Are you trying to create a good habit or break a bad one? That’s Dr. Jud Brewer’s speciality.
Dr. Jud (MD, PhD) has over 20 years of experience with mindfulness training and a career in scientific research. His interest in how the brain works has led him to work with people to make deep, permanent change in their lives. He has developed mindfulness programs for habit change, including in-person and app-based treatments for smoking, emotional eating, and anxiety.
Earlier this year, Dr. Jud released a new book, “Unwinding Anxiety – New Science Shows How to Break the Cycles of Worry and Fear to Heal Your Mind.” His book is a clinically proven step-by-step plan to break the cycle of worry and fear that drives anxiety and addictive habits. Dr. Jud explains how to uproot anxiety at its source using brain-based techniques.
Check out Sonya’s previous interview with Dr. Jud in early 2020 about how to overcome bad habits and cravings using the power of the mind.
“You do it better if you just relax your mind and let your body do the work. The more we worry – like am I going to make it to the top or if it’s a race, am I going to bonk…The more we worry, the more likely we are to actually fail because we’re using all that energy up in our head as compared to putting it into our legs. The idea is really to see what the grit is for. Grit helps us get up the hill but grit doesn’t get us through a technical section. It’s really recognizing that willpower isn’t a way to change habits.”Dr. Jud Brewer
- Anybody can learn how their minds work and start to work with it
- Looking at anxiety as a habit
- Willpower isn’t a way to change habits
- Focusing on what’s happening right now instead of the why
- Curiosity as the light switch
- Mindfulness is about awareness
- Check out Dr. Jud’s new book Unwinding Anxiety
- Liked this episode? Listen to other episodes about mindset, motivation and psychology
- Check out my Athlete Mindset Academy
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Sonya Looney: Let’s get into today’s podcast guest, Jud Brewer. I really like Jud Brewer. He’s an M.D. You might have heard him on the podcast before when I had him on to talk about his last book, The Craving Mind. And now he’s back to talk about his new book, Unwinding Anxiety. And so many of us have experienced anxiety. In fact, you might not be a human if you’ve never experienced anxiety.
And one of the big takeaways from his book is using curiosity to unwind anxiety, asking questions like what am I getting from this? And also realizing that worrying about something makes you feel like you’re doing something while worrying is actually not productive. And we get into all of those things in this episode. But Dr. Jud Brewer’s specialty is about creating good habits and breaking bad ones. He has over 20 years of experience with mindfulness training and a career in scientific research.
In fact, he has his own lab where he researches how the brain works, and it’s led him to help people make deep, permanent changes in their lives, from eating differently to smoking cessation to helping with anxiety. And he’s also created several apps that are research based to help people do these. Earlier this year. Dr. Jud released a new book called Unwinding Anxiety. New science shows how to break the cycles of worry and fear to heal your mind.
The foundation is using kindness and curiosity, and I highly recommend you pick up this book. And after you listen to this podcast, you’ll also have some key takeaways. Some of the key takeaways you will walk away with are how anybody can learn how their mind works and how to actually get started with it, how to look at anxiety as a habit loop, and what habit loop actually is, how willpower isn’t the way to change habits and why willpower fails.
And also focusing on what’s happening right now instead of why it’s happening right now, which often happens with anxiety. Curiosity is also something that comes up all the time in Dr. Jud’s books and research and just asking, what am I getting from this? That is such a powerful question. And you’ll hear some examples of that in a few minutes. We also are starting to include transcripts in the show notes of some of these podcasts. So if you want to go back or you just want to do a quick skim of the podcast, you can go to sonyalooney.com/podcasts, where you will see all of the show notes for the different guests.
If you love training your mind, don’t forget to check out the Moxie and Grit Mindset Academy. That is my own personal course with over 22 modules to help build confidence, help you set better goals and help improve yourself. All of the learnings in this course are backed by psychology research and I loved putting it together for you. Go to sonyalooney.com and look for Mindset Academy in the menu and check it out. And last big shout out to our podcast sponsor, Inside Tracker, who gives all of us the power and the agency to change our Health and Insight Tracker is a company that does blood work.
They take all of your results that you can get from hundreds and hundreds of labs across the U.S. and also in Canada. And they make recommendations that have a much tighter reference range than it would be if you were to go to the doctor to optimize things like performance, like gut health, like sleep and use lifestyle and diet recommendations in order to improve these biomarkers. And many of us, especially those of us who listen to this podcast, really believe that we have the power to change our lifestyle and that can affect our health.
So go to insidetracker.com/sonya to get 25 percent off any tests they offer so that you can at the minimum get a baseline of where you’re at and at the maximum start making changes to feel better and to perform even better. So go to insidetracker.com/sonya to get 25 percent off. OK, let’s get right into it with Dr. Jud Brewer. All right, Dr. Jud, the mountain biker, is back.
Dr. Jud: Thanks for having me. It’s great to be back.
Sonya Looney: Mountain biker, M.D., Ph.D.. Man, I wanted to ask you about your relationship with achievement because there aren’t many M.D. Ph.D.s out there.
Dr. Jud: I know. Now, you know, I’ll just say this wasn’t what I expected. I never even thought I’d go to graduate school. And here I am. I love learning. I think that’s what it all comes down to.
Sonya Looney: Yeah. Love of learning is definitely a good strength to have for sure. So let’s dive in your new book. If people are familiar with our last podcast, we talked about the craving mind and we talked a lot about addictions to many different things. And this book, Unwinding Anxiety, is all about anxiety. So what prompted you to write this book and can you define anxiety for us?
