Speaker 1: Today. It's great to have jud Brewer on the podcast.
Speaker 1: Doctor Brewer is a New York Times bestselling author, addiction psychiatrist,
Speaker 1: and neuroscientist. He's an associate professor and the director of
Speaker 1: Research and Innovation at the Center for Mindfulness at Brown
Speaker 1: University and the executive medical director of Behavioral Health at
Speaker 1: share Hair, Inc. He has developed clinically proven, apt based
Speaker 1: mindfulness trainings, including those to help people with quitting smoking,
Speaker 1: emotional eating, and anxiety. He's the author of the Craving
Speaker 1: Mind From Cigarettes to Smartphones, to Love while We Get
Speaker 1: Hooked and How we Can Break Bad Habits, and more recently,
Speaker 1: the book Unwinding Anxiety. New Science shows how to break
Speaker 1: the cycles of worry and fear to heal your mind. Jud,
Speaker 1: so great to chat with you today on this podcast.
Speaker 1: It's so great to be here. This is a topic
Speaker 1: that's just a little bit timely, so you know, I
Speaker 1: think that there's very few topics that are more important
Speaker 1: than this one. But I'd like to start with tracing
Speaker 1: your the development of your own career because you're a psychiatrist.
Speaker 1: But I think you said you never planned on becoming
Speaker 1: a psychiatrist, Is that right? That is true. You know,
Speaker 1: I did this mdphd program where you do a couple
Speaker 1: of years of medical school and then you do your
Speaker 1: PhD for long enough that you forget everything you learned
Speaker 1: in medical school and then you go back into the
Speaker 1: wards and have to kind of catch up. So I
Speaker 1: actually did psychiatry as my first rotation back on the wards,
Speaker 1: thinking that, oh, I'm never going to become a psychiatrist,
Speaker 1: and you know, here I am. It turned out to
Speaker 1: be really good, much better than expected. Well, I'm glad
Speaker 1: to hear it. Something I thought was really cool was
Speaker 1: this connection you made in your work between the mindfulness
Speaker 1: work that you were practicing on your own and the
Speaker 1: addiction where that you're learning as a psychiatri student, and
Speaker 1: that feeling of craving and clinging and grasping that a
Speaker 1: lot of people who are addicted to things mentioned. I
Speaker 1: thought there was a really brilliant connection, and you thought
Speaker 1: it was a valuable connection too, right, I did, I did?
Speaker 1: You know? It was really interesting to see. You know,
Speaker 1: I've been training for about ten years in mindfulness and
Speaker 1: was seeing these terms come up over and over around
Speaker 1: craving and clinging, and then when I started working with
Speaker 1: patients especially in my psychiatry residency. They were using the
Speaker 1: same terms, and I was thinking, this cannot be a coincidence,
Speaker 1: and so I really looked into it a lot more
Speaker 1: to see, you know, a very very deep connection. Yeah,
Speaker 1: why did you start meditating? Was there a particular reason? Well,
Speaker 1: I was stressed beginning of medical a good reason. Yeah,
Speaker 1: And around that time, you know, what was the science
Speaker 1: of meditation showing? So around what year was that, if
Speaker 1: I may ask, Yeah, I started medical school in nineteen
Speaker 1: ninety and back then there were probably literally a handful
Speaker 1: of papers that had been published on the science of mindfulness.
Speaker 1: You know, I think John cobbitts In had started his
Speaker 1: mindfulness base stress production program in the seventies. He started
Speaker 1: publishing a couple of papers in the early eighties, but
Speaker 1: there was really a long drought between you, literally just
Speaker 1: two or three papers being published to until probably the
Speaker 1: mid two thousands, and then the field really just started exploding. Yeah,
Speaker 1: and you've contributed quite a bit to it. I've tried
Speaker 1: to do my piece here and there. You sure have.
Speaker 1: You've done more than a little. Yeah. So I really
Speaker 1: like this phrase you said in your book, I try
Speaker 1: to science the shit out of anxiety. And that was
Speaker 1: a reference to the movie right that Matt Dylan was in, Yeah,
Speaker 1: Demon Matt Damon the Martian, Yes, where he gets stranded
Speaker 1: on Mars and then he's he's got quite a quandary
Speaker 1: and instead of you know, getting anxious, he turns that
Speaker 1: energy into to good use to help him get off
Speaker 1: the planet. Good. Well, let's use your powers to good
Speaker 1: use to help all of us unwine today, because I
Speaker 1: know that we're all stressed. Great, I'm going to I'm
Speaker 1: just going to speak for everyone. How's that? And I
Speaker 1: think you would be speaking pretty adequately. You know, we've
Speaker 1: seen well we've seen a rise of anxiety over the
Speaker 1: last four or five years, but there was a huge
Speaker 1: spike in the year to twenty twenty. Yeah, yeah, for sure.
Speaker 1: So how can we work with our anxiety and break
Speaker 1: these unhelpful habits and addictions. Well, the way I think
Speaker 1: of this is, you know, and I see this a
Speaker 1: lot in my clinic, is that a lot of us
Speaker 1: really don't know how our minds work. And I can
Speaker 1: certainly speak for myself. I didn't know how my mind worked.
Speaker 1: Even learning a bunch of medical school stuff didn't really
Speaker 1: give me a good handle on how my mind worked.
Speaker 1: So here, I think it's really helpful to start with
Speaker 1: just really understanding our minds and not you know, every
Speaker 1: single neuron in every single brain region, but really understand
Speaker 1: being some of the most essential basics, like how habits
Speaker 1: form and why we form habits, and how some of
Speaker 1: those habits can spin out of control and start move
Speaker 1: from helping us survive to actually being anti survival when
Speaker 1: we really get caught up in anxiety. So that's the
Speaker 1: place that I start. That's a good stritting place. You
Speaker 1: have this phrase in your book, every Day Addictions. I
Speaker 1: think there's like there's quite a bit of controversy in
Speaker 1: the field about what actually counts as an addiction and
Speaker 1: what doesn't count as an addiction, Like what is an
Speaker 1: everyday addiction and what are the features of that. Well,
Speaker 1: I think of this as related to a definition of
Speaker 1: addiction that I learned back in residency, which was, you know,
Speaker 1: an addiction is continued use despite adverse consequences. And that's
Speaker 1: basically the definition that the American Society of Addiction Medicine
Speaker 1: uses now, and it's one that I've used throughout my
Speaker 1: clinical practice because it's very pragmatic, you know, It doesn't
Speaker 1: label people as, oh, you use cocaine, or you use heroin,
Speaker 1: or you use you know, you smoke cigarettes. It's, you know,
Speaker 1: is what you're doing causing problems, And that of course
Speaker 1: covers the classic addictions, but it also helps us see
Speaker 1: things that we might not have noticed otherwise that are
Speaker 1: causing us problems. So, for example, you know, when people
Speaker 1: are text when they drive. It's been shown that texting
Speaker 1: is more dangerous than drunk driving. So there's an example
Speaker 1: of continued use despite adverse consequences. When somebody can't wait
Speaker 1: to check their phone when somebody has texted them while
Speaker 1: they're driving, that's a problem, you know. And so there's
Speaker 1: you know, it can fall into this realm of addiction
Speaker 1: where we're you know, we're so addicted to our phones,
Speaker 1: for example, or social media or checking our news. It's
Speaker 1: really causing adverse consequences, whether it's personally or professionally, or
Speaker 1: even you know, riffs or breakdowns in our relationships and
Speaker 1: our family. Well, can all addictions be reversed? Like are
Speaker 1: there any addictions or anything? Like how do you know
Speaker 1: when you've passed the play of no return? I'm like
Speaker 1: obsessed with that question. Yeah, it's a really great question.
