How Habit Loops Drive Anxiety and Stress—And How to Break Free With Dr. Judson Brewer

This week on the Redefine What’s Possible podcast, Shanon is joined by psychiatrist, neuroscientist, professor, and mindfulness expert, Dr. Judson Brewer for an enlightening conversation on negative behavior patterns and how mindfulness can transform behavior. Dr. Jud is a bestselling author known internationally as a leading voice in studying anxiety, addiction treatment, and behavior change. His TED talk, “A Simple Way to Break a Bad Habit,” has now been viewed over 38 million times. 

In this episode, Dr. Jud shares insights from neuroscience, practical techniques, and his latest program 'Going Beyond Anxiety,' to help us reframe our relationship with stress and anxiety. This conversation explores the myth of willpower, and how to leverage mindfulness, curiosity, and understanding to break bad habits and create lasting change. 

If you are curious about the science behind behavior change, neuroplasticity, and what mindfulness does to the brain, this episode is a must-listen. 

You can keep up with Dr. Jud by checking out his website or signing up for his free weekly Substack newsletter. 

Transcript

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What if anxiety isn't actually a personality trait? What if overthinking, perfectionism, stress, doom scrolling, distraction, even emotional eating aren't signs that something is wrong with you? What if they're loops? Learned patterns your brain has practiced over and over again. And if that's true, what else in our lives that feels fixed may actually be changeable? Today's conversation is one of the most practical and hopeful discussions we've had on behavior change, mindfulness, and what it really takes to create lasting transformation. 

Welcome back to the Redefine What's Possible podcast, where we explore the stories, science, and mindsets that help us expand what we believe is possible in our health, leadership, relationships, and lives. Today's guest is Dr. Judson Brewer, a psychiatrist, neuroscientist, and professor at Brown University and one of the leading voices studying anxiety, habit loops, mindfulness, and behavior change. 

Many people were first introduced to Jud through his TED Talk, A Simple Way to Break a Bad Habit, which has now been viewed more than 23 million times. More recently, his book Unwinding Anxiety explored why so many of us get caught in loops of worry, overthinking, stress and reactivity, and how awareness and curiosity, I love that, can help us begin changing those patterns. And one of the things I appreciate most about Jud's work is this: he doesn't approach people as broken, he approaches them as patterned. Today we're going to explore how anxiety becomes a habit loop, why high performers often normalize stress, why willpower usually fails, how mindfulness changes the brain, and what becomes possible when we stop identifying with the loop itself? Jud, welcome to the podcast.

Jud Brewer MD PhD (02:38)
Thanks for having me.

Shanon Tysland (02:39)
Yeah. So Jud, before we get into the neuroscience, I'd love to start with your story. What originally drew you into studying anxiety habits and mindfulness?

Jud Brewer MD PhD (02:51)
It was a long and winding road for me. I didn't know at the beginning of medical school that I was very anxious. My body was actually telling me about this through some signals called irritable bowel syndrome. I won't go into the the gory details, but let's just say I had no idea that I was anxious to the point where my body was saying, you know, wake up, wake up, wake up. And at the same time, when I was graduated from college and started medical school, I started meditating and learned that I had no idea how my own mind worked. So fast forward eight years when I finished my MD PhD program and started residency, I started getting panic attacks myself. It's a perfect formula for getting panic attacks when you're sleep deprived and you're expected, you know, put in this huge role of responsibility where people's lives are in your hands, you know, in the hospital and all of this. And that led me to really start to repurpose my career and bring together some of the things I was learning about meditation, where it was helping me work with my anxiety, together with places where there were clear lacks in the scientific literature around anxiety. And then most importantly,

Where I was struggling helping my own patients with anxiety. When I started working as a psychiatrist, the the best medications out there help about one in five people. The numbers. It's called number needed to treat. And that's 5.2, meaning, you know, one in five. So I was basically paying the medic playing the medication lottery where

I didn't know which of the next five patients came in was gonna win that probably genetic lottery where they would benefit from the medication. And then most importantly, what to do with the other four? How do I help these people? And so as I started my career studying, I was very interested in addiction and a lot of my specialties around addiction. In fact, we have a nonprofit that we'd that we developed a couple of years ago out of the 20 years of addiction research that I've done.