Dr. Jud: Yeah, well, so I’ll start with the definition and then I’ll talk about what prompted me to write this. So there’s a definition that I like that’s basically this feeling of nervousness or warrior unease about an imminent event or something with an uncertain outcome. You can basically distill that down to fear of the unknown. And we can talk about why that’s why we get freaked out and why we worry and how that how that’s kind of hijacking some of our old evolutionary machinery.
But what got me into writing this book was actually my own anxiety around my helping my patients with anxiety. So I certainly write in the book about how I’ve had my own panic attacks and what not and how I use mindfulness practices to work with them. But it’s really interesting. In medical school, I learned to prescribe medications, you know, and in residency I learned the same thing, basically. And it turns out that the best medications that we have for anxiety, there’s this medical term called number needed to treat, which gives us a rough and dirty estimate of how well something works. And that number needed to treat for medication is 5.2, which means I have to treat five patients before one of them shows a significant reduction in symptoms. So I was basically playing the medication lottery in terms of helping them with their anxiety. I didn’t know which one of the next five patients I was going to see was going to benefit. And then I didn’t know what I was going to do to help the other 80 percent. How was I going to do this so serendipitously?
My lab had been studying an app that we’d been developing called Right Now that is actually for overeating and stress eating and things like that. And somebody in that program, they were mapping out why they were stress eating. And they said, you know, anxiety triggers me to stress. Can you make a program for anxiety? And I was thinking, well, I don’t really prescribe medications for anxiety, but it put a bug in my ear and I went back and looked at the literature and no kidding, from the 1980s. So this was the same time that the Stones were singing about the mother’s little helper and the accessories were being developed like Prozac first came out in the 80s. So folks were really focusing on medication in that time. In the 80s folks were talking… So for example, Thomas Berkovic at Penn State was talking about how anxiety could be driven like a habit. And when I read that, I had this crazy aha moment because I was like, I never thought about anxiety that way before.
That’s what my lab studies, that’s what we develop programs for. So long story short, we develop this on one anxiety app and studied it to see how well we could actually take this idea of approaching anxiety like a habit and help people with their anxiety and did a couple of studies. One would, with anxious physicians, got a 57 percent reduction in clinically validated anxiety scores, did a study with people with generalized anxiety disorder. We got a 67 percent reduction and there we could calculate that number needed to treat, which was, are you ready for this? So medications, it’s over five… 1.6. Wow. So which one would you want to do. Which one would you want to use.
Sonya Looney: Yeah exactly.
Dr. Jud: So yeah, that’s what got me into it. It was not being able to help my patients. I have to say it’s been tremendously gratifying to kind of study the mechanism, even develop programs. And the reason I wrote the book was to try to put this in the hands of anybody. Anybody can learn how their mind works and start to work with it.
Sonya Looney: I think that especially lately, there used to be a stigma around having anxiety or going and seeking out help or even doing any type of mindfulness based practice. And I think that that has gotten way more mainstream and way more accepted.
Dr. Jud: I totally agree, and I think a lot of that is driven by people, at least in the West. A lot of folks approach science like a religion. You know, if they see it on the news and it says that it’s based on science and they show a picture of the brain, then people are more likely to believe it. So here there’s been an explosion over the last 20 years in the science around mindfulness. And one of the strongest findings in the science of mindfulness is around anxiety.
Sonya Looney: So how can we look at anxiety as a habit?
Dr. Jud: Great question. And so I’ll talk your ear off, but I’ll try to keep it brief for today. The idea here is any habit is formed through a three step process. And we probably talked about this on our last time we spoke, but just to remind everybody, you need to trigger a behavior and a result or reward from a brain perspective. And this is set up to help us survive, to find food and remember where it is and to find danger and avoid it in the future, like to eat, not be eaten.
And anxiety is driven habitually through this same process. Yet it’s not through a physical behavior, but through a mental behavior. Sometimes it can be physical behaviors that can support it, like stress eating and things like that. But it’s really the mental behavior of worry that drives anxiety. So you can think of anxiety, the feeling of anxiety as a trigger, the mental behavior of worrying. So, for example, my patients with generalized anxiety disorder, they wake up in the morning, they feel anxious and they start worrying, why am I anxious or am I going to be anxious all day?
Which, of course, just makes them anxious all day. And that worrying gives their brain a couple of different rewards. One is that it can distract them from the worst feeling, feeling of anxiety because they’re worrying and that worrying doesn’t feel as bad as the anxiety. And another is it gives them this false sense of control or they feel like, you know, well, if I can’t figure out what this is, at least I can worry about it.
And that worrying gives them something to do and that is rewarding. So if they worry and it makes them feel a little bit better or distracts them from the anxiety, then that’s going to feed back in the next time they’re anxious, they’re going to worry more and it becomes this vicious, vicious cycle.
Sonya Looney: So would you say that worrying and overthinking are the same thing?
Dr. Jud: Well, how would you define overthinking, just to make sure that I’m understanding?
Sonya Looney: Well, I say that there’s something that you’re worried about and then you just start thinking about thinking about it. How am I going to solve this problem? Or you go to the Internet because you’re worried about it. You start Googling whatever it is that you’re struggling with. And we all know never to do that, but we all seem to do that. So you just keep keep trying to find a solution. And just like going around and around in circles, because there isn’t actually a solution you can control.
