The Art of Manliness - Anxiety Is a Habit — Here's How to Break It

00:00:00.000 We're taking a break from new episodes today, so we're rebroadcasting episode number 782,

00:00:05.060 Anxiety is a Habit, Here's How to Break It, with Dr. Judson Brewer.

00:00:08.920 Hope you enjoy the show.

00:00:10.060 We'll see you back on Wednesday with a brand new episode.

00:00:19.660 Brett McKay here, and welcome to another edition of the Art of Manliness podcast.

00:00:23.820 Now, you may think of anxiety as a reaction, a feeling, or a disorder.

00:00:27.000 My guest today says that perhaps the best way to think about anxiety, especially if you want to treat it effectively, is as a habit.

00:00:33.100 His name is Dr. Judson Brewer, and he's a psychiatrist and a neuroscientist, and the author of Unwinding Anxiety,

00:00:38.400 New Science Shows How to Break the Cycles of Worry and Fear to Heal Your Mind.

00:00:41.900 Dr. Judd and I begin our conversation with what anxiety is, and how it gets connected into a habit loop

00:00:46.260 that can lead to other maladaptive behaviors like drinking, overeating, and worrying.

00:00:50.120 Dr. Judd then explains how to hack the anxiety habit loop by mapping it out, disenchanting your anxiety-driven behaviors,

00:00:55.640 and giving your brain a bigger, better offer by getting curious about your anxiety.

00:00:59.960 We also talk about why asking why you're anxious is not part of this process,

00:01:03.920 and end our conversation with how this habit-based approach to behavior change

00:01:07.160 can also work for things like depression and anger.

00:01:09.620 After the show's over, check out our show notes at awim.is slash anxietyhabit.

00:01:13.580 Judson Brewer, welcome to the show.

00:01:29.060 Thanks for having me.

00:01:29.980 So you are a psychiatrist that specializes in anxiety, addiction, eating disorders,

00:01:35.160 and you got a new book out, Unwinding Anxiety.

00:01:38.120 How did you end up specializing in anxiety and addiction disorders as a psychiatrist?

00:01:43.580 Well, my own anxiety.

00:01:47.500 You know, it was kind of serendipitous, so I used to get panic attacks when I was in residency,

00:01:53.700 and then I actually got anxiety trying to help my own patients with anxiety.

00:01:59.020 And I say that because with the best medications out there, it takes about, you know, for every five patients,

00:02:06.920 only one of them shows a significant reduction in symptoms.

00:02:09.740 There's this term called number needed to treat, which is basically what that means.

00:02:14.860 And so I'm placing the, I'm playing the medication lottery.

00:02:18.240 I don't know which of the next five patients I'm going to treat is going to benefit.

00:02:22.780 And also, I don't know what to do with the other four.

00:02:25.740 So serendipitously, I was doing a lot of research.

00:02:29.660 You know, I'm just really interested in addictions.

00:02:31.980 It's a tough field to work in, and I like challenges.

00:02:37.100 So I'd been doing a lot of research with addictions and habit change, and we'd gotten some good results with, you know,

00:02:43.720 we'd developed a program for smoking cessation.

00:02:45.900 We'd gotten five times the quit rates of gold senior treatment, so that was nice.

00:02:49.260 And we'd developed this eating program called Eat Right Now that we had developed through an app so we could deliver it as a digital therapeutic.

00:02:58.360 And somebody in that program said, hey, you know, it looks like anxiety is driving my eating habits.

00:03:05.360 Could you create a program for anxiety?

00:03:07.620 And I was thinking, well, I generally prescribe medications for this, but it put a bug in my ear.

00:03:12.600 And I went back and looked at the literature, and it turns out way back in the 1980s, people had been talking about anxiety being driven like other habits.

00:03:21.980 And when I saw that connection, I was thinking, well, you know, I know how to work with habits.

00:03:27.340 That's my research.

00:03:29.120 I never thought about anxiety that way, so I developed a program called, you know, that we called Unwinding Anxiety,

00:03:35.760 and we delivered it through an app so that we could measure it and study it.

00:03:39.860 And we got a 67% reduction in clinically validated anxiety scores.

00:03:45.400 And just to put that into context, the number needed to treat, you know, for medications was 5.2, you know, one in five.

00:03:52.720 And for this study, it was 1.6.

00:03:55.700 So much, you know, much better effect than I had seen with medications.

00:04:01.420 Well, so I want to go back to this idea of anxiety being a habit, because that's the big thrust of your book is looking at anxiety as a habit that you have.

00:04:08.940 But before we do, what is anxiety exactly?

00:04:11.680 Because we see this word thrown around a lot.

00:04:14.240 People, you know, I even hear like kids, like, I'm anxious.

00:04:17.540 So as a clinician, how do you define anxiety?

00:04:21.160 Yeah.

00:04:21.340 One of the definitions that I like is that it's a feeling of nervousness or unease about an imminent event or something with an uncertain outcome.

00:04:31.020 So it's this feeling that comes up.

00:04:34.460 And I summarize it as fear of the future, you know, because we start to worry about something in the future, not something that's happening right now.

00:04:44.520 Gotcha.