Speaker 1: I have yet to find an addiction that cannot be
Speaker 1: reversed and some of the yeah, So it's good news
Speaker 1: because you know, if we can form them, we can
Speaker 1: unform them. Well, that's amazing. And sometimes it might just
Speaker 1: take as long as it took to form them. It
Speaker 1: might yeah, and it doesn't have to. So this is
Speaker 1: one of the beautiful things about our brains. There's so
Speaker 1: many beautiful aspects of the brain, but one of them
Speaker 1: is that our brain has to adapt very quickly to
Speaker 1: rapidly changing circumstances. Otherwise we won't survive. You know, if
Speaker 1: you think of our ancient ancestors, they didn't have They
Speaker 1: couldn't afford to be chased by the saber tooth tiger
Speaker 1: twenty times before they realized that was dangerous. They had
Speaker 1: to adapt pretty quickly. And so here, even if we
Speaker 1: form a longstanding habit or addiction, we can actually unlearn
Speaker 1: it relatively quickly if we really tap into our brains.
Speaker 1: Just as an example, you know, I work with a
Speaker 1: lot of folks that try to quit smoking, and I've
Speaker 1: had people that have been smoking or dipping for you know, decades,
Speaker 1: and you know, within months, they're able to quit that
Speaker 1: that addiction. And this is despite having reinforce those habit loops.
Speaker 1: One guy, I actually calculated it with one patient, he'd
Speaker 1: reinforced this habit loop of smoking two hundred and ninety
Speaker 1: three thousand times over his forty year smoking career. Yeah,
Speaker 1: can you imagine that three hundred thousand times. Yeah, this
Speaker 1: is this is like, this is giving hope. Yes, there
Speaker 1: is hope. We're not all doomed. You know, really, it
Speaker 1: really about understand we're not all doomed. Some of only
Speaker 1: some of us. Are only some of us? Well, because
Speaker 1: I like, I mean, I can't stop picking my nails.
Speaker 1: It's like a lifelong thing. So well, let's zoom in there,
Speaker 1: because you know, this adverse consequences piece is a really
Speaker 1: critical element for changing any habit. So it's got to
Speaker 1: be causing us enough pain, let's say, for us to
Speaker 1: want want to quit. You know, the classic addiction. You know,
Speaker 1: somebody hit rock bottom before they actually are motivated to
Speaker 1: change the behavior. But for example, my guess is that
Speaker 1: picking your nails isn't going to get you fired from
Speaker 1: a job or you know, ruin a relationship or something
Speaker 1: like that. It's just kind of annoying. Perhaps am I
Speaker 1: am I on track there? Yeah, it hasn't been a
Speaker 1: deal break or any dates yet, but if it did
Speaker 1: become a deal breaker, then I would quit immediately. Yeah, excellent.
Speaker 1: So there's a great example adverse consequences gets us to
Speaker 1: change behavior. But the nice thing there is we don't
Speaker 1: have to actually hit rock bottom on everything. We can
Speaker 1: kind of dial in and bring awareness in and help
Speaker 1: ourselves see very clearly in the moment when we're doing
Speaker 1: something that it's not that helpful, that actually can help
Speaker 1: us break those habits without having to go to those extremes. Okay,
Speaker 1: so why do we prefer cake to broccoli? Like, can
Speaker 1: you explain that to me? Yeah, I'd be happy to.
Speaker 1: And this actually forms a whole section of my book
Speaker 1: because this is one of the most critical elements. This
Speaker 1: is like the element of neuroscience if anybody were to
Speaker 1: pay attention to be to this piece. And so just
Speaker 1: a tiny bit of background here. You know, I've been
Speaker 1: studying habit change for a long time and one of them,
Speaker 1: probably the most predominant tactic or approach that people take
Speaker 1: to have a change is willpower. You know, just to
Speaker 1: eat salid instead of cake or whatever. Yet as we
Speaker 1: see with the diet industry, for example, you know, BC
Speaker 1: rates have been going up despite us knowing this formula
Speaker 1: for decades, despite you know, programs like weight Watchers being
Speaker 1: around forever. So you know, there's something that we're missing there,
Speaker 1: And what we're missing is that that's not actually how
Speaker 1: our brains work. Willpower is more myth than muscle, and
Speaker 1: at best, it gets depleted throughout the day of Those
Speaker 1: data are controversial, but let's just say it best. Willpower
Speaker 1: is a limited resource. I think most folks could agree
Speaker 1: with that. So here it's really about looking at what
Speaker 1: how our brains actually form habits and then taking that
Speaker 1: and saying, okay, can we turn it on its head?
Speaker 1: Can we actually change habits using that very very powerful
Speaker 1: part of the brain. And that's really why, you know
Speaker 1: why I wrote that whole section around why we prefer
Speaker 1: cake to broccoli our brain. There's a part of our
Speaker 1: brain called the orbitofrontal cortex that actually forms and stores
Speaker 1: reward value. So you can think of it as making
Speaker 1: a list of like the most rewarding things in our
Speaker 1: lives and the least rewarding things, you know, most rewarding
Speaker 1: at the top least rewarding at the bottom. And what
Speaker 1: it does is it uses that list to make quick decisions,
Speaker 1: so you know, we don't have to go in you know,
Speaker 1: if we're given a choice between say cake and broccoli.
Speaker 1: You know, when we've learned the reward value of broccoli
Speaker 1: and when we've learned the reward value of cake, it
Speaker 1: kind of stores those and then it can recall that
Speaker 1: reward value quickly, and instead of having to eat some
Speaker 1: of each one and decide which one we want, our
Speaker 1: brain just you know, launches for the cake because it
Speaker 1: tastes better. From a survival standpoint, that's all about, you know,
Speaker 1: calorie density. It's a cake is much more calorie dense.
