E369: Dr. Jud Brewer - end ANXIETY and WORRY today! | CPTSD and Trauma Healing Podcast

Michael: Hey! What's up, Unbroken Nation! Hope that you're doing well wherever you are in the world today. Very excited to be back with you with another episode with my guest, Dr. Jud Brewer, who has a huge Ted talk with over 10 million views called a simple way to break a bad habit and in my own personal journey and you'll find this out for the first time. My friend has played a massive role in me, understanding, really changing my thoughts and processes around anxiety. Dr Brewer my friend, how are you today? What is happening in your world?

Dr. Jud: I'm good. Thanks for having me.

Michael: Yeah, it's a pleasure. I'm very excited to dive into this and I think that we should go full bore right into it. I was listening to you doing my research as I tend to do on rituals podcast and you said something really fascinating. And I wrote a note here says, can you describe the parallel between anxieties and addictive behaviors and can anxiety be habituated through negative reinforcement? So, we're just going right in.

Dr. Jud: I love it. Well, so the little backstory, the short answer is yes. And the longer answer is, you know, I never learned this in medical school, a residency, maybe I slept through that class or something like that. But I have to say, as I was starting out my clinical practice as a psychiatrist and in particular as an addiction psychiatrist, I was really struggling with helping my patients, with their own anxiety. So, the best medications out there, there's this medical term called number needed to treat, which gives us a rough estimate of how many people are gonna benefit from a treatment, that number is 5.2 for the best medications that we have, which means one in five people is gonna show significant reduction in symptoms.

So, I'm sitting here, plan the medication lottery, trying to figure out, you know, which one of my next five patients is gonna benefit from medication and then also what I'm gonna do with the other four. So, I'm getting anxious, trying to help my own patients with anxiety. Forget about the fact that I used to get panic attacks and all this in residency, but, you know, so I can certainly relate, but here I am sweating it out like not knowing what's gonna happen next. And you know, we can get into this later, our brains hate uncertainty, well, my brain is no different than anybody else's. So, I'm really struggling here for a number of years and in the meantime, my lab as a neuroscientist, we're studying habit change. And so, we'd developed some programs like one for smoking cessation, and we'd done pretty well with it like our first study, we got five times the quit rates of gold standard treatment. We'd even developed app-based mindfulness training programs for helping people with overeating. for example, we had this eat right now, app that is study UCSF showed 40% reduction in craving related eating.

And I mentioned that because somebody in that program said, you know, I'm mapping out my habit loops around eating and anxiety is the big thing that triggers me to eat. You know, like stress, eating a big thing for a lot of people. And she said, hey, can you make a program? Can you make an app for anxiety? And I was thinking, ah, I prescribe medication for anxiety, you know, this isn't my lane, but it put a bug in my ear. And so, I went back and looked at the literature and lo and behold, back in the 1980s, this was back when the SSRI were just being developed and being put out onto the market, also back in the day when MC Jagger was singing about mother's little helper, you know, benzodiazepines as like everybody's taken them for anxiety and they're not recommended as a first line treatment anymore. All during this, you know, medication frenzy, there was a researcher Thomas Ve, who was studying anxiety and he suggested that it can be driven through negative reinforcement. And when I read that, you know, mind blown because I'm thinking, man, I never thought about anxiety as a habit, and I'd been studying how to help people change habits for a long time, so, let's bring these two together. At long story short, you know, I started testing the mechanism first in my own clinic with my patients like, hey, does this make sense? And they're like, how did you read my mind? You know, and then we developed this app called Unwinding anxiety so we could study it. And so, we've published a number of studies. One of our recent ones was with people with generalized anxiety disorder. We got a 67% reduction in anxiety, right? So there, the number needed to treat was 1.6, right? The lower numbers better. So here it is, you know, anxiety concept as you know, driven by negative reinforcement. I see that concept we tested out in real life in randomized controlled trials and lo and behold, it outperforms medications by like three times.

