Behavioral Neuroscientist Shows You How to Break The Coronavirus Anxiety Cycle | Judson Brewer | Transcription

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Introduction

Intro (00:00)

- Hey everybody, welcome to a very special episode of Impact Theory. Because of the coronavirus, we're all on quarantine here. So this is gonna be our first ever interview filmed on Skype. And I cannot think of a better guess. Today I've joined in me, Dr. Judd Brewer. He is the Director of Research and Innovation at the Mindfulness Center, an Associate Professor in Psychiatry at the School of Medicine at Brown University, as well as being a research affiliate for MIT. And I think that he has some really cool stuff to offer us in the way of the anxiety that's cropping up for a lot of people in the midst of the coronavirus outbreak. This is really historic times. This is something I don't think any of us have seen in our lifetime, certainly not here in Los Angeles. So a lot of people are dealing with the stress in different ways, some of which maybe not as ideal as they would like it to be. So we wanted to bring somebody on, even though we're not able to film in person that can help people with that. So we are doing this special episode. This is gonna be unlike the normal episodes that you guys are used to and that this is gonna be completely unedited. So if there are any mistakes, Dr. Judd, this is you and I, we're walking the tightrope with nothing to catch us if we fall. But I'm pretty eager to get your take on what's going on. What do you think is happening to people in terms of their mindset right now? Why is talking about dealing with anxiety as it relates to this so important? I've had so many people say that we needed to do this episode. We needed to talk about the stress and the anxiety. So what's happening with people right now? - Yeah, I was just at the grocery store for the first time. I left my house for the first time in probably four days. Brown had its first confirmed case over the weekend. So I've been laying low and the shelves are relatively empty. And I think that phenomenon comes where these survival mechanisms start to spiral out of control. So I think that might be a good place to start is just to help us all understand like how our basic survival mechanisms work and how they spiral out of control because then that lets us get back into control. So the first place to start is really understanding fear and fear responses are normal. They're healthy, they're adaptive, they help us survive. Simple example, if we walk out into the street and we look to the side and we see a car barreling down on us, jump back on the sidewalk and that fear response says, "Hey, remember what almost happened?" So we learn to look both ways before crossing the street. So it's a very adaptive learning mechanism. Some time over the last million years or so our survival brain kind of layered on this neocortex, this new part of the brain that includes the prefrontal cortex, the thinking, the planning part of the brain, planning also very, very helpful for survival. Yet the planning part of the brain needs something really important which is accurate information. Right now with coronavirus, we have some accurate information but we actually don't know a whole lot about what's the time window of contagion, this, this and that. So we're getting more information every day but we don't really have a lot of accurate information. So if you pair fear with uncertainty, your thinking brain starts to spiral out of control in these what if, what if, what if scenarios and we get anxiety, okay? So anxiety makes our thinking brain start to go offline.

Understanding Social Behavior And Crisis Management

Social Contagion (03:29)

On top of that, you add in social contagion, okay? Social contagion is basically the path of emotion from one person to another. You know, if somebody's talking to somebody else on the phone and that other person's anxious, we're more likely to get anxious or if we talk to somebody who's panicking or if we go on social media and we see all these panic posts, you know, like bare shelves at the grocery store, whatever, that social contagion, we can actually catch that anywhere in the world. We don't need to be six feet, you know, closer than six feet to somebody to catch that. So social contagion might even be more contagious than viruses and bacteria. When you add social contagion to anxiety and that anxiety starts to spiral out, that's when we get panic, right? And panics when our prefrontal cortex goes completely offline and we start doing things that are not helpful, like buying all the toilet people at the grocery store, you know, probably don't need six months worth of toilet paper. And we probably didn't go to the grocery store thinking, you know, I'm gonna stock up on toilet paper this six months. We don't do that. We go to the grocery store looking for groceries and then we see everybody else, you know, where there's a run on toilet paper. And suddenly one thing I wanna make sure that we cover today is gonna be what to do about this and how we get people back to normal, but I'm super curious. Yeah. Speaking to your social contagion idea, how did toilet paper become the thing? Because I guarantee that's not like just where people naturally go. Someone somewhere must have said something. I think it, but I actually don't know what happened. I don't know when this became a thing and when people started panicking about toilet paper. So do you know how that particular idea spread? I don't know what the vector of origin was, but somewhere somebody started talking about toilet paper and then other, you know, it spread to other people, spread to other people. And then suddenly it was the toilet paper meme. I actually was talking to somebody two days ago and they said, yeah, we're actually calling it the toilet paper index. You know, the stock market has a fear index. Well, you know, you can think of our consumer market being, you know, what's the toilet paper index? But I think it just got seeded somewhere and that became the meme for, you know, panic. - It's really interesting. So the notion of memes and the notion of how rapidly ideas can spread, I think gives people a really clear understanding of how this stuff ramps up and how you can plant a seed in somebody's mind that then mushrooms into something. Because this one, the toilet paper index caught me off guard. I was like, what is going on? Of all the things to get weird about toilet paper? Like it just seemed like food I get. I get how people are panic buying food. I even understand like sanitizer and soap, but man, that toilet paper is the thing that people are lining up for in grocery stores and getting in fist fights over. That one really caught me off guard. It's, so what I'm hoping we can do in this episode is plant a similar idea in people's minds. And having researched you, I'm pretty sure I know what the idea is gonna be. But I want people watching this to get an idea planted in their mind around how to use the basically the habit loop triggers, positive reinforcement and negative reinforcement to re-align their mind. And I'm hoping that in the way that you're able to do, 'cause for people watching, Dr. Judd is also a specialist around addiction and has helped people tremendously there. And it's really extraordinary, the amount of impact you've been able to have was something that I never would have imagined was useful in addiction. So walk us through one, what is the central idea? If you were gonna plant something in people's minds and have it be the mean that takes over now in this sort of crisis state, what is that idea that you would plant? - The idea though I would plant is really to understand how our minds work so we can keep our prefrontal cortices online, that's one, I'm gonna plant two. The second one is find what I call the bigger better offer. And there are bigger better offers than fear and anxiety and panic, they don't actually feel good.