00:04:45.060 And so is anxiety the same as, is it synonymous to fear?

00:04:49.480 Is it the same as worrying?

00:04:50.600 I think those are words we throw in interchangeably with anxiety.

00:04:53.240 Yes.

00:04:54.320 So I think of anxiety is a feeling in the body.

00:04:58.160 Okay.

00:04:58.640 And worrying is a mental behavior.

00:05:01.380 So those two are very, very closely linked.

00:05:04.400 Whereas fear is fear.

00:05:07.280 You know, fear is different.

00:05:08.640 So that feeling of nervousness, that feeling of unease can lead to the mental behavior of worrying, which then feeds back and drives more anxiety.

00:05:21.420 That's how these two can get connected in a loop.

00:05:24.520 You know, to form any habit, you need three elements, a trigger, a behavior, and a result.

00:05:29.700 And from a neuroscience perspective, that result has to be rewarding in some way.

00:05:33.720 So the feeling of anxiety can then trigger the mental behavior of worrying.

00:05:39.360 And that mental behavior of worrying gives us the reward of feeling like we're in control, or at least that we're doing something, which feels better than doing nothing.

00:05:48.340 And then that feeds back so that the next time we feel anxious, our brain says, oh, last time you worried, you should do that again.

00:05:55.260 Okay.

00:05:55.300 So that's how anxiety is a habit.

00:05:57.560 You have the trigger, the feeling of anxiety.

00:05:59.780 The behavior is the worrying or thinking about stuff, ruminating.

00:06:04.040 And then the reward is, well, I feel like I'm doing something, even though you're actually not.

00:06:09.800 Exactly.

00:06:10.460 Yeah.

00:06:10.720 We are doing something for, you know, to be clear, we're worrying.

00:06:16.180 But are we doing something that's helping the situation?

00:06:18.900 Not so much.

00:06:20.680 So what causes the anxiety in the first place, that feeling you have?

00:06:24.800 Is it just depends on the person?

00:06:27.140 Yes.

00:06:27.440 And it could be anything, you know, often we get stuck in these more habit loops of trying to figure out why we're anxious.

00:06:34.540 That's just a dead end.

00:06:36.020 So sometimes it just comes on.

00:06:37.700 For people with generalized anxiety disorder, for example, that can come on early in the morning and go all day.

00:06:45.720 Okay.

00:06:45.780 So that's when it becomes like you just have a general anxiety about pretty much everything.

00:06:50.720 Some people, you might be anxious about your job, for example.

00:06:54.620 And that's it.

00:06:55.100 Whenever you're not working, you're okay.

00:06:57.440 But a person with generalized anxiety disorder, like they're going to be worried about pretty much everything throughout the day.

00:07:03.480 Yes.

00:07:03.780 And it could just be that they're worried.

00:07:06.140 There might not even be anything that they have to be worried about.

00:07:09.460 They're just worried.

00:07:10.560 And in fact, I've had patients who've worried so much in their lives that it's, you know, been such a habit.

00:07:16.960 But as they start to worry less and have moments where they're not worrying, they start to worry that they're not worried because they feel like there's something wrong that they're not worrying.

00:07:28.220 Based on your work with patients and your research, why does it seem like there's an uptick in anxiety amongst Americans and Westerners in general?

00:07:37.020 Like, what's going on that's encouraging more people to get on this anxious habit loop?

00:07:42.400 Yes.

00:07:42.740 And I would say this is worldwide.

00:07:44.680 And it really, you know, the pandemic was a great, well, I should say unfortunate but amazing natural experiment in anxiety.

00:07:54.340 So the hypothesis is that our brains don't like uncertainty.

00:07:58.320 Uncertainty prompts us into action to get information to try to reduce that uncertainty.

00:08:03.640 So we've had waves and waves of uncertainty over the last couple of years where, you know, anybody can think of a gazillion different things, whether it's, you know, how dangerous the original coronavirus or the COVID-19 was to, you know, economics, to schools, to whatnot.

00:08:23.960 Anytime there's a new wave of uncertainty, our brains start to, well, they're supposed to be thinking and planning.

00:08:30.920 But if there isn't accurate information, our thinking and planning brains spin out into fear and dread where they worry about this or that or this or that or this or that.

00:08:40.440 So, you know, we've seen that come into play where anxiety levels have spiked.

00:08:46.320 They've stayed pretty high because there's pretty constant uncertainty, a lot more uncertainty than there has been in the past.

00:08:53.420 And we're also, as a world, getting more in the habit of worrying.

00:08:58.800 And you also make this point that the digital world that we live in through our devices also contribute to this anxiety habit loop.

00:09:06.680 How so?

00:09:08.120 So information is like food for our brain.

00:09:11.540 You know, it helps us survive.

00:09:12.560 It helps us think and plan.

00:09:14.280 So if there's uncertainty, if we get information, you know, that uncertainty reduces.

00:09:18.440 If you think of our ancient ancestors, you know, if they saw a saber-toothed tiger, they knew that was accurate information.

00:09:25.800 They could run away and survive.

00:09:27.680 In modern day, not only do we have a deluge of information, you know, thanks to the internet, we can get more information than we could ever digest.

