couched under this umbrella of love, right, as a way of rationalizing something, that was in truth, like, very unhealthy and pernicious. Yeah, well imagine a mother of a teenager. So, let's say Rich as a high school student goes out partying with his friends, and his mother worries all night, until she hears the door knob click or the garage door open, or whatever, and then she can get to sleep. Well, I'm gonna guess, that her worrying did not keep Rich safe. Mm mm, no, but it did color my worldview, and what I entertained as possible for my life. Like, it made me very conservative in my choices, like, my risk analysis was very conservative, and I think it limited me until I got enough adequate therapy, to kind of see more broadly what was actually going on. But I think what's interesting about that, it's almost, you know, I don't know if it's epigenetic, but the extent to which the anxiety or the worry or the fear that's carried by the people in your immediate environment, affect those around those people. Yeah, yeah. And it's so pervasive, that there's a scientific term for this, called social contagion. And I think like you alluded to with social media, you know, you can prevent the spread of a virus, you know, a physical virus by social distancing and masking and all those things, but somebody can sneeze on your brain from anywhere in the world,
Yeah. especially if we're going on social media, and constantly getting sneezed on. Yeah, I mean, 10 minutes before we started this podcast, I was looking at Twitter, which I shouldn't be doing but I was, and I watched the video of the the engine on the United Airlines flight from Denver to Honolulu, that like caught on fire and was exploding. And suddenly I was super, you know, I was like unnecessarily agitated. Like it's terrible to see that, and I'm glad that everybody's safe, and that that had a happy ending to it, but that caused me to enter into this conversation, in a state that, you know, I would have preferred to not be in, and I did it to myself. So, I think the lesson is we need to be more circumspect with these tools of social contagion. Yes, and I think here, you know, often people, they beat themselves up, and not saying this is the case for you, but I've seen a lot of people say, "Well, I shouldn't use social media so much," or "I shouldn't go on social media "right before a big meeting, so I can calm down," or whatever, and then they have another reason, they get in the habit loop of beating themselves up, Right.
because they can't just force themselves to stop, which goes back to this willpower myth, that's more myth than muscle. So, I think that's one important thing for folks to keep in mind.
Right. There may be other ways to help us get off social media, not just telling yourself
Right, that you shouldn't be on it.
Right, right, right. There is an interesting relationship between uncertainty and control. And I suspect that people have, you know, various relationships with their respective control issues, but those seem to be kind of intricately intertwined. When you enter into a situation, in which you feel like you don't have agency or control, that propagates a certain level of uncertainty, and somebody who has robust control issues, it seems to me, would be more susceptible to an anxious response. Does that track? Yeah, absolutely.
With the research? So, yeah, you can think of this, going back to this idea of, you know, our survival brains, the cave is a safe place because we're in control, you know, no saber tooth tigers in the cave. When we go out into the savanna, if we're just of the habitual mindset, of like, "I've gotta be in control," we can actually, that uncertainty can feel like panic, and so we move from our safety zone into our panic zone. And then of course, wildly unthinking behavior, either we run back to the safety of the cave and we stave to death because we don't get food, or we freak out and run off a cliff, or do something that's not thinking. So here, I think it's really important, to see how we how we work with that uncertainty. And in fact, instead of moving into the panic zone, this is, it goes back to the lean in, if we can lean into what's happening, we can actually move into our growth zone. So, instead of thinking, "Oh no, this is happening again. "This is terrible, this is awful," we can go, "Oh, this is different," and we can start to see this as as that FGO, the freaking growth opportunity. Right.
You know? And I love Carol Dweck's work, you know? She was a professor
Right. at Stanford, talks about fixed versus growth mindset. You know, fixed mindset is that safety or the panic, where we're in some habitual way of being, either never venturing out or always freaking out. And that growth zone, is the, "Oh what can I learn from this?" zone. Right, but the first step in that process is it not having the ability to on some level, step outside yourself, so that you can recognize what's going on? I mean, you have this RAIN acronym, that kind of speaks to that. Like most of us are on some level of autopilot, where we're not recognizing the triggers, the behaviors, the results, we're just repeating a cycle, without any kind of mindfulness whatsoever. So, talk a little bit about how you initiate that process of becoming a little bit more self-aware of what is actually transpiring, so that you can then look at it as a growth opportunity, or recognize that there's something that you can actually do about it. Sure, I think of this as a three-step process. And this actually came to me as I was working more and more with my clinic patients and with our folks in our eating group, actually, before we'd even developed an anxiety program. And the first step, is really just kind of mapping out these habit loops. So, if we can't map them out, if we can't see that we're stuck, we have no way, you know, there's no way that we can use RAIN acronyms, or anything else to get out of them, because we don't know what we're running from. So here, maybe I'll give an example, a concrete example. I had a patient who was referred to me for anxiety, and when he walked into my office, I could see that he was anxious, so that was pretty straightforward. But when I started taking his history, he started describing how, when he would be driving on the highway, he felt like he was in a speeding bullet. And so he said, that thought was the trigger that triggered him to start avoiding driving on the highway, because he would get panic attacks. And so that avoidance behavior, helped him avoid getting panic attacks, and then he stopped driving on the highway. In fact, he had even gotten a bit anxious just driving the local roads to get to my office. So, the first thing we did, I pulled out a piece of paper and a pen, and I just wrote trigger behavior result out on a piece of paper. And I said, "Okay, let's go through this. "What's your trigger?" And he was like, "Those thoughts." "What's the behavior?" "Well, I avoid driving." And then what's the result, "Well, now I'm kind of stuck, "because I'm really limited in what I do, "yet it helped me avoid having future panic attacks." So, there's a great example of just taking five minutes, literally, to map these out. So, anybody can do this, they don't need a psychiatrist just to sit down with them to do it.
Right. But that's the first step. If we don't know our habit loops, we can't work with them. And so that's what I sent him home to do. I said, I gave him, we have an Unwinding Anxiety app, I sent him home with that, and I said, "Just start mapping out your habit loops." And interestingly, I'll just say a little bit more about him, he came back two weeks later. So I said, you know, "Let's set up a follow-up appointment "for two weeks." He came back two weeks later, and he said something really striking, that I had not expected him to say, okay? And this actually leads into that second step. So, first step is mapping out these habit loops. The second step is kind of seeing how rewarding they are. And what I failed to mention, was that this gentleman was 180 pounds overweight, okay, when he walked into my office. So he also, when I took his full history, he had hypertension, he had high blood pressure, he had a fatty liver, he had obstructive sleep apnea. So, when he walks in for his follow-up visit, he looks less anxious. But the first thing he said to me, was, "Hey doc, I lost 14 pounds." Yeah.
And I said, "What?" 'Cause I was thinking, "Did we talk about weight loss? "I don't think we talked about weight loss yet. "We're gonna save that "until he worked on his anxiety." And he said, you know he saw that I was a little confused, and he said, "Okay, I was mapping out my habit loops "like you suggested, "and I realized that anxiety was driving me to stress eat, "and that stress eating was not actually fixing my anxiety, "and it was making me feel worse about myself, "because I know I need to lose weight, "because I'm at a very unhealthy weight." So, just by mapping out these habit loops, he started to see that some of his compensatory behaviors were actually not very rewarding for him. And this gentleman went on to lose over a hundred pounds, he's still going strong with that. But the way he describes it is, you know, that 14 pounds and that next 86 pounds or whatever, he said, "It was effortless, "because I didn't feel like, 'I need to lose weight,' "I was just paying attention, "and mapping out my habit loops around stress eating, "and realizing that they weren't rewarding." So, that's really this second step here, which is tapping into our brain's reward system, and helping it get updated. So, is this Dave, who has the recurring
Yes. narrative throughout the book, right? Yeah.