Dr Judds Idea to Keep in Mind in a Crisis (07:43)

So if I could just start planting the seed around kindness, connection and calm, they actually all feel better in our brain and my lab's actually done research around this. So those are the bigger better offers we're gonna help guide ourselves toward and the secret ingredient for that is awareness. - Okay, so I think that is, there's some really interesting things that people are gonna need context around, they're used to hearing ideas around mindfulness, kindness, connection, that sort of drifts into outer space in a way that I don't particularly resonate with. But the way that you are able to bring that down for people and make it accessible, I think starts with the first idea you wanted to plant. Now, dude, this was when I started learning about you, I was like, whoa, I have come at this from a very unscientific standpoint. But the thing I always tell people is if you wanna understand how I got out of this feeling of hopelessness that I was in in my early 20s, it was I had to research the brain, how it actually works. Because for me, being able to imagine the brain and the idea that I'm obsessed with getting people to understand is you're having a biological experience. Because you're having a biological experience, I highly recommend getting your mind around some of the biology. So this notion of actually understanding the brain process, I think is really important and I'd love for you to walk people through, what are some of the basics that if they understood, they'd begin to have an easier time wrangling their thoughts? - Yeah, so I've been studying this for a couple of decades now and the more I study, the simpler it gets.

Dont have to be a brain surgeon (09:23)

So the one thing I wanna start with is telling people, you don't have to be a brain surgeon to understand this stuff. You don't even need to be a neuroscientist like I am to understand this stuff. Anybody can understand this and we can actually get this out there in ways that people can really see significant changes, whether it's addiction or anxiety or eating or whatever. So the basic process, let's start with survival, right?

3 Stesp to A Habit Loop (09:42)

So three steps or three elements of a habit loop that's really set up to help us survive, a trigger, a behavior and a reward. So let's start with positive reinforcement that you mentioned. So you see food, right? Out on the savannah, our ancient ancestors, they see food, that's the trigger, they eat the food, that's the behavior and then their stomach sends this dopamine signal to their brain that says, "Remember what you ate "and where you found it." So that's that brain reward and we can talk about what reward actually feels like later, but that's from a brain perspective, that's the reward. That's positive reinforcement. So we remember where to go get food. Same thing is true with negative reinforcement. You know, you're out on the savannah looking for food, saber to tiger comes at you, if you run away, that behavior helps you survive, that's your reward. And so that negative reinforcement says, "Hey, avoid that part of the savannah in the future." So it's actually a relatively simple process. So habits are actually really helpful. So think about this, setting up habits every morning. If we had to relearn everything from walking to putting on our clothes to making breakfast, to making coffee, to eating, to talking, you know, we'd be exhausted by breakfast. So setting up these habits is actually really important. I think of it as set and forget. Our brains set a habit. So, okay, this is a good thing for survival. And then we forget about the details, okay? So that's the first step in terms of understanding how this process works. Three elements trigger behavior reward. Positive reinforcement is we do more of the things that make us feel good, like eat food. And then we do fewer of the things that make us feel bad. You know, we avoid things that make us feel bad, like avoid things that are dangerous. That's the first part. Does that make sense? - Yeah, definitely. So in this context, one thing going back to how the brain works that I found really interesting is you've talked about how, so this is often called operant conditioning if I'm not mistaken. - Yes.

Arguably, The Oil of Modern Society (11:34)