00:09:35.420 But we also have layered on top of that misinformation where people are inadvertently saying things that are inaccurate.

00:09:42.560 And then disinformation, where people are overtly, where on purpose, they are saying things that are not true.

00:09:49.440 And we have to sort through all of that.

00:09:51.200 Suddenly, we have to become, you know, an expert in every one of these fields to really try to figure out whether what somebody is saying or posting online is true.

00:10:01.380 And that, in itself, adds to those layers of uncertainty and all of that builds anxiety.

00:10:09.020 All right.

00:10:09.140 So let's go back to this idea of anxiety as a habit.

00:10:12.640 And we've talked about the general habit loop.

00:10:14.140 So there's the trigger.

00:10:15.200 It's a feeling of anxiety.

00:10:16.400 It can be caused by anything.

00:10:17.940 It just depends on the person.

00:10:19.200 Particularly, it's uncertainty about something.

00:10:21.560 Typically, the action when we experience anxiety is worrying.

00:10:25.020 We start thinking about what's going on.

00:10:28.040 And then the reward is, oh, it feels like we're doing something.

00:10:30.160 We are doing something.

00:10:30.940 And so we just keep doing that anxiety habit loop.

00:10:33.420 Besides worrying, are there other actions you find that people take whenever they experience the trigger of anxiety?

00:10:41.300 Yes.

00:10:41.800 I see a number of generally unhealthful coping mechanisms.

00:10:46.500 And I see this in my clinic.

00:10:47.680 And I see this in everyday life where, you know, anxiety triggers us to do something because it feels unpleasant.

00:10:54.480 So our brains try to do something to make it go away.

00:10:57.020 And that could be anything from distracting ourselves by going on our social media feeds.

00:11:02.940 We could be drinking alcohol, eating food.

00:11:07.040 So I see a lot of this.

00:11:09.180 I've even seen it, you know, where they call it the COVID-20, you know, where somebody's gained 20 pounds during COVID because they're anxious and they are working from home and they go to their refrigerator and they eat.

00:11:21.980 And so the other ways besides worrying, it could be eating, shopping online, surfing the internet, smoking.

00:11:29.260 It could be like anything that just soothes the anxiety is going to be a potential action you take because you experience that anxiety.

00:11:36.240 Yes, yes.

00:11:37.680 And we get that brief relief, whether it's drinking alcohol or doing any of these other things.

00:11:42.480 And that brief relief feeds back and says, oh, next time you're anxious, you should do this again.

00:11:46.760 Okay, so knowing that anxiety is the trigger for worrying or drinking or surfing the web or whatever, I can see someone getting the idea that, okay, you can change the anxiety habit loop just the way you change any other habit loop, you know, by substituting the behavior of worrying for something more adaptive, you know, or something that will give you more positive results.

00:12:08.520 So, you know, someone might think, when I experience anxiety, instead of doing my typical response of worrying, I'll just replace worrying with, you know, something like, I'm going to do 10 push-ups instead.

00:12:20.460 But you make the case that hacking the habit loop like that for anxiety doesn't work.

00:12:25.240 Why is that?

00:12:26.020 And what do you recommend doing instead?

00:12:28.260 Yeah, so it makes sense, you know, 10 push-ups.

00:12:31.000 But you could, you know, if you're anxious, you could suddenly become pretty strong because you're doing a bunch of push-ups.

00:12:35.520 The, so the problem there is that 10 push-ups don't actually fix the root cause of the anxiety.

00:12:43.440 And often we don't know what the root cause of the anxiety is.

00:12:47.380 And so if we try to go to some substitution behavior, some distraction behavior, we just have to do it more and more and more.

00:12:54.460 So if it's, let's use the 10 push-ups as an example, somebody might be anxious.

00:12:59.820 They do 10 push-ups.

00:13:00.660 They don't actually feel less anxious, you know, by that much.

00:13:04.560 So they do 10 more and, you know, suddenly they just can't do any more push-ups, but they're still anxious.

00:13:10.000 So here it's helpful to really go to the root cause and really understand how any habits formed, anxiety or otherwise, and then really tap into that system.

00:13:20.240 Once you can, you can really work with it, you know, it's kind of like understanding how your mind works is the first step in working with your mind.

00:13:29.340 And with anxiety, that's absolutely true.

00:13:32.300 And so, yeah, you say the first step in getting a handle on your anxiety, unwinding anxiety is you call map out your, your anxiety habit loops.

00:13:39.920 Yes, and that's as simple as, you know, just finding what the trigger is, what the behavior is, and what the result is.

00:13:47.680 So the trigger typically is the feeling of anxiety.

00:13:50.280 That's pretty straightforward.

00:13:51.860 The behavior is that worrying.

00:13:54.700 That's one of the typical ones, but you've named some of the others as well.

00:13:58.420 We might eat some food, drink alcohol, smoke a cigarette, go on the internet, procrastinate, or whatever, and then map out what the result is.

00:14:05.940 You know, is it an avoidance behavior, do I feel a little bit better because I'm avoiding it, do I feel like I'm in control because I'm worrying, or whatever the result is.

00:14:15.800 And once we can map those three things out, that starts to give us a picture of what our mind is doing.