Speaker 1: So we prefer cake to broccoli from a neuroscientific standpoint
Speaker 1: because it's more, it has more calories. From a hedonic standpoint,
Speaker 1: it just tastes better, and that better taste is what
Speaker 1: alerts us to pick that behavior in the future when
Speaker 1: given a choice. Does that make sense It makes sense
Speaker 1: to me, excellent, But I no, I hope that makes
Speaker 1: sense to people, because you know, people just describe distinguished
Speaker 1: between the wanting and liking system of dopamine, and it's
Speaker 1: very important to unpack the difference between wanting and liking.
Speaker 1: Absolutely absolutely, so we can take a moment to geek
Speaker 1: out on that. You know, the pleasant taste of cake
Speaker 1: actually alerts our brain. So the first time we eat cake,
Speaker 1: you know, it could be when we're a kid at
Speaker 1: a birthday party or whatever. First time we eat that cake,
Speaker 1: it's there's a surprise because our brain says, oh, that
Speaker 1: looks interesting, and we try it, and our brain says, oh,
Speaker 1: that's pretty good, and we fire dopamine that which down
Speaker 1: that memory that says, oh, cake taste good, Remember that
Speaker 1: and eat cake in the future. We also associate that
Speaker 1: taste with all the environmental cues, all the things around it,
Speaker 1: so the context. So if it's a birthday party, it's
Speaker 1: having fun, opening presents, probably eating some ice cream as
Speaker 1: well as cake and all of that. So we lay
Speaker 1: down this composite reward value when we eat cake for
Speaker 1: the first time. Then our brain starts shifting how it
Speaker 1: fires dopamine. It shifts away from when we receive when
Speaker 1: we actually do the behavior to anticipating doing the behavior.
Speaker 1: So the next time we go to a birthday party,
Speaker 1: we see the cake and our brain fires dopamine that says,
Speaker 1: ooh cake good, go eat it, right, and so it
Speaker 1: drives us to go do something. So it starts with this,
Speaker 1: you know, the liking quality, which is probably more than
Speaker 1: just dopamine. That dopamine fires to lay down that memory
Speaker 1: that then drives us to want the cake in the future.
Speaker 1: And this is true for any habit. So if we
Speaker 1: form a positive association around drinking alcohol, same thing. If
Speaker 1: we form a positive association or even a negatively reinforced
Speaker 1: behavior around smoking. If we're stressed out and we smoke
Speaker 1: a cigarette and we learn, oh, when I smoke, I
Speaker 1: feel better, that also lays down that same type of
Speaker 1: habit loop, so that that urge to go do the
Speaker 1: behavior is really dopamine driven. Absolutely, that was a great
Speaker 1: description of it. So, okay, how can we learn and
Speaker 1: grow from from this? Though? Like, how can we use
Speaker 1: our more evolved conscious control centers so that we're not
Speaker 1: being driven by these more subcortical structures that have learned
Speaker 1: things in the past. Is that Is that a fair
Speaker 1: way to ask the question. You can, it's a fair
Speaker 1: way to ask the question. But I'm actually gonna ask
Speaker 1: the question, is that actually the way that we can
Speaker 1: actually change behaviors, right, because that was good. Yeah. I'll
Speaker 1: suggest that that there are a couple of elements here.
Speaker 1: One is that the more evolved centers are younger and
Speaker 1: they're weaker, so they are actually going to go offline
Speaker 1: when we get stressed, when we get anxious, for example.
Speaker 1: So it's harder to utilize those unless we're mister Spock,
Speaker 1: who doesn't have emotions. So unless we're vulcan, our pre
Speaker 1: funeral cortex isn't quite evolved enough to be able to
Speaker 1: outcompete these more primitive centers. And in fact this goes
Speaker 1: I remember I wrote a little bit about this in
Speaker 1: my own Running Anxiety book. There's a relief on the
Speaker 1: Parthenon in Greece from like four point fifty AD or
Speaker 1: something very very old relief that depicts a horse and
Speaker 1: a rider, and the horse denotes the passions, these urges,
Speaker 1: these cravings, and the rider depicts our reason, our willpower,
Speaker 1: and the rider is trying to tame this horse. Yet
Speaker 1: we all know what is stronger. So this debate has
Speaker 1: been raging literally for centuries, like how do we actually
Speaker 1: utilize willpower? And what neuroscience is suggesting is that that
Speaker 1: might not be the best way to go. And the
Speaker 1: reason I say that is, you know, besides the fact
Speaker 1: that this is the youngest and weakest part of our brain,
Speaker 1: if we want to change a behavior, what is now
Speaker 1: pretty clear is that we have the only way to
Speaker 1: change a habit, for example, is to update the reward
Speaker 1: value or to change the reward value in our orbito
Speaker 1: front on cortex. And this has been shown since the
Speaker 1: nineteen seventies. There are these two researchers with Scola and Wagner,
Speaker 1: who now have this famous reinforcement learning or reward value
Speaker 1: curve called the Rascorla Wagner model, which basically says you're
Speaker 1: going to keep doing a behavior if it's especially if
Speaker 1: it's habitual, if you don't update the reward value, and
Speaker 1: if you bring awareness into the equation. And this is
Speaker 1: what I love about the interplay between Buddhist psychology and
Speaker 1: modern day psychology and even modern day neuroscience, is that
Speaker 1: there's what Rascola and Wagner pointed out was that there
Speaker 1: was this error term that they called either a positive
Speaker 1: or a negative prediction error, meaning that if we don't
Speaker 1: pay attention and there's the behavior, you know, eat the
Speaker 1: k we see the cake we eat the cake and
Speaker 1: we're not paying attention, that reward value is going to
Speaker 1: stay the same, or we're just going to keep that
Speaker 1: same reward value in our brain if we pay attention
Speaker 1: when we eat the cake. Let's say it's we've gone
Speaker 1: to a new bakery or something and we eat a new,
Speaker 1: new chocolate cake, so we're really paying attention. We're like,
Speaker 1: what's this like and it's the best chocolate cake that
Speaker 1: we've ever had, or brain goes, oh, wow, that was
Speaker 1: really good. That gives our brain what's called a positive predictionary,
Speaker 1: and it says, ooh, cake from this bakery is killer.
Speaker 1: You got to go back there. So we lay down
Speaker 1: this memory that says, oh, that's really good cake at
Speaker 1: that bakery. Or if we eat the cake at the
Speaker 1: bakery and it's eh, it's not that good, our brain
Speaker 1: says it gets a negative predictionary. It's expecting it to
Speaker 1: be good, especially if it looks like other cake that
Speaker 1: we've had before and it's lower. Our brain says, eh,
Speaker 1: not that great. We get this negative prediction error, and
Speaker 1: then we're less likely to go back and eat cake
Speaker 1: from that bakery. That's the only way that we can
Speaker 1: update reward value. And change habit is through that. Notice
Speaker 1: how no willpower is involved there, only awareness is needed
Speaker 1: for that. And so we can actually capitalize on this
Speaker 1: we by really bringing in the essential elements. So if
Speaker 1: we want to change a habit, So ironically, what I
Speaker 1: do with my patients who want to quit smoking and
Speaker 1: they come in and you know, they want to quit smoking,
Speaker 1: I tell them to smoke, and they look at me
Speaker 1: like I'm crazy, because they're like, Doc, I want to
Speaker 1: quit smoking. Why are you telling me to smoke? And
Speaker 1: I say, pay attention when you smoke, and maybe I'll
Speaker 1: explain a little of the neuroscience, maybe not, you know,
Speaker 1: just to help them really get a sense for why
Speaker 1: they're doing this. But nobody has ever come back to
Speaker 1: my office and said, you know, Doc, thank you so much.