And if I'm not mistaken, at some point, he honks at you, driving down a busy street. So, he's able to conquer his fear of driving along the way, which was the initial thing that brought him into you, right? Yeah, yeah. Yeah, it's amazing, 'cause it seems almost too simple to be true, but very powerful. And if you kind of extend the extreme example of someone like this person, who's going out of their way to avoid the thing that's causing them anxiety, you know, ultimately leads them to become like a shut-in, right? Avoid anything that would provoke you to have any kind of anxiety response, that then creates a scenario, that's far worse than the anxiety itself. Yes, absolutely.
Right. I'm trying to square this a little bit with with 12-step, wherein there's this adage that self-awareness will avail you nothing. And here is an example of self-awareness availing you quite a bit, right? But that self-awareness has to be followed with the action. Like, you had a patient who had a level of of willingness to actually roll up his sleeves and do the work, right? Just being aware that this is the case is not enough, it was his dedication, to actually tracking these triggers, behaviors and results, that led him to kind of course correct. Yes, and I would say, so here, I would say self-awareness coupled with just some basic understanding of how our brains work, like, you know, this reward-based learning system, really gets us pretty far. And so I'd be curious to hear, 'cause I obviously, I know some about 12-step programs, working as an addiction psychiatrist, but I'm curious, this "Self-awareness avails you nothing," not many of my patients talk about that. Oh, it's interesting. Yeah, it's one of the many,
Yeah. you know, many, many catchphrases, I think, what, at the heart of what that's getting at, is the fact that you can't just passively become sober. Like, you actually
Right. have to do the steps, and you know, all the other stuff that comes with it. Like, just attending meetings, and sitting in the back, listening, isn't going to provide you with the solution. Or just coming to the realization, that you have a problem, that's important, but rectifying the problem, is gonna require you to get out of your comfort zone, and do a little bit of heavy lifting, that, you know, is gonna be unfamiliar for you, so. So, yeah, that makes sense. If I'm understanding what you're saying, it's kind of like somebody could even, that self-awareness could even perpetuate a self identification with the behavior. So, if somebody says, you know, "I am an alcoholic." I have tons of patients who say "I'm just an anxious person." And what I say to them is, "Well, let's see "if that's a habit, "or if that's a persona that you've taken on, "that you can actually let go of." And, and actually, Dave, you know, you mentioned him, he had been so identified with anxiety, you know? He had started getting anxious around the age of eight, and he was 40 when he came to see me. So, he'd been wearing this sweater, let's say, for, you know, over 30 years. When he started to reduce his anxiety, one visit, he came in to my office, and he said, "Doc, it's kind of weird. "I'm starting to feel prolonged periods "of calmness and peace and all this, and it feels strange. "So, I'm getting anxious that I'm not anxious." Right, right, right, right. It's like the person who grew up in a dysfunctional household, and is then attracted to a mate that has the attributes of that dysfunctional parent, and, of course, is in a string of really bad relationships, finally meets somebody who's healthy, and they self-destruct that relationship, because it's so unfamiliar. Like the healthy habit feels wrong until it feels right. So, there's an acclimation period, especially when identity is so deeply woven into the fabric of how this person sort of navigates and sees the world. 100%. And I remember somebody who was pilot testing an on-running anxiety program, sent me an email and said, you know, "I feel like this anxiety is deeply etched in my bones." That's how identified she was with it. And what's interesting is, that sort of, in my mind, when I hear that, I'm like, "well, that's gonna be a tough road to hoe." Like, how are you going to get that person, I mean, 'cause you're basically telling them, they have to grow into, you know, a completely new sense of who they are. Like how does that transpire? And yet the success rates that you're experiencing, you know, demonstrate how powerful this is. Well, and so I can talk about that briefly. What I would say, you know, as a clinician, I was looking for solutions. As a researcher, I'm not gonna believe anything until I see that it actually works, including my own work. You know, I'm the easiest person to fool, thinking, "Oh, I'm gonna create a program. "It's gonna work for everybody." Right. It could just be a, you know, "Oh, this worked for me and I've won, "and therefore, if it doesn't work for you, "there's something wrong with you as compared to me." So, you know, the nice thing about being a neuroscientist is I can actually study this stuff, in addition to developing it. Long story short, you know, we've run several clinical trials now. We started with anxious physicians, because they are really hard to work with. And I say that as a card carrying member, you know? We can be a pain in the ass, and I think a lot of it is conditioned, culturally, where we have to be the martyrs. You know, there's this phrase, armor up, where we have to armor up, you know, we have to take care of everyone else, but there's no time to take care of ourselves, because we could have been spending that time taking care of our patients. So, a lot of physicians don't take care of themselves, and we now see an epidemic of burnout with physicians. So, we worked with anxious physicians. It was, unfortunately, the easiest study I ever recruited for, because there were so many people that were eligible. And long story short, you know, we tested out this Unwinding Anxiety app, and after three months we saw a 57% reduction, in these clinically validated anxiety scores. We also saw significant reductions, in measures of burnout, because the two can be correlated, especially callousness and things like that. So, that was interesting. But it was a small trial, single arm, you know, we didn't have a control group. So, we got NIH funding to do a randomized control trial with people with generalized anxiety disorder. I think of these as the Olympians of worry, you know, they're really good, really practiced at worrying. We did a randomized control trial, had people do their usual clinical care, or clinical care plus this Unwinding Anxiety app, and we got a 67% reduction, in these clinically validated anxiety scores. Wow. And just to put that in perspective, so remember that number needed to treat I mentioned earlier? So, I need to treat over five patients, for one person to benefit from the medication? The number needed to treat here was 1.6. Hm, that's crazy. I mean, when you're looking at going from basically a 20% success rate, to an over 60% success rate, it's almost unheard of in your field, right?
Yeah. And this was with an app. (laughs) Right, right. Not even, you know, in-person treatment. Yeah, no, to be fair,
Wow. as part of this app-based program, I wanna give people support. So, we have an online community, that I and other experts moderate, and I lead a live weekly group, that anybody can join for an hour, and they can ask questions. You kind of ask the doc, type of thing. So, we do try to give
Right. people support, but the majority of folks just use the app, and do pretty darn well. Right, so you drop a statistic in the book. I believe it's something like 264 million people are dealing with anxiety. Is that globally or in the United States? I can't recall. I've mostly looked at data in the US, and so what I can say, and I'm terrible at remembering statistics, that's why I write them down (laughs) and then promptly forget them. But in the US, the most prevalent category of disorders, again, I don't like that term, is anxiety disorders. So, I think it's basically one in three people in their lifetime, is gonna be diagnosed with an anxiety disorder. That's just the disorder spectrum. So, you know, anxiety is pretty darn prominent. I think in the United States, those data are probably from at least the Western world, if not the US, but let's just say anxiety is pretty prevalent all over the world. Right, so, so chances are, there's a high percentage of people that are listening or watching this right now, who maybe they're not having full blown panic attacks, but are contending with anxiety, in some kind of material way, on a daily basis in their lives. So, I think it would be really helpful and instructive, to kind of walk through this therapeutic process, of how we unpack anxiety, and get people to, you know, develop that self-awareness with the tools to confront it, and create healthier responses. Yeah, I'd be happy to. So, and we've actually already talked about the first step which is just to map out these habit loops, which anybody can do. And we even put out a free resource. I think it's mapmyhabit.com, where somebody can download a PDF, that gives them a habit mapper and explains it, and gives them worksheets, where they can just map it out on their daily basis, which is something, you know, it's free, anybody can do that. And the idea is just to help people start to develop that first level of awareness. "Oh, I didn't notice X habit." And often there can be habit that builds on habit, that builds on habit. So, after that first step, you know, we talked a little bit about the second step, about tapping into the reward value of the brain. This step is somewhat counterintuitive, because and this may, I'd love to hear your perspective on this, this may be this Western mindset of just do it, where, "Okay, I've identified the problem. "Now I'm going to fix the problem." Okay?