00:14:22.880 And that mapping process is really critical, is that critical first step for working with the behavior.

00:14:28.880 And you, you highlight, you give some case studies of patients you've worked with, where just doing this mapping process that goes a long way.

00:14:36.740 They, they suddenly, like it decreases their anxiety, not significantly, but some, for some people significantly.

00:14:41.880 What is it about mapping out your anxiety habit loops that can immediately, before you even start doing anything, decrease anxiety?

00:14:48.980 What's going on there, you think?

00:14:50.480 Well, this goes back to the uncertainty and how our brains don't like uncertainty.

00:14:54.300 And if we don't know, you know, if our brain is like a black box, suddenly if you, you know, or it's like a dark room, you don't know what's in there and you go in there, what could it be?

00:15:04.560 And you flip on the light switch and you're like, oh, this is what's in the room.

00:15:07.860 Yeah, I'll give a concrete example.

00:15:09.080 I had a patient who came in, who was referred for anxiety.

00:15:12.720 He had, he described how when he was in a car, he would have this, these thoughts, like you might get in an accident.

00:15:19.700 He would have panic attacks and avoid driving on the highway.

00:15:23.460 And so I just mapped this out with him, you know, like, okay, what's the trigger of these thoughts?

00:15:27.520 What's the behavior avoiding driving on the highway?

00:15:29.900 What's the result?

00:15:30.840 You can avoid having panic attacks.

00:15:32.400 And then I just drew arrows between those three.

00:15:35.180 And importantly, so that first arrow from the trigger to the behavior, that second arrow from the behavior to the not having panic attacks.

00:15:42.720 And then the third arrow, not having panic attacks feeds back to those thoughts.

00:15:48.840 So the next time he has a thought, he says, I can't drive.

00:15:50.880 And then suddenly, you know, he's really limiting himself and having, you know, meeting all the criteria for panic disorder.

00:15:57.220 Just seeing that, I pulled, literally pulled out a piece of paper, mapped it out with him for 30 seconds after taking his history.

00:16:04.540 And I could see the light bulb go off in his head because he just didn't know how that process worked.

00:16:10.940 As simple as it is, most of us just don't see these things.

00:16:15.440 And so that reduces the uncertainty because he can see how his brain works.

00:16:19.880 And I can explain to him, well, this is a normal process.

00:16:22.600 Your brain is, you know, adopting this old system that helps you survive.

00:16:26.540 That's just ironically making you more anxious.

00:16:30.420 And that in itself can reduce the anxiety because the uncertainty is lowered.

00:16:35.900 And one thing to keep in mind when you're mapping out these habit loops, you're trying to, you're supposed to take like a mindful approach to it.

00:16:41.080 You're not supposed to beat yourself up.

00:16:43.080 It's like, man, why am I such a dummy that I have this dumb anxiety habit loop?

00:16:46.280 You're just supposed to be as objective and distance from it as possible so you can get a grasp.

00:16:52.080 Because if you do that, beat yourself up, you're just putting yourself in another anxiety habit loop.

00:16:57.780 Yes, absolutely.

00:16:58.620 That self-judgmental habit loop.

00:17:00.800 And then that habit loop distracts us from working with the original habit loop as well.

00:17:05.700 So yes, this is about, I think of it as approaching it like a scientist or a physician or a lawyer or somebody that's just trying to get the facts, you know, so they can really understand what's happening.

00:17:17.260 We're going to take a quick break for your words from our sponsors.

00:17:19.000 And now back to the show.

00:17:22.780 All right, so the first part is you map out your habit loops.

00:17:25.200 And this, again, requires you to be mindful throughout the day, kind of noticing things and then making observations.

00:17:30.620 After that, the next step is to update your brain's reward value.

00:17:36.860 And this involves, I like how this word, you use the word disenchant.

00:17:40.160 You want to disenchant your anxious actions.

00:17:43.460 What do you mean by that?

00:17:44.520 So this really is what gets to the heart of how our brains learn.

00:17:50.580 And our brains are set up to be as efficient as possible.

00:17:54.200 And we set up habits as a way to learn how rewarding a certain behavior is and then forget about the details.

00:18:01.740 I think of it as set and forget.

00:18:03.200 So you set the reward value and you forget about the details.

00:18:06.600 What would be it?

00:18:07.340 So a concrete example would be food.

00:18:09.200 You know, our brains are set up to try to maximize calorie intake because back in the day, you know, our ancestors didn't have refrigerators.

00:18:17.620 And so, you know, when you've got a good calorie source, the idea was to pack them in.

00:18:22.100 So we prefer cake to broccoli because our brains are set up to say, hey, cake has more calories.

00:18:27.620 So we set that as a habit loop.

00:18:29.260 And we don't have to relearn the reward value of cake every time we eat cake.

00:18:33.000 We don't have to say, hmm, I wonder if that's any good.

00:18:35.300 We just look at it and we're like, cake, let's eat it.

00:18:37.080 So that reward value system is set up for every behavior that we do, where we'll prefer one behavior to another.

00:18:45.560 We set the behavior as a habit and we don't change it until we update that reward value.