Michael: What is it about the negative reinforcement that we tend to hold onto? I had this interesting thought probably I wanna say like five or six years ago, and this was based off my own clinical research of myself, of being like, oh, I like to suffer. So, I'm gonna keep doing the same stupid shit all the time until I actually had thought Jud, nothing about my life was different. So, I'm really curious, just like, what is it about that mechanism of negative reinforcement that we as human beings are so drawn to? Like, even though we know the chocolate cake is bad, we go to it, the cigarette is bad, we go to it, the booze, the cheating, whatever it's bad, it's still like, but I need it.

Dr. Jud: Yeah, I know, isn't that crazy. So, this goes back to our basic biology. So, our basic biology is set up way, before refrigerators way before social media way, before junk food way, before newsfeeds way, before any of this stuff. So back in the day, our ancient ancestors, they needed two main things to survive, they needed to remember where food was so they could go get some more and they needed to remember where danger was so they could avoid it. Right. So positive reinforcement is really set up through this trigger behavior result process we're searching for food, we see the food, there's a trigger. We eat the food, that's the behavior. And then our stomach sends this dopamine signal to our brain that says, Hey, remember this spot, so you can come back here again. That's positive reinforcement in a nutshell. Okay?

Negative reinforcement, same thing. You see the tiger, the lion, the whatever that's gonna come eat you, you run away, there's the behavior. And then you survive, there's the reward. And then you learn to avoid that dangerous place. So, negative reinforcement at a basic level is really, really helpful. That mechanism is still in play when, you know, it's very easy to find food, it's a lot of us are not in constant danger or we're generally in places where we don't have to be worried about danger for most of us. And so, these processes are still in play and then we learn to associate things with them.

So, for example, our ancient ancestors probably didn't worry as much about the future as we do now, but in the modern day, because most of us can predict that we're gonna be alive tomorrow, our brains start projecting into the future farther and farther. And so, when we start to feel anxious, a little bit anxious, right? Cause uncertainty is like, you think of it, I guess like our stomach being empty, so when our stomach's empty it rumbles and it says, go get some food. So, we have that urge to get food. When we're not sure of something, you know, we're like, oh, is that what's that sound? Is that danger? Is that not? Our brain rumbles and says, go figure it out, okay?

So, uncertainty drives us to do things and that's what our fear response is in the present moment. Now, if you pair that with our brain, trying to plan for the future fear is a helpful survival mechanism planning for the future is a helpful survival mechanism, but when you mush those two together, fear of the future is basically what anxiety is, and we start worrying, oh no, is this gonna happen? Is this gonna happen? Is this gonna happen? And that worrying ironically is an anti-survival mechanism because it doesn't help us think and plan, and it actually is bad for our physiology, you know, anxiety is not good for us. So, here where our brain is taking a useful survival mechanism, fear, it's taking a useful survival mechanism planning, but those get mushed together, our brain starts to spin out an anxiety. So why is that negatively reinforced? Well, the feeling of anxiety is unpleasant, right? So, there's that negative thing and our brain says do something. And what can we do while we can't predict the future, but we sure can worry about it?

You know, I should say we can predict to a little degree, but then we can worry, like, is it's really gonna happen. And that worrying feels better than doing nothing because it makes us feel like we're in control. You know, our brains love to feel like we're in control. And so that's reinforcing enough because it's less unpleasant than the feeling of anxiety, our brains learn to do it again and again, and again.

Michael: And it does feel like a loop, right? And for me, in my experience, it's felt looping until I've been able to make meaning of it like I'm always thinking about causation and correlation. I'll rewind and I'll go back to experiences of like childhood and I'll think about my mother, my grandmother, my community, everybody's worried and fearful all the time in my environment growing up. And what I discovered was in my own personal journey, that became a habit that I had to break by just being willing to, for lack of a better term, like jump off the diving board. And I think for so much of my experience, and I think for many people, like we stand on the precipice of that, we look down in that, we are either ruminating or we're in anxiety and we're like, I don't know so we're stuck. Like is worry, like a part of why people are stuck?

Dr. Jud: Absolutely. Worry is the primary driving force for us getting stuck. So, we often think of habits in terms of physical behaviors, you know, if we stress eat, it's the eating, that's the habit. If we smoke a cigarette, it's that smoking that's the habit. But the mental behavior of worrying is what drives that anxiety cycle, so, the feeling of anxiety triggers worry; that worry feeds forward and triggers more anxiety because that rewarding component of like, feeling like we're in control, that gives enough juice that says, Hey, do this again again and again. The worrying is really that the crux of it. And if you look at, you know, generalized anxiety disorder and the psychiatric literature, if you look at the definition of anxiety, all of these centers around worry, you know, the feeling of worry, and then the mental behavior of worrying.