- And I forget the guy's name, but somebody won a Nobel Prize for showing that this goes back all the way evolutionarily to sea slugs. So you wanna talk about something that is just baked in to the foundation of how our mind works is really important. So give people an understanding. So what's going on now in the context of COVID-19, how is this mechanism working against people? - Yeah, so let's focus in on anxiety 'cause that's what we're seeing a lot of right now. So anxiety can actually get reinforced in a negative reinforcement loop through operant conditioning. So if we're afraid, if there's fear, that's the trigger, the behavior is worry and that worry helps us feel like we're doing something, right? We might not know what to do, but at least our mind is doing something. The problem is that worry doesn't actually feel that good. It doesn't get things done and it actually starts to make our prefrontal cortex go offline so we can't think. And worry can start to trigger more anxiety. So if we're anxious that trigger is worry and that worry triggers more anxiety, we can start to see how that spirals out of control. I think of this as like going over the event horizon into that black hole of anxiety. It's just, it's really hard to pull yourself out. - And so now when people find themselves in this loop, what are some of the things that they can do? So you've got a whole book obviously called Unwinding Anxiety or an app, excuse me. How do you help people begin to unwind? And how did you come up with that phrase? Because as somebody who's dealt with anxiety, I would say literally of all the words you could choose, that is the be perfect one. So why unwinding? - Well, I don't know anybody that's never been anxious in their life and I've been treating anxious patients for a long time and I'd have plenty of anxiety myself. So it feels like we actually get all wound up in anxiety and it literally feels that way. It's like it's tight. There are studies showing that people report most that anxiety is kind of this tightness in their chest. And so when we get all wound up, what winds us up? It's that worry. Worry is that thing that's like tightening it down and down and down and down. So it just felt like the right term for that app is like, oh yeah, we're all wound up. How can we unwind? It's not fix or change or ignore. That's not what we're doing. The only way we can work with this is to work direct, the only way out is through. You've probably heard that phrase. So the only way out of anxiety is actually through it. And as we go through it, and we can talk about what that means, it actually helps us unwind so that we don't, those habitual mechanisms of getting wound up don't actually, they're not as sticky anymore, not as contracted. - I think we do need to touch on how you go through, this is probably the right time to talk about awareness as well, a quick definition on what awareness is, how we achieve it, and then how we use that to go through anxiety I think would be really, really useful. - I'm terrible with definitions. Awareness is a really tough one. It's kind of like we all have this faculty of being aware of stuff. But I'm not sure how I could scientifically define it beyond when we're awake and aware of something, we're aware, when we're unconscious, we're not aware. So pragmatically speaking, hopefully that's at least a good enough working definition. It's not even a definition, but a working description of what awareness is. It's like, we can bring a little. - So with what I find is the big breakthrough moment for somebody, and I am very much speaking from my own experience here, is when I hear a word and I feel like I know what it means, and yet there's still a disconnect for me in that experientially, I'm hearing somebody talk about awareness is a perfect example, I'm hearing somebody talk about it, and I don't feel what they're trying to convey, but I know what the word means, so now I'm really lost. And so this is an idea that I'm not sure I'll be able to articulate, but let me give it a shot. So there is a, God, I'm gonna try to do this, I'm gonna try something that may not be useful for people, but it is how my mind has connected things. So there are games where, video games, where it's more about the rhythm in which you press the buttons than that you press the buttons in a certain order, and the slight variation, so if anybody ever plays a fighting game, they'll understand this. There's a certain rhythm that if I were to just tell you, press the buttons in this sequence, the move wouldn't happen, but if you get the rhythm of the exact sort of spacing, between that, then you get something, same with music, right? It's the space between the notes. There is this same thing with words where the words are meant to convey a feeling, that there's an activity, an action behind the words. So I think what people need to understand about awareness, you are going to have to do some work that I'll say that exists at a physical level to actually understand the definition. So I'm going to give you how I would define it experientially through meditation, but if I'm going astray of what you mean, jump in and stop me. So I did not understand what people meant by awareness until I started trying to meditate. When I started trying to meditate, I realized that, okay, I'm sitting here, I'm thinking stuff, of course I'm awake, I'm aware, I'm conscious, like you were saying, as the sort of antithesis to being unconscious, but I don't get it. I'm not having whatever experienced people wanted me to have. And then when I got into mindfulness meditation around, what do you hear right now? And recognizing that when you're not thinking about what you're hearing, you're just hearing it. That's mindful awareness. And I was like, oh shit, because I could, now I get at a body, like I have the chills. I have at a body level, I understand now what you're saying. Where I am literally just here with the rain. I use rain because when I meditate, I put over the ear headphones on and I listen to the sounds of nature. Nine times out of 10, it's gonna be the sound of thunderstorm. And what I find is, when I'm completely present with the sound of the rain, then I'm actually in what I'll call an alpha wave state. When I am not noticing the sound of the rain, it's there for sure, but I'm not there with it. It isn't, it's sort of the only thing I'm experiencing. Then I know that I'm drifting, I'm sort of not aware, even though I'm awake and I'm conscious and all that, I'm having thoughts, but I'm not aware of the way I think you mean it now. Does that get pretty close?

What Is Awareness? (18:13)

- I think that's great. And I think when differentiation, you're pointing out to people, it's experientially is, there's awareness and there's attention, right? So our attention can wander to maybe our mind, we get lost in thought, like daydreaming, or something else. So there's a tension that can be over here, and so that means we're not aware right here. So if you're meditating and you're listening to the sounds of nature, and your mind drifts off into a thinking pattern, you're not aware of that sound. And so I think that awareness and attention piece applies here as well, but I think you've described it beautifully. And like you're saying, this is really ineffable. It's hard to really define what awareness is, but we all know it because we're conscious of things. And when we're conscious or mindfully or consciously aware, that's the awareness that we're talking about here. - Yeah, so I wanna bring that home for people 'cause for them to go through your process of unwinding the anxiety, they have to translate, I think. This was certainly true for me with dealing with anxiety. You have to learn to translate an intellectual idea into a body experience, which by the way, I've heard you often refer to when somebody gets it into their body as wisdom. And I think it was really interesting. - Yeah, I think of that as like concepts, so up in our head concepts in the service of embodied wisdom. And so our thinking brain doesn't actually hold a candle in terms of what drives action. It doesn't hold a candle to our feeling body because those feelings are where urges and cravings and things like that come from. So we can understand something intellectually, but it doesn't actually affect behavior until we have this embodied wisdom where we know this in our bones. - That makes sense. Okay, so now hopefully we've gotten people a little bit closer to awareness. How do we go through anxiety? What does that mean? - Yeah, so just as an example in our unwinding anxiety app, we have a three-step process. And the first step is to map out these habit loops around anxiety, but somebody could do this with anything. You could do it with panic, you can do it with any habit that anybody's struggling with.

1.1 Become Aware (20:21)

So if we're not aware of these habit loops, that trigger the behavior and the reward, we're just gonna keep acting them out automatically, unconsciously, not aware, right? So the first step is to just become aware. Oh, there I'm stuck in my habit loop again. Let's use worry as an example. Oh, there I'm worrying again. Oh, there I'm worrying. The next step is really about hacking into our brain's reward-based learning system. And the way that this works is that our brain stores a hierarchy of values of different behaviors. I'll use chocolate as a simple example. So if I eat some broccoli, my brain stores a certain reward value for that. And then if I eat chocolate, my brain stores a different reward value for that. And because chocolate is more densely packed with calories, from a survival perspective, my brain's gonna be like chocolate, dude. And so let's say broccoli milk chocolate for me, when I compare milk chocolate to dark chocolate, no brainer, dark chocolate. And then it's like 70%, okay, I like 85% better. Does it have sea salt? Does it have cayenne pepper? You know, what brand is it, all this stuff? So I've got this very nuanced hierarchy of dark chocolate in there. But basically my brain, when given a choice, it's gonna pick chocolate over broccoli, okay? So this reward hierarchy is actually set up in a part of our brain called the orbital frontal cortex. Not that important, but if anybody wants to know some of the neuroscience here. And that part of the brain is always deciding, when given two choices, what should I do? And it's gonna pick the one that's more rewarding. So from that perspective, we bring an awareness and we have to help ourselves see really clearly how rewarding is this behavior right now? So let's use cake or smoke, let's use cake as an example. We tend to lay down the reward value of cake early in life, right? Every birthday party we go to, we're gonna reinforce that value of cake. And we're gonna add not just to the taste of cake, but we're gonna add friends, fun, presence, party, all this stuff. So that gets laid down in that composite reward value, gets stored and it goes up and gets reinforced every party we go to. So by the time we're 40 and our brain's like, "Dude, don't think about it, there's cake, just eat it." And so that reward value from when we were five is still playing out now and we can't, we're like, "Well, why can't I just stop eating cake? We can't think our way out of a bad habit. That's not how our brains work." We have to update the reward value.