00:18:53.540 And the only way to update the reward value is to pay attention, is to bring awareness in.

00:18:58.740 A concrete example would be if a new bakery opens up in my neighborhood and I don't know how good the cake is there.

00:19:05.520 I go in there, I eat some cake.

00:19:07.100 And if it's the best cake ever, I get what's called a positive prediction error where it's better than expected.

00:19:12.860 I learn, okay, go back there for cake.

00:19:14.900 If I eat it and it's crappy, my brain says, yeah, don't bother.

00:19:18.760 And I get this negative prediction error, which says it's worse than predicted.

00:19:22.640 So don't go back there.

00:19:23.920 So I learn, right?

00:19:25.000 That's how the learning process happens.

00:19:26.520 We can apply that process to any behavior so that we can update the reward value to how rewarding it is right now.

00:19:34.580 So if I learned the reward value of cake when I was five and I'm just mindlessly eating cake when I'm 45, that's probably not so helpful.

00:19:43.900 If I pay attention and I notice, oh, when I just eat a ton of cake, I get a sugar rush and I crash and I gain weight and I get cavities and I get diabetes, I can start to see that's actually not that rewarding.

00:19:58.880 And in fact, my lab, we did a study.

00:20:01.200 We have this app called Eat Right Now that helps people pay attention as they overeat.

00:20:04.760 It only takes about 10 or 15 times of somebody really paying attention as they overeat for that reward value to drop below zero where they start to shift their behavior.

00:20:14.440 So we can do the same thing with worrying.

00:20:16.740 And I have people ask a simple question.

00:20:19.320 As they're worrying, I ask them to ask themselves, what am I getting from this?

00:20:24.540 And feel into their direct experience.

00:20:27.200 And what people typically report is that worrying doesn't feel very good itself.

00:20:31.720 It doesn't keep their family member safe or solve a problem or do whatever their brain thinks it's going to do beyond distracting them.

00:20:41.260 And when they can start to see that really clearly, they start to become disenchanted with it.

00:20:45.640 They're not as excited to do it.

00:20:47.660 We see the same thing with my patients who want to quit smoking.

00:20:51.240 I have them pay attention as they smoke and they start to realize, oh, it doesn't feel very good.

00:20:55.820 I run a live group for anybody using our apps.

00:20:59.440 And just today, I was running a group and a woman was talking about how she ate some tortilla chips with cheese on them for dinner.

00:21:08.300 And she air fried them. 1.00

00:21:09.780 So better than deep frying, I guess.

00:21:12.660 And we explored, what did she get from that?

00:21:15.340 And she said, I had a stomach ache and I couldn't get to sleep until 3 in the morning.

00:21:20.040 And I said, well, what does it feel like now?

00:21:21.660 If I put some of those chips in front of you, would you eat them?

00:21:24.540 What would be your likelihood?

00:21:25.700 She said, zero.

00:21:27.480 It's disgusting.

00:21:29.500 So there's a great example of becoming disenchanted with our behavior simply by paying attention to the results, what it gives us when we do it.

00:21:41.080 Does that make sense?

00:21:41.860 No, that makes perfect sense.

00:21:42.720 In fact, I applied this to social media.

00:21:45.480 You just notice, you keep going there and you open up Instagram and you scroll through.

00:21:49.700 And then you have to sit and think, I don't feel good doing this.

00:21:53.760 I'm not getting anything out of this.

00:21:55.560 And then it's amazing.

00:21:57.220 It extinguishes any desire to open it up anymore.

00:22:01.460 Yeah.

00:22:01.700 That's disenchantment.

00:22:02.880 So the question you asked is like, what am I getting out of this?

00:22:06.520 And usually the answer is not a whole lot.

00:22:08.920 In fact, it makes me feel terrible.

00:22:10.640 And if that's the answer, then you just stop doing that whenever you experience anxiety.

00:22:14.600 Yes.

00:22:15.920 And I wouldn't say, so often people think, oh, just stop doing that.

00:22:19.300 You know, that's right.

00:22:21.020 Yeah.

00:22:21.240 It'd be great if I could just, you know, I'd have one visit with every patient where they come in and they say, I want to stop social media.

00:22:27.180 And I would, you know, dub them, I'd say, stop doing that.

00:22:30.180 And they would just leave and stop doing it.

00:22:31.780 So the, the critical piece here is that the reflection on the previous action helps us load that reward value into our brain.

00:22:40.720 So we can ask ourselves, do I really want to do this again?

00:22:43.560 And we can feel into the experience of last time.

00:22:46.780 And like you described with social media, we're like, this doesn't feel so good.

00:22:50.780 And so we naturally are disenchanted so that we're not pulled to do it again without having to force ourselves not to do it again.

00:23:00.200 Right.

00:23:00.380 There's no, yeah, that's what I like about it.

00:23:01.760 There's no force or gritting your teeth with this approach.

00:23:05.300 Nope, not at all.

00:23:06.680 Okay.

00:23:06.920 So after you disenchanted the maladaptive behavior, whether it's worrying or eating or smoking, whatever, the third part is creating what you call a bigger, better offer for your brain.

00:23:19.040 What do you mean by that?

00:23:19.840 Yes.