Right. If we could tell ourselves, you know, if we could think our way out of anxiety, I would happily find another job. It's just not how our brains work. Right.
Right? So, there's this idea of just telling ourselves to stop being anxious. Did you ever see, there was a Bob Newhart skit from his show in the '70s called "Just Stop It." No, I don't think I ever saw that. Okay, so there's this five minute skit where this woman walks into his office, as this therapist's office, and she says, you know, "I have this fear "of being buried alive in a box." And basically, the skit, where he just leans over his desk, and he says, "Just stop it," you know? And there are various iterations of this, and then eventually he says, you know, "Just stop it or I'll bury you alive in a box," you know? So, that that's the concept around anxiety is, you know, "Oh, if you're anxious, just stop it," you know? Same with addiction. Yeah, yes, it's no different. "Just cut it out, "stop doing that thing
"What's wrong with you?" "that's killing you." Yeah, "What's the matter with you?" And that- "You a weak person." Right, it opens it up to a broader conversation about self-will and the inability to leverage self-will to confront these problems. Yes, yeah. So, basically, at best, willpower can be depleted throughout the day. At worst, and I think the science is leaning in this direction, we may not really have a whole lot of willpower, it may be more a myth, than muscle. And there's a fair amount of research suggesting that, you know? But these debates have been going on since the Greece, ancient Greece, even probably before that, you know? There was this relief on the Parthenon about this writer and this horse, you know, and trying to tame the wild horse. The horse was passions, you can think of anxiety that way. And the writer is reason, you know? And so, we haven't gotten any better at taming our passions, whether they're addictions or anxiety. So here, what I would say as well, what we do know in modern day, is a little bit of neuroscience you know, that wasn't known back in ancient Greece. And one of the pieces that we do know, is that reward-based learning is the strongest mechanism in our brain. So why not start there, rather than the prefrontal cortex, which ironically goes offline when we're stressed or we're tired, or, you know? That's where the HALT acronym comes from, you know, hungry, angry, lonely, tired. That's when our prefrontal cortex goes offline. So, if that's not accessible or useful or strong enough, why not tap into the reward-based learning part of the brain? And it too, is relatively simple, and the research has been known for decades about how this works. So, basically there are these two researchers in the '70s, Rescorla and Wagner. They developed this model called the Rescorla-Wagner model where we'd developed this, basically, a prediction value or a reward value of different behaviors. And the way this is set up, is to help us not have to relearn everything every day, you know? So, if given a choice between two behaviors, we don't have to try the A, and then try B, and then compare the two, you know, we've tried them enough before, that we say, "Oh yeah, I'm gonna do B, "because I know it's more rewarding than A." So, our brains are gonna pick what's more rewarding. So, for example, I don't know, tying our shoes, let's say A is not tying your shoes, B is tying your shoes. You realize if you tie your shoes, you don't trip, it's more rewarding, we just do it as a habit, okay? So, the only way to change a behavior, is by updating that reward value, and that reward value can get laid down for a long time. I dunno, we could use eating or smoking as an example, right? So, think of all the times we've eaten cake, you know, birthday parties, celebrations, all these things, that gets laid down as this rewarding behavior, and then we see cake and we eat cake, 'cause our brain says that's rewarding. The only way to change that, is to bring awareness to it. And the Rescorla-Wagner model, talks about these terms that sound fancy but they're pretty straight forward, positive prediction error, or a negative prediction error. So, using cake as an example, if we see a piece of chocolate cake, and we haven't had it from a certain bakery before, we expect it to have, you know, like, "Oh, I like chocolate cake." We expect it to have a certain reward value. Then we eat it and we go, "Oh my goodness, "this is the best chocolate cake I've ever had in my life." And suddenly there's this positive prediction error, because we predicted it to be of X reward, and it was actually X plus a thousand, you know? It was much more rewarding. So, we're like, "Oh, I gotta remember that bakery." And we learn to go back there for a good chocolate cake. Let's say we go to the same bakery, and they put a bunch of salts in the recipe, instead of sugar, you know, oops. And we eat it and we go, "Ugh, what idiot?" You know, "Boy, this is not very rewarding." And we get this negative prediction error, that says, "Man, don't go back to that bakery again," okay?
Right. So, that's how reward value is updated, all based on one thing, which is awareness. We have to pay attention to the behavior, or we're just gonna keep doing it. Right. And you can see how this applies to addictions. So, for example, in our smoking program, we have people pay attention when they smoke, and they realize that cigarettes tastes like shit. and they stop, you know, that reward value goes down. We did a study recently with our Eat Right Now app, where we actually found that within 10 to 12 times of people paying attention, we give them this craving tool in the app, to really pay attention as they eat, that reward value drops below zero. So, it doesn't actually take that long to update a reward value, whether it's a addiction like cigarette smoking, or even a habit like over eating cake. Right, that's super fascinating. I'm just thinking about, you know I can only couch this in my own experience. And I'm thinking about my alcoholism, and the self-awareness that I would have before picking up a drink, knowing if I pick up one, that ain't gonna be the only drink, and God knows what's gonna happen, but 100%, I'm gonna at a minimum, I'm gonna wake up feeling terrible, and there's the possibility that I'm creating, that all kinds of havoc is gonna ensue, Yeah.