Dr. Jud: That sounds like the two are pretty much aligned or almost synonymous in that sense, the other way you put overthinking. I ask the question because our brains learn things and learn to survive through planning for the future. So overthinking is often kind of a spinning out of control of planning because our brain… you can think of it this way is our old survival brains learn to survive through that three step or that the three elements have a loop and the newer parts of the brain, like the neocortex, helps us survive through thinking and planning.
Yet the thinking and planning needs information. It needs accurate information in particular. And if we don’t find that like you’re talking about with overthinking, we go searching on the Internet, we can’t find a solution. That’s what it spins out of control into anxiety. So anxiety, overthinking, however you want to think of that. So one way to differentiate those is to check in experientially to see what it feels like. When we’re planning for something, usually where it actually feels pretty good, it feels productive.
We’re generally pretty calm, relaxed when we’re planning, but when we start worrying, we start to feel closed down and we start to feel contracted, restless, driven. It’s like, I got to find this answer, I got to find the answer. And so that physical difference between the two, one feels closed down, one feels a little more open, can help us differentiate between what is normal and helpful, which is planning and what is worrying.
And ironically, the more we worry, the more it makes our thinking and planning brain go offline. It makes it harder to think and plan.
Sonya Looney: I love that you said you can’t think your way out of habit change because that part of your brain goes offline. Can you talk more about that?
Dr. Jud: There’s this myth around willpower where it’s the end all, be all, just do it. You just do it works when you’re trying to just climb a hill. Right? Especially if it’s not technical and you’re just you just got to get up to the top, you know, you just do it right. But you do it better if you relax your mind and let your body do the work.
You know this better than I do. The more we worry, like, am I going to make it up to the top? Or if it’s a race like, am I going to bonk or whatever? The more we worry, the more likely we are to actually fail because we’re using all that energy up in our head as compared to putting it into our legs to actually move. So here the idea is really to see what the grit is for. Grit helps us get up a hill, but it certainly doesn’t help us through a technical section on a mountain bike ride, for example. You can’t just grit your way through a technical section. You’re going to grit yourself over your bar. You flip your bike and land on your head. So here it’s really recognizing that willpower isn’t a way to change habits. You know, wouldn’t it be great if my patients walked in to my office and I said, just stop smoking or just stop overeating or just stop worrying?
You know, they could use their willpower part of the brain and do that. That’s not how our brains work. So that’s the the bit about you can’t think yourself out of any habit, whether it’s worry or procrastinating or overeating or anything or smoking. It just doesn’t work at best. Our brains go offline when we get stressed or when we’re anxious. So ironically, the more anxious we are, the harder it is to use this part of our brain.
So there we can step back and say, OK, well, what can we do if this isn’t really how our brain works? That’s what we can tap into the stronger parts of our brain and actually use those.
Sonya Looney: So what do you do if you can’t outthink your way or you can’t think your way out of something that how do you actually do it?
Dr. Jud: Yeah, so the nice thing is it’s pretty simple. I’m not saying it’s easy, but the process is pretty simple and I actually set up the book in this in this way. I think of it as a three step process. And I use this analogy of gears. So it’s very appropriate for this conversation. So you can think of first gear is just really about helping us map out our habit loop. So if we can’t see the process, if we can’t if we can’t see how our minds are working, we can’t possibly work with them.
And so the the simplest way to do that is just to bring awareness in as we’re stuck in a habit, whether it’s overthinking or overeating or procrastinating or whatever, and then we can trace backwards and say what triggered this? Was it a thought, was it an emotion? Was it something outside of my environment, even a time of day? So what’s the trigger? What’s the behavior? And then what’s the result of it? That’s all for the first gear is and that helps us start to say, oh, this is how my mind works.
This second gear, once I think of first gears, it helps us get moving. You get started in first gear. Second gear is about tapping into the reward based learning processes in the brain. And so this, too, takes only awareness. And the reason I say that is our brain set up these reward hierarchies, basically a list of what’s most rewarding, what’s least rewarding so that we can easily and quickly make decisions. And if something is high up on a reward value list, we’re just going to keep doing it over and over, especially if we’re not paying attention and it’s a habit, we’re just going to do it.
So a lot of folks worry as a habit. It’s just habitual. They’ve been doing it for a long time. They don’t even think about it. They’re not even aware that they can change it and their brains are convinced that it’s rewarding in some way. So that second gear is all about asking themselves and dropping into their direct experience when they’re worrying and checking to see, what am I getting from this? I have them ask that simple question. What am I getting from this?
Same is true for overeating. When somebody is overeating, I have them ask themselves, what am I getting from this? In fact, my lab just did a study where we embedded a mindfulness tool to have people pay attention as they overate when they were using this Eat Right Now app, and we found that it only takes 10 or 15 times if somebody’s paying attention as they overeat for that reward value to go below zero to the point where it is so unrewarding that they shift into not overeating.
So we can even show this scientifically, that reward value is key to have a change, any type of habit change. And it really only just takes awareness to do it. And it doesn’t take that long. It doesn’t take forever to do that. So that’s really the second gear. And that’s the key aspect of this and how it’s different than willpower. We’re not telling ourselves to stop overeating or stop worrying. We’re simply asking ourselves, well, what am I getting from this and dropping it into our direct experience.