But the addiction work and that nonprofit's called Mind Shift Recovery, in case anybody's interested, free app and program for people struggling with addiction. But what I learned there was that, we were developing programs for smoking, for overeating, and things like this. And then patients were coming in and saying that anxiety was leading them to overeat and asked me to make an anxiety program. And that's when I went back and looked.

At the literature and realized that we had missed something really critical and missed being that I never learned this in medical school or residency, but the idea that anxiety could be driven like a habit. There was a psychologist, Thomas Borkovic, that put this idea forward back in the 1980s, right around the same time that Prozac came out. And so there was this whole promise of Prozac. And I think his suggestion was largely ignored. And now we know.

you know, even with the best medications, not that many people benefit. So seeing that idea where he suggested anxiety could be driven as a habit, you know, was a big aha moment for me because at that point I'd been studying habit change for about 10 years and we had found good way, you know, we gotten five times the quit rates of gold standard treatment for smoking. We got a 40% reduction in craving related eating. And we were even working out the neurobiological mechanisms behind all of this.

So then shifting to apply that to anxiety just seemed like an obvious and natural choice. And boy, have we learned so much and and ended up helping tons of people. We've done number of randomized controlled trials now. Our one of them with generalized anxiety disorder, we got a sixty-seven percent reduction in anxiety. This is people with generalized anxiety disorder, right? Compared to fourteen percent in the usual care, which is about one in five.

Shanon Tysland (07:05)
That's astronomical. Yes. And I'm curious, so mindfulness, did that initially feel intuitive for you, or was there skepticism from the scientific brain?

Jud Brewer MD PhD (07:20)
I think any scientific brain is going to naturally question things and at the same time have a level of curiosity of don't know, right? So it's like, well, one of my favorite phrases I learned way back in the day was like, well, that's an empirical question, right? So let's collect some data and find out and

Ironically, you know, in Korean zen, there's this whole phrase, don't know. Like, don't know mind is helpful. Because it helps us not jump to conclusions. Often skeptical minds will ignore something that's right in front of them because they've already jumped to a conclusion. So, in one sense, my scientific mind was wondering, well, nobody's you know really looked at this. And another sense, intuitively,

I'd seen that this was helpful for me, but on top of that, these trainings have been around for over 2600 years now. And so if you take a scientific Darwinian perspective, and say what has lasted the longest? This is from a psychological training standpoint, this is h hundreds, if not thousands of years older than any of our modern day

whether it's psychoanalysis or cognitive behavioral therapy or anything else, those are like blips, tiny little specks on the time span compared to this Buddhist psychology, which is largely unchanged. And so that in itself was fascinating to me. But most importantly, I started just testing out some of the basic principles in my clinic. And my patients were showing remarkable results. And, it's hard to ignore that.

Shanon Tysland (09:09)
Absolutely. I've been meditating for about 20 years now. And I feel, yes, there's the anecdotal what it does for you. And now the science coming out about the impacts of meditating and mindfulness are just seem to be skyrocketing. So I think we'll dive into that a little bit more. So, Jud, your TED talk on breaking bad habits came out over a decade ago, and it clearly resonated with millions of people. And since then,

Through more research, clinical work, and even the experience of the global pandemic, what has evolved or deepened in your understanding of anxiety and behavior change?

Jud Brewer MD PhD (09:52)
That's a great question. So we when we first developed our first digital therapeutic for anxiety, you know, and this is where we did the randomized control trials and got some pretty good clinical results. We were we had we were developing this three-step, or I call it the three gears, because I like to ride bicycles, and the analogy seems to work pretty well. And, that's what my own running anxiety book was based on.

What I've learned since then, so probably over last five years since that book came out, really refining the methodology in my clinic, I found that we can actually do a rapid induction of that methodology where people can get back to baseline pretty quickly. And so, 10 years ago, I was just looking for something that could help people reduce anxiety.

And then five years ago, I was seeing, wow, a lot of people benefit quite a bit from this methodology. Can we do a rapid induction? And the short answer is yes. So we can refine that. I even did a LinkedIn course on anxiety that's, like 250,000 people have taken that course. Which is basically, I don't know if you add up the minutes, that's probably 45 minutes. That's not everything, but that just gives people an introduction.

