Eps 266: Unraveling Anxiety with Dr. Jud Brewer

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Casey O'Roarty 0:00
Music. Hello friends. Welcome to the joyful courage podcast, a place where we tease apart what it means to be a conscious parent and a conscious human on the wild ride of parenting. I am your host. Casey o'rourdy, positive discipline trainer, parent, coach and Mama walk in the path right next to you as I am perfectly raise my own to teenagers. Joyful courage is all about grit. My friends growth on the parenting journey, relationships that provide a sense of connection and meaning and influential tools that support everyone in being their best selves. Today's show is an interview, and I encourage you to listen for how grit shows up as my guest and I tease things apart. Thank you so much for listening. I am deeply honored to lead you. Super grateful that what I put out matters to you, and so so excited to keep it coming. Thank you for who you are and for being in the community. Enjoy the show.

Hi, listeners. My guest today is Dr Judd Brewer. Dr Judd is a thought leader in the field of habit change and the science of self mastery, having combined over 20 years of experience with mindfulness training with his scientific research therein, he is the Director of Research and Innovation at the mindfulness center and associate professor in behavioral and Social Sciences and Psychiatry at the schools of public health and medicine at Brown University. He is also the executive Medical Director of Behavioral Health at Sharecare Inc, and a research affiliate at MIT, a psychiatrist and internationally known expert in mindfulness training for addictions. Brewer has developed Brewer That was funny. Dr Judd has developed and tested novel mindfulness programs for habit change, including both in person and app based treatments for smoking, emotional eating and anxiety. He's trained us athletes, Olympic athletes and coaches, foreign government ministers. And his work has been featured all over the place, including 60 minutes Ted. He has the fourth most viewed talk of 2016 with 16 million views the New York Times, Time Magazine, as well as tons of other places. Dr Judd founded mind sciences to move his discoveries of clinical evidence behind mindfulness for anxiety, eating, smoking and other behavior change into the hands of the consumer. He's the author of the craving mind from cigarettes to smartphones to love, why we get hooked and how we can break bad habits and unwinding anxiety. New Science shows how to break the cycles of worry and fear to Heal your mind. I am so excited to welcome him. Hi, Dr Judd, welcome to the podcast.

Jud Brewer 3:08
Hi, thanks for having me.

Casey O'Roarty 3:10
That was a lot. I'm super excited and honored to have you on the show. Will you talk a little bit about how you got interested in doing the work that you do?

Jud Brewer 3:20
Yes, so the work around anxiety was somewhat serendipity. Actually, all of the work was somewhat serendipity. I was pretty anxious. Coming out of college, starting medical school, pretty stressed out. And I found that I actually started meditating my first day of medical school, and I found it really helpful for me. And just thought I would kind of do that as a personal gig, while I was doing the business of medicine and research, and after about 10 years, when I was in residency training, I actually shifted my entire research career to studying mindfulness because I was so blown away by how well it was. It worked for me, and started looking to see if it could help my patients regarding anxiety as a as a resident physician, and actually, when I first started my career, kind of out on my own, after residency, I found that I was really struggling to help my patients work with their anxiety. You know, typically, the thing we learned in the medical model is medications, you know, give people medicine to help with their anxiety. And if you look at the best medications out there, there's this, there's this figure. It's called a number needed to treat, which is basically a quick and dirty way of getting a sense for how well the medication is going to work. So the number needed to treat for anxiety is 5.15 which means you know about you have to treat five people before one person benefits. So you can imagine that wasn't very satisfying as a psychiatrist, where, you know, I'd have five patient visits, and one of them would benefit somewhat with the anxiety medication. Nothing against that. I still prescribe medications, but I started looking to see what I was missing. And it turned out, some of the research I'd been doing with habit change, I. Fit. It fit very nicely with anxiety. And I had no idea. I never learned that anxiety could be reinforced as a, you know, in a habitual way. But I started studying that to see if that was actually true. There was some research literature from the 80s suggesting that that might be the case. So, you know, building on some of the previous work that we'd done, like my lab had done some studies with mindfulness for smoking cessation. For example, we've got five times the quick rates of gold standard treatment for smoking. We even developed an app for eating called Eat right now, and we found in a study at UCSF, found 40% reduction in craving related eating. So we found that we, you know, we were pretty confident that we could actually target some of these mechanisms underlying smoking and eating, and I wanted to see if we could actually help people with anxiety. And selfishly, I wanted to see if it could help my clinic patients, because I wanted my patients to stop suffering as much as they were. And, you know, I wanted to be a little more effective as a clinician. So that's where all of this came forward around working with anxiety. Oh, and by the way, I used to get panic attacks when I was a resident physician, so I kind of I had a little personal experience with anxiety myself.