Speaker 1: I never realized how good a cigarette tastes. They always
Speaker 1: come back and they're like, wow, I never realized that
Speaker 1: cigarette tastes like shit? How did I not notice that before?
Speaker 1: And I'm thinking, well, it's because it's a habit. You're
Speaker 1: not paying attention. But as they realize that, they get
Speaker 1: a negative prediction error and that helps them become disenchanted
Speaker 1: with the behavior. So they naturally start to move in
Speaker 1: the direction of quitting. And in fact, my lab just
Speaker 1: finished a study we did this with overeating. So we
Speaker 1: have this eat right now app that we were studying,
Speaker 1: and we built in this function to have people, you know,
Speaker 1: walk people through a mindfulness exercise as they were overeating,
Speaker 1: and it took as few as ten or fifteen times
Speaker 1: of people paying attention for that reward value to drop
Speaker 1: below zero. We can calculate this all out using these models.
Speaker 1: It dropped below zero where they flipped their behavior from
Speaker 1: overeating to not overeating. So this goes back to you know,
Speaker 1: it can take years to break a bad habit. No,
Speaker 1: it can actually happen pretty quickly if we're really really
Speaker 1: paying attention. Does that make sense? Yeah, But it requires
Speaker 1: a certain sense of discipline as well. I mean, are
Speaker 1: there individual differences in discipline itself required to do that?
Speaker 1: I think certainly there are individual differences in discipline. Yet
Speaker 1: we all have the same capacity to be aware. And
Speaker 1: so talking about discipline, I would say, you know, if
Speaker 1: somebody is interested enough, so there's a level you know,
Speaker 1: interest will drive discipline. If we're really interested in doing something,
Speaker 1: we're going to be disciplined to do it. If we're
Speaker 1: really interested in changing a behavior, that interest is going
Speaker 1: to drive discipline in any and all of us. If
Speaker 1: we're not that interested. So for example, let's go back,
Speaker 1: you know, you use the example earlier of like picking nails.
Speaker 1: You know, if we're not that interested, because we're not
Speaker 1: that you know, it's it's not that painful for us,
Speaker 1: it's going to be hard to change that behavior, whether
Speaker 1: it's picking our nails or overeating, or smoking or using opioids.
Speaker 1: It really spans the entire range there. How does how
Speaker 1: do like different mindfulness personality types come into play here?
Speaker 1: Because I want to get to the individual differences level
Speaker 1: a bit. Yeah, So what we've an interesting question that
Speaker 1: we asked probably about ten years ago now where we've been.
Speaker 1: I had a friend, Jake Davis, who's a poly scholar,
Speaker 1: who so who really knows the ancient language in which
Speaker 1: the Buddhist teachings were written down, And there was this
Speaker 1: fifth century commentary called the Path of Purification. I love
Speaker 1: that title, the Path of Purification. Yeah, and in that
Speaker 1: it doesn't sound fun, No, it doesn't. It doesn't sound
Speaker 1: like you know, this this long, arduous process. But the
Speaker 1: idea there was, you know, there was a section of
Speaker 1: that of that commentary in which different basically different personality
Speaker 1: types were described, and those personality types line up very
Speaker 1: nicely with modern day you know, propensities to kind of approach.
Speaker 1: You know, it's the fight, flight, freeze thing where we've
Speaker 1: got these you know, these very basic instincts too. You know,
Speaker 1: if there's danger, we're either going to fight or we're
Speaker 1: going to run away, or we're going to freeze, and
Speaker 1: you know, try to look like we're not there. And
Speaker 1: in fact, they really did a nice job of, let's say,
Speaker 1: describing the tendencies that we all have, where some of
Speaker 1: us have more of a tendency to approach things, some
Speaker 1: of us have more of a tendency to pull away,
Speaker 1: and some of us have more of a tendency to
Speaker 1: kind of freeze or do whatever everybody else is doing.
Speaker 1: So we did a study where we developed this basically
Speaker 1: a personality questionnaire around these different you can call them
Speaker 1: mindfulness personality types, let's say, just as an overarching thing.
Speaker 1: And you know, with thirteen questions, basically anybody can kind
Speaker 1: of get a good sense of what their propensity is.
Speaker 1: And it's not that it's you know, sometimes it could
Speaker 1: be predominantly one. Sometimes it could be a combination, just
Speaker 1: like any other personality type of thing, and with those
Speaker 1: we can start to see where our strengths are and
Speaker 1: where our weaknesses are. So, for example, folks that tend
Speaker 1: to be more likely to approach things they're they're gonna
Speaker 1: with mindfulness practices. They're going to be more likely to
Speaker 1: easily practice things like loving kindness or these practices that
Speaker 1: have more of a positive feel to them. Whereas folks
Speaker 1: that are more of the avoid type, they tend to
Speaker 1: be more analytical, and they're going to benefit from doing practices.
Speaker 1: You know, they're going to starting with practices that are
Speaker 1: more fit with that personality type. So getting somebody started
Speaker 1: with the mindfulness practice, it can be helpful to know
Speaker 1: what that predominance is, so you can pick something that's
Speaker 1: easy for them to pick up and they can get
Speaker 1: some quick wins and some immediate gains, and then over
Speaker 1: time they know what's going to challenge them, so then
Speaker 1: they can start shifting into some of these other practices
Speaker 1: that might not be so easy for them to kind
Speaker 1: of challenge their skill sets, so they can really, you know,
Speaker 1: keep going at times when they've kind of mastered some
Speaker 1: of the earlier practices. Cool, How can like people take
Speaker 1: the test? That is a great question. So we published
Speaker 1: published this, I think in plus one, which is an
Speaker 1: open access journal, several years ago. There's also a list
Speaker 1: of the questions and scoring mechanism in my in my
Speaker 1: book on Wending anxiety, and I think there's also an
Speaker 1: appendix in The Craving Mind in my first book where
Speaker 1: people can also take the CLIs Okay, So how does
Speaker 1: all this relate to anxiety? Because all this stuff is linked, right,
Speaker 1: so you know, where does the anxiety part come into play?