00:23:21.000 So this is an homage to, to myself and all of us that, you know, back in high school, when we had a date set up for Friday night and then, you know, Friday afternoon, our dates lets us know that they have, you know, their parents are requiring them to power wash the car or some, something that's ridiculous and clearly an excuse.

00:23:39.420 Yeah.

00:23:39.620 Yeah.

00:23:39.740 Yes.

00:23:40.280 Yeah.

00:23:40.780 Where, where clearly somebody else called them and wanted to go out on a date and that was, that person was the bigger, better offer.

00:23:46.900 You know, and so, so I think of it this way, cause that's how our brains work.

00:23:52.560 You know, our brains are, you know, given a choice between A and B, they're going to pick the one that's more rewarding.

00:23:57.740 So if we become disenchanted with these old behaviors, why not give our brains something better to do?

00:24:04.420 And not in the case of, you know, if you're anxious, just go scroll on social media or drink alcohol, because we can start to see that those things aren't that rewarding themselves and don't fix the root problem.

00:24:14.960 But instead we can tap into things that are intrinsically rewarding.

00:24:19.640 So if we're anxious, we can get curious about what that anxiety feels like instead of worrying.

00:24:27.820 And we can even compare those two.

00:24:29.240 Like, well, you tell me what, what feels better being curious or worrying about something?

00:24:34.500 Being curious.

00:24:35.120 Yeah.

00:24:35.660 Yeah.

00:24:36.260 Yeah.

00:24:36.480 It's a no brainer to our brains.

00:24:38.220 Of course, curiosity feels better.

00:24:39.880 And here we can actually get at the root cause of the issue.

00:24:44.880 So again, anxiety pops up often out of the blue.

00:24:48.100 It doesn't matter what caused it.

00:24:49.860 But what the problem in there is, is that we feed it by worrying or pushing it away.

00:24:55.900 And so instead of pushing it away, you know, this, this phrase, the only way out is through comes to mind.

00:25:01.400 You might've heard that before, you know, the only way out is through.

00:25:04.680 So instead of running away from the anxiety or distracting ourselves or worrying about it, what if instead we turn toward it?

00:25:12.160 And what helps us turn toward anxiety is curiosity.

00:25:15.480 I love this quote from James Stevens, who said or wrote, you know, curiosity will conquer fear even more than bravery will.

00:25:23.200 So curiosity is like a superpower.

00:25:24.960 And as we turn toward the feeling of anxiety, we can start to notice that it is simply sensations and thoughts and emotions in our body.

00:25:35.020 It's not, you know, it's not something that we have to run away from.

00:25:38.840 And the more we turn toward it, the more we become familiar with it.

00:25:42.520 And the more we can see, oh, these are sensations.

00:25:44.340 They come and go.

00:25:45.680 I don't have to do anything about them.

00:25:48.580 I can simply learn to be with them.

00:25:50.980 And the curiosity helps me not only learn about them, but also be with them.

00:25:56.540 And that, that's the healing process where we can learn to be, you know, it's like the being is the new doing.

00:26:03.740 So, and what this looks like.

00:26:04.880 So if you're, you start experiencing anxiety, a curious approach, you'd be like, well, okay, where am I experiencing this?

00:26:10.020 Am I feeling like a tightness in my chest?

00:26:11.620 Is my pulse?

00:26:12.320 Like you can check your Apple watch and you feel your heart rate's going.

00:26:15.060 Is that what it, what it look like?

00:26:17.220 Yes.

00:26:17.580 Yes.

00:26:18.080 Really sticking with our direct experience, not the concept or worrying about why am I anxious and trying to figure that out.

00:26:25.780 Really just dropping in and seeing what's going on.

00:26:29.820 And then you have that, you had that section about like using like some little hacks, I guess you can call them about widening your eyes to maybe encourage or nudge yourself into the curious.

00:26:39.340 Like what's going on there?

00:26:41.420 Yes.

00:26:41.780 So this, again, goes back to evolutionary neuroscience and psychology.

00:26:46.780 There's some great experiments where people looked at, you know, what, what do our eyes naturally do when we are, let's say, let's start with something different, like angry.

00:26:58.400 So when we're angry, so just think of a time when you are angry and anybody listening in can do this themselves and see what your eyes naturally do.

00:27:07.760 So would you say that your eyes narrow or do they widen when you're angry?

00:27:12.860 Oh, they narrow, they narrow.

00:27:13.860 Yeah.

00:27:14.660 Yeah.

00:27:14.860 Get that flinty look in your eye.

00:27:16.380 Yeah.

00:27:16.900 Yeah.

00:27:17.260 Yeah.

00:27:17.500 Because anger is about focused behavior.

00:27:21.300 It says, I know what the problem is and I'm going to do something about it.

00:27:24.940 You know, so we're, we're literally narrowed in on the quote unquote problem and we are laser focused on doing something about it.

00:27:34.360 With curiosity, well, you know, what do your eyes do when you're curious?

00:27:39.380 Do they narrow or do they widen?

00:27:40.720 Typically you get narrow.

00:27:42.440 Yeah.

00:27:42.740 Let's say widen, but then like if I'm getting focused on, I'd probably narrow my eyes.