Casey O'Roarty 6:13
Yeah, when we were talking before I hit record, and I was sharing about my daughter and thinking about the parents that are listening. I know that there's people that are saying, yes, yes, yes. I too, have had these anxious experiences and panic attacks. And then there's some of us also who are like, I don't think I've ever had a panic attack. I don't know what that feels like. And so to be the support person for a child or a teenager who's in the middle of that, it feels really daunting, and I love that you were looking and finding other ways to complement treatment of anxiety, because I think it's really scary for parents when their child is struggling with anxiety, To have it immediately go into, well, they they just need medication. So,

Jud Brewer 7:05
yeah, absolutely, wouldn't it be great? You know, the way I think about treating patients is really figuring out what the underlying issue is with them and going for that. And for some people, medications are kind of like a brain vitamin, where they just need this, you know, they need a little extra serotonin or something like that. And, you know, give them an SSRI or some medication, and really helpful for them, for, you know, unfortunately, that's, that's really the minority of folks today. So I'm thinking of my clinic patients. So I saw when a follow up of one of my clinic patients that I've been treating for about a year. And here's a great example of what we're talking about. So this gentleman, he was about 40 years of age when he first came to see me, and he and I, he was anxious, but, but the first thing you know, that was pretty easy to see, but you know, long and story short, he met all the criteria for both panic disorder and generalized anxiety disorder. And he said, I'm really not interested in medications. And so he would, we just mapped out, okay, so what are your triggers? And so he started to say, you know, said, Well, when I drive on the highway, I would get this thought that I'm in a speeding bullet. And so there's the triggers this thought his behavior would be to freak out and avoid. Eventually he stopped driving on the highway altogether. He would avoid driving on the highway. And the result of the reward for his brain was that he could avoid those anxious thoughts. And just taking 30 seconds to map that out with him on a literally on a piece of paper in my office, was already helpful for him. He he looked at me, you know, and said something like, you know, I'd never noticed that before, but yeah, that is true, you know. So I just sent him home to start mapping out these habit loops himself to see how he could, you know, how he could start to see how his mind works. That's fundamental process for all of us, yet most of us don't know that stress and anxiety can actually be perpetuated in this very simple way. Yeah,

Casey O'Roarty 9:08
can you dig a little bit deeper into that? So, Hugh, you have, you know, you send people home to map their habit loops. So we just called them the habit Yes, yeah,

Jud Brewer 9:20
think of it as a habit loop.

Casey O'Roarty 9:22
So you notice the and I've read your book, well, I've read most of your book, and there's the trigger and the behavior and the reward. So can you talk about where that comes from and how it's I mean, you just shared how it helped. You know, even just recognizing that it exists. But how like talk a little bit more about how that works? Sure.

Jud Brewer 9:43
Well, from an evolutionary perspective, if we look at human survival, this comes from this very basic reward mechanism that helps us remember where food is. So if you think of our ancient ancestors out on the Savannah, and they have to go out in four. For food. They didn't have refrigerators. So their brain, you know, as they're looking for food, they come across a food source. So there's the trigger, they eat the food, there's the behavior, and if it's, you know, has calories, their stomach sends this dopamine signal to their brain that says, Remember what you ate and where you found it. So it's really set up to help us develop context dependent memory, meaning remember the place and the thing that you did in that place, so that we can go back and find it again. The same is true for avoiding danger. And if we go out in the Savannah and we see a saber toothed tiger that hangs out in a certain place, we can know to avoid that place in the future. These are called positive reinforcement, like keeping pleasant things or learning from pleasant experiences, and negative reinforcement avoiding unpleasant experiences, such as getting eaten by a saber tooth tiger in modern day a this this mechanism is still in place for all of us, even though we know where food is, and this also is at play for anxiety. In particular, there was some research done back in the 80s by this guy, TD borkovec, at Penn State, in which he found that worry and anxiety could be perpetuated through negative reinforcement. So anxiety or an unpleasant motion would be the trigger. The behavior would be worry, and the results would be that people would feel like they were in control, or they could distract themselves from the negative feeling, feeling of anxiety or fear or whatever, so that worry can actually get perpetuated. And often people don't think of worry as a behavior, right? That's

Casey O'Roarty 11:37
what I was just thinking. Yeah,

Jud Brewer 11:39
it's very much a mental behavior. So behaviors aren't just physical things that we do. They can also be mental things that we do. They're just, we just do them in our heads.