1.2 Make Things Consciously Hum (22:51)

So here, we have to ask ourselves, bring conscious awareness in and ask ourselves, "Hey, how rewarding is this right now?" Not intellectually, but in an embodied feeling. I'll give an example with smoking, for example. So with my patients in my clinic who want to quit smoking, I have them smoke and they look at me like, "Doc, I thought it was, you know, aren't I supposed to quit smoking?" The point there is I have them smoke, but I have them pay attention when they smoke. And they realized that smoking actually tastes like shit. You know, it doesn't taste very good. That's all the vaping stuff aside, so they've kind of bypassed that piece, which is why vaping's so addictive. We can talk about that later. But with cigarettes, they realized, "Oh, this really doesn't taste that good." I remember a guy who was, he'd been smoking 40 years and I had him smoke consciously and he came back and he's like, "I can't believe I never noticed this before." We calculated it out. He had reinforced that process 293,000 times, right? So it was totally unconscious for him until it became conscious. As soon as it's conscious, whether it's cigarettes or eating three pieces of cake when we're not hungry, when we're stressed, if we bring awareness to that, our brains can actually see how rewarding is this, not that rewarding. Doesn't take willpower, doesn't take effort. It simply takes awareness, right? So as that reward value drops, it becomes-- - Which they're doing consciously, right? They are telling themselves. So we are-- - No, no, no, no. - This actually tastes gnarly. - They're not telling themselves anything. They're simply tasting, right? My patients come in and they know that they're supposed to quit smoking. They don't tell themselves, "Oh, this should taste bad." 'Cause that doesn't actually land in their experience. - So how did you do chocolate cake, which really is fucking tasty? - Yeah, there's nothing wrong with chocolate cake, but tell me, does the fourth piece taste as good as the first? - No, but it's still fun. - Yeah, and then what happens afterwards? Stomachache? - Sometimes, so maybe not-- - I wanna make this as difficult as possible so that people don't write it off 'cause I actually think it is super, super powerful. So what I wanna know is how you get people, and I think it's in your line of questioning, I think you're answering it, but when you take something that is actually pleasurable, are you just trying to find that part of it that isn't pleasurable? So for instance, if I ate as much cake as was pleasurable, I would, I mean, what, what? Reasonable sized pieces, I wouldn't go crazy, but like one piece, reasonable side piece, a day, maybe twice a day would be pretty easy if I did one early and then one late. Now, over time, it's gonna have consequences, inflammation and stuff like that, but I don't know without sort of thinking my way through it if I would ever reduce its value. - Yeah, and we can't think our way into changing behavior. So if we could do that, we would just remind ourselves that smoking is the worst thing we can do for our health and nobody would ever smoke, but that's not how it works. So what we have to do is actually feel into it. And I think you're bringing up a really good point, this is awesome, which is this is not to try to convince ourselves that cake or whatever is bad, it's to help us see the natural consequences. I'll give an example with an experiment that one of my friends did for her PhD thesis, really briefly, she was doing a chocolate experiment where she was feeding people chocolate as she was getting their brains with a pet scanner.

2.1 Drop Your Tinfoil Hat (26:01)

Her name is Dana Small, she's a food researcher at Yale. And what she did was she would have people pick their favorite chocolate and then she would feed them, and she would just have them rate how good is this? And so of course, I'm getting spoon fed my favorite chocolate. This is awesome. And she'd keep feeding them and feeding them and feeding them and you can imagine how that rating changed. Okay, it's still okay. And then they're thinking, what the hell did I sign up for? This is terrible. By the end of the experiment, same chocolate, they're like, ugh, this is awful, get me out of here. So we all have these reward value set points, right? And this is not that chocolate is bad or we should tell ourselves to stop eating chocolate. It's simply that when we bring conscious awareness in, we can see where we need to stop. And with cake, for example, it's not just the taste of it. It's everything that comes with it. So for example, my folks, we have an app called Eat Right Now. And folks that are coming to use that program, they're really struggling with losing wage or sugar addiction or whatever. And what we have them do is look at all of the results, right? Just like with a birthday party, we bring together cake plus party plus this plus this. In the same way, when we're in our mid 40s or whatever, and we're looking at cake and we're saying, I ate this because I was stressed. I wasn't even hungry. So it's not just the taste of it, right? Really paying attention. A lot of people don't actually pay attention. It doesn't taste that great when we're not hungry, when we're stressed. It's just there to do something and distract us. One of my patients said, it's about numbing out. So if we pay attention, it might taste good for a couple of bites, but if we're not hungry, that satisfaction is gonna go down pretty quickly. And then there's the guilt, there's the gut bomb, there's all that stuff. So it's bringing our awareness to the results of that behavior, which is actually step two of this process. So I hope that makes sense in terms of, this is not about demonizing any behavior. It's simply about helping us tap into our natural bodies wisdom, which knows, hey, I'm not hungry, why are you eating this? If you're stressed, let's do some stress reduction as compared to eating cake, because it doesn't fix the cause of the stress. - One thing I'd love to talk about is, so I'm sure some people watching right now are thinking, COVID-19, my anxiety, my fear, there's no reward mechanism here. But I've heard you talk about this. So what is the reward mechanism? How does it fall into a habit loop cycle? When it's something that seems so inherently negative. - Right, so this is probably where the planning mind just got tipped a little bit. So planning helpful, right, like we talked about, but when we don't have enough information, that planning literally tips into worry. And worry is not helpful, 'cause worrying makes us more stressed, more anxious, makes our prefrontal cortex go off on them. We can't actually plan when we're worried, but there's this fine line where it's like this rager's edge where it's like, okay, let me plan, but then when we tip that into worry, where it's like, oh, maybe I missed something, or maybe I should just think about this one more time. It's like, you plan a trip to the airport, which nobody's gonna be doing any time soon. But if you plan a trip to the airport, it's good to check that twice, make sure you haven't missed anything. But if you go and you check it three times, and four times, and 18 times, there's gonna be a level of diminishing returns where you're starting to think, oh, what if Uber goes on strike? Or we're thinking about all these crazy things that are not gonna happen. So there's this tipping point where planning is helpful. It tips into worry. The worry itself has this reward of feeling like we're doing something. Maybe I'm gonna catch something that I missed before. And that's kind of like the lottery. Maybe one time in 100, we do catch something. We're like, oh yeah, I forgot this. Well, that sends this huge dopamine spritz in our brains. Like winning the jackpot on the slot machine. And our brains are like, oh yeah, you should do this all the time.