Michael: Does worry in any capacity actually serve us in a practical way?

Dr. Jud: Do you want the truth?

Michael: Of course.

Dr. Jud: No. So, this is crazy and I like how you mentioned correlation and causation, because I've had people go to the mat where they say, no, you know, they're so attached to this concept that worrying is helping them, you know, like performance, anxiety, or whatever. I've gotten pages and pages of emails when I've done a weekend, seminar or something where somebody's like, no, but the worry, the anxiety's so helpful, but all of this there's no evidence for that. And in fact, you know, thanks to the internet, there's a bunch of stuff out there that's not actually true, that gets perpetuated as memes. So, for example, this whole inverted U-shaped curve, U's Dodson curve, you might have heard of this is around, you know, people saying that there's some optimal level of anxiety that helps performance. You ready for this? I'm not kidding. I wrote about this in my unwinding anxiety book. This is based on a study from 1908 of Japanese dancing mice. Okay. And then people write books because they think it's helpful and because in their experience, they're like, well, if I wasn't anxious, I wouldn't have performed well. This is the correlation versus causation thing, because you were anxious true and you performed well true, doesn't mean that anxiety caused you to perform well, that's the correlation without causation, you know, and you get this, but a lot of people until they actually see this and ask the question, did that anxiety make me perform better? They can get stuck in this as well and there's plenty of evidence to show that there's an inverse correlation between anxiety and performance. It's not an inverted U-shaped curve. A little bit of anxiety is not helpful, a lot of anxiety is even less helpful. I like to look at the opposite of anxiety and say, okay, you know, somebody's like, they're so attached to that idea say, well, when do you perform your best? And hands down, people perform their best when they're in flow. Right. Flow is so far away from anxiety that, you know, if you think of Mihaly Robert Csikszentmihalyi and Mihaly definition of flow, it's selfless, right? You're so merged with your experience that you're not even there. And if you're not there, how can you not be there and have anxiety? There's no one there to be anxious.

Michael: Yeah. You know, and the reason I get it, and I appreciate you pointing that out is just literally for my own experiences, hitting rock bottom effectively destroying my life 10 years ago, you know, being morbidly obese, smoking two packs a day, drinking myself to sleep in 50 grand in debt. I was like, oh, something here is not fucking working. So maybe I can figure out a way to navigate this. And one of the things that I came to realize, and I'm wondering if there's truth to this. Is that maybe it's like this communal confirmation bias because I was around people that were drinking and smoking and in debt and all of it and anxious. And dude, I had massive, massive, massive, massive anxiety in my twenties, is there any truth to that or is that just something I've made up?

 Dr. Jud: Truth to the confirmation bias piece?

Michael: Yes.

Dr. Jud: Well, the confirmation bias is certainly a very, very true thing. And it sounds like you were in up to your ears in it.

Michael: Very much so. And so, with that is, you know, people will say, well, my mom had this or my grandma had this, or my dad had this is, is there a reinforcement happening just in the way that we're using words around things like anxiety, depression, worry?

Dr. Jud: Absolutely. Yes. So, we can learn to be anxious from other people cuz they model it and we learn the most from the people that were around the most. And so often people will learn, they don't even know that they're learning, but they'll learn these subtle habits and that become not so subtle as they get older of worrying, you know, because they've learned it from family members, they've learned it from their communities, they've learned it from people that they've been around.

Michael: So, with your work and stepping into addiction, and now looking at this from this whole body, mind, spirit approach, for lack of a better way to phrase it. One of the things that I love that you talk about is like trigger behavior reward, and trying to navigate that loop. Can you go into that for us, dive into what that actually means and what people can do to understand their behavioral patterns a little bit better?