Casey O'Roarty 11:51
Yeah, oh my gosh. Well, there's a lot of worry going on when you have a couple of teenagers under the roof. Let me tell you what you so do you feel like anxiety is something that and because you've been in this work for a long time, it feels like, and I'm not sure if it's just my own personal context or if it's happening more on a broader scale, is anxiety actually increasing, or has it always been there, and we have new ways of talking about it. What is your take on anxiety?

Jud Brewer 12:30
I would say it's both. Yeah, so and there, the research is now backing that up, especially with the pandemic, there's been a huge increase in anxiety across the board, across multiple, you know, in any country, basically that's reported on it, they're seeing large increases. I think the largest increase I saw was something like 30 or 40% 30 or 40% is pretty big, you know, just in a jump in a year. And I think a lot of this has to do with uncertainty. So again, this goes back to to our survival mechanisms. You can think of fear as a learn as a essential, helpful survival mechanism. So if we step out into the street, we almost get hit by a car, we have that fear reaction that says, hey, you should look both ways before crossing the street. So that looking coming up to the street becomes the trigger. Looking both ways. Become the comes the behavior, and then, you know, the result is that we don't get killed. There's that negative reinforcement. Yet, when our brains have evolved more recently to be able to think and plan more than just crossing the street, that thinking and planning part of the brain needs accurate information, and it, for example, with the pandemic there was, there's a lot of uncertainty. So at the if you think back to the beginning, people didn't know how contagious it would be, how deadly it was going to be. Even more recently, we've seen with the variants, you know, how, how are those going to affect things? How are those going to affect the vaccines and all that. All of that uncertainty makes our brains start spinning out into these different what if scenarios, you know, like, what if this, what if that, what if this. And so, if you pair of fear plus uncertainty, we get anxiety, which ironically, is anti survival. It doesn't help us survive, because it makes our thinking and planning brain go offline.

Casey O'Roarty 14:22
Oh my gosh. I just all I keep thinking about is how good we are at worst case scenario. And, you know, working with parents, being a parent of a teenager, working with parents of teenagers like I'm looking even on my screen, I have fear plus uncertainty equals anxiety. And I'm thinking about my own experience of, you know, being worried when, when my daughter was in really in the throes of her anxiety, and didn't have any tools, hadn't really gotten the really good help that she needed. And then couple that with, what does this mean for her future? Sure, how is she ever gonna take care of herself? You know, like all this uncertainty and dead in a ditch, because I love my mom, but that was kind of her catchphrase growing up, was you're gonna be dead in a ditch. And so I tend to go there. And I think that as a parent, it's really easy to continuously go there, forgetting that uncertainty doesn't result in one outcome. Uncertainty can result in a whole range of outcomes, you know, including dead in a ditch, but there's also a lot of other places to go. So I would love to pick your brain just right now. Dr Judd and so with that, when parents find themselves in that loop of worry and uncertainty and they've got a teenager, maybe it's not as extreme. I mean, sometimes it's simply like they're going to their first party, oh god, they're gonna, you know. I mean, fill in the blank, and we can be worried and anxious about it, but how, what are some tools that you have that can help parents, even in that one simple place of just like, Okay, calm down, trust your kid, like, recognize where you're at, right? I'm guessing you're probably going to talk about that, recognize that you're freaking out. Step one. And then what? Well,

Jud Brewer 16:19
I think the first thing to do is to help our thinking and planning brain to come back online. So I like to have people use some simple grounding practice. And this can be as simple as taking a few deep breaths. Or one thing that I love is this practice called Five Finger breathing. And the idea there is that you take the index finger of one hand and start tracing your pinky of your other hand, say, from the outside as you breathe in, and then as you breathe out, you trace down the inside of your pinky. I'm doing this right now as you breathe in, trace up the outside of your ring finger as you breathe out, trace down the inside of your ring finger. We'll do one more as you breathe in. You trace up the outside of your middle finger. As you breathe out, trace down the inside of your middle finger. And you can imagine. So if we just do this for five breaths, we've traced our entire hand to our thumb. We can trace back to our pinky for 10 breaths. And what that does is it as we're looking at our fingers, as we're feeling the sensations of two different fingers and the breathing that basically takes up all of the bandwidth of our working memory part of our brain called the dorsolateral prefrontal cortex. Think of that as like the analogous to the ram of a computer. If you use up all the RAM on your computer, it forces all the other functions to turn off for your computer freezes. This is helpful because we tend to have this program, so to speak, running in the background of our mind of worry. And what this does is it kind of reboots the whole RAM system in our working memory, and when that comes back online, our physiology is calmer. So if those thoughts come back there, there's a mismatch between the intensity or the amplitude of our physiology and the thoughts. And typically you need to have a match where it's like, I'm anxious and I feel anxious. Because if the thought that comes in and says, I'm anxious, and we're not anxious. Our body's gonna be like, that's just a thought, and it's much easier to be able to just see that as a thought, rather than get caught up in it. So something like five finger breathing can be a really helpful way to kind of calm the physiology, so that our thinking brain can come back online. And then we I first thing I do, and this is why I wrote this book, was because I wanted people to have a have a guide, where they could just guide themselves. Yeah, the first step, and the first part of the book is about helping people map out habit loops, and it uses anxiety and procrastination and other worry types have, at least