Then the third gear is also fun because I call this the BBO finding the bigger, better offer. And the idea is once you’re moving, you’ve got some momentum. You’re mapping out these habits loops. You’re seeing that worrying isn’t working or overeating isn’t working. Then we need to give our brain something better based on that reward hierarchy. And it’s not just giving it anything that’s better. It’s really tapping into something that’s intrinsically rewarding so that our brains don’t become habituated to it and we don’t form another habit around doing something outside of what we’re doing.
So, for example, during the pandemic, I’ve seen a lot of patients who turn to alcohol when they’re anxious. So the anxiety drives them to drink. And so their brain says, well, I’d rather be inebriated than anxious because it feels better. There’s a bigger, better offer. Yet then they start to get problem, all sorts of problems around alcohol and some of then form alcohol use disorder. So that it’s not just finding something better. It’s finding something that’s intrinsically rewarding and isn’t going to lead to problems on its own. So here I think of two categories or two buckets. One is curiosity and one is kindness. And both of those actually go back to what we talked about earlier, both of those feel completely different than anxiety. So anxiety feels closed. Curiosity, kindness – they both feel open and you can’t be closed and open at the same time. So in the moment that somebody is anxious, they can actually drop in and get curious, what does this feel like in my body?
You know, are there sensations? Are there thoughts or is it tightness that is that and is that anxiety? No, that’s just tightness. Is it heat or is it restlessness? And they can start to unpack all of these physical sensations that make up this concept of anxiety. And they can start to see, oh, these are sensations. I can be with that one. I can be with that one. I can be with that one.
And as they’re with them, they can also see that they change and they don’t have to be caught up in them and they don’t have to resist them. What we resist persists. And so it’s really important to be able to accept what’s actually happening in our experience, rather. And trying to get rid of it, so that’s the third gear, the third step of the process.
Sonya Looney: OK, so there’s this framework with three gears and we said that thinking your brain turns off at a certain point whenever you’re stressed and you can’t think. But some of these questions that you’re asking yourself require you to think like, what am I getting from this or what does curiosity feel like? So how does that type of thinking differ from the thinking of when you’re going down the rabbit hole?
Dr. Jud: And it’s a really good question. So the question, what am I getting from this, is actually injecting curiosity into the equation, right? Then like what am I getting from this? And that helps us step out of the anxiety in the moment so that our observation, the observing parts of our brain can actually pay attention, which is really different than, I need to figure this out.
Sonya Looney: And I think you talked about this in your book. It’s like the why chapter of anxiety. Can you talk about the why versus the what question? Because I think that that’s an important point.
Dr. Jud: I’d be happy to. And I wrote a whole chapter on this because I’d been seeing this over and over and over and actually had a patient who came in and she’d say, well, why am I anxious? And she has been hurt all the time, just trying to figure out why that was. And so we explored like what? You know, what are you getting from going down that rabbit hole? Well, she’s just getting more anxious because not only was she not alleviating her anxiety, but she couldn’t figure out what it was that was causing her anxiety.
So often there’s this myth that we have to go back and figure out what was it in my childhood or whatever that led me to being anxious. Whatever it was that happened in the past, we can’t change that. So the idea is what drives her behavior now, especially if it’s a habit, is what’s reinforcing right now. So we can focus on what’s happening right now. And we don’t actually have to worry about what happened in the past, which I say this as a card-carrying psychiatrist.
You know, this might sound like sacrilege, but that’s not how our brains work. Our brains work based on reward-based learning. And if something is still rewarding, now we’ve got to tap into the reward. How rewarding it is right now? So that’s that’s why I talk about the what as compared to the why. So instead of saying why is this happening and I figure this out, we focus on what’s happening right now. What am I doing and what am I getting from that?
That’s that second gear process. Does that make sense?
Sonya Looney: It does. And I have a follow up question to just looking inside your body and seeing how something is sitting with you. I’m actually graduating from a health coaching program at Vanderbilt right now. It’s through the national board certification program. And the first part of the practice is leading a mindful moment for the client. And one of my clients was doing this mindful moment and she had to stop because looking into her body and seeing how she felt actually caused anxiety.
So how does that show up? Whenever somebody is trying to defang their anxiety, but then looking inward about how they feel makes them feel more anxious?
Dr. Jud: Yeah, I think that’s a really important question. So it’s not just about looking at what anxiety is, it’s really about injecting that curiosity. So if we bring an attitude of curiosity and especially when someone is guiding us into a mindful moment, for example, what would I do? And we even do this in our own running anxiety app is I have people identify where they feel anxiety in their body. And then I ask them to say, OK, check in with yourself to see is it on the right side or the left side of your body?
What that does is it injects some curiosity like, well, I don’t know, is it on the right side or the left side? And that curiosity helps them start to explore things, explore this as physical sensations, as mental phenomena, rather than, oh, here’s anxiety. I’m going to rub your face in it. Not that folks are trying to do that. But I think if somebody just says, oh, I’m going to guide a mindful moment, oh, here, you have anxiety, well, look at your anxiety. And then somebody says, oh, yeah, I’m looking at it. And it feels really, really bad. So the idea is to guide them in in a way that skillful. And that’s also why I start with the first step and the second step or the first gear and the second gear, which is like map out your habit loops. See how anxiety is driven, because if they’re just kind of shoved into the dark room of anxiety and then somebody closes the door behind them, that can be even more scary.