that's gonna have a very negative impact on my life, and yet I make the choice anyway, there's a powerlessness over it. So, maybe that's a little bit of a distinction between somebody who's fully addicted to something, versus an anxiety response, because the counter to that, you have an example in the book, of the woman who does the very thing you just mentioned, which is goes to the bakery, is used to getting some kind of sweet and savory food. She opts for the blackberries instead and she feels better afterwards, and so she's creating a new reward mechanism. And I think piggybacking on top of that, and this is what I would like you to get into a little bit, is she's opting out of that kind of vicious cycle that takes place, after you've made the choice you know you're not supposed to make, that makes you feel bad, and then you beat yourself up, and you just continue to dig that hole deeper. So, she arrests that cycle, she doesn't have the shame reaction, she actually feels better physically, hence she's more likely to make the correct choice the next time, she's carving that new neural pathway. Yes, yeah. And that's really the secret sauce in terms of learning anything, whether it's letting go of an unhealthy habit, or even fostering a healthy habit, is to reflect back on what it was like last time. So, as you described, you know, that playing the tape forward, "What am I gonna get from this?" Well, the only way we can project into the future is based on past experience. And if anybody has enough experience, let's say drinking to excess, that they can clearly see, you know, 99 out of 100 times, I'm gonna wake up with a hangover, and, you know, with a worse relationship with my partner or whatever, then that starts to take hold as a reduced reward value. And if they can recall that, then their brain says, "Do I really wanna have a drink?" And the same thing is true for the eating example. It's like, "If I overeat again, "what am I gonna get from this?" So, I actually like the very simple, I have folks in the step two of the book, just ask the simple question, "What do I get from this?" Right. And again, it's not intellectual it's experiential. Yeah, yeah, yeah. Like try to really connect with the emotional experience of following through on that unhealthy behavior. And one of the things that I've learned in recovery, is called playing it through. And it's not, it's about having a longer view on like, "Okay, if I'm gonna drink," like, "Oh, I'm gonna ameliorate this emotional feeling "of dis-ease that I'm experiencing right now. "That's what's triggering me to do it." But play it through like, "Okay, then tomorrow "I'm gonna wake up and feel like shit, "I'm not gonna be able to do my job, "or study or whatever it is that I have in store. "My partner is gonna give me a little bit of side-eye." You know, like just like play it all the way to its conclusion, not just the reward, but what's on the other side of that reward. Absolutely, yes. Yeah. A big part of rewiring this reward system, has to do with not just mindfulness, but also curiosity and kindness. So, I wanna spend a couple of minutes talking about curiosity. And what I loved about what you wrote in the book, is there's a distinction, there are two different kinds of curiosity. There's deprivation curiosity, and there's interest curiosity. 'Cause you hear a lot about curiosity in the mindfulness space, "Just be curious." But it is a little bit more complicated and nuanced than that. It is, you know, and I'm laughing because I didn't even know there were two types until I think it was about two and a half years ago. And I was just, you know, you're probably this way, I was just a naturally curious kid. Like, I loved to learn how things work. I used to destroy my toys, to see how they worked.
Uh huh. And so I just thought, "Oh curiosity, "yeah, there's one flavor to that." But it turns out there's a fair amount of science suggesting that there are two types, and it's helpful to differentiate them, because they both work in different ways. So, the first flavor is deprivation curiosity, which is basically a lack of information. So, when we don't know the answer to something, you know, this is our brain seeing, "Oh, there's uncertainty here." It is driven literally in a survival mechanism way, same type of urges that we get, when we go to get food or whatever, we're driven to go get the answer to that. You know, whether it's a trivia question or, you know, where is water, you know, 'cause I don't know where water is. And that can be negatively reinforced. So, the trigger is, "I don't know the answer." The behavior might be, you know, if it's a trivia question, we'd go to our weapon of mass distraction and look it up. And then the relief comes from knowing the answer. So, I think of this as destination curiosity. You know, once we get to the destination, we're satisfied, but until we get there, it's called deprivation because we feel deprived, and that deprivation drives us, to go and seek out that information Right, like a heroin addict in a new city. The deprivation curiosity would be like, "Where am I gonna score?" You know?
Yes. And the level of intentionality and determination that gets channeled into that curiosity, could power a nuclear, could power a city, right? Like that person is gonna figure it out and find their heroin. Not such a good curiosity. Yes, exactly, yeah. Don't get in their way, basically. (laughs) Yeah. (laughs) They will be like that bus, and you'll be hit by that bus. Yeah, 100%. All right, so distinguish that from interest curiosity. So, the other flavor is interest curiosity. And in contrast to the destination, I think of this as the journey, where we are just finding that it's very joyful to discover new things to learn, right? So, it doesn't matter, there's no destination in mind, we're just happy to learn new things. It's kind of like being in our growth zone. When we can go, instead of go, "Oh no," we can go, "Oh, what can I learn from this?" This can be in any day situation, where we're out of our comfort zone, or it could be when we're specifically, you know, learning a new topic, or learning some new sport, even. It's like, "Oh," you know? Learning some new sport, and we're struggling, we can go, "Oh, this sucks, this is terrible." We can go, "Oh, well that was different, " you know, "let me try this," and we can be open to that experience. And it feels very, very different. So, instead of it being negatively reinforced, so the deprivation is driven by this urge, you know, "Get out of my way, I gotta find this," the interest is very much more open, where we are curious and like, "Oh," you know, and that actually puts us in growth mindset, so we can actually learn a lot more, rather than just, "Okay, here's this one, you know, "I need to find where the heroin is. "Now, I found it, done." We haven't really learned a whole lot except that one specific thing. Right. I would think that that type of curiosity, and the extent to which somebody is able to develop the open-mindedness required to explore that, is gonna calibrate pretty closely with how much that challenges their core values, or their identity. I mean, this is something that I talked about in a different context with Adam Grant, just like how do you have conversations with people that see the world differently? Well, one of the things you do is you lead with curiosity. If you're in a situation in which that person's worldview is so different from your own, that it feels like a threat to who you are, or how you see the world, it's gonna be more difficult to marshal that level of curiosity. So, how does that map onto anxiety? If you have a patient or an individual, who is so self identifying with their anxiety as part and parcel of who they are, I would imagine that that's going to be a tougher case than somebody who's relatively less aware of the extent to which anxiety is driving their behavior. Yes, so I think even going to that example of trying to have a conversation with somebody, you know, if we are trying to put ourselves in their shoes, and truly understand where they're coming from, as compared to how, you know, we don't have a destination in mind, we're not trying to beat them over the head with our point of view, and keep them yelling at them until they acquiesce, or, you know, that curiosity itself, going back to social contagion, can be contagious, where they see, "Oh, this person "really wants to understand who I am." And of course, people love to talk about themselves, and so you can actually capitalize on that piece, where, you know, we're sneezing curiosity on that other person. And so that can be translated into the clinical setting, where as a therapist or as a psychiatrist, it's really helpful if I am truly curious about my patients, as compared to them walking in the door, looking anxious, and then I just peg them as, "Oh yeah, you're anxious. "Take this medication." Right.