Casey O'Roarty 18:58
I don't know anything about procrastination.

Jud Brewer 19:02
Yeah. We'll get to that tomorrow, yes, but it uses those and then any habit loop, you know, people, if people stress eat, if people smoke, and you know this is they can apply it to those as well. But the first step is to map it out. Once we can see those, then we can start to work with them. And, you know, just to bring back in my patients as an example, so I sent my patient home, and this guy was also, I actually write a little bit about him in a in the book, because he was a really remarkable case where he was 180 pounds overweight, he had hypertension, he had a fatty liver from his obesity and all this. But we were just going to start focusing on his anxiety, because that's what he was because that's what he was referred for. So I sent him home to map out his habit loops. He comes back two weeks later, and he says he was actually excited. He wasn't nervous. When he came in, he was excited. He said, first thing, he said, when he sat down, he said, I lost 14 pounds. Oh my gosh, yeah. And I looked at him. Um, because I was thinking, I don't think we even talked about weight loss yet, right? Okay, let's go with it. And he said, Yeah, I was mapping out my anxiety habit loops, and I realized that my behavior so anxiety was triggering me to stress eat. And I realized that the result of that stress eating was that I was actually just feeling worse because I'd feel bad about eating because I knew I needed to lose weight. So I lost 14 pounds. So long story short, this guy went on to lose 100 pounds, over 100 pounds, he's still going strong. And he said it was really, he even reiterated this today on our call. He said it was effortless, because it, you know, he just, he saw that it wasn't, it wasn't rewarding. And the reason I bring him up is because that's the second step. So once we map out these habit loops, we can then start to tap into our brain's natural reward system, because that the reward based learning is the strongest part of our brain. You know, this is, this is evolutionarily conserved all the way back to the sea slug, right? That's how, how inbuilt this is. So, you know, typically, we try to use willpower or these types of things to break habits or try to think our way out of anxiety, you know. And if at work, I wouldn't have a job, which would be awesome, you know, I just tell people stop worrying, right, right? What's that? That old skit from? There's this, you know, just stop it. From New heart or state. I think, you know, this woman comes in and says, you know, I'm afraid of being buried alive in a box. And he said, I'm going to charge you for five, you know, $5 for five minutes. And he just says, Just stop it,

Casey O'Roarty 21:34
right? Well, I mean, it's we laugh right now, but, I mean, I was in it with my daughter, like, just stop like you don't have to feel like that. You know, nobody's looking at you. One of her things was walking down the hall or having to walk to the front of the classroom, and it was just excruciating for her. Yeah, and, I mean, my impulse was to be like, well, like nobody's looking at you. Stop looking like that.