Speaker 1: When you know, because we so far we've be talking
Speaker 1: a lot about addiction and being mindful and change and
Speaker 1: habit change, where does anxiety come into play? So this
Speaker 1: is this was a turn in the road for me
Speaker 1: that I had not actually noticed, which prompted several years
Speaker 1: of research and then writing this entire book because I
Speaker 1: was so blown away by something that I had missed
Speaker 1: in medical school and in residency. So there's this medical
Speaker 1: term called number needed to treat. You're probably familiar with that,
Speaker 1: but for folks that aren't, it's basically a quick and
Speaker 1: dirty way of telling how well a treatment works, and
Speaker 1: basically the higher the number, the more people, you know,
Speaker 1: the worse the treatment. So, for example, with medications, when
Speaker 1: I prescribe gold standard medications for anxiety, the number needed
Speaker 1: to treat as five point two, meaning that I have
Speaker 1: to treat just over five patients before one of them
Speaker 1: shows a significant benefit. So there one I was playing
Speaker 1: the medication lottery because I didn't know which one of
Speaker 1: the five, you know, five people walked in my door.
Speaker 1: I didn't know which one was going to benefit on average.
Speaker 1: And the other part was, well, I didn't know what
Speaker 1: I was going to do with the other eighty percent
Speaker 1: you know that weren't showing a significant benefit. So at
Speaker 1: the time that I was developing my own anxiety around
Speaker 1: helping my patients, I was studying the seat right now
Speaker 1: app and somebody in that program was saying, you know,
Speaker 1: she said, you know, I'm realizing that anxiety drives me
Speaker 1: to stress eat. Can you develop a program for anxiety?
Speaker 1: And I was thinking, well, I prescribed medications. I'm not
Speaker 1: you know, this isn't really my lane. But it put
Speaker 1: a bug in my ear, and so I went back
Speaker 1: and looked at the research literature to see if there
Speaker 1: was something that I had maybe I slept through a
Speaker 1: class in medical school or residency or something like that.
Speaker 1: And back in the eighties, so this is when Benzo's
Speaker 1: were being prescribed like candy. You know, do you remember
Speaker 1: the Stone song Mother's Little Helper, right, that's about Benzo's.
Speaker 1: She goes running to the shelter of Mother's Little Helper.
Speaker 1: So Benzo's are being prescribed like candy. They're no longer
Speaker 1: first line treatment for anxiety in modern day. You know,
Speaker 1: a lot of problems there, and the SSRIs were first
Speaker 1: starting to be developed. I think Prozac the first one
Speaker 1: was on the market around mid eighties, so people were
Speaker 1: really focusing on medication, yet they were ignoring a literature
Speaker 1: that was starting to blossom. Thomas Borkovik at Penn State
Speaker 1: and others were suggesting that anxiety could be driven like
Speaker 1: any other habit, through the mental behavior of worry. And
Speaker 1: when I read this, it just light bulb moment. I
Speaker 1: was thinking, Wow, I never realized that anxiety could be
Speaker 1: driven this way, and I know something about habits, So
Speaker 1: so I put the two together and I said, well,
Speaker 1: let's develop you know, a habit driven program in terms
Speaker 1: of helping people approach anxiety from a habit perspective. So
Speaker 1: we developed this on Winning anxiety app and I and
Speaker 1: of course, as a clinician, I wanted to see how
Speaker 1: we could help people. As a researcher, I wanted to
Speaker 1: see if this thing actually worked, because you know, this
Speaker 1: was an old literature. You know, it wasn't really people
Speaker 1: weren't really talking about it that much in modern day.
Speaker 1: So I wasn't sure if it was just you know, overlooked,
Speaker 1: or it just you know, hadn't panned out. So we
Speaker 1: did some clinical studies. We developed this on Wending Anxiety app.
Speaker 1: We did a study with anxious physicians right for this,
Speaker 1: we got a fifty seven percent reduction in clinically validated
Speaker 1: anxiety score. So that was pretty good. I was like, wow,
Speaker 1: that's that's pretty good we did. It's amazing. Yeah, And
Speaker 1: so we followed that with the randomized controlled trial of
Speaker 1: people with generalized anxiety disorder. Okay, you ready for this,
Speaker 1: got a sixty seven reduction in anxiety scores. And here
Speaker 1: we could calculate the number needed to treat. So if
Speaker 1: you remember, for medications, that number is five point two,
Speaker 1: So I have to treat five patients before one person
Speaker 1: benefits with this on lending anxiety app. That number needed
Speaker 1: to treat was one point six. What does it mean
Speaker 1: to be half of a person? Yeah, I'm joking or
Speaker 1: two thirds? I try to treat the whole person. But yes,
Speaker 1: these are these are statistics, these are numbers. Well that's
Speaker 1: that's really amazing, amazing effects science. Wow. Now is this
Speaker 1: an app that that people listening today can can download
Speaker 1: and can use? Yes, anybody can download this from you know,
Speaker 1: the from the app store, Google Player or the app
Speaker 1: store on their iPhone. I'm just going to do that
Speaker 1: right now. I forget the rest of the interview. I
Speaker 1: need I need this. Wow, that that's truly effect. What
Speaker 1: do you think was you know, the underlying causal mechanism
Speaker 1: there that that played the biggest role in such a
Speaker 1: large effect. Funny that you ask, because you know, we
Speaker 1: got these nice clinical results, but of course I wanted
Speaker 1: to know what was happening mechanistically so we we could
Speaker 1: actually look at that and we found that. So we
Speaker 1: had measured a number of things like increases in mindfulness
Speaker 1: and in particular looking at emotional reactivity. So the theory
Speaker 1: is that with mindfulness, people will become less reactive to
Speaker 1: their emotions. So if they're anxious, they'll be less likely
Speaker 1: to just jump in and worry. So that was that
Speaker 1: was one aspect that we looked at. We also looked
Speaker 1: at worry itself, because worry is a core component of anxiety.
Speaker 1: It's even baked into the definition and is a big
Speaker 1: element that's measured whether you look at generalized anxiety or
Speaker 1: other types of anxiety. So we looked at worry, and
Speaker 1: then of course we looked at these clinically valid anxiety scores.
Speaker 1: We looked at we used the generalized anxiety to or
Speaker 1: seven measure, which is one that I use in the clinic,
Speaker 1: and we found that mindfulness training specifically increased non reactivity,
Speaker 1: and that non reactivity mediated a decrease in worry, and
Speaker 1: that decrease in worry mediated a decrease in anxiety. So
Speaker 1: I should also back up and mention we were specifically
Speaker 1: training people to map out these anxiety worry habit loops.
Speaker 1: So anxiety so you need three three elements for any habit,
Speaker 1: a trigger of behavior, and a result, So anxiety was
Speaker 1: the trigger, worry was that mental behavior, and then the result.