Dr. Jud: I'd be happy to. And so, you know, we talked a little bit about these positive and negative reinforcement mechanisms, right? These survival mechanisms, and that both of them are broken down into trigger behavior reward. And I think a reward can be a challenging concept for people ‘cause they're like, you know, worrying doesn't feel very rewarding. So sometimes it can be helpful to think about it in terms of trigger behavior result. And the behavior result relationship is really what drives a behavior, so from a scientific standpoint, this is called reward-based learning and it's called that for a specific reason, when a behavior is rewarding, we're gonna repeat it.  if it's not rewarding, we're not gonna repeat it. And so often people focus on triggers like, oh, if I could just get avoid my triggers, you know, this won't be a problem, that's not actually how our brains work.

So, from the trigger behavior result a reward standpoint, the critical piece of that is looking to see what the behavior is and how rewarding it is. So, the more rewarding it is, the more likely we're we are to repeat it. And then when we repeat it enough, it can become a habit to the point where we don't even notice whether it's rewarding or not rewarding. Let's use a real-world example. So, you're saying back in the day you were smoking two packs a day. How old were you when you started smoking?

Michael: So, I started smoking weed at 12 but I started smoking cigarettes at 20.

Dr. Jud: Oh, okay. Interesting. So, when you started smoking weed is about the average age that most people start smoking cigarettes. Okay. And like in the studies that my lab is done, the average age of onsets around 13, and I saw a statistic recently it's like 90 or 95% of people have started smoking before they are 20, so, you're right within that window. And the reason I mentioned that is that, you know, cigarettes aren't advertised as like these tastes great. They're advertised by our peers as, Hey, you wanna be cool at school? You know, have smoke a joint, smoke a cigarette, whatever the cool kids are doing, or we do it as a way to rebel against our parents ‘cuz our parents say, Hey, you know, you can do whatever you want, just don't smoke. And of course, we're like, okay, I'm gonna smoke, of course. So, we do all of these things and we actually overcome all of the negative reinforcement that comes from nicotine because it is a toxic, right? So, the first time somebody smokes a cigarette, they actually feel nauseated because their body's saying, Dude, why are you putting toxin in me? You shouldn't be doing this, but we're like, but the cool at school is better than this negative feeling that I'm feeling from smoking the cigarette. So, we overcome it to the point where we become habituated and then ironically addicted to cigarettes. The reward piece is this composite reward, that's all based in context. It's not just the chemical, but then the chemicals themselves can reinforce the process. So, nicotine drives dopamine release and then, you know, the dopamine pathways are one of the main ways that we get addicted to any substance.

So, any substance like alcohol, nicotine, you know, heroin, cocaine, all of these things, stimulants, they all release or release dopamine or cause dopamine to increase in the synapsis in our brains. So, all of those feeds back and says, Hey, you know, do this again even when it's not, you know, initially rewarding and to the point where it becomes a habit, we're not even noticing all of the negative effects. Like we're not noticing that cigarettes taste like crap. So that's actually the first place that we have to start with breaking any habit or any addiction is really seeing what are we getting from this right now, so, we can actually tap into this reward-based learning system in our brain.

Michael: So, I recall a couple years ago sitting and listening to you go over this. And I had a thought and this thought felt a little bit more true after I had a conversation with, with Dr. Lembke who wrote dopamine nation, and recognized like, oh wait, maybe dopamine is actually the driving factor in pretty much all addiction. Right? It's kind of easy to say that. What I'm curious about though to what you just said is, you know, bringing that little bit of awareness around the reward or whatever the result is, when you are in that moment and I think this was my struggle, and I think this is probably the struggle for most people who face addiction is you're like, I know it's killing me, take a drug, I know it's killing me, take a drink. How do you navigate that aspect of it, because that's the place where I always would get stuck, especially in my mid-twenties, when I was starting my healing journey, I was like, oh my God, this cigarette makes me wanna throw up everywhere, but that's okay, I'll throw up later drag. So, how do you navigate that conversation in your head of like, I know this is really bad, but the habit of it is just pulling you back in?