Jud Brewer 21:58
Just stop it. Real helpful. So so if that were, it'd be great if that works, because I would happily find another line of work yet, that's our thinking brain is the weakest part of our brain. From an evolutionary perspective, it's the first that goes offline when we're anxious or stressed. So of course, it's not going to work that well. So why not tap into the strongest parts of our brain? And this is where some of my research from our eat right now app actually came into play. This, this mindful eating program that we developed. We were looking at some of the research from the early 70s, where, basically, these, these folks postulated, the researchers were named Rescorla and Wagner, and they postulated that reward value gets set up basically as a habit in our brain, and so it helps our brains not have to relearn everything every day. So for example, if we're given a choice between broccoli and cake, once we've learned you know what broccoli tastes like and cake taste like, it's a no brainer. If we are given both at the same time, from a calorie perspective, to our brain. So, you know, it says, Oh, of course, I'll eat the cake. Which is why we don't serve our kids cake and broccoli at the same time at the meal, right? Dinner, right? So this, this is set up as a survival mechanism. And what happens is, we don't have to relearn that every time we see cake, and we're like, Oh, I know how rewarding that is. I'm going to do that again. So we actually set up worry as a habit loop with a certain reward value, just like we set up food as a certain reward value. So we tested this hypothesis in our in our eating app, where we had people pay attention as they ate. So whether it was overeating or eating junk food or whatever, so they could really examine and explore what the results were now, not what the old habitual reward value was in the past. And what that helped them do is update that reward value. And typically this is called a negative prediction error. So our brain is predicting that it's going to be such, you know, have a certain reward. And if we really pay attention right now, and it's not as rewarding, there's this negative prediction error that says, Oh, I was predicting it's going to be this rewarding. It's not as rewarding. There's negative and we, if we do that enough, that actually updates that reward value in our brain. And my lab found that it only takes 10 to 15 times of people doing this with overeating or even smoking, that they could significantly update that reward value to the point where that reward goes below zero, below not eating or not smoking. So we can actually apply this to anxiety as well, in particular, worrying. So I have people pay attention when they worry and to just simply ask themselves this simple question, what do I get from this not intellectually, but physically? What's it feel like when I worry? Exactly, yeah, physically. That's the critical piece, because our our thinking brain does not hold a candle to our feeling body. Our feeling body is really what drives. Behavior. Oh,

Casey O'Roarty 25:01
man, that is profound. And yet we try to think our way out of everything. I know I'm listening to you, and I'm coming back again and again to that tendency of, you know this time, and I'm just, I know that you don't have teenagers, but I'm guessing you know some people with teenagers, and you were a teenager, and so I am just thinking about how powerful fear and worry is, while we also know in our heads that we have to give our kids space. They need more space. They need more freedom. They need more responsibility, and that tension of letting go and trusting, not only trusting that our kids will make, you know, quote, smart choices, but also trusting that when they don't, they're gonna be okay and they're gonna learn from it. And I'm just trying to imagine mapping this loop and the I know when I feel the fear and the uncertainty is when I become the most controlling, and that's when I'm like, no. It's a hard No. Or, you know, I just want to shut everything down.

Jud Brewer 26:19
Do you tell yourself, just stop it?

Casey O'Roarty 26:25
No, I'm totally righteous. I'm totally like, I am in that right, right now, I gotta put my foot down. Like, this cannot happen. You are going to plus, it doesn't help that I was kind of a wild and crazy teenager, right? So I'm also projecting what I was doing, granted, I had a very different relationship with my parents than my kids have with me. So there's, well, what I think is there's all these layers that make it so complicated. Dr, Judd, but really it's not that complicated, right? Because when I think about how it makes me feel in my body, when I go there, it feels tight. I feel disconnected from my child, like I can feel, I don't know if I could physically feel the relationship being damaged, but it's this tension. And I know I'm trying, yeah, actually, I am. I'm like, Just shut up. Like, stop talking right now, case get it together, calm down, and yet it's still coming out of my mouth. And again, working with parents and knowing this is a really, this is a big place that feels hard to change.

Jud Brewer 27:33
Yes, so would you mind if we use that as an example? I would love it. Okay, okay, so think back to the last time you did that with your daughter, and just feel into, you know, what you got from it, physically, like, how much it helped the situation, what it felt like afterwards? Was there any emotional like guilt or regret or anything like that? And just describe what you what you notice, just from bringing that back up,

Casey O'Roarty 28:03
yeah, it felt like, like, tension and tingling in my body. I felt like, I it felt out of I felt out of control. I felt like, yeah, like, all of a sudden, I didn't have any control over the situation. Okay, so really, if I'm honest,

Jud Brewer 28:28
yeah, so imagine the next time you're about to have that conversation, you feel yourself moving into that territory with your daughter. Imagine just bringing to mind this last scenario and asking yourself, Well, what did I get from this last time? What do you think that might do?

Casey O'Roarty 28:49
Well, it would prompt me to keep my mouth closed and to be curious instead of commanding and demanding.

Jud Brewer 28:59
Yeah. So would you keep your mouth closed, out of a forced just stop it mode, or out of a Wow, that really didn't help me last time. So why am I going to do this again mode? Obviously, this is a leading question,

Casey O'Roarty 29:11
yeah. Well, no, it's like, I want to create something different than last time, you know, so I'm going to do something different than last time, yeah, which requires the thinking brain to be online.