But the idea is to open the door, flip on the light and help them see, oh, here’s how anxiety gets driven. Oh, here it’s built of thoughts and emotions and sensations. Oh, are you ready? We’re going to guide you into this. And the idea is to guide them in, have curiosity, kind of take them by the hand and then it’s much less scary. And they’re also not triggering more reactivity, which is key, because if somebody is anxious and they pay attention, and it’s worse, the last thing they want to do is do that again.
Sonya Looney: So curiosity is basically the light switch.
Dr. Jud: Absolutely. Yeah. Curiosity and then also seeing the processes that just… I’ll give you an example of how important first gear is. So I had a patient who came in. I wrote about him in the book. So this might sound familiar to you, but a patient who came in and was referred for anxiety and basically when I took his history, he described how he’d drive on the highway. There was the trigger. He would start to get these panic attacks on the highway. So he stopped driving on the highway. So that became his new avoidant behavior. And then the result was that he wouldn’t have those panic attacks. So we spent 30 seconds, I pulled out a piece of paper and we just wrote triggered behavior results on the paper. And I said, OK, let me see if I got this straight. Trigger is these thoughts the behaviors that you avoid driving? And then the result is that you feel a little bit better or you can avoid those panic attacks.
And his eyes just lit up and I think it was he’d never seen that process before, just mapped out. And so just mapping it out gives people much more power. And it makes this like that dark room. It’s scary until you flip on the light switch and then you realize, oh, it’s just stuff in the room. You know, it’s a noise maker as compared to a monster or whatever her brain makes it out to be.
Sonya Looney: Why is it more powerful to write it out or talk it out instead of just do it in your head?
Dr. Jud: That’s a good question. And some folks can do it in their head just fine where they can map this out. But I think seeing it concretely on a piece of paper… there’s something for a lot of people where they just see it and then it gives them a little bit of perspective, a little bit of distance, from these thoughts where it’s just easier to see, oh, that’s a habit loop as compared to, wow, this is a bunch of jumble of words and thoughts and emotions in my mind.
Sonya Looney: And I have a question about your talking about alcohol disorders or overeating, and a lot of times some people use food or alcohol they’re trying to soothe themselves because of the neurochemicals, like, is it dopamine that’s that’s doing that. So if they have their sip of wine or whatever and they start feeling better and then they ask, what am I getting out of this in that moment? What if they actually are getting something out of it, but then they regret it later? Like, how do you work with that overlap?
Dr. Jud: Yeah, that’s another great question. So here with alcohol, for example, it’s not just they’re a bunch of things happening. So they’re going to get these dopamine hits, but they’re also going to get other types of feelings that that feel good, that probably aren’t dopamine. Dopamine is really hyped up in the popular literature as like the feel good chemical. It does not feel good. Dopamine is just there to help us learn and it also is there to help drive us to do things.
So when we have an urge to drink alcohol, there’s this restless, itchy urge that says go do something, often described as a craving. Well, that’s dopamine firing, saying go do that thing. Doesn’t feel good. So there are probably other things that get opioid or endogenous opioids and things that get released in the brain when people drink alcohol just as an example. And so here people have to look at all of the results.
So it’s sometimes I’ll have folks just kind of list. OK, what’s it what do you get from drinking alcohol while it tastes good, it feels good, whatever. And then what else do you get? Well, they feel guilty. The anxiety comes back later. I’ve had patients who, when they wake up the next morning after having had a bunch of alcohol to avoid anxiety, it actually triggers more anxiety in the morning. There was one guy I wrote about in my book who actually would procrastinate and feel terrible in the morning when he drink alcohol to get away from anxiety, and then he’d wake up the next morning and not have any work done and then just get into deeper into that vicious cycle.
So the key is to look at all the results, not just in the moment. And when somebody is inebriated, then it’s it’s really hard to do this stuff. So if it’s alcohol or some other intoxicant, I have folks really look back on it. Well, what what did you get from that? And when they’ve sobered up a bit and then they can look at all the pros and cons.
Sonya Looney: And then that helps them the next time they do it to drop in sooner before they’re the morning after feeling bad about what happened.
Dr. Jud: Yeah, absolutely. So they can drop in before and they can. And I have I have them do this where where they reflect back on the last time they had a drink. You know, it’s like, well what I get from this last time and there’s this great saying, I think this was I don’t know if it’s originally from AA, but I learned it from one of my patients who had been in Alcoholics Anonymous… this term called Play the Tape Forward, where they imagine, OK, if I have one drink, then what? Well, then I’m going to have another drink. Then why then I have a third drink. Then what? Then I can’t control myself. Then what? Then I get in a fight or I get to have problems. And so that can help them, kind of based on their previous experience, it can help them project into what’s going to happen in the future. And I have a number of patients who use that really effectively, which is really just bringing to mind what happened last time and helping them bring up that reward value from before they’re inebriated.
Sonya Looney: It helps you create that space and you mentioned this earlier, to like being able to almost dissociate yourself. Kind of like a meditation when you’re you’re seeing like your thoughts as the clouds in the sky, but you are the sky and it dissociates you from the thoughts. Is that how it works?
Dr. Jud: Yeah, absolutely. Yeah.
Sonya Looney: Can we go through a couple different habit loops that I wrote down?
Dr. Jud: Sure. I’d be happy to.