Wow, that's not gonna be that helpful. So, if I'm truly curious, and the nice thing about people is everybody has their own story, so there's tons to be curious about. And I'm sure you're this way, it's just like hearing people's story makes my day, it just fills me with energy, because I'm learning something about somebody, you know, and everybody has a unique and interesting story. So, it starts there as, you know, with the therapist, or even having a conversation with somebody. It's like, "Oh," you know? So, when somebody walks in my door and they're anxious, if I can sneeze curiosity on them, it helps them open up to starting to see their own, you know, their own habit loops around anxiety, for example. Right. And then the next thing I can do, once they've kind of gotten a taste of that, is I can give them specific things to practice, to awaken that curiosity. Because we all have it, it's not like something you have to buy at the store. You know, "I'm a little short, "I have to go pick that up at the store." This is about just awakening something that we already have, that's our own natural capacity. And so simple things like if somebody is anxious, we even have a tool built into our Unwinding Anxiety, the app, to do this. We have somebody feel into their anxiety, and then ask themselves, you know, when they feel into where they feel it strongest in their body, ask themselves, "Is this stronger on the right side "or the left side of my body?" And the idea there is to go, "Hmm, well, I don't know." It doesn't matter what the answer is, but that, "Hmm" is that first hint of curiosity that they're starting to awaken curiosity, instead of being sucked into their anxiety. And what this can help do, is it's like the observer effect in physics, you know when they were trying to measure the mass of an electron, they would hit it with photons, with light. And by hitting it with photons, you're actually changing the velocity and therefore the measurement. So, they call this the observer effect. By observing, you're actually gonna affect the results. And the same thing is true in psychology or psychiatry. If we are very identified with our thoughts and emotions, it's hard to change them, but if we can observe them, by observing, we are less identified. And so we can start to see, "Oh there's anxiety. "Oh, that's on more on the right side or the left side "of my body." So, we can see, start to see it more clearly, simply through that awakening process, and that's truly fostered by curiosity. It helps us be able to step back and observe more. Hmm, yeah. And it seems that it would follow that curiosity works as a salve to the shame response, to experiencing these types of emotions, right? I'm imagining the person who is in, perhaps they're having a panic attack, or some kind of anxious response. They don't really wanna reflect on it because then they start to feel bad about it and themselves. So, I've seen people just, they shut down emotionally, or they avoid any kind of conversational confrontation about that, because it provokes so much difficult emotion around it. But curiosity seems to just kind of allow that to evaporate. It creates space, right? And so maybe that's where the kindness piece comes in? Yes, I think of these two, so curiosity and kindness as being complimentary buckets. And so there are many pieces or things in each of those buckets, that can help support each of these. So, for example, with kindness, gratitude is a great way to reflect on kindness, whether it was the kindness of others or whatever, that helps us tap into that feeling of kindness. So, on a broad scale, my lab's actually done a study, where we queried several hundred people, to see where on the reward value spectrum, different emotions are, or different mind states, and we found uniformly, probably not surprisingly, that anxiety, frustration, anger, all feel less rewarding and more closed down, than I think kindness and curiosity, basically. And so connected, you can think of connection, as being, you know, in the bucket of kindness, let's say. So here, when we look at this, uniformly, kindness and curiosity feel more open and expanded than feeling anxious or disconnected or whatever, or being, you know, being mean, or being the object of somebody's anger. So here, just being able to tap into what it feels like to have kindness bestowed upon us, or to be kind to others, and truly being kind in a selfless way, not thinking, you know, "I'm gonna hold the door, "so she's likely to smile at me," or whatever, you know, not looking for anything in return. So, that's where these two share this overlap of openness, of connection, of expansion, that is just more rewarding, because it feels better than being closed down or disconnected. Is there a difference between kindness towards others, versus self-kindness, in terms of how that affects someone's anxiety? I would say pragmatically, it can be more challenging for a lot of people to tap into the feeling of self-kindness, but the feeling itself, whether it's kindness toward others or kindness toward ourselves, that expanding feeling is the same. Right, right. It seems that a gesture of kindness to another person, irregardless of motive, still has an impact. And it could be just a simple gesture, but to do that to yourself is very unfamiliar for a lot of people, they feel like it's indulgent, or they don't deserve it. It seems like it's a more complicated web to unravel. Yeah, I think it can be. And I see this a lot, when people are working with their eating habits, where they mix up self-indulgence with self-kindness, you know? And so they have a bad day and their habit is to stress eat, or eat some ice cream at the end of the day. And someone, you know, a lot of people say, "Well, how do I know whether it's, it feels like "I'm just being kind to myself "by eating that tub of ice cream." And I say, "Check in with yourself, "how kind it is that?" You know, "What do you get from that?" And, you know, typically it's they numb themselves for a little bit, but then they feel guilty, and they don't feel, you know, they get the gut bomb and all of these things. And when they add up the reward value, they can clearly see, "Oh, that's self-indulgence, "that's a habit," versus, you know, "I've had a hard day." And then they can ask themselves, "Well, what do I need?" You know? Maybe a little bit of ice cream but not a whole tub, you know? Maybe a little bit of chocolate. And when they really pay attention, they can actually find that pleasure plateau, where, you know, it's just enough, and then they can stop, simply by bringing awareness to that. And so I think that's one of the big challenges for people, is to differentiate that self-indulgence versus the self kindness. Right, and I think built into something that you just said, which is super important, is that no matter what behavior, errant behavior you're indulging in, you are getting something out of that. You are being rewarded, right? Like, it's not all bad. There's a reason why this is locked in for you. And so the process of reconfiguring that whole thing, is identifying that reward. I mean, it goes back to your paradigm here, but understanding like, "Oh, I eat ice cream, "because, you know, I hate myself." Well, no, actually it is doing something positive for you in a certain way, that also leads to negative effects. But recognizing what that positive thing is, I think, is an important step. Absolutely. And that actually leads us to the third step, which is, you know, for a lot of us, that's been the plateau of our pleasure, of our, you know, of a reward, where we think excitement or eating ice cream, or binge watching Netflix or whatever, is the peak of experience, you know? But there is such a thing as too much of a good thing, right? We can't go on vacation forever. We can't have sex forever. We can't just keep eating ice cream forever, you know? Our body says "Enough!"
Uh huh. So here, we can learn to see not only how unrewarding some of, you know, when we peak at that pleasure plateau, and then start going off the other edge, we can see how unrewarding these things are, including habits around guilt and all these things, which are echo habit loops, typically, on top of these other habit loops. And then we can go back to that brain paradigm and give ourself something better. So, I think of this as the BBO, the bigger better offer. So, our brain, again, setting up reward hierarchies, if it starts to see that one behavior is not as rewarding, there's that negative prediction error, it's gonna say, "Okay, give me something better." And this is where kindness and curiosity come in. So, we can, when we're kind to ourselves, versus beating ourselves up, which feels better, you know?
Right. When we have a fixed view versus being curious in a conversation, which feels better? Which one helps us feel more connected with the other person? Which helps us learn something or discover something new about that person? To our brains, literally, it's a no brainer. You mentioned bringing mindfulness to all of this, which is kind of like the umbrella component to all of this. I think for a lot of people, we talked about this extensively last time you were on, everybody should go back and listen to that episode. But for a lot of people, that lands kind of in an esoteric space, like what does that mean? Like, "Oh, bring mindfulness to my bad behavior pattern." Like, walk us through what specifically you're talking about, and how that can be helpful. You know, less and less these days, I use the term mindfulness, because it's a concept, right? It was actually from this old term, Sati, which means to remember, and you're thinking how does "to remember" have to do with, you know, paying attention and all this stuff. So, in modern day, there are many definitions of mindfulness, you know, Jon Kabat-Zinn, most famous, I think, in the Western sphere, for giving this definition, of paying attention on purpose, in the present moment, non-judgmentally. Well, honestly, that's a pretty long definition that could trip people up along the way. What does it mean to be nonjudgmental? So here, I like to break it down into its element components, and there are two, you can think of this as two sides of a coin. One is awareness. We all know what awareness is, right, we're either aware or we're not aware. And the other you've already touched on, which is curiosity. And so you can think of the positive framing of non-judgment as curiosity, being curious, not jumping to conclusions, not assuming we know what's happening, truly bringing a fresh perspective. Which is why in a lot of the Buddhist circles, you know, they talk about