Jud Brewer 29:22
It does and and it's really a matter of memory at that point. So the way that this reward value system works is it updates the reward value, and then we have to recall it. So if it's a newer memory where it's not quite as established as the old ones, where we've done it a gazillion times, we need to get a little X, you know, a little more repetition there, or we need to get something that's really in proximity, close temporally, so we can really feel what it feels like. And that helps us become disenchanted with the old behaviors, where it doesn't take force to undo the old behavior. So we use this. Same practice having people pay attention when they smoke, when they're trying to quit smoking, so they become disenchanted and then recalling that last time they smoked, when they're about to, you know, when they have a craving to smoke again. So they're like, do I really want to do this? But you can do the same thing with worrying or, you know, kind of trying to, I don't know how to characterize what that interaction with your daughter was, but let's say trying to control the situation. Yeah, perfect when we recall what it was like to try to control it last time, and it only made things worse. You know, like it distances us from our from our family members. You know, we don't feel more connected or feel more disconnected. That disenchantment is what that second step is about that provides that negative prediction error for our brain to say, you know, I'm

not as excited to do it. But you also brought forward what the third step is,

which is, you know, if our brain becomes disenchanted with something that, you know, the old behavior, our brain's going to be looking around saying, well, give me something better. And I call that the BBO, the bigger better offer. And so that's actually what part three of the book is all dedicated toward. But you touched on my favorite, bigger better offer, which is curiosity. So when you I'm sorry to keep quizzing you, so I will stop doing I like in your own show.

Casey O'Roarty 31:22
No, no, no, please, everybody. This is this is real. I'm all about transparency here. Dr dread,

Jud Brewer 31:29
so you tell me what feels better worrying or being curious?

Casey O'Roarty 31:35
Being curious?

Jud Brewer 31:36
Yeah, yeah. And my labs actually study this. So it seems like a no brainer, but apparently you have to do the research studies to prove that it is true. Yeah, we did this with like seven or 700 bunch of hundreds of people to have people basically lay out the reward value of different mental states and universally shocker, anxiety and worry and feelings of restlessness and things like that are universally rated as less rewarding than things like curiosity or kindness or connectedness. You know, so connectedness feels very good when you're actually communicating well with your daughter. It feels I'm sure, it feels great. Yeah, feels awesome. Yeah. So this is about not only seeing how unrewarding these old behaviors are, like worry, but also tapping into intrinsically rewarding behaviors, like being curious, and that has the bonus of moving us out of, you know, I love Carol dweck's framework of fixed versus growth mindset, which is basically, you know, fixed mindset is, like, this is the way it is. It's never going to change, and growth mindset is, hmm, well, I don't know. Let's see.

Casey O'Roarty 32:52
So funny too, Jed, because, like, it's so in the parenting conversation, like we want our kids to have a growth mindset, and yet, we're so we're so we get so fixed as parents on so many things, and we don't even realize that that's where we're at. So I just think it's hilarious, myself included. Yeah,

Jud Brewer 33:12
so maybe modeling growth mindset is a better way to teach our caps.

Casey O'Roarty 33:16
Yeah? Just concept. So again, and this is similar, you know, I love what you're talking about, and it really supports how I work with parents and and my own personal practice. And I know that for me as well as I'm sure for a lot of people that you work with, you know, again, coming back, talk a little bit more about mindfulness and, like, how we can, like, train ourselves to even be in a place of having the wherewithal to recognize we're having this a craving or a, you know, a tendency that shows up, you know, how do we support ourselves? Because often I'll hear from parents. Like, well, yeah, I thought about it after,

Jud Brewer 34:03
yeah, so that the after is actually still helpful, just like what you and I did. I call that retrospective. So I step 123, I sometimes call them the gears model, because I grew up riding a bicycle, you know? So it's like, you shift into first gear, then second gear, then third gear. Love it. We can actually do a retrospective second gear, meaning we don't have to be right in the throes of a situation to learn from it. As long as we can recall the experience enough where we feel those feelings in our body again, that body being the thing that drives behavior, we can still learn from those you know, it's like, oh, the last time I yelled at that person that didn't feel very good. That helps me become disenchanted from doing it again, you know. So there's still juice there for us to learn from. So here, you know, with mindfulness, and I think there are a lot of misconceptions around mindfulness, I'll just admit I, I had this, this mindset around mindfulness, where, you know, for the first 10 years of. My own mindfulness practice I would I thought it was just about gritting my teeth and forcing myself to pay attention to my breath, for example, as a mindfulness practice, no

Casey O'Roarty 35:09
thinking, no thinking. That's

Jud Brewer 35:11
right, clear that mine and I remember my first seven day silent meditation retreat. By day three, I was crying uncontrollably on the shoulder of the retreat manager, who was a stranger to me at the time. She became my first meditation teacher.