Speaker 1: What they started to pay attention to was seeing that
Speaker 1: the result of worry was that it wasn't actually that rewarding. Now,
Speaker 1: often we'll lay down the habit of worrying because it
Speaker 1: feels like we're you know, we're in control, or it's
Speaker 1: distracting us a little bit from the worst feeling feeling
Speaker 1: of anxiety. But in fact, when we help have people
Speaker 1: pay attention and they realize they're not really in control
Speaker 1: of whatever they're worrying about, and that anxiety feeds back
Speaker 1: and I'm sorry, that worry feeds back and drives more anxiety.
Speaker 1: So anxiety triggers worry, Worry feeds back and drives more anxiety,
Speaker 1: and then people get into this vicious leap of anxiety, worry, anxiety, worry.
Speaker 1: They realize that it wasn't that rewarding. You know, if
Speaker 1: you go back to these Rescolo Wagner models, it helps
Speaker 1: people see, oh, worrying's not actually making me feel better,
Speaker 1: it's making me feel worse. So that they can then,
Speaker 1: you know, not learn to become less reactive to the anxiety,
Speaker 1: learn to be with those physical sensations and have that
Speaker 1: not not trigger worry. So that's mechanistically what we were finding.
Speaker 1: They're less reactive, they worry less, and that led to
Speaker 1: a big reduction in anxiety. Well, that's huge, that's so huge.
Speaker 1: So tell the people the name of the app again,
Speaker 1: is it just called Unwind Anxiety? It's called Unwinding Anxiety. Yes,
Speaker 1: I'm sure everyone's going to their app store right now.
Speaker 1: This is huge. How much does it cost? You know,
Speaker 1: I don't remember. That's I don't pay attention that much.
Speaker 1: It's probably I don't know, it's I honestly don't know. Okay,
Speaker 1: So people, it's certainly that. Yeah. And I think they
Speaker 1: were trying to price it around the cost of a
Speaker 1: copay for somebody to see their primary care physician here
Speaker 1: once a month or something like that. So I think
Speaker 1: they're trying to make it reasonable. Great. Great, okay, So
Speaker 1: what's good about rainy Days? Yeah, that's a that's a
Speaker 1: kind of a chapter title that I used because there's
Speaker 1: this practice, this mindfulness practice that we've been studying a
Speaker 1: lot in my lab called RAIN And the idea behind
Speaker 1: that is that you know, we can use so the
Speaker 1: acronym RAIN stands for recognize, allow, investigate, and note and
Speaker 1: the ways that your model. No, it's it's built offter Well.
Speaker 1: Tara has popularized it. When I traced it back. Michelle
Speaker 1: McDonald was the one that first put this forward, and
Speaker 1: you know, Tara really did a great job of popularizing
Speaker 1: as used it beautifully in her writings and her teachings,
Speaker 1: and she's it's interesting, you know she when I first
Speaker 1: learned it, that end stood for non identification, which is
Speaker 1: a little conceptual for my clinic patients, some of them.
Speaker 1: And so we actually adapted that to a note where
Speaker 1: there's this Burmese practice of kind of noting experience moment
Speaker 1: to moment, and we've I found that that started testing
Speaker 1: this in my in my VA when I was at
Speaker 1: the VA Hospital, taste testing it with my outpatient clinics
Speaker 1: and found that that was very accessible. You know, somebody
Speaker 1: could note whether it was seeing, feeling, hearing, tasting or
Speaker 1: whatever the fifth sense is that I'm missing, you know,
Speaker 1: they could basically note any of their senses plus thinking,
Speaker 1: and that noting practice help them not be as caught
Speaker 1: up in whatever the thought or the emotion or the
Speaker 1: feeling was. So so we started testing this first with
Speaker 1: our smoking program. So we have this app called Craving
Speaker 1: to Quit. So we started developing it and testing it there.
Speaker 1: Used it also for helping people with overeating, you know,
Speaker 1: when they had an urge to eat. And then also
Speaker 1: people can use this with anxiety. So if they're let's
Speaker 1: use the eating example, because we've been talking about cake
Speaker 1: a lot. If somebody has an urge to eat some cake,
Speaker 1: that R comes in. If they want to use this practice,
Speaker 1: they can recognize, oh, I've got a craving, right, because
Speaker 1: if we don't recognize that we have a craving, we're
Speaker 1: just going to be lost. We're going to be an autopilot,
Speaker 1: We're just going to eat it. So we first have
Speaker 1: to recognize what's happening. That AA stands for allow. So
Speaker 1: often when we have a craving, we'll try to resist
Speaker 1: it and we'll think, oh, bad craving. I need to
Speaker 1: make that go away, so I don't eat the cake. Well,
Speaker 1: we can only resist for so long. And you probably
Speaker 1: know the saying what we resist persists, So you know,
Speaker 1: these things tend to get stronger. Craving stif to get
Speaker 1: stronger if we resist them. So instead of resisting, we
Speaker 1: invite them in and say, Okay, here's a craving. You know,
Speaker 1: come on in, let's see, let's see what you're all about.
Speaker 1: And that let's see what you're all about is what
Speaker 1: that eye stands for, where we investigate what's happening in
Speaker 1: our experience. And I love this, you know. Basically it's
Speaker 1: about being curious about what's happening. And one thing that's
Speaker 1: beautiful about that is curiosity. If you compare a craving
Speaker 1: to curiosity, curiosity feels much better than a craving. So
Speaker 1: in that moment where we've got this unpleasant urge to
Speaker 1: eat the cake, we can bring in curiosity and go, oh,
Speaker 1: what does this urge feel like? And we kind of
Speaker 1: break it down into its component elements, where this is
Speaker 1: where the end the noting comes in. We can note, Okay,
Speaker 1: what is craving feel like. Huh, well, it's tightness, it's
Speaker 1: it's heat, it's you know, it's restlessness. Okay, now it
Speaker 1: is you know, it's this, Now it's that, And from
Speaker 1: moment to moment we can start to dissect it into
Speaker 1: its component elements where we can see, oh, instead of
Speaker 1: this being some big, bad, scary craving that feels like,
Speaker 1: you know, my head's going to explode. I actually had
Speaker 1: a patient walk into my office saying his head was
Speaker 1: going to explode if he didn't smoke. That's how scary
Speaker 1: it can be. Instead of that, we can break it
Speaker 1: down and say, okay, well, how scary is tightness, Well,
Speaker 1: it's just tightness. It's not that scary. How scary is heat, Well,
Speaker 1: it's just kind of heat. How scary is burning? How
Speaker 1: scary is restlessness? You know? And these things themselves are
Speaker 1: not that scary. Also, as we note from moment to moment,
Speaker 1: we see that these experiences they might get a little
Speaker 1: more intense, but then they eventually fade and we can see, oh,
Speaker 1: I don't have to actually act on this craving. I
Speaker 1: don't have to eat the cake, I don't have to
Speaker 1: smoke the cigarette. You know, I don't have to do whatever.