beginner's mind in Zen, or they talk, in vipassana, they talk, vipassana literally means seeing clearly, where we've taken off our subjective bias glasses, where we see the world a certain way, we've taken those off, and we're just seeing things without any of those biases. I want to pivot and talk a little bit about teens. There is an epidemic of teen anxiety going on right now. I've got a 17 year old daughter, who's having an unbelievably difficult time with the pandemic, and having to do all of her schooling on Zoom. We tell our kids, you know, "Get off the screens," now it's "Get on the screens," it's very confusing. My daughter's an extrovert, she's unable to see her friends to the extent that she would like, she doesn't have the freedoms, that perhaps she would have, if things were a little bit different, and it's taking quite a toll, and we've been struggling with trying to figure out how to, you know be of service to her in the most productive way. So, I'm interested in whether you have any experience working with teens specifically, or what it is about the teen experience that perhaps is a little bit qualitatively different from maybe, you know, people like you and I. So, we've done a little bit of research with teens, for example, teenage smokers, and we've done a little bit of pilot work with our Unwinding Anxiety program to make sure it was accessible to teenagers, but by no means am I an adolescent psychiatrist, so I just want to start with that. What I can say from my own experience as an anxious teen, you know, we moved around a bit when I was a kid, and that's can be challenging, (laughs) you know, in terms of being anxious, going into a new school, you know, not knowing anybody and all that stuff. What I can say is that it's really, really challenging. But what I can also say is that here, you know, I think kids are actually best, and I mean, younger kids in particular, are really good at being curious. And I think somewhere that starts to get, I'm gonna use the word, beaten out of them, but that's probably too strong, but somewhere as we move toward adulthood, you know, we're told things like, you know, "Make sure you know everything," you know, "Try to act like you're in control," you know, all this stuff, that actually gets in the way, or thwarts our natural curiosity. You know, there's not a lot of reward for being curious. Although if you actually look at it, the curious people, the authentic people, tend to do pretty darn well in life. So here, I would say teenagers are super interested in knowing themselves. I think that's where a lot of adolescence, you know, is really focused, is like, "Who am I as a person? "How can I differentiate myself?" You know, whatever, at least in the Western world. So here, I would say helping teenagers foster their own curiosity, and in particular, you know, they love to learn how their own minds work. And I would even add to that, if there's a pain point, like anxiety, that can be a doorway in that's nonthreatening, 'cause they're hurting, they're looking for that pain reliever, to say, "Oh," you know, "let's help you understand "how your mind works in general, "how everybody's minds work." So, that gives teenagers kind of a window into the world, and then they feel like they're a little more control, 'cause they can see how the world works, but also give them a window into their own minds, and their own anxiety, where they can not only work with their anxiety, but work with themselves, learn how to live happier, healthier lives. So here, I would say helping foster that curiosity, by being truly curious as parents, not always easy to do, but being truly curious, and not jumping to conclusions, might be a really good place to start. Mm, yeah, that's helpful. I mean, I just, at times feel powerless, I can't solve the problem for her, and we're trying to figure out what the best way of communicating with her is. But there's also a lot of hormones going on, like it's a very volatile situation at times, as anybody who's parenting a teenager can probably relate to. Sure. So, I think it's a common thing. Thank you for that. You mentioned at the beginning of the conversation, performance anxiety, and that perhaps we'd pivot back to that. So, maybe we could talk a little bit about that for a few minutes? Yeah, I'd be happy to. So, I've gotten so many questions when I do workshops or retreats, or even in our Unwinding Anxiety app, about, you know, "Well, if I'm not anxious, "am I not gonna be able to get through the day "or perform at a meeting or, you know, in music, "or sport or whatever?" And so I went as a researcher, you know, I wanted to actually see what the research shows. And it turns out, I read this very interesting review article from 2015, that's titled something like, you know, "The Yerkes-Dodson Curve: From Legend to Law" or "From Law to Folklore" or something like that. And what this review article highlighted, was that many people have heard of this curve, Yerkes-Dodson law. I don't know if you've heard of it, but it's, okay.
Mm mm. So, 1908, these two researchers, Yerkes and Dodson were studying Japanese dancing mice. Don't ask me why Japanese dancing mice, but that where they were studying. And they found, that it was like they were measuring "Goldilocks," for some reason. So, it's like, "I'm going to shock them a little bit, "a medium amount or a lot, "and see how well they perform in a maze," or some measure that they could look at. And of course, you know, if they shock them a medium amount, they did the best. And so they concluded that, you know, a moderate amount of arousal, is gonna help these mice perform well in a maze. Now, I don't know how they would measure things like motivation, 'cause the mouse is like, "Eh," you know, when you shock them a little bit, or they're like, "Dude, that hurt," when you shock them a lot. But anyway, that was 1908. Nobody really paid attention to that paper. It was cited like four times in the next 50 years. Yet this very famous psychologist in the 1950s, Hans Selye, in an address to some conference, he gave a talk where he speculated without any data, that anxiety might help improve performance, in the same way that this arousal piece in Japanese dancing mice did. And then one of his old students took it and ran with it, where he took rats and he used holding their head under water, as the arousal or the stressor. And the longer he held their head under water, the worst they did. And again, I don't know how he accounted for them, like, just catching their breath before swimming, but that was his experiment. And what he did, was that he used the terms anxiety and arousal interchangeably. And he said, you know, "This irrevocably, "or, you know, undeniably, "says that this Yerkes-Dodson law," he called it a law, "was true," okay? So, this sets the stage, you know, still relatively quiet, and then the internet comes along, okay? So, I think it was before the year 1990, this Yerkes-Dodson paper had only been cited 10 times. And then between 1990 and 2000, if I've got this right, it was cited a hundred times. And then between 2000 and 2010, it was cited over a thousand times. Wow. And people were writing books about this, and saying, you know, you need to have some anxiety to perform well. Yet this review article also highlighted, when you look at the data, 4% of studies suggested that increased anxiety improved performance, that, you know, "Goldilocks" piece, and 10 times that number, it was over 40%, suggested that there was a direct, inverse relationship, more anxiety equals worse performance, regardless of how much anxiety there is. And you know this yourself, and I think anybody that looks at this, when you're performing your best, you know, you're in flow. I think that that is the optimal performance. And anxiety is not within miles when we're in flow. Yeah, I think that's 100% correct. I mean, first of all, is there a difference between arousal and anxiety? 'Cause I do feel, well let me just say this, part of, like, I sort of self identify with some level of anxiety, as being a precursor to performance. I'll approach a podcast in the same way that I would approach a swim race as a kid. And if I, you know, a little bit of butterflies, like I'm excited, that tells me that I care, that this is important to me, I want it to be good. All of those things are information that help me feel like I'm in the right place at the right time. But if it tips over and it's a little bit too much, suddenly I can't think straight, I can't find the words, or my body isn't doing what my brain tells me to do. And I've often wondered like, is this necessary at all? 'Cause I know, as somebody who's done a little bit of public speaking, more often than not, I get up on stage, and I have tremendous performance anxiety, and I don't deliver on the level that I know I'm capable of. And then every once in a while, like I don't care, or like I'm just super casual about the whole thing, and I go up and I'm very relaxed, and those are always the best performances. So, I think for me, I've spent a lot of time thinking about the story that I've crafted, around that arousal state, and how important it is, when in truth, I'm not sure it's really relevant at all. And perhaps it's undermining me. Yes, and I would agree. And that perhaps it's undermining you, is an experiment that you or anybody, or any of us can do, right? This goes back to something that my old PhD mentor used to say. Lou Muglia, great guy. He used to say, you know, "Jud, is it true and unrelated, "or is there actual causal connection?" And so we can think of performance anxiety, we get anxious, true, we perform well, or you're describing how we might not perform as well as we hope, but let's say we perform well, and then our brain makes this causal inference, that says, "Oh, that anxiety is what made me perform well" when in fact we don't have any causal evidence that that was true. And yet we might even be able to tap into evidence to the contrary, like you're suggesting. When we're relaxed and go into a performance or whatever, we tend to do better. I love, there was a performance at the, was it the 2018 winter Olympics? Chloe Kim, who's a snowboarder on the half-pipe, she rocked it and got the gold medal. And she was just so relaxed when she did it, you know? It was like, "Wow." And I caught her social contagion, when she was doing, you know, I've never snowboarded in my life, but like I could catch that. Or if you look at Usain Bolt, you know, when when he used to be cruising past people, he had this shit eating grin on his face. 'Cause he it's like he's having so much fun, you know? Right. That's when we perform our best.