Casey O'Roarty 35:28
Oh, I really wanted you to say she became my wife.

Jud Brewer 35:33
It's okay. It's okay. Yeah, the idea there was that, you know, I could make it into medical school, I could do all these things, but I couldn't pay attention to my breath, and I felt like I was doing something wrong. And so I'll say, first off, mindfulness is not about forcing ourselves to to lock onto, you know, the the Zen Mind, or whatever these ideas are. The second piece around mindfulness is I really see this as awareness plus curiosity. So we can mindfulness is a concept, but awareness is awareness. You know, we are either aware of something or we're not aware. And when we are aware, we bring, we can bring a certain attitude, so we can be aware of something, and we can be like, Oh, that sucks, you know. So there's a judgmental attitude that we're bringing, but we can be aware, and we can also bring an open, you know, kind of this growth mindset, like an open mind, like, Oh, that's interesting, even if it's Oh, I'm anxious, that's interesting, as compared to oh, I'm anxious. That sucks. When is this going to end? Am I going to be anxious for the rest of my life? Yeah, yeah, yeah. So, so mindfulness, I like to just use the word awareness. So let's use awareness plus curiosity. So we can train ourselves to be aware, but we can't force ourselves. Is you know this awareness training is not a forced march. It's really about tapping in to how that awareness helps us live happier and healthier lives. So we we can train this by helping people, first off, see how awareness helps them work with unhealthy habits, because there's a pain point right there for them to work with. This is why, when we've developed apps, it's been around specific pain points like smoking or overeating or anxiety. You can start there, and then once you get the general concept, you can apply it everywhere in your life, right? So, so the idea is, give people a conceptual understanding of how awareness is helpful, then have them start to practice it. So we have people eat mindfully, for example, so they can see when they're actually full, like I gave the example of earlier with with my lab's research, or we can have people map out worry habit loops and have them pay attention to what they're getting from worrying. And a lot of the you know, mindfulness comes from this Buddh tradition, you know, from Southeast Asia. And what they really emphasized there was what they described as cause and effect, where, you know, what's the effect of a behavior that you do, which fits beautifully with reward based learning or positive and negative reinforcement, because the idea is, it's not the behavior that drives a behavior, it's actually how rewarding it is, which is, you know, somewhat counterintuitive. You'd think, well, if it's, you know, if it's the behavior, I could just tell myself to stop smoking or stop worrying. We know already know that that doesn't work. It's really what am I getting from this? And so they talked about this cause and effect relationship, and that awareness helps us start to see that very, very clearly, what am I getting from this? Just like you were doing earlier, when I was having you feel into the experience of what it was like to interact with your daughter in that way. And then awareness itself can become that bigger, better offer, where we can get curious about what anxiety or panic or whatever feels like, rather than getting sucked into it. And you know this, this might sound far fetched, but of course, my lab, we've done the research to see if it's actually true. So we've actually done several clinical studies of our unwinding anxiety app to see how well mindfulness specifically can work to help people with this process. And I'll just skip to the results. We did a study with anxious physicians. We got a 57% reduction in clinically validated anxiety scores in that population, we also found a significant reduction in burnout, even though we didn't even say anything about burnout. But we, you know, the two are related. We did a study, a randomized, controlled trial. This was funded by the NIH of people with generalized anxiety disorder. You know, I think of them as the Olympians of worry. They're really good at worrying. Yeah, and we got a 67% reduction in these anxiety scores. And I don't know if you remember back to the beginning, but I mentioned this number needed to treat for medications, which is just over five. The number needed to treat in this study was 1.6 Wow. So. What lottery would you like to play? Yeah,

Casey O'Roarty 40:02
right, the second one well, and I love you know, one of the things that was supportive for my daughter, we went through a dialectic behavioral therapy program together, and one of the pillars in that program is mindfulness like that was that was just woven into every single session that we had and was has been so useful to her. And when I think about the other things, the other tools that she and I both learned, because just because I'm a parent educator doesn't mean I didn't have more to learn. There was, you know, it was awareness. Was all over the place. So I love that. And I feel like, too when we can dip into awareness, I feel like that's the only place where we can really create space to make a choice. You know, it's like, Okay, I am feeling anxious, or I'm feeling I'm feeling scared for my kid, my kids going out in the world. And then I get to be, I get to realize, like, Oh, I know why my whole body's tight right now. It's because I'm I'm nervous, I'm projecting, I'm doing all these things. And now do is this who I want to be? Is this going to be useful? Is this like it feels like there's a choice there when an awareness kind of puts everything into a little bit more slow motion. Is that, am I on the right track there? Is that what you find in your lab?