Keep Calm and Carry On World War II propaganda poster (30:04)

No, worry is not helpful. - So when you're dealing with a crisis, like we're dealing with now, where there really are consequences if you don't take it seriously. And this is where when I'm talking to people, I'm always like, oh, you need to take it seriously, but you also need to calm down. You need to center yourself. You need to laugh still. How do you help people, like if you were gonna give instruction on how to begin to break themselves out of that cycle in this context where yo, you do need to pay attention. Yo, you do need to take this seriously. But at the same time, we wanna help people manage that stress and anxiety and keep it in a useful place. If you had a couple steps or tips tricks, however you wanna think of it, what should people be doing? - I would say there's a simple three step process that ends in, what did they say in World War II, keep calm and carry on, right? Which is when London was getting bombed all the time by the Luftwaffe or whatever, they had to keep calm and carry on because they didn't know their lives were literally in peril. So there was real danger there. So here, step one, map out habit loops around anxiety so that we can actually see how our minds are spinning out of control. If we don't know how our minds work, we're never gonna be able to work with them. So that's step one, right? Trigger behavior reward, map out the anxiety, have loops, map out the worry, habit loops, map out the panic, habit loops. Step two is actually relatively simple, but it's the one that our brains don't wanna see, which is really ask yourself, drop in your direct experience when you do something that is a worry, habit loop, when you're in the middle of worry, ask yourself, what am I getting from this? And like you pointed out, it's relatively straightforward. We don't get much from worry. So we have to be able to feel that, feel into that, and really see, wait, this really isn't helping right now. Then our brains need to be able to compare that to something else. That's where this bigger, better offer comes in. So step three is helping ourselves see what's the bigger, better offer. So for example, go into the bigger, better offer neurologically.

The Brain LOVVVVESSS The Bigger Better Offer (32:17)

What is that? I've heard you talk about how the mind is sort of always looking for the BBO. I found this so interesting, it really hit me as immediately recognizable in my own experience. - Yeah, so the BBO is basically anything that feels better. So we talked about that getting wound up in anxiety. We can all feel what that contracted, closed down feeling feels like, right? In our own direct experience. And anxiety feels closed down. So compare feeling fear to, in your own experience right now, what does fear feel like compared to joy? Does it feel more closed or more open? - Definitively more closed. - And which one feels better? - Joy all day long. - Okay, so we're not all gonna necessarily be joyful right now. Now compare fear to calm, which one feels better? - Calm. - Okay, and what does calm feel more expanded? - Yes, I don't know that that's the word I would have used but-- - And that's not even a choice. - Yes. - Yeah, so calm feels better than fear. So our brains got this fear lower on the BBO list, calm higher on the BBO list. How about connection when you feel connected with others? - Yeah, that feels better. - Which one feels better? - Amazing connection for sure. - Okay, so let's use to use calm and connection. BBO is compared to fear, anxiety and panic, right? That's a no-brainer, okay? So what we need to do is remind ourselves and really feel into what calm and connection feel like. And I actually just, so I just put out a video this morning on YouTube. So I'm putting out daily videos to help people with coronavirus anxiety. And I was in a conversation yesterday on a podcast or something where somebody was asking me, what are some practical tips that you can do? And it occurred to me, we have these two, my wife and I have these two very furry cuddly cats. And so I was thinking, wow, cuddling feels so much better than being anxious. And so I did a short video this morning on tips to help us spread calm as the contagion, rather than fear, right? Let's let connection be that new infection, so to speak. And so I just, on camera, my cat was game. You can actually hear him purring. So I just demonstrated, okay, what's it feel like when you cuddle with the being? You know, if you're spouse and you are together, you know, you cuddle with your spouse. If you live alone, you can cuddle with your pets. If you don't have pets, we can actually, I just made up this yoga move called the hug pose where we can just go like spread our arms wide and then we can just hug ourselves, right? So that physical connection actually feels pretty good. So there are these bigger, better offers that are out there right now. One thing I would like to add is, you know, hopefully a silver lining here could be, people could go out and adopt or foster pets right now. 'Cause, you know, I don't know of them as coronavirus vectors, right? So if anybody's listening to this and has thought about fostering a pet, especially dogs that need this, go out, foster a puppy, adopt a pet and cuddle, right? You can quarantine yourself with your pet. It's okay. - I'm actually almost certain that they prove that dogs are not vectors for COVID-19. People should look that up, don't take my word for it, but definitely heard that that is true. And most things don't jump from animals to humans anyway. Obviously COVID-19 being an exception, but for the most part, that doesn't happen. So that's really interesting. Talk to me, go a layer deeper into isolation. So if you, the worst punishment that a human being can have is to be isolated. You actually see fractures in people's psyches if they're isolated long enough, which I cannot believe is true, but does seem to be actually true. Even people in solitary confinement in prison would rather be around murderers, rapists, than to be completely isolated. Legitimately, that just seems shocking to me. So what is it about isolation? What's going on in the brain? That would actually be really interesting. And then in this time period, I think that the pet thing is huge, fostering, for anybody that didn't hear the distinction between adopting and fostering, fostering would be a temporary placement. Of course, if you end up falling in love of your dogs as much as I love mine, then maybe it does become a permanent home. But that's really interesting. Are there things beyond that that we can do to get out of that? So just to recap, isolation, what's going on in the brain, and then beyond pets, is there anything that we can do to feel more connected over the internet? I don't know, anything. Yeah, so it's interesting you mentioned solitary confinement because to really kind of torture, and I really feel like it's torture, for solitary confinement to work, to fracture people's psyche, they can't have any contact, right? So no, they try to talk to people through the cells and all this, it's just like complete silence, they have to be with themselves. So in the brain, I don't know all of the specific ends and outs of that. I'm not sure that people have done FMRI studies with people who have been in solitary confinement. But what I can say is it's pretty clear that as you're pointing out, the social isolation is really challenging.