He's connected to the joy. Like the problem that I run into, is that I have a certain level of perfectionism, that works at cross purposes with my goals. And I can be a bit of a control freak, and I'm a grinder. And so to use the podcast as an example, you know, I wanna be as prepared as I can possibly be, and I wanna feel like revved up and excited to go. And if I'm not experiencing that internally, then the story that I tell myself is "You didn't work hard enough," like, "you're not earning this." Like I have to be in some level of pain, you know, that's telling me like, "Okay, you've you've exerted yourself appropriately. "You're rising to the occasion." And it's all bullshit, and I know that, and yet it's so difficult for me to counter program against that. Like, if I just waltzed into this podcast to talk to you, it was like, "Yeah, I didn't really look at his book, "but like, you know, I know I could talk to him, "I've done a bunch of these podcasts, it'll be good," I feel like I'm not doing you an adequate service and I'm not respecting the audience. So, I feel like I need to experience suffering in order for it to be good. And I know intellectually, that those two things don't necessarily calibrate, and yet I'm powerless to change it. So, I think that's a great example that we could use to kind of highlight these aspects of how to change behaviors, whether it's anxiety or anything else. So, for example, if you were unprepared for your podcast, which I've never heard you be, and this is one reason I love talking to you, is- Which is why I continue to do this, because everyone's like, "You're so prepared." So, then I've set the bar at a certain level, right? And I have to live up to that, I put that pressure on myself. And I'll experience shame, if I can't live up to that, Jud, what am I gonna do? So, let me ask you this. When you feel shame or when you have all that anxiety piece, does that actually help you prepare better, versus when you are just truly interested in the subject matter, and you're like, "Oh, this looks like an interesting book"? No, but I will say that, you know, that pressure will get me to do the work, you know, because I want to avoid the sensation of feeling unprepared, because that's very uncomfortable for me. Yeah, yeah, so that's that negative reinforcement. If the behavior is coming unprepared to a podcast, and then you can't really get an in-depth into a conversation, which is I think what you're really great at doing, then that negative reinforcement says, "Ooh, that didn't go so well, "you need to be more prepared next time." Yet here, you can ask yourself, and I'm not trying to give you advice, but I'm just using this as a hypothetical experiment, is, you know, "Okay, so the anxiety helps me prepare." What if you cloned yourself and you prepared through curiosity. Would that get you just as prepared, and would it be less painful in the process? Does that make sense? Yeah, I'm sure it would be. And that would be that new, healthier behavior pattern, that's so uncomfortable, right? And that's the work, but it's not like I wrote performance anxiety down in my notes. Like this was not on the list of things that we were gonna talk about, but this is what's coming up, and this is probably the most fun and the most, you know interesting part of the conversation. So, I have the awareness that when I can let go of what, you know, trying to direct this whole thing, that I make the space for it to be something better than I would have originally anticipated. But that leap of faith, and faith is something you talk about in the book too, like you have to have that kind of faith that there's something better on the other side, if you're willing to like release your hard grip on your way of doing it, because it's the way you've always done it. Well, and I think that's just bringing this to one aspect, I don't think you're naming, so I will name it, which is authenticity and wisdom. So, when we try to control things, we have this closed down view of the world, and we try to, let's say you're doing a podcast, you're trying to force answers, or trying to force a great quippy line or whatever- Because I don't want anyone to find out that I don't know what I'm talking about. Yet, you're a curious, and these podcasts are not about you. This is why I love listening to your podcasts, I'm not just blowing smoke. It's not about you talking about your experience all the time, and letting the guests like say things here and there to support what you think about yourself in the world. This is about you truly being curious and having a really interesting conversation. And you've got the wisdom, from having done this a bunch of times, to know that that always works better than the other alternate. Except I just did make it all about myself for a couple of minutes there. (both laughing) I did, for the record,
Right? I made it.
Yeah. As an example.
Yeah, yeah, yeah. Yeah, but it's instructive for me, because it helps me develop greater self-awareness of the triggers, the behaviors, that are leading me awry, what's beneath the anxiety. Like, if I try to excavate what is driving me to behave in this way, it's that I want to create the best podcast that I can, I wanna equip myself responsibly, I wanna be liked, I want Jud to respect me, I want the audience to receive, you know, there's a lot of like infantile emotions baked into that as well, like, being a people pleaser or what have you, you know, that are also a mountain that I need to climb, in terms of self-esteem et cetera. Yeah, and all of that begins with awareness. You know, it comes back to just being aware of those things. But not just being aware, you know, like you talked about right at the beginning, but being aware and knowing how our minds work. Right. Then it inspires us to climb the mountain, rather than seeing it as a grueling slog. Mm, I wanna round this out in a couple of minutes, but I can't let you go without talking a little bit about breath work, and how breath work can be really beneficial in this process. Sure, so I think there are a gazillion ways to talk about breath work, you know, whether it's yogic or mindfulness or, you know, whatever. But I think of breath work in particular, as helping develop curiosity, where, you know our breathing is generally a neutral object unless we have COPD or some other, you know, asthma or something else that affects our breathing process, where it can, or panic attacks sometimes, that, you know we can associate breathing shallowly and rapidly with anxiety. But the breath is something that we're all doing all the time, unless, you know, bigger problems if we're not. And we can use that as an anchor to keep us in the present moment. So here, I think of helping foster that awareness and curiosity, through something that's neutral and always changing. So, not only can we use curiosity to help us anchor, you know, I like to have, especially students who are just starting meditating or whatever, I have them ask themselves, "Well, how do I know that I'm breathing right now? "Hmm, what's letting me," you know? And so that awakens their curiosity, not like, "Hey, pay attention to your breath," you know, "blah, blah, blah, count to 10," or whatever. "How do you know that you're breathing?" I'm doing this right now. Well, it's my diaphragm, I'm feeling my abdomen stick out. That's what's telling me most prominently right now that I'm breathing. And so that awakens the curiosity. And then we can use that curiosity as an anchor and ask ourselves things like, "Well, what are the sensations, "that are letting me know that I'm breathing as we breathe?" And we can even ask questions, like, "How do I know you know, is this a long breath "or a short breath? "Is it deep or shallow?" 'Cause we don't know what the next breath is going to be. Our body is just doing regulating itself. And so that can foster curiosity. It can also anchor us in the present moment. It can help us see that things are constantly changing. And with that anchor, it can help us start to see when our mind gets lost in a thought pattern. So, for example, related to anxiety we get lost in a thought where we're sucked into it, we're identified with it, we're lost. Well that anchor can, it's like that ship, you know, yanking on the anchor when the winds blow, boom, "Oh, oh, I'm lost." And then we can wake up. Without that anchor, we're just adrift at sea. So, I think of breath work in that way, as one way to help us really start to anchor in the present moment, stay more present, see that things are constantly changing, and also start to see how identified we are, with our thoughts, emotions and body sensations, and start to be able to have a greater perspective where we can observe them. And is there like a specific protocol that you could share with people? Or is it more of just an amorphous paying attention? I think, well there are many different techniques to do this, and each person has to find what works best for them. Right. And out of full disclosure, I spent probably 10 years banging my head against the proverbial wall, trying to focus on my breath. I would even, you know, my first silent meditation retreat, you know, for seven days, right, silence. By day three, I was crying uncontrollably, on the retreat manager's shoulder, because, you know, here it was. So, I could make it through college, I could get into medical school, but I couldn't pay attention to my breath. And so the first thing I would say to people is this is not about that forced, you know, willpower-based paying attention to your breath, which is what I was doing. That not the way to do it. It's really about curiosity. And I would say, you know, finding something that helps us be curious, say, about the breath as an anchor, but we can also use other physical sensations in the body, we can use hearing as a anchor, you know, for some people that's easier. So, finding whatever anchor it is, that helps us be curious, and then, you know, awakening that curiosity, and using that curiosity to explore our own sensations. So, just like I was saying, you know, it could be as simple as "How do you know that you're breathing?" And then, you know, follow your breath and just be curious about when the in breath ends, be curious about how long that pause is, and then be curious about when the out breath starts and when it ends. So, those can be anchor points as we explore, you know, what are these physical sensations, that help us stay present and curious? So, it could be as simple as that, like, having these anchoring questions, that layer on top of this simple but not easy practice of just paying attention, to these changing physical sensations, that let us know
Right. that we're breathing. One of the things that I talked with Andrew Huberman, neuroscientist, was the way in which you can use eye movement to kind of essentially like, reset your state. Do you have thoughts on how all of that works? Have you practiced that or studied that at all? I've not practiced or studied it, but I've been at conferences. So, the most common technique that I've seen that's been studied, is EMDR, what is it? Eye movement, desensitization, response or something. Right, like the lateral, is that the lateral eye movement? Yeah, yeah.