Sonya Looney: OK, so the first one and I think you’ll appreciate this just with social media and just everything out there, like our brains are always comparing its like part of being human, but people compare themselves to these standards that are not even real. So how can we go through the habit loop of somebody going through social media and comparing themself and then feeling bad about themselves?
Dr. Jud: I’m glad you bring this up, because I think this is is really problematic in modern day. Social media seems like, well, we’ve got to be on Twitter or whatever so we can keep abreast of what’s happening. And we’ve got to be on social media for this or that reason. So people really struggle with, well, how can I be on social media? Because it’s beneficial. And then I’m on social media and I’m seeing the perfect version of everybody else.
How much how much time are people spending taking a gazillion photos of the same thing so they can have the perfect photo? So the comparison piece actually goes back to ancient Buddhist psychology. There’s this a part of the Pali canon, the Buddhist teachings, where they basically talk about the mind, where it says worse than same as better then. And all of these cause suffering as in it doesn’t matter when we compare ourselves to others.
It doesn’t even matter what the result is because it causes suffering in the process of doing it. So here, just recognizing, I’m on social media and I see somebody’s picture and then I have this thought like, oh, I wish I looked that good. I wish I was on vacation, like they’re on vacation or I wish I’m always winning at everything. Like they’re always posting about everything that they’re winning or getting awards or whatever. And so just being able to map that loop out itself and then ask ourselves, like, what do I get from comparing myself to somebody else? Oh, I feel bad. And that’s pretty straightforward. But we have to actually feel into the direct experience and then we can ask ourselves what’s better than comparing myself? Well, what’s it like if I just switch into “well, that’s great for them.” And wishing them well as compared to the envy or the jealousy or the whatever that comes us feeling bad, you know, that comes with that social comparison.
Well, for me, it certainly feels a lot better to not do that social comparison, because I know it always feels bad when I do it, no matter what the result is, even if I go, oh, I’m better than. That pride is also poison. So just seeing what it’s like not to do the social comparison and maybe just send them some silent well wishing where that’s where the kindness comes in. It feels good to be kind to other people and we can be kind to other people without them even knowing it because it makes us feel good.
Sonya Looney: Yeah. And also self kindness. Like I think it’s really hard for people. They beat themselves up because they don’t look a certain way or they don’t they don’t have something that somebody else has. And it’s really hard to be kind to yourself sometimes.
Dr. Jud: Yeah, absolutely. So just applying that to habit loop of beating ourselves up something triggers us to beat ourselves up, like going on social media and comparing ourselves to other people. The mental behavior there is judging ourselves, oh, why can’t I be better, why can’t I look differently or whatever? And then asking ourselves, what am I getting from beating myself up? And then like you’re pointing out that so that’s a second step. Oh, this isn’t feel great when I beat myself up. Third gear, what was it like when I’m just kind of myself, even if I just give myself a hug? I jokingly have people stretch their arms really wide and then kind of give them a self a hug. I call that the hug pose in yoga. You know, it just feels good to give ourselves a hug and give ourselves a break every now and then.
Sonya Looney: Yeah. And like you said, I think goes with the eating app, like it’s not something that’s going to fix itself right away. It’s something that you have to work on. And eventually it’ll get easier, but it probably won’t ever go away completely.
Dr. Jud: These habits and it’s actually doesn’t matter if they don’t go away completely. It’s kind of like an old road. And the longer we go and we don’t drive on the road and we don’t pave it, eventually the grass is going to grow up through the cracks and that remnant will be there for a long, long, long, long time. But if we’re not driving on it, it doesn’t matter if it’s still there or not.
Sonya Looney: This is like asking yourself lots of questions, like introspective questions to try to not avoid your feelings, but just to see how those actually feel and be curious about them. But some people don’t want to do a meditation practice. They don’t want to, like, sit and try to watch their thoughts. Or if they don’t do that, are they still able to do these mindfulness based practices?
Dr. Jud: The short answer is yes. And the longer answer is we did a study in my lab where the hypothesis was… So we had people do both formal meditation practices and we had them do informal practices. This is what the smoking study that we did. And we found that the informal practices where they just paid attention as they were smoking just got curious, like, what’s it taste like? What’s the smoke smell like? What’s it feel like going into my lungs? Just that act of being curious like, oh, what’s this like? That actually drove the smoking outcomes more than the formal meditation practices. And in fact, we got five times the quit rates of gold standard treatment in that study. So it worked pretty darn well. And that actually inspired us to flip the approach because I had been meditating for a long time and I was thinking, oh, it’s these formal practices. That’s what I do. It must be helpful.
But those data, they didn’t lie at all. And so we actually use that as the basis for the development of these app-based mindfulness training programs. And we lead with the informal stuff because somebody is overeating. They can’t say, well, I don’t have time to pay attention because they’re overeating. They can just pay attention as they eat. Or somebody smoking a cigarette, they can just pay attention as they smoke a cigarette. Or if somebody worrying, they can just bring a little curiosity in as they’re worrying.
It’s much more accessible that way. And, you know, we get really good results when we focus on even having the foundation be these these short practices. So I think of it as short moments many times, that’s how you form a habit. So you might as well form the habit of being curious. Short moments many times throughout the day.
Sonya Looney: I didn’t realize that you had done a study on formal seated practice versus informal practice, and I really love hearing about that.
Dr. Jud: Yeah, it was it was a surprising finding for us. But over and over, that’s what we’re seeing, especially with these app based mindfulness training programs.