The Social RESET Button That Already Exists (37:41)

The nice thing here is we have this thing, this double edged sword called the internet. And so on one hand, it can spread social contagion in a negative way. On another hand, it can spread social purel, so to speak, or brain sanitizer in a positive way. So we can stay connected with others through texting each other, calling each other on the phone, getting on Skype like we're doing, and just having these face-to-face interactions. And I think the face-to-face is really key here. There's something really different about having a conversation with somebody on the phone, then having it with them face-to-face. A lot of that probably has to do with most communication actually happens non-verbally. You're nodding your head right now. So you've just communicated with me non-verbally, right now you're smiling. So all this stuff, so the fact that we've got Skype and Zoom and all these teleconferencing and video conferencing pieces is really helpful. I actually run a live group every week for the people using our apps, and we use Zoom to video conference, and it's really connecting. People connect from all over the world. And to be able to answer questions and interact with people literally face-to-face, even if they're in Europe or in Australia or whatever, is really, really helpful. - Yeah, so I've always been shocked. When my wife and I first got together, obviously a boyfriend and girlfriend at the time, she was living in London, I was here in LA, and all we had was phone call and email, and this is in the days of long distance, and I was poor. So doing phone calls was, we did it rarely, so it was mostly email. And when Skype and video calls came out, I was like, I can't believe how impactful this is. Makes a huge difference if I'm able to see her or anybody for that matter, or just hear them. It's really interesting. Have you done VR with other people? - I have not, but I would. Now you're peaking my curiosity. - Dude, I'm telling you right now, do it. It is crazy. So I did a version with just like a Samsung phone, so it was really low quality, but it was filming. I think, oh, one of the Cirque du Soleil, and so there was this character from, oh, and they start really far away in the background, and they just keep walking closer and closer and closer to the camera until you literally feel like you need to back up, because the sense of presence is so real, I was really surprised by how impactful that was. I think that's a really good piece of advice for people, is just if you've got somebody that you can video with, do it, I'm gonna ask you a curveball question. So let's say that somebody unfortunately finds himself in this position, they're a sort of social isolationist. They, because they're bumping into people all the time, they don't even think about it, so they don't have a network of friends, they don't have somebody that they can call and hang out with on a video call.

Addressing Fears And Isolation: A Perspective

Should we be reading books to counterbalance social isolation? (40:30)

Does reading help? - That's a great question. Thank you for the curveball. Let's see how I do. So there, I would say, if we can connect with the characters in the book, like if it's a really good novel, there's a feeling of connection there, where it's like, oh, and I don't know about you, but when I read a really good book, it feels pretty darn good. So that's the first thing I would say is, if you're reading a book, don't read a book about COVID-19. 'Cause there probably isn't one, 'cause nobody's written the book yet, but I would say read a really good book where you can really relate to the characters. And in that sense, we're gonna start to fire off these brain systems that are around, really around being able to put ourselves in other people's shoes. And I would guess that that absolutely can foster connection as well. But it's an experiment that people can try for themselves. - Yeah, it's one that, so I was thinking about this, I've often thought about, because I don't feel compelled to be around people, which I think would surprise people, but I find, especially at, I don't know, called the last 10 or 15 years of my life, I have felt very introverted, which wasn't necessarily true when I was growing up. I definitely would have identified as an extrovert as a kid. But as I got older, I found myself retreating more and more into my imagination. And so I thought, would I really break if I were isolated long enough, and I don't know why, but like thought, what if I were like Tom Hanks in how men I'm blanking on the movie? - Is it lost? - No, where he is-- - The island? - Lost on the desert island. We are both blanking on the name of this right now. I can't believe it, I've seen this movie so many times. It's so good. But anyway, he's on the desert island by himself, and would I over time break? Would I be able to talk to an inanimate object or something like that? I really feel like I would, because when I'm reading a book, I get so immersed in that world. And it really makes me want to know why isolation is so hard. Is it what you're talking about? Is it projecting yourself into somebody else's shoes? What are the mechanisms? Is it the emotional change? Because there are things from the outside that are taking you on this emotional rollercoaster because you're getting input from the outside? I don't know, but for me, reading books, even more, even though I am definitely a movie guy over books, I would say reading has an intimacy that nothing else has. And so the good news is, even if you don't have books in your house, if you have an internet connection, you'd be able to get into a book. And I have a feeling, at least in the short term, that it would be a pretty viable way to solve whatever that pain is that's created through isolation, which is my big concern. So when I think about what's going to freak people out, and this admittedly is probably just a blindness that I have, I don't get freaked out by the disease itself.