Yeah, mm hmm. And the idea there that I understand, and so I could be getting this wrong, is that one core aspect of that, is helping people anchor on physical experience. So, when you have somebody move their eyes laterally, from this side, to this side, to this side, they have to focus on doing a task that is physical, and it gets them out of their thinking head, right, into their physical body. And if you think of this, by focusing on something like that, you can take up all of the working memory in your dorsolateral prefrontal cortex, that part's not important, but like in this working memory part of our brain, and kind of reboot the system, because our brains only have a certain amount of working memory, a certain amount of RAM so to speak. So we can use things like EMDR, or other eye movement techniques, but you can even think of this more broadly. One practice related to the breath that I love, in particular, is called the five finger breathing. I love this in particular, because people can teach it to their young kids, and then have their kids walk them through it when they're anxious. And the idea is to just add, you know, take the index finger of one hand, and place it at the base of the pinky on the other hand. And then as they breathe in, feel the physical sensations of their breath and their fingers, and look at their fingers at the same time, pause at the top, as they breathe out, trace down the inside of their pinky, as they breathe in, trace up the outside of their ring finger, you know, and down. So, for example, if you make five full breaths, you've traced your whole hand. If you do 10, you can trace back from your thumb to your pinky. And what that does is it takes up a lot of working memory, 'cause we're paying attention, we're seeing, we're feeling three different aspects of our experience, you know, two fingers and our breath, and that reboots the whole working memory system. And at the same time, paying attention to breathing, often helps regulate our physiology where it calms down. So, if those worry thoughts come back in, they actually need a level of arousal that meets them, you know? We're used to being worried and feeling worried, you know, thinking worried, feeling worried. Well, if we're thinking worried and we're not feeling worried, that body is gonna say, "Hey, that's just a thought," and we can identify and let go of thoughts more easily because there's a mismatch between the arousal. So, and it's the physical body that drives experience and behavior, more than thinking brain. So, that one's gonna win, if we can really help regulate that physiology. Sure. It's so crazy that these, I mean, it's so simple that it's like, "Okay, breathe, "and like, look at your fingers," and you can have like such a powerful impact on the mind. There's so much-
Yeah, it's called science, you know?
Right. If we actually understand how it works. (laughs) Final thing, I mean, there's so much interesting science that's occurring right now, in the study of the mind and the brain, and yet so much of it remains unmapped. There's so much that we still are grappling with trying to understand. From your perspective, like, what is the study, that you would like to see performed, that has yet been performed, that would help elucidate, you know, a lot of the things that you are curious about? Well, there are a gazillion things that I'm curious about, yet one thing that really interested in, is this idea of personalized medicine, right? This has been a buzz word in medicine for a long time and it hasn't really yet come to fruition, where, you know, the idea would be to take somebody's genes, and all these, you know, their environment and behavior, and find what medication works best for them, or tailor a medication to them. If you approach that same personalized medicine, away from the taking a pill perspective, which is where I focus more, the idea here is can we actually personalize medicine through understanding someone's habitual reactions to their world? And we did one pilot study that gave us some really interesting data, that says to me that this is possible, where we can actually take a, what we're calling a psychological phenotype, of asking people just 19 questions, at baseline before they start a program, and we can predict who's gonna do better, than somebody else, and with a pretty striking result. And so what my next experiment, that I wanna do, is to do this at scale, where we really look at, you know, is there a way to simply and cheaply get a sense, at least for somebody's anxiety profile, let's say, and can we use that as a way to not only determine who's gonna do best with our Unwinding Anxiety app, but also ask, "Well, why are the people "that aren't doing well," and this is fortunately a small minority, but the folks that are not doing well, why aren't they doing well? And what do we need to do to help them do better? Because I'm sure you can relate to this, I'm always looking like, how can I do better? You know? (laughs)
Right. How can I help my patients more? How can we do research that helps people at a broader level in the population? Right, well, that's a lot of bold aspiration, you know? I'm still hung up on the fact that 200 million plus people are suffering from anxiety right now. There is so much suffering that's occurring right now, and it's encouraging and hopeful to, you know, hear about the solutions that you're working on. So, I applaud you for the work that you do. So much respect for your field, and you're a servant to humankind, Jud, thank you. Appreciate you.
Well, thank you, thank you. I feel like my anxiety has been unwinded as a result of this hour and a half. You have succeeded at doing what you do best, my friend.
All right. I feel good.
Success! Cool, so, the new book is called "Unwinding Anxiety," of course. Jud also has these amazing apps, if you're struggling with everything from quitting smoking to trying to ameliorate your anxiety, Crave to Quit is the one app that you still have, right? And you have an Unwinding Anxiety app, which is really kind of a compendium piece to the to the book itself, right?
Yes. And if you wanna learn more about Jud, drjud.com. Anything else coming up that you want to alert people to, other than the new book? I think that's it, you know, folks who are on Twitter, they can hit me up on Twitter @JudBrewer. But other than that, I think the Dr. Jud website's got it all. I'll just mention, we've got a bunch of free resources on the website as well. So, if anybody's just looking to learn a little bit more about their habits or how their minds work, you know, I love to put together short animations that describe these things in simple terms. That's one of my challenges and passions. And so if folks are interested in those things, take a look. And in particular, I would say I'm really proud of this very short two minute animation that we put together with Share Care, that talks about spreading kindness virally, as compared to fear. So, if anybody's interested in checking that out, there's this, you can probably find it on my Twitter feed, or also on my Dr. Jud website. Cool, we'll link that up in the show notes as well. Perfect.
Awesome. How do you feel? I'm well.
You don't feel anxious, do you? No, this is great, I feel energized. Cool, well, hopefully at some point in the not too distant future, we'll get together for a run and a surf out here, have you back on the show, you're welcome any time. So, thank you again. That would be awesome. All right.
Thank you. Peace, plants.