Speaker 1: If I just bring curiosity in, it helped me ride
Speaker 1: that wave out. So the rain practice helps anybody that's
Speaker 1: got an urge to do something, you know, if it's
Speaker 1: a craving for cake or a cigarette or whatever, to
Speaker 1: really help them be in the moment and start to
Speaker 1: break that link between urge and action. And in fact,
Speaker 1: you know, of course, my love to study, so we
Speaker 1: did a study on this, and we found that after
Speaker 1: four weeks of mindfulness training, smokers in particular could completely
Speaker 1: break that link between that urge that craving to smoke
Speaker 1: and the smoking itself. This is incredible. But there's so
Speaker 1: many complexities when we talk about humans because we have
Speaker 1: first order desires and we have second order desires, and
Speaker 1: we have third order desires. I'm still not sure I
Speaker 1: fully understand who the real me is, Like, like, how
Speaker 1: do I? How do I? I mean I've argued that
Speaker 1: there is no real me and a bus this thing
Speaker 1: is real. Mean when we talk about authenticity, I mean
Speaker 1: we have where these we have so many like evolutionary
Speaker 1: modules that are pulling us in so many different directions
Speaker 1: based on environmental stimuli and triggers and things and internal
Speaker 1: things going on as well. But you know, we might
Speaker 1: have an urge docing, but then we have the urge
Speaker 1: that says I don't want to want that urge. You
Speaker 1: know what if you know, I mean sometimes what someone
Speaker 1: can ever just do things that are you know, in
Speaker 1: moderation are just fine? Is it just is? Is the
Speaker 1: problem when it gets out of control and it kind
Speaker 1: of like overtakes the whole system? Is that is that
Speaker 1: the problem? Yes? And that's one of the beautiful again,
Speaker 1: beautiful aspects of our brains is that you know, if
Speaker 1: you go back to this definition of addiction, you know,
Speaker 1: continued use despite adverse consequences. So if we bring awareness
Speaker 1: in that and we start to see a habit loops,
Speaker 1: say around eating, and we bring awareness in and we
Speaker 1: really pay attention as we eat, it's not that suddenly
Speaker 1: we're going to magically not like cake. That's not how
Speaker 1: our brains work. But what we can do is see
Speaker 1: when we're over consuming, we can start to see where
Speaker 1: that pleasure plateaus, and that naturally helps us start to
Speaker 1: moderate behavior when it previously we would just overeat and
Speaker 1: not pay attention. And so you know, I even have
Speaker 1: some of folks in our programs or my patients and
Speaker 1: my clinic have them pay attention with each bite and
Speaker 1: say just ask, you know, is this better than same
Speaker 1: as or worse than the last bite? So they can
Speaker 1: kind of map out that that pleasure plateau in their
Speaker 1: experience right in that moment, and they can and that
Speaker 1: also helps them bring curiosity in is this as good as?
Speaker 1: Is it better than? Is it worse than the last one?
Speaker 1: And it helps them start to see, oh, you know,
Speaker 1: it's plateauing. It's really not that great. Oh, it's actually
Speaker 1: worse than when I than that last bite. Now is
Speaker 1: a good time to stop. So with things like eating food,
Speaker 1: awareness itself helps us moderate our behavior where we don't
Speaker 1: have to you know, we don't have to go all
Speaker 1: psychological on our on ourselves too much if we're really
Speaker 1: you know, if we're really just focused on that awareness
Speaker 1: of that behavior in that moment. Wow, this is this
Speaker 1: is this is so useful and practical information for people
Speaker 1: and hopeful. What is what is anxiety? Sobriety? Well here,
Speaker 1: you know, I like that term because I was so
Speaker 1: which so this this came to me when I was
Speaker 1: so with any Anybody using our apps can join a
Speaker 1: live group. We run a Zoom group on Wednesdays at
Speaker 1: noon Eastern, so anybody can join that group and ask
Speaker 1: questions basically where we can you know, we can help
Speaker 1: clarify concepts, help people work through struggles, things like that.
Speaker 1: And there was a guy on there that joined us
Speaker 1: one day that said to me, you know, he said,
Speaker 1: you know, I feel pretty anxious. How can I work
Speaker 1: with my anxiety? And I said, well, you know what
Speaker 1: tools of the program that you've been using and how
Speaker 1: well have they worked? And he said, you know, I can,
Speaker 1: I can. I think he was using rain or he
Speaker 1: was using some of the tools, and and he said,
Speaker 1: you know, in the moment, I actually notice how calm
Speaker 1: I can feel when i'm when I'm mindful. But I
Speaker 1: get real, you know, I'm I'm I might get really
Speaker 1: anxious later. And so and he kept coming in with
Speaker 1: his butt. But but and he was always having spinning
Speaker 1: out into the future, which is, you know, anxiety is
Speaker 1: basically fear of the future. You know, that's a big,
Speaker 1: big piece here. And so that it occurred to me
Speaker 1: that he was describing something that a lot of my
Speaker 1: patients with addiction struggle with, which is, you know, I
Speaker 1: have a patient who's got alcohol's disorder, and they say,
Speaker 1: you know, I don't know if I can be sober
Speaker 1: in a week, you know, and I really don't know
Speaker 1: if I can be sober in a month. What I
Speaker 1: have them do is I have them dial it back,
Speaker 1: and I say, Okay, if you're not sure you can
Speaker 1: be sober in a week, how about can you know
Speaker 1: if you can be sober tomorrow? And they say, well,
Speaker 1: I don't know, a lot of things could happen between
Speaker 1: today and tomorrow. And so we dial it back and
Speaker 1: we say, well, how about you know, if I'm meeting
Speaker 1: with them in the morning, how about noon today, can
Speaker 1: you be sober for the next couple of hours? And
Speaker 1: that actually kind of brings their future into more focused
Speaker 1: because it's more immediate, and they're like, well, I could
Speaker 1: probably be sober, you know, for two more hours. And
Speaker 1: then I say, let's dial it back right now. Are
Speaker 1: you sober right now? And they say, yeah, Well, I'm
Speaker 1: sitting in your office. And not everybody's always say you know,
Speaker 1: but in general, folks come to my office sober, and
Speaker 1: so it's like, okay, take it one moment at a time, right.
Speaker 1: So with AA, they talk about one day at a time. Time.
Speaker 1: If you think too far into the future, you're going
Speaker 1: to run into trouble because our brains are not good
Speaker 1: at predicting the future, especially if a lot of things
Speaker 1: can happen between now and tomorrow or next week or
Speaker 1: next month. So this anxiety sobriety term came to mind
Speaker 1: when I was talking to this guy, and I was thinking, oh,
Speaker 1: this sounds a lot like what my patients struggle with addictions.