00:27:45.840 It's like, yeah, yeah.

00:27:47.400 So again, it's when we're trying to gather more information.

00:27:50.900 So both with curiosity and interestingly, also with fear, which makes sense, our eyes get really wide, you know, because they have to take in information.

00:28:00.260 And so here, if we aren't curious, we can simply use this trick.

00:28:05.300 It's called somatic memory.

00:28:06.520 So somatic memory basically just means that our bodies will hold certain postures or positions or feelings that are associated with, with emotions.

00:28:16.560 So for anxious, you know, for example, my shoulders tend to be more contracted or hunched or, you know, kind of closed in than when I'm not anxious.

00:28:26.540 So if we're not curious, we can simply open our eyes really wide and see if that can help induce the feeling of curiosity itself.

00:28:38.340 That's kind of why it's a hack because we simply open our eyes really wide and anybody can do this right now.

00:28:44.340 It's like when you open your eyes really wide, does that actually help you become a little more curious in that moment?

00:28:51.580 Well, you also have, you tell people to like say, hmm, like, hmm, like verbally say, like, I'm interested in that.

00:28:58.660 And you might feel silly, but I did it.

00:29:01.580 I was taking a walk the other day and I did it and I think it works.

00:29:04.920 There's something to it.

00:29:06.840 The thing I like about, hmm, I think of it as a curiosity mantra is that it takes us out of our thinking brain and really into our feeling body because that's where all the action is.

00:29:18.060 And so if we're anxious, for example, we can go, hmm, where am I anxious right now?

00:29:25.700 Like, is it more on the right side or the left side of my body?

00:29:28.960 And that, hmm, can really open us to our experience.

00:29:33.340 It's another way that I like to play with this is, you know, it's kind of like if we feel anxious and we start to worry and we go, oh, no, I'm anxious.

00:29:43.180 Why am I anxious?

00:29:43.980 Am I going to be anxious all day?

00:29:45.220 Is this, you know, is there anything that's going to fix that?

00:29:48.020 And we can notice that.

00:29:49.620 We can map out that habit loop.

00:29:51.400 And then we can go, oh, here's anxiety.

00:29:55.720 What does this feel like in my body?

00:29:57.880 So instead of why am I anxious or how long is this going to last?

00:30:01.100 Instead of, oh, we can go, oh.

00:30:03.980 And that opens us to our experience so we can really drop in and feel what it feels like and step out of the worry habit loop.

00:30:11.720 Okay, so just to recap here, first steps, map out your habit, your anxiety habit loops that you have.

00:30:16.020 This just requires you to be mindful throughout the day whenever you experience anxiety.

00:30:20.400 Pay attention to what you do and what the reward you get out of that.

00:30:24.560 And then after that, the second step is to disenchant that anxiety behavior.

00:30:29.500 So just think about, man, what am I getting, how do I feel whenever I do this thing?

00:30:33.660 Usually the answer is not great.

00:30:35.720 And so just doing that naturally, your body or your mind and your body, I guess you'd say, would kind of extinguish that behavior because you're not getting any value out of it.

00:30:45.100 And then the third part is offer a bigger, better offer to your brain through curiosity.

00:30:50.000 That's it in a nutshell.

00:30:50.800 But I think it's interesting to point out, and you've mentioned this, but I really want to hit this home.

00:30:54.940 In this process, you are never figuring out what is making you anxious or why are you anxious.

00:31:01.100 And you say that actually it's, you call it the why trap.

00:31:04.000 It's actually not very useful to sometimes or to figure out why you're anxious.

00:31:08.220 Why is that?

00:31:08.740 So as a card-carrying, board-certified psychiatrist, this might sound heretical that we're not trying to go back to someone's childhood or figure out why they're anxious.

00:31:20.180 And the reason for that is that here my neuroscience hat wins out.

00:31:24.140 When I think about and I look at the equations that have to do with behavior change, none of them have to do with childhood or past experience.

00:31:34.680 It's not that that experience isn't important or meaningful.

00:31:37.760 It absolutely is.

00:31:39.600 But that's not what changes behavior.

00:31:42.120 And like you're pointing out, we can get stuck in these why habit loops, trying to figure out why am I anxious, thinking that suddenly if we figure out why we're anxious, it's going to fix it.

00:31:50.280 Well, that why is generally in the past.

00:31:52.720 So it certainly can be insightful, it can reduce uncertainty, but it's not going to fix the habit itself.

00:31:59.580 This is why I focus on the what.

00:32:03.820 Like what's happening and what am I getting from being stuck in this loop.

00:32:08.920 And also, even if you do figure out what's causing the anxiety, you might not be able to do anything about it.

00:32:13.840 Maybe it's something at your job, right?

00:32:15.500 And no matter what you do, you cannot get rid of that thing that triggers the anxiety.

00:32:20.680 So this approach is, okay, well, what can I change?

00:32:24.920 What can I focus?

00:32:25.460 Well, I can change my behavior by discounting or disenchanting that maladaptive behavior and have a different approach to it.

00:32:35.040 Absolutely.

00:32:35.900 You know, this is, I think of the serenity prayer.