Sonya Looney: There’s a term that I keep hearing and I wanted to ask you what it means, mindfulness based cognitive therapy.
Dr. Jud: So that is a program that was developed, I think the book was written around the year 2000. So it’s about 20 years old. And this is developed by Zindel Segal, John Teasdale, Mark Williams. So some folks, these are all psychologists based in Canada and then also in the UK. And what they did was they came and studied the mindfulness based stress reduction program at UMass, the one that Jon Kabat-Zinn developed. And they studied with Jon for a bit.
And then they adapted mindfulness based stress reduction specifically to help people with depression, to help them not relapse into depressive episodes. And they got gangbuster results. They’ve done a bunch of studies. Others have now replicated the results. And I would have to say that mindfulness in cognitive therapy is probably one of the most evidence based programs, especially around mindfulness for depression to the point where the UK has adopted it as a first line treatment for depression. And it’s brought it into their national health system, which is pretty remarkable.
Sonya Looney: And with your smoking cessation study, the mindfulness based technique was way better than the cognitive behavioral technique. So where does reframing and positive self talk and all of those play into this, if at all?
Dr. Jud: In our programs, it doesn’t play a role at all. So that reframing the positive self talk, things like that, the research has shown that those generally rely on the prefrontal cortex to do because you’ve got to reframe something. You’ve got to hold all these things in mind as you’re reframing. And so that requires cognitive effort. That’s the first part of the brain that goes offline when we get stressed. So for some people, that can be helpful.
The cognitive therapy, and its gold standard still in the United States for a lot of different ailments, yet it’s not really what drives behavior change long term in terms of how our brains work. So mindfulness, really, there’s some shared things. So, for example, you’ve got to be aware of cognition to change it. The quick and dirty on cognitive therapy is catch it, check it, change it. You’ve got to catch the cognition. You’ve got to check to see if it’s problematic or true or whatever. And then you change it like you’re saying. You reframe or something like that. Mindfulness is about awareness, awareness, awareness. Become aware of the habit, you become aware of how unrewarding it is, and then notice how awareness itself, the curiosity itself, is that bigger, better offer. So they’re pretty different in the end, but they both start similarly in terms of needing to be aware of what’s happening.
Sonya Looney: I’ve lots of just like follow up questions, but I don’t want to take people into the weeds, so I’ll just leave those out. But my next question is about environment design, because I’ve interviewed James Clear about his book, Atomic Habits and identity based habits and changing your environment. How did those play into curiosity and this type of habit change?
Dr. Jud: There’s been some research, but no of different labs about changing the environment. So the classic example is if you don’t want to eat ice cream, don’t have ice cream in the house. But relatively recent research, and there’s a great article, I think, in Vox about this. I don’t remember who wrote it, but it was a couple of years ago, I actually cited in my book, where they were highlighting some recent research showing that the folks that are good at doing that, actually they’re good at setting habits in the first place. That might apply to some people, but the majority of folks, it’s not just about avoiding having ice cream in the house. And it’s especially problematic with worry because you can’t just, like, tell your worry, check your worry at the door. It’s like, OK, where you can’t come in the house. So it’s especially problematic when it comes to working with anxiety.
Sonya Looney: Another habit loop just popped in my mind, I have basically a one year old but like there’s going to be things that are going to come up in the future when he goes into the wider world that I’m not going to be able to control. Like, what if this happens to him or what if that happens to him or, oh, my gosh, he’s 20 minutes late. So through that and I’m sure a lot of people can relate, like I would just ask myself, like, what am I getting from worrying about something bad happening to him?
Dr. Jud: f you worry about him being late, my guess is that you’re worrying isn’t going to keep him safe, if that’s what you’re worried about, like, oh no, I was going to happen to him. So, like you’re saying, the best thing to do there is ask yourself, well, what am I getting from worrying about him? Is it keeping him safe? No. Is it making me more anxious? Yes. So if he walks in the door in two minutes, would you rather have a mom who’s calm and collected or a mom that’s worrying about it?
Because one thing we do know is that worry can be learned. It can be a learned behavior. So if we can learn to worry, we can learn it from our parents. And so, as parents, it’s great to be able to work with our own anxiety, work with our own worry, so that we’re not teaching that to our kids as well. And at the same time, it’s making us less anxious.
Sonya Looney: I’m kind of jumping around here, but I want to go back to talking about anxiety and then stress as it’s cousin and Kelly McGonigal’s book, The Upside of Stress, I think she talks about anxiety reappraisal, where instead of saying, I’m anxious or I’m nervous or I’m stressed, you actually say, no, no, I’m excited, because physiologically, some of the things are the same. How does that does that work or should we be using this other approach?
Dr. Jud: It’s a good question. I don’t know the research behind it. I mean, theoretically, it makes sense and there’s a feeling of restlessness and of energy, energized feeling, that is shared between you. If you’re on a roller coaster, you could be on a roller coaster and it could be “wooo” or it could be “ahhh” – same roller coaster. So it’s it’s what our mind is doing with that. So in theory, it makes sense. I don’t know any research that shows that that is tremendously helpful.
If it were, it would become the gold standard and everybody would do it. So I’m sure folks can try it out and see if it works for them. The other thing that I would say here is if we’re anxious and that we’re revved up, that’s actually wasted energy that she’s saying, OK, there’s a fire, just see if you can now throw a pot on it and heat something because there’s a fire there. Ideally, we wouldn’t have that fire in the first place. So we’re not wasting energy.