Why people are afraid of the future (43:40)

There's, even though we don't know a lot about it, there just seems way too much data. Like, I would say most people probably pay get it one to one and a half percent fatality rate. You see some people saying even lower, even if it was insane, and it was 5%, which it is not. But even if it was, 95% survival rate, right? So that one doesn't freak me out. But the thought of people having to isolate themselves, the thought of like the economic disaster that could happen from that, that's where I worry about people really beginning to wind themselves up as you're saying and having a hard time. And so going back to that pleasure loop of having some way to emotionally connect with something is a way to lower that, books seem like the sort of great equalizer. - Absolutely, absolutely. And I think there's one other piece that we can even add to that. And I love your idea about books. I hadn't thought about that, it's brilliant. This fear of the future, anxiety is about fear of the future. And so if we think about, you know, you brought up a couple of things like, oh, what about economic collapse? What about this? You know, and our minds spiral out of control, right? They wind up more and more and more, the more out in the future we get, because the less certainty we have. So the idea there is, this comes, you know, I learned so much from my patients one day at a time, right? If we notice that our minds spiraling out, say, hey, take a deep breath, ground yourself in your experience, you know, short mindfulness practice, let your prefrontal cortex come back online and say, hey, do I need to worry about six months right now? I don't know what six months are gonna look like, let's start with today. And if today even seems overwhelming, let's start with what needs to happen this next hour. So we can take it, or this next minute, or this next moment, right? So we can take it moment by moment, and that will help us stay grounded in actionable stuff, because we have accurate information for this moment. Like, do I need to eat something? Do I need to drink something? Do I need to relax? Do I need to cuddle my pet? You know, what do I need right now? We know that. And we can say, okay, let's take it this moment, let's take it this hour, let's take it today. And then we'll worry about tomorrow tomorrow. Or not worry about tomorrow. We'll plan for tomorrow as tomorrow comes.

When the Mind is Broken (46:01)

- Talk to me sort of from the trenches, as somebody who has spent a lot of time seeing patients, what does, I find that looking at the extremes or looking at when the brain is sort of broken and gone into like a whole 'nother place, helps us sort of view where we're at through a different lens. What does this look like? The anxiety, the worry, the isolation. What does that look like when it's taken to the extreme in a person? What are some real life, obviously abstracted, but real life stories that you've encountered and what did people have to do to come back? - One thing I'm thinking of is I have a patient who suffered from severe panic. So the extreme of anxiety is panic, right? Where, and it's interesting, panic disorder is only a disorder when we, it's not about the panic attacks themselves. It's about worrying about having panic attacks in the future. And when we start worrying, that's when things go out of control. So just to give an example, I had a patient who was about 40 when he came to see me. And it's like, I've only been seeing about six months now, I guess. And he was describing, he was visibly shaken when he came into my office. And I sat him down, got his history, and he was describing, he said, when I drive in my car down the highway, I feel like I'm in a speeding bullet. So he was this freaked out, there's that extreme. He was this freaked out about driving to the point where even driving to my office, which was just a couple of miles away, not even on the highway, he was visibly shaken. The other thing I noticed about him was that he was extremely, he was very very obese, he was about 180 pounds overweight. So with him, there's an extreme, I just sent him home with our on-wedding anxiety app. And I said, okay, just map out your habit lips, just start there. He came back two weeks later, and he's like, oh, I lost 14 pounds. I was like, what? I thought we were talking about anxiety. But this is where we can learn from the extreme. So he's like, oh yeah, I would eat because I was anxious, and I realized that doesn't actually help the anxiety, so I stopped doing that, right? He became disenchanted and not excited to have that stress eating anymore. Long story short, over the next six months, he lost 97 pounds. - Whoa. - His hypertension went back to normal blood pressure rains. He had a fatty liver that was back to normal, and get this, I was walking out of class one day, this is like a month ago, or a little bit longer. So walking out of class one day at the School of Public Health at Brown, and it's in downtown Providence on South Main Street. So I walk out into the courtyard, and this car pulls up to the curb, and the guy rolls down the window and I look over, and it's my patient. And he's got this big smile on his face, goes, hey, Dr. Judd, I was like, you're driving? And he's like, oh yeah, I'm an Uber driver now. - Did not see that one coming, that gave me the chills. - I know, I know. So he learned how his mind worked, and he started working with it, and the way he talks about it when I see him now, is he says, I'm in version 2.0. I'm in version 2.0. Like, he's so, he came in the other day and said, well, you know, I feel so, like I feel normal for long periods of time, it feels strange, because he just never experienced what it feels like to be normal. He just anxiety was how he identified with his experience. So there's an extreme where it goes from panic disorder where you can't drive to becoming an Uber driver, all from mapping out how his mind worked, and losing a bunch of weight too, as an aside. - The being in a speeding bullet thing, that is really interesting to me. That is, that reminds me of how I ended up getting more and more anxious as time went on, because I think in metaphors so much, I think in visual imagery, which I'll often convert to words. So I would say something like that to myself, right? Like, man, this isn't a car, this is like being in a speeding bullet. Now you have imagery that escalates. So you go from, I'm in a car and it is fucking traveling fast, and you really should take it seriously, because it is, you know, I mean, it is probably the most dangerous thing everybody does in any, you know, any average day. But once you go, oh, this is like a speeding bullet, now it gets scarier, you've actually given yourself the imagery, the words to help you escalate at a neurological level, you hardwire that, and now just through sheer repetition, and now it's like you're feeding your own sort of escalation protocol, and I find that the de-escalation protocol is very much the same. It's finding a new way to reframe what you think of. So for him, like, if you just think about it in simple terms, obviously I'm gonna skip a bunch of steps, but if you think about the story he told himself from, this is a speeding bullet, bullets kill, I'm gonna be killed by this speeding bullet, to this is an economic opportunity, I'm gonna thrive because of this. It's like, they are the same thing, they are the same act. All he has done is reframe it, and that's why I'm so obsessed with this notion. So I don't know how much you know about my story, but impact theory was born out of working in the inner cities a lot, and I'm like, fuck, these people are really bright, but what are they doing? Like they're living their life in a way that does not make any sense. They're caught up in gangs, they worked with many former drug dealers, gang members, people that have been arrested for violent crimes, and I was like, dude, you're like a normal person, you're so rad, you're so bright, so how on earth is it that you look at the world like in this weird ass way? And I was just like, oh man, this is a frame of reference problem, and so just trying to get them to, and the punchline of frame of reference is, it is all fucking encompassing, it is not one thing, you have a frame of reference for everything, and it creates like this almost impenetrable force field of intellect, I don't know how else to explain it. You're just seeing the world from such a weird vantage point that everything seems dangerous or a threat, like there was one guy, and I'm telling you, this is one of the most extraordinary human beings I've ever met in my life. I am so desperate to either make a movie about his life or have him write a book or something. Crazy life story, but this guy, super bright, if you challenge him, there's actually like a Socrates quote or something, I forget who said it, but it's like, may I never mistake criticism for an attack? And he mistook criticism, like if you said he was doing something wrong, you invalidated his whole existence, and he wanted to fist fight right then and there. And watching it from the outside was so bizarre, because you're like, dude, he said that don't wipe the sanitizer off your hands, you have to let it dry naturally, because it will protect the food that we're preparing. And for him, that was just like, we have to fucking fight, we have to fight right now. And I'm like, what is happening? It was so strange to be a frame of reference, like getting people to see in what's going on with, like even I'm hesitating to use the words crisis, because that is a frame of reference, right? As of right now, if you haven't gotten sick, it's like to exist in crisis mode to be framing it like that, you're just, you're gonna ratchet it up. And so this is where I sketch out, and I talked about this earlier, but I want people to take it seriously. I told my employees to work from home about eight or nine days before the mayor of Los Angeles started implementing things to keep people at home. It's like, hey, it struck me as self-evident that that was gonna be a great way to go about it. But I didn't want people to think that I was panicking. So it's like getting that nuanced frame of reference of understanding that, hey, for sure, take it seriously, sanitize, don't shake hands, don't hug, the social distance, wherever you can, but don't make it worse with your frame of reference. - Amen, brother.