00:32:38.880 It's like, let me, you know, accept things that I can't change and have the strength or courage to change that which I can.

00:32:46.300 If we can see very clearly what we can't change, we can stop banging our head against that wall so that that frees up the energy to look for the doors.

00:32:56.460 Sometimes, you know, we do need to find the door.

00:32:58.940 We're like, wow, this job really isn't a good fit for me and we can walk out it as compared to being too exhausted to even notice.

00:33:06.080 So you mentioned some other issues that, you know, hacking the anxiety loop or unwinding anxiety, addiction, overeating, smoking, it works for this.

00:33:15.580 Does it work for other things like depression?

00:33:17.100 There's a lot of good evidence showing programs like mindfulness-based cognitive therapy can really help people with depression.

00:33:25.920 And what that highlights is that this habit loop, you know, whether I think of worry and anxiety as, you know, future-oriented habits, this story of me in the future worrying and trying to protect myself against the future or what might happen in the future.

00:33:40.080 Depression is more about beating ourselves up over what happened in the past.

00:33:44.580 And so when we ruminate, we can get stuck in those habit loops around, you know, this is terrible, I'm terrible, the world's terrible or whatever.

00:33:53.640 And bringing awareness to this and using these same processes can really help us not reinforce those habits.

00:34:00.700 And, you know, these programs have been shown to be really, really helpful for depression.

00:34:06.060 Yeah, there's another, Richard O'Connor is a psychologist.

00:34:09.560 He wrote a book, Undoing Depression.

00:34:10.760 And he kind of makes the case that you do with anxiety that depression is just a series of habits that you have and you have to undo those habits.

00:34:19.080 Certainly.

00:34:19.620 And I think that's part of depression.

00:34:21.260 It's often not the whole thing.

00:34:22.980 Certainly for some people, there's a really strong biological component where they just, you know, they're too exhausted.

00:34:31.140 Let's put it that way.

00:34:32.180 The term may not be perfect, but they're just, you know, they have such low energy that they can't even think.

00:34:38.760 Like thinking feels like they're going through sludge or through some bog.

00:34:43.680 And so here, you know, it certainly can help with the thinking elements, but it's not necessarily, you know, I just want to emphasize how it can be very helpful for some people where some medications can be really helpful for those biological components.

00:34:57.180 As we were talking, another problem I can see, this habit approach could help is anger.

00:35:06.180 Anger is a habit, right?

00:35:07.280 You have this trigger and then your typical response is, I'm going to get all angry.

00:35:10.800 And then the reward is, well, I feel like I did something.

00:35:13.120 But then you just sit and notice, like, how do I feel when I'm angry?

00:35:16.020 Not really good.

00:35:17.500 And so you sort of start disenchanting that anger response.

00:35:20.460 Yes, and I think here, and I've certainly, this has been helpful for me in terms of working with my own frustration and anger, is looking at how we're directing our energy.

00:35:31.240 So anger can feel empowering.

00:35:34.200 You know, it can often make us feel like we're self-righteous, like, I'm doing, you know, I'm doing this for the right reasons or whatever.

00:35:40.040 I'm getting angry.

00:35:40.700 I'm doing something.

00:35:41.420 But we have to look to see what our anger is getting us.

00:35:46.220 And is it the most skillful or helpful way to change something?

00:35:51.180 You know, if there's some injustice in the world, is getting angry going to be the best way to solve that problem?

00:35:57.440 Or is it just going to make other people push back and make it harder to solve a problem?

00:36:01.860 Is it going to be an inefficient use of our energy?

00:36:04.920 So here, even, you know, for myself, I ask myself, what am I getting from the anger?

00:36:11.140 And that opens up the space when I become disenchanted with it.

00:36:15.020 It opens the space and frees up the energy to ask, well, is there another way to go about changing things?

00:36:22.220 Well, Judson, this has been a great conversation.

00:36:23.860 Where can people go to learn more about the book and your work?

00:36:26.180 I have a website, drjudd, D-R-J-U-D dot com, that has a bunch of free resources, links to my books, to the apps that we talked about, and other various and sundry things.

00:36:39.920 Fantastic.

00:36:40.400 Well, Judson Brewer, thanks for your time.

00:36:41.420 It's been a pleasure.

00:36:42.340 It's been my pleasure.

00:36:43.440 Thank you.

00:36:44.340 My guest today is Dr. Judson Brewer.

00:36:46.140 He's the author of Unwinding Anxiety.

00:36:48.040 It's available on Amazon.com and bookstores everywhere.

00:36:50.200 You can find more information about his work at his website, drjudd.com.

00:36:53.640 Also, check out our show notes at awim.is slash anxietyhabit, where you can find links to resources, where you can delve deeper into this topic.

00:37:06.640 Well, that wraps up another edition of the AOM Podcast.

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00:37:39.900 Until next time, it's Brett McKay.

00:37:41.200 Remind you on the list of the AOM Podcast, but put what you've heard into action.

00:37:44.640 I don't remember.

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00:37:48.400 Take care.

00:37:48.700 Bye.

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The Art of Manliness - February 28, 2022

Anxiety Is a Habit — Here's How to Break It

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