Dr. Jud: Yeah, you're highlighting this critical aspect of human experience is that we think that we can think our way out of stuff, you know, we privilege the irony of the enlightenment where it totally screwed up humans. You know, you back at my wise say’s Bible scholar, and so, you know, she keeps pointing out there was all this great mystic spirituality and then the enlightenment came and killed it all, cuz everybody got stuck in their heads. So, whether you look at it from a religious perspective or a spiritual perspective, or just a human perspective, we privilege our thinking brains to our detriment. The way I think of it is our feeling bodies are much stronger than our thinking brain. Just to give you a concrete example, our prefrontal cortex, which is the seat of our cognitive control or thinking and planning brain, guess what happens when we get stressed? What is the first part of the brain that goes offline?

Michael: Thinking prefrontal cortex.

Dr. Jud: Yes. So, it's the youngest, it's the weakest part of our brain from an evolutionary perspective, we cannot trust it. What can we trust we can trust these more basic processes and the more basic processes, all feedback into our bodily sensations. When we're hungry, our stomach is gonna rumble and make us go get food. We can think, oh, I shouldn't eat.  you know, anybody that's been on a diet, you can ask them how well that goes, especially when they're stressed out. You know, there's this saying I learned in this acronym, I learned in my addiction, psychiatry is halt when you're hungry, angry, lonely, or tired, you're more vulnerable to relapse, right? So, we can't rely on this thinking and planning part of our brain, we can't rely on the cognitive control. And some neuroscientists and even philosophers would go as far as saying, control is an illusion. You know, so whether it's an illusion or not, we don't need to go there, what we can do is look at the science and say, well, how do we learn? What's the strongest part of our brain and how does that work? How can we tap into that? So, we can tell ourselves we can be sitting there taking a drag saying, yeah, I don't wanna get cancer or we're coughing, you know, you see people smoke a cigarette and then cough, where does that cough come from? Smoking cigarettes. Right. You know, so they're hacking up a lung as they're trying to get some more nicotine into their lungs. It's crazy. But the point there is, you know, we think that we can just tell ourselves to stop. Well, boy, would my outpatient practice be so much easier if I could just tell my patients to stop, you know, it'd be one visit. They come in, I wanna stop smoking. I'd just, you know, say stop smoking, you know, and then they'd stop. Stop overeating, stop worrying and then I could go find another job because all my patients would be cured, that's not how our brains work, you know, it's really about reward.

So, we've got it. You know, if we set up these habits through this reward-based learning system, why don't we tap into that to help people break habits and help them break out of addictions? So that's what I started testing in my clinic when I was struggling not only with anxiety, but helping my patients with addictions work with their addictions, because I'd learned all this, you know, cognitive therapy stuff in residency, like, you know, all this stuff where it's like, you gotta change your cognition.

No, you’re thinking brain's the last thing that's gonna help you out. You gotta start with the reward system, so that's what we started doing. And I started testing it in my lab and that's where I mentioned, we got five times a quit rates of gold standard treatment for smoking. I'd actually done a study earlier, I did it in residency, where we looked at mindfulness training as a way to help train people, to pay attention and tap into that reward system. We basically got better outcomes for alcohol and cocaine dependence, than gold standard treatment. When we did these physiologic stress measures people, they were able to not get as caught up in these personalized stressors, when they got mindfulness training as compared to cognitive training. So, you know, it's really about not getting stuck in this, you know, this hubris, this of like, oh, I can think my way out of this. No, if we could, nobody would have an issue with anything they just stopped.

Michael: It's actually a very valid point. And I love what you said about not being able to trust your prefrontal cortex in that moment and your brain in general, cuz I've been trying really evaluate the idea that you can't trust your brain over the last probably six or seven months, so it feels more new to me. And instead going like, can I trust my gut? Can I trust my intuition? Is that truly where understanding lives and exists. And so, with that, and I appreciate you what I feel like in that as confirmation, because I've really been on this for a while. What I'm wondering is what were some of the things that you were seeing, not only in your own anxiety, but in the research and the studies that you were doing that is tangible, that other people can apply to their life in perhaps a simple way?