Not Taking Things Personally (53:44)

And I think one thing you're pointing out is related to some of the neuroimaging, just some of the brain imaging research that we've done with experience meditators, for example. So a lot of meditation, as you know, from your own direct experience, is about learning to not take things personally, right? So when we feel something as an attack, we close down. Just like we close down with fear and anxiety. It's a survival mechanism. But when we close down, we're not open to learning, right? Carol Dweck talked about fixed versus growth mindset. We have to be in growth mindset to learn. So if we can learn that being closed to criticism is actually painful, it physically feels painful. And at the same time, it doesn't open us to learning. If we can start to see, wait a minute, this is not a threat, right? And this is where awareness comes in. Wait a minute, is this really threatening right now? Is somebody physically or whatever threatening me? Oh, no, they're not. They're actually trying to help. We can bow to that as a teacher and say, oh, oh, I had this reaction. Can I learn from this? And then that automatically opens us to growth mindset. And all of this is about learning to take things less personally so that we can keep our prefrontal cortex online and thinking and taking things seriously, but not personally. - No, man, that's really, really good advice.

Connect with Dr. Jud (55:00)

Where can people connect with you and get a litany of that kind of stuff? Website, where can they find your app? All that good stuff. - Yeah, so my website's drjud.com drjud.com. We have a YouTube channel that is just, I think, drjud as well. So people can subscribe to that. Again, I'm putting out daily short videos to help people understand this stuff so they can subscribe to get the latest on those. They can hit me up on Twitter @judbrewer @judbrudbr. And then the app that we talked about most was the unwinding anxiety app. So I think that's just unwindinganxiety.com. We have an eating app called Eat Right Now. And I think that's at goeatrightnow.com. And then we have a smoking app. Soon to also be a vaping app. It's called Craving to Quit. So people can find all of those through my website, drjud.com or look at the, go directly to those websites. And I think our company is so mission. The folks that run the company mostly just do research. They're so mission oriented. I think they're even giving people a big discount on the unwinding anxiety app right now to just try to help people whenever they can. So I think that's the best place to connect with me. I might have missed something. I wrote a book, but it's just about Craving, called the Craving Mind. But it's not as critical as this other stuff right now where we're all in this together. - Very cool.

One Change (56:29)

And if you were gonna have people make one change or do one thing that would help them have the biggest impact on their fear and anxiety right now during COVID-19, what would you have them do? - I would say connect. So let's spread connection rather than contagion or whatever, let's have connection be infectious. So connect with others, whether it's on Skype, whether it's on a phone call, whether it's offering well wishes on social media, but don't spread the panic, don't spread anxiety, even if you think you're being helpful, take a pause, ask yourself, is this post-helpful? Is this gonna, and if you're like, well, I'm spreading and I'm helping people see that the grocery stores are empty, don't do that. Probably not that helpful. If you're showing people that the grocery stores shelves are full, that's helpful. And that also spreads calm. So let's spread calm and connection rather than some of the panic that we're seeing going around. - Love it, man.

Conclusion

Outro (57:33)

All right, guys, thank you for joining us for this very special episode of Impact Theory. I hope that you got a lot of value from Dr. Judd. I think that his information and his knowledge is really powerful. He's actually gonna be teaching a class at Impact Theory University for us, which I'm super excited about. I think that he's got tremendous ideas. I think his apps are really extraordinary in terms of helping people get real results, which is of course how I judge everything. I will echo his words in this time, and finding ways to bring things down and find that calm, creative space, which I think exists for all of us, no matter what's going on. Super important. If you've been taking cold showers, like I suggest, this is that moment, right? In the midst of heightened anxiety and heightened fear to actually be able to center yourself and be calm in these moments, this is exactly what you've been practicing for. So long may that continue connection, man. I did not expect that to be the answer when we're talking about COVID-19, but there you have it connected each other over the internet and find ways to get that connection, whether it's reading a book or just sending some love. And I love that he made it about something that's positive, giving somebody a well done on social media. It puts you in a different frame of reference, something positive and uplifting, I think that's super important. All right, guys, if you haven't already, be sure to subscribe and until next time, my friends, be legendary. Take care. If you're feeling anxiety, there's actually a place from which you can just feel it, right? And be actually indifferent to it or anything else you could be feeling. My first you can notice that anxiety isn't even that unpleasant.