So what I’d love for folks to do is be able to learn how anxiety works and how to work with it, so they’re not building that fire in the first place. And if they’re not building the fire in the first place, they don’t have to try to reframe it and then see if that works for them or not. Does that make sense?
Sonya Looney: Yeah. And another thing I’ve been thinking about is people have to ask themselves questions. What am I getting out of this or what is this worrying doing for me? And you brought up that worrying, and the example of kids is I’m worried because I’m trying to keep them safe with my worry. But that requires a deeper level of awareness to be able to label that in a certain way. So how can you work on getting from the point of, like, OK, I know I’m worrying what is this worrying do for me? But then getting to the next step down the road of like, oh, I’m worrying because I’m trying to keep them safe, like that part.
Dr. Jud: Yeah, so that’s where the mapping is very helpful. So if somebody is worrying in that moment, they can then be like, why am I worrying oh I want I want to keep my kids safe. That’s generally pretty straightforward for somebody to do. And then as they go forward into second gear, they can ask themselves, what am I getting from this and just feel into their body. So it’s not really, there’s not a lot of analysis. There’s not a lot of stuff that they have to do. It’s really just saying, OK, what’s happening right now? Basically, oh, I’m worried about my kid. OK, there’s the trigger, there’s the behavior. And what’s it feel like when I worry? Oh, I feel more anxious. So it actually keeps things more at the observational level as compared to the analytic level. The analytic level, I agree with you, is challenging to do. The idea with this stuff is really keep it observational.
Again, it’s about awareness. And this is for folks to try. This is why we did the studies to see does this stuff actually work. And in fact, in one of the studies, the study we did with generalized anxiety disorder, the one where we got 67 percent reduction in these symptoms, these are folks that are constantly spinning out and worry all the time. What we found was when we did the mediation analysis, which is just mathematically trying to dissect the elements of what’s making their behavior change… We’re getting the mindfulness training and at the end we’re seeing that their anxiety goes down, well, what’s in the middle that’s actually causing that change? We find two things. One is that folks can learn to become a less emotionally reactive. So that’s what mindfulness trains people to do, is to see the thoughts as thoughts, see the emotions as emotions, see the body sensations as body sensations. And that increase in emotional non-reactivity directly mediates a reduction in worry. And that reduction in worry mediates a reduction in anxiety. So here we can see just bringing awareness and mindfulness is about bringing a kind, curious awareness to what’s happening, helps people be less emotionally reactive. That reduces worry, which then reduces anxiety.
Sonya Looney: You use the words kindness and curiosity for your two buckets for the BBO, did you have to think about what words you were going to use? Because there’s a lot of different synonyms for curiosity and kindness.
Dr. Jud: You know, that’s a great question. The curiosity one, that’s the only word that ever came to mind for me and maybe my vocabulary may not be big enough to know other synonyms for curiosity. But it seems to be something that when I say curiosity, people don’t say, oh, can you define, what do you mean by curiosity? Although I learned, this is part of my exploration, I learned that there are two different types of curiosity.
I wrote a whole chapter on that in my book because it is important to figure out and to know that there are two types which I didn’t know. So one’s called deprivation, curiosity, which is basically if we don’t know the answer to something, we have this urge, this restlessness, this itch that says go look it up. The type of curiosity that you and I are talking about is the other category, which is called interest curiosity, which is kind of just the joy of discovery. I think, of the difference between these one is the destination, hat you get there when you get that information, you’re done. And the other is just the journey like, oh, oh, what’s this anxiety feel like, oh, you know, that type of thing. So I didn’t have a sense of curiosity that came to mind. It just seemed like the right word to use. As far as kindness goes, there are a lot of self compassion, things like that. I like simple terms and that that seemed like the simplest term to me that could really capture the category of what we’re trying to convey.
But now I’m curious. I don’t know if there are other synonyms that come to mind for you that you would use for those.
Sonya Looney: I didn’t really think about those categories specifically, but there’s lots of things that I try to write about or describe, and I just try to think about the words that I’m using and what words are going to not drive people away. Like somebody might hear self compassion to be like, oh, gross. Like, you know, they might not want to hear about that. So, like, different words that you can use so that people can really understand.
And those two words I thought they’re just really good choices because you can’t really argue with either one of those.
Dr. Jud: Well, thank you and now that you mention that these did go through a vetting process of probably multiple years that I never did consciously, where I tried a bunch of different words in my clinic with my clinic patients, and over time there would be the selection process where the ones that didn’t land well, they would get booted and the ones that kept coming back and people could understand and get, would stay. And then we did a bunch of pilot testing with our apps with folks trying out early versions of them and giving us feedback to say, oh, this is accessible, this isn’t.
Kindness and curiosity really were the ones that kind of had this Darwinian selection process and had an advantage over the others just through me teaching and doing research and then in trying these things out with my clinic patients as well.
Sonya Looney: Well, thanks so much for coming on the show. It’s always a pleasure to get to talk to you. And I always think about your work, and I really admire everything that you do.
Dr. Jud: Well, thank you, it’s been a pleasure talking to you.
Sonya Looney: And where can people find you for all these amazing books and things you’re doing?
Dr. Jud: The easiest place to find me is my website, which is drjud.com. I’m also on Twitter @judbrewer. I’m on Instagram at @Dr.Jud. And I’ve got a YouTube channel where I put some videos out with some resources as well.