Speaker 1: He was struggling with thinking way too far into the future,
Speaker 1: and so what I had him do. We kind of
Speaker 1: worked through this in real time. I said, okay, well,
Speaker 1: if you're not sure, if you cannot be anxious tomorrow,
Speaker 1: can you dial it back to two hours, can you
Speaker 1: dial it back to one hour? And we dialed it
Speaker 1: back to right now, and I said, well, how do
Speaker 1: you feel right now? He's liked, well, I feel relatively calm.
Speaker 1: And I said, well, you know, in the next five minutes,
Speaker 1: if you feel anxious, can you bring in your mindfulness tools?
Speaker 1: And he said, yeah, I can do that, and I said, okay,
Speaker 1: take it five minutes at a time. And so in
Speaker 1: this way we all can develop our anxiety sobriety by
Speaker 1: one noticing when our mind is spinning out into the future,
Speaker 1: worrying about I don't know if I'll be in acxious tomorrow,
Speaker 1: and then two dialing it back and taking it one
Speaker 1: day or one hour or one moment at a time,
Speaker 1: because in this moment we can actually work with what's
Speaker 1: happening and work with our anxiety. This groundbreaking. How does
Speaker 1: this relate to suicidal thoughts? Great question? So you know
Speaker 1: people can have suicidal thoughts based on a number of
Speaker 1: different things. So when I have a patient who might
Speaker 1: be having some suicidal thoughts. One thing I work with
Speaker 1: them with is to help them identify those, you know,
Speaker 1: is the thoughts that they're having, the emotions that they're having,
Speaker 1: and even bring it into very concrete terms like what
Speaker 1: is it that's driving the thought? For some people, suicidal
Speaker 1: thoughts can actually be somewhat can be driven in the
Speaker 1: same manner as other habits or addictions, where there's some
Speaker 1: type of reward that their brain's getting from having that thought.
Speaker 1: And you know, on a very basic level, you know,
Speaker 1: think of a trigger behavior result pathway. The you know,
Speaker 1: if somebody's really stressed out or really has a lot
Speaker 1: of existential anster is feeling really depressed, that feeling that
Speaker 1: negative emotion can drive them to have a thought about, boy,
Speaker 1: it would be better if I just weren't around, you know,
Speaker 1: and that thought can give them this you know, this
Speaker 1: where they can project into the future and like they
Speaker 1: get this role where that like, oh, yeah, it'd it'd
Speaker 1: be better if I weren't around. So they have this thought,
Speaker 1: oh yeah, it'd be you know, it just feels better
Speaker 1: in that moment, and then that that drives back and feeds,
Speaker 1: you know, the next time they have that really negative emotion,
Speaker 1: their brains more likely to have that suicidal thought. So
Speaker 1: here we can even start to map out this process
Speaker 1: itself with with anything, whether it's a suicidal thoughts or
Speaker 1: you know, or a cigarette or or anything that there's
Speaker 1: this shared mechanism there in the brain. Yeah. And then
Speaker 1: after six years and five minutes of anxiety is sobriety?
Speaker 1: Then what then we take it that next moment? Why
Speaker 1: do you why do you label? Tell me about the
Speaker 1: significance of six years and five minutes? Oh okay. So
Speaker 1: at the very end of my book, I wrote about
Speaker 1: so I had when we first developed our first digital therapeutic,
Speaker 1: this first app for smoking craving a quid app. I
Speaker 1: was down, I think I was giving a ted X
Speaker 1: talk down in Virginia, somewhere near d C. And there's
Speaker 1: a talk on flow. And since I was in d C,
Speaker 1: I figured I had a friend Tim Ryan, who's a
Speaker 1: congressman from Ohio, and I said, I'll look him up
Speaker 1: and you know, see if we can get together. And
Speaker 1: so I stopped by his office and I said, hey,
Speaker 1: you know, we just developed this app for smoking, and
Speaker 1: you know, he's very interested in mindfulness related things, and
Speaker 1: he said, oh, that's interesting, you know, tell me about it.
Speaker 1: And I was telling him about it, and he got
Speaker 1: this glint in his eye and there was this He
Speaker 1: suddenly calls out to one of his young aides and
Speaker 1: he goes, hey, you get in here, and he goes,
Speaker 1: you smoke, don't you? And the poor kids? You know,
Speaker 1: it's scared to death. You know, what's he going to
Speaker 1: make me do now? And Congressman Ryan goes, hey, you
Speaker 1: know you don't have to quit smoking, but just try
Speaker 1: this app and tell me if it's any good. And so,
Speaker 1: you know, the kid down is the app. So he
Speaker 1: starts trying it out, and in fact, he I think
Speaker 1: he wrote me an email saying, you know this. A
Speaker 1: couple of weeks later he said, you know, I wasn't
Speaker 1: actually interested in quitting, but I tried it, and you know,
Speaker 1: and I actually quit smoking. You know, I was never
Speaker 1: expecting to do that. So the six years later thing is,
Speaker 1: Tim and I were giving talks at this at a
Speaker 1: conference six years later, and he was sitting next to
Speaker 1: me right before I went up to get my talk,
Speaker 1: and he leans over and whispers in my ear and
Speaker 1: he goes, hey, you remember this guy And I go, yeah,
Speaker 1: of course, and he goes he's still smoke free, and
Speaker 1: I just you know, I just got these tears in myles.
Speaker 1: I was like, wow, that was that's amazing. You know.
Speaker 1: So six years later, this guy, you know, was just
Speaker 1: trying this app out because Congressman Ryan was asking him to,
Speaker 1: and he learned, you know, basically these basic mindfulness skills
Speaker 1: that helped literally, you know, prevent you know, smoking is
Speaker 1: one of the leading causes of morbidity immortality in the US,
Speaker 1: and so he had just he had helped himself in
Speaker 1: a way that you know, his body was going to
Speaker 1: thank him for for the rest of his life. And
Speaker 1: so it was just really nice to see that, you know,
Speaker 1: six years later it still had taken. Wow, I can't
Speaker 1: wait to try this app and maybe it can help
Speaker 1: me stop picking my nails. You know. Funny you mentioned
Speaker 1: that because folks have used our our smoking app for
Speaker 1: everything from internet porn to trick atilomania like hair pulling
Speaker 1: to skin picking. Because the skills are the same, it's
Speaker 1: just what you apply it to. So let me know,
Speaker 1: let me know what you find. Yeah, Hey, doctor Brewer,
Speaker 1: just thank you so much for coming on the show
Speaker 1: today and given dropping your wisdom. It's so important during
Speaker 1: this time, and like I said at the beginning of
Speaker 1: this chat, I can't think of too many topics that
Speaker 1: are more important than this right now. So thank you
Speaker 1: so much. That's my pleasure. Thanks for listening to this
Speaker 1: episode of The Psychology Podcast. If you'd like to react
Speaker 1: in some way to something you heard, I encourage you
Speaker 1: to join in the discussion at the Psychology podcast dot com.
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