Jud Brewer 41:30
Yeah, I was gonna say that is backed by science.

Casey O'Roarty 41:34
Great, yeah.

Jud Brewer 41:36
The short answer is, we can't change behavior unless we're aware of how unrewarding the behavior is, and we can't start a new habit unless we're aware of how rewarding that behavior is, and that's what you're describing.

Casey O'Roarty 41:55
And back to mindfulness, and like you had mentioned your practice of meditation, I had a really good friend who just blew my mind because I said the same thing, like, you know, I'm just not good at it. I can't empty my mind. I'm always thinking about something and realizing I'm thinking about something. And she said, that's the point. That's where you're strengthening that mindfulness muscle is when you recognize, oh, I'm thinking about the grocery store. I'm going to come back to breath, that that movement, that that awareness, the more we do it, the better we get at it. And then later on in the day, when my kid wants to go, you know, out into the world, and I'm worried about it, the muscle memory of, oh, I'm sitting inside of my fear and my worry and my projecting, I can come back to my breath and decide to get curious and connect with him and find out a little bit more information, and be open to the possibility that maybe he won't end up dead in a ditch.

Jud Brewer 43:00
Yeah. Yeah. And we can also reflect on it right afterwards, so that that reward value gets laid down in our brain and

Casey O'Roarty 43:07
reflecting on it afterwards. Like, look at me, I'm such a good parent. I went right into curiosity. Is that what that sounds like?

Jud Brewer 43:15
Well, and even the Oh, I'm such a good parent, can be a judgment call, where we can also judge ourselves as, oh, I'm a bad parent.

Casey O'Roarty 43:24
Oh, yeah. So, because that shows up too when I lay down the law, yeah. So

Jud Brewer 43:28
even there, we don't even have to get to that that stage of I'm an good or bad parent. What's it feel like to be connected? Yes, you know, those in themselves are very rewarding.

Casey O'Roarty 43:39
Oh my gosh, so great. Where can people find your book and you wake where are you? Where can everybody

Jud Brewer 43:49
find you? Anywhere books are sold. Okay, I have a website that is named Dr judd.com dr j u Dean, that we talked about, and also we put a bunch of free resources out there for folks. So I really have enjoyed putting together animations that help people understand how our brains work. And so there's a bunch of stuff on there. Folks are interested in, kind of getting that that visual of how all of this stuff works, or diving in deeper

Casey O'Roarty 44:18
awesome. And everyone I played around on Dr Judd's website, and I would definitely encourage you to watch his TED Talk. And there's some other interviews that are just fascinating to listen to and to watch. So we'll make sure that all those links are in the show notes. My business is called joyful courage, and I always end my interview by asking my guests, what does joyful courage mean to you? Dr, Jed,

Jud Brewer 44:46
you know this, this phrase comes to mind. I think it's a quote from James Stevens, who was an author who said that Curiosity will conquer fear even more than Bravery. Well, and so to me, joyful courage means that when we can be bring curiosity with us everywhere we have the courage to face anything that we need to face.

Casey O'Roarty 45:15
I love that. Yes, go curiosity, yay. I love that, and my people, my listeners, they've heard me talk lots about curiosity, so this just aligns so well. Thank you so much for your time and coming on and all the work that you do. So appreciate it. It

Jud Brewer 45:34
was my pleasure. I really enjoyed this. You

Casey O'Roarty 45:43
all right, thanks again for listening to the joyful courage podcast. If you feel inspired, moved, stoked, empowered and you haven't already, do me a favor and head over to Apple podcast and please leave a five star review. We are working hard to stand out and make a massive impact on families around the globe. Your review helps the joyful courage podcast to be seen and found by even more parents. Thank you so much for taking a few minutes to do that. Also you can follow joyful underscore courage on Instagram and Facebook. We love connecting with you on social media, and don't forget about that living, joyful courage membership wait list. Head over to joyful courage.com/ljc to put yourself on the wait list to hear more about the upcoming membership offer that will be unfolding soon. Yay, love you. Thank you. Thank you. Thank you. Mwah

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