Dr. Jud: Yeah. Well, after this decades of work, it gets simpler and simpler. You know, the more you learn, the more ACOMs razors really too, like the simplest possible explanations, usually the right one that has been true over and over and over. So, I started noticing this three-step process and I write about it in the unwinding anxiety book, but basically, it's about the basic ideas if we don't know how our minds work, we can't possibly work with them. So, the first step is being able to map our own habit loops like what's the trigger, what's the behavior, what's the result. If we can't see what the process is, we're gonna be stuck in it, we're gonna be, you know, tumbled by it. So that's actually pretty straightforward. And I have my patients do this at intake. I start listening for these things and then we map these processes out together, it takes 30 seconds. We even have a free habit map or the name we can download from. I think it's just maphabit.com where you can download this PDF, print it out and start mapping out your own habits.

The second step is a little more involved, but it's a critical piece, which is really tapping into this reward system in our brain. I'll give you an example and explain how this works. So, my lab just did a study with our EatRight now app, where we had people who were overeating. We basically put this what we call a craving tool into built it into the app so we could measure the reward value and help people pay attention to how rewarding or unrewarding the behavior was. And the idea is, if you don't see that something's unrewarding, you're gonna keep doing it. If you see that it's not rewarding, you get what in neuroscience is called a negative prediction error, cuz it's not as rewarding as you predicted as you expected and then you start to become disenchanted. You're like, you know, if somebody smokes a cigarette and I have them pay attention when they smoke and they realize that cigarettes taste like crap, they get that negative prediction, error. And so tangibly, I have patients in my clinic, pay attention when they smoke. I have patients who are overeating pay attention when they eat. And I have them mask themselves with each bite, is this more rewarding or less rewarding than the last bite? So, we did this study with this craving tool to eat right now, app. And we found, are you ready for this? It only takes 10 to 15 times of somebody really paying attention as they over eat for that reward value to drop below zero and for them to start changing their behavior. So, it doesn't take long, it just takes awareness. So, that's the second step, anybody can do that. They can pay attention when they're doing the behavior. And I have them simplify it to this, ask yourself a simple question. What am I getting from this? Right. Not thinking, what am I getting from this? But feeling, what am I getting from this? So, the folks in our study, they were feeling when they overeat, it doesn't feel good.

My patients in my clinic, they are tasting what cigarettes taste like cigarettes taste like crap, they start to become disenchanted with them. We just actually publish a study with our smoking app, same thing, you know, where people are, they're becoming disenchanted with the behavior simply by paying attention, so that's tangible that anybody can do that too.

The third step, I think of it as finding the bigger better offer.

So, if our brains are gonna do things that are rewarding and they're gonna stop doing things that are not rewarding, then let's give them something that's rewarding that's not just a substitution for what they just did. I've had plenty of patients who've come to me and said, you know, I quit cocaine, but I substituted exercise and now I over exercised, I'm addicted to exercise, right? The process itself is the problem. It's not certainly the substances can be problematic, but it's when we're caught in the process that those are problematic. I mean, cigarettes are never helpful, but it's not that that opioid themselves, you know, like taking a pain pill is gonna kill somebody. No, it's when somebody's addicted to that. So, we've gotta find that bigger, better offer. And so here. Often, people are taking substances, for example, because they've got these negative loops running in their heads about how they're a bad person or their life's awful. Often people have had really terrible life circumstances, they've had a troubling childhood or their current environment, there's something in there that says, Hey, this is bad I wanna make it go away. And they have that used that substance, they drink alcohol, they use opioids, they do whatever to make it go away. And that has been the biggest bestest offer that they've had so far, yet if they can pay attention and see, oh, this is really not serving me. And we can give them something that's more rewarding that doesn't have those negative consequences, then they win the game. So here, you know, with addiction, for example, it's finding connection. Right. That is so much more rewarding than running to mother's little helper or whatever the helper is, because that helper is only gonna help for a little bit and then it's gonna make us want more and more and more. And then we're chasing that on top of it.

So, kindness, for example, if we beat ourselves up, what is it like when we're kind to ourselves? What kindness feels better than judging ourselves? So there already is an intrinsic bigger better offer. If we're disconnected from community, from family, from friends, finding that connection is a really strong way and that a much bigger better offer. I would say that is the biggest best dis offer of all, is finding those things that are not only better than the substance or the behavior, but also rewarding and fulfilling and generative like where they pay it forward, when we're connected, everybody benefits from connection.

Michael: And the guise of this. So, a thought came to me as you were going through this. In the guise of this, can people be addicted to avoidant and self-sabotaging behavior? And the reason I'm asking that question, cuz I think about like this idea about success or getting unstuck or moving towards what's next in your life, right? Maybe it's success or a relationship or happiness or peace, whatever that is and yet every single day of a moment in these small little incremental areas in which they can step into the possibility of what's next, they tend to do what they've always done. So, does that hold true in circumstances like, you know, avoidant behaviors and self-sabotage as well?

Dr. Jud: Absolutely. Yes. Our brains don't like uncertainty, so they go to what they know. And so, for example, let's say somebody's in an abusive relationship and they know it's abusive, everybody tells them it's abusive, they say, get out when they just even think about what's it like to do something different change is scary for our brains. And if we're not used to working with change, that fear of change can make that activation energy to get out, so high that we're gonna stay with what we know, even though it's not helpful. And that goes, so that's just an example, but self-sabotage, like that fear of, oh no, what if I fail? Can be so fear inducing that we're like consciously or subconsciously we sabotage it so we can say, well, I know what's gonna happen, I'm not gonna make it.

Michael: Can it also be, oh no, what if I succeed?

Dr. Jud: Yeah, because that's uncertain too. Then what? Then I have to perform, I have to show it, I have to keep showing up, I have to keep, you know, there's that anxiety that comes around? Like, what are people gonna think of me or am I gonna be able to live up to others or my own expectations? So anytime, if we succeed, there's the, then what? Oh no, well now I'm up here and I could fail, whereas if I'm always down, you know, I can't fall off the pedestal or wherever I've made it because I've never made it up there in the first place.

Michael: Yeah. And is that in those moments, is that really where you start to double down on kindness and to just go forward? Cause in my head I've always thought to myself, you know, I go look at my life a decade ago, incredibly different than it is today. And I kind of just came to the conclusion one day as long as I just keep going forward and I give myself the space to just feel whether or not I believe what I'm doing is right then on a long enough timeline it'll play out. Do you feel like that holds true?

Dr. Jud: It's funny, you mentioned that I described what you're saying in terms of, I call this evidence-based faith. Okay? So, this is a play on medicine where we always look for evidence-based medicines or evidence-based treatments. Right? And so, you look for your randomized control trials or whatever, but the best way that we know that something works is if we've experienced it ourselves. And often we have to take that leap of faith to try something first because we don't know until we try it. So, we see others do it, or somebody says, Hey, you know, this worked for me. And so, we take that leap of faith and we start walking that path. It sounds like you started walking that path and as you walked you were collecting evidence from your own experience and the more evidence you collect, the larger that database becomes where you can then lean on that when something's not quite going, you know, the way you're expecting, you're like, well, you know, let me look back on how this has gone for me in the past and if it's worked consistently over and over and over, you'd be like, well, this right now is an anomaly as compared to all this evidence that I've gathered. The best evidence is the evidence from our own experience and consistent evidence is what our brain's gonna start believing and gonna take as default. So, at the end of our app-based training programs, we have these core modules is about 28 modules and we get to about 27 or so that's where I bust out this evidence-based faith module. And say, okay, you've gotten this far, how far do you think you've actually gotten? Well, look at your own experience. And if you haven't worked the program, keep working it so you can gather evidence to see if it's actually working for you or not. You can't deny your own experience, that's faith, that is unshakeable. So, the way you're talking about this, I think of this as evident, you're describing evidence-based faith.

Michael: That actually makes a ton of sense to me. And that's the same thing when I'm working with my clients and coaching them. I'm like, what have you done that can prove you're capable of doing other things. Right. And like, look, and let's be honest, like, dude, sometimes it's like, I brushed my teeth today. Right. And we all start somewhere and that's the beginning of this process. So, I really appreciate you going into that. One of the things that's also kind of ruminating with me as we're having this conversation is thinking about this idea of self-medication when we feel discomfort or anxiety. So, obviously if this idea about change and uncertainty is the scariest thing that we know as human beings and that role can be satiated or can be mitigated that experience through self-medication like, why do we do that? Like, is it because of this reward mechanism that we're like, okay, I feel anxious, I'm just gonna self-medicate?

Dr. Jud: Yes, in short. So, there are these quick fixes, you know, so we learn to smoke weed, we learn to drink alcohol, we learn to take opioids, these things that can numb us out, or just make us feel warm. You know, like if somebody's had a really tough childhood and they take an opioid and they're like, wow, this is the first time I felt like something was warm to me and it was a substance, they're gonna turn to that as something that just feels better than anything else, for some people, anything that else that they can remember feeling in their life.

Michael: I think what's really interesting is recognizing that there are other strategies and mechanisms like what we've been talking about today that can help replace that. And the willingness to step into the discomfort or the uncertainty can ultimately become that thing that changes your life at least that's how it was for me. And so, I'm curious for yourself personally, as you battled going through anxiety, what was the greatest thing, that's an odd question to ask. What is the thing that you think was the most beneficial thing that you learned about navigating your own anxiety?

Dr. Jud: Well, I would say at a high level, it was learning how my mind worked. So, you know, and you don't need to learn every apps in every brain region and every network, that's not what I'm talking about. You know, I just happen to be a neuroscientist. What I'm talking about is learning behaviorally, all the things that are helpful for behavior. So, for example, this reward-based learning systems probably responsible for 95 or more percent of the behaviors that we do every day. Right. Think of all the things that we do that are habitual and most habits are helpful, right? If we had to relearn how to put on our clothes, how to walk, how to make breakfast, you know, we'd be exhausted by midday, you know? So, these habits are really helpful. And so, I would say what was most helpful is just kinda learning this basic process, so I could start mapping it out and then asking which of these habits are helpful for me and which ones aren't. The other thing that I would say that was critical for that was curiosity. I think of curiosity as a superpower because it can help us lean into uncertainty, and instead of saying, oh no, you know, this is bad or this isn't gonna work or whatever, we can go, oh, this is different  and instead of kind of moving in or falling into our panic zone, when something is uncertain or something, isn't going the way we expected, we can move into our growth zone and we can learn and grow from it no matter what's happening.

So, I would say that was just really, really key for me to start developing as a habit, you know, and we all can develop curiosity as habit. We all habit, it's just a matter of dusting it off and seeing how rewarding it is to be curious, instead of panicked or afraid or running away from uncertainty.

Michael: I wanna come back to something you said and kind of close a loop. You mentioned that worry is an emotional behavior, right? When you think about that, what are some of the misnomers about just worry, anxiety, habits that people we can demystify and kind of throw away that the general consensus might have?

Dr. Jud: I think the biggest one is one that we touched on, I just want to reiterate that, which is the worry is helpful. And so, because it's a habit for a lot of people, they just assume that it's helpful or for some people they're so identified with it, they just think this is who I am. I always worry. No, it's a habit, so, I would say is the biggest one. And the fact, you know, that people think, oh, it must be useful for something because I do it. No, you know, because somebody smoked cigarettes, does that mean it's useful? No, it was a habit, they probably started when they were 13, because they wanted to be cool at school, so that's the biggest thing I would say, I see over and over and over is the people either think it's helpful for them and if they don't worry, they're not gonna make it in life or they don't know who they are if they don't worry, I would say that's the biggest thing.

Michael: Yeah. That makes a lot of sense to me. And I think it's a good idea to not know who you are by not worrying, so, you can try to do something else with your life. Dr. Brewer, this has been an amazing conversation, before I ask you my last question, can you please tell everyone where they can find you?

Dr. Jud: I'd be happy to. So, I have a website, drjud.com, where folks can got a bunch of free resources on there, as well as links to the apps that we talked about and the books that I've written.

Michael: Brilliant. And of course, we'll put the links in the show notes for the audience. My last question for you, my friend, what does it mean to you to be unbroken?

Dr. Jud: I would say, boy, that was such a great question. I would say that is to have our mind. I think you said it earlier, the mind, body, spirit have all of those be connected in a sense where they are not distanced from each other and they're not fighting each other, but they're really, truly integrated with each other. So, when we're truly integrated with ourselves, our bodies and our minds that I would say is unbroken.

Michael: Brilliantly said my friend. Thank you so much for being here. Unbroken Nation. Thank you so much for listening.

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