But the idea is that we can do a rapid induction here. And so what we've learned since then, and just relatively recently, last year, we launched a program called Going Beyond Anxiety. And this is what I learned that I'm just over the moon excited about. So I was already excited that we could help people with anxiety get back to baseline, which in itself, I would I'd be that would that be enough of a career for me to be satisfied.

But I typically I would discharge a patient after they got back to baseline because you know it's like, well, you don't need to see him anymore. You don't have anxiety. But my patients were smart enough to say, hey, can we keep using this methodology to keep going? You know, because I want to keep learning and learn how to work with my mind. And so it gave me the idea to say, well, let's use these same methodologies to help people thrive and flourish.

And so we just they already knew the basic techniques and we just started to leverage them in different and non-obvious ways to help people build a really solid foundation and a really good baseline from which they could, launch into lives of flourishing. For example, I'm working with a high powered lawyer in New York City right now who she's in her early 30s and,  she came ith severe health anxiety. And we've, relatively quickly you know she doesn't have those issues anymore. And so now we're working on concepts of humility and flow, and she works in this high-powered law firm that doesn't necessarily have humility written on the wall, let's just put it that way. But she's learning how painful the ego is and how she can actually progress better and faster in her career and at the same time be happier.

When she builds a foundation of humility. And so all of these share this common theme of kind of like transcending the ego, which is interestingly something that, so here's a fun fact: Maslow, his hierarchy of needs, most people know this. this at the top of his pyramid for what if you go on the internet and look for Maslow's hierarchy of needs, the top of the pyramid is self-actualization.

Well, it turns out that late in his career, he talked about self-transcendence as the the true peak, which most people I don't know if that didn't make the internet because people it just doesn't compute for a lot of people, or the his other stuff was more famous or whatnot. But that's the basic idea, is that we learn about all the ways that we're getting in our own way, starting with anxiety. And then we learn how to let go of the the subtler ways that can even be related to what Maslow talked about in terms of self actualization, where we're we're getting ahead in life.

Shanon Tysland (14:05)
So that self-actualization is like who what is the pinnacle that we can we can become? And then the self-transcendence is going beyond the self, right? And

Jud Brewer MD PhD (14:17)
Yes. Yes. Yeah.

Shanon Tysland (14:19)
so your new program, Going by Anxiety, is going beyond

Jud Brewer MD PhD (14:23)
going beyond anxiety. Yes.

Shanon Tysland (14:25)
anxiety is in that program, you you mentioned you're helping this client with humility.

Is it all about states of being depending on the client that you're working with, where you pick a a state of being to focus on, or is humility a part of the program?

Jud Brewer MD PhD (14:46)
It's part of the program and there are different aspects depending on whether I'm working with somebody individually or with this program. We have a systematic way of training people with these lessons. So humility is one of the basic lessons. We also have lessons on integrity. We have lessons on generosity, and all of these things, but they all build on this core foundation of the learning process itself. And there there are some interesting, I've

Wrote a Substack article about the paradox of gratitude, for example. You know, gratitude, there's a lot of research on gratitude that's pretty solid in the psychological literature showing that gratitude's helpful for people and for people that practice gratitude or keep a gratitude journey, a journal, or simply, reflect on things that they're grateful for, it feels pretty good. You can actually take this a step farther. There's a Buddhist slogan.

From these Tibetan Buddhist trainings called the Lozheng Mind Training series. And this slogan is called Be Grateful to Everyone. And so there's this paradox where it's like, yeah, you know, gratitude feels good to be grateful. Well, that's just the beginning. When we're when we can really lean in and, you know, when somebody honks us at us in traffic or shoots down an idea that we have, or, is somehow.

ruffles our feathers or pokes at our egos, we can either get defensive, which is the habitual reaction, or we can become thankful. We can bow to them with a with gratitude, saying, oh, you're helping to teach me about my own reactivity. And so that's, you know, those are the kind of elements that we talk about in the going beyond anxiety program. And the fun part is I get to write new lessons for this basically every week.

Where I can record those lessons and then people can consume those podcast style so that they can they can go back to a lesson anytime they want. But we can now build in generative conversational agents that quiz people on their comprehension to make sure they understand the lesson. Because often people, somebody comes into my clinic, they nod their head, they say, Yeah, I understand, Dr. Brewer, yeah, I get it. They go home, maybe they don't understand or they forget. Here we can have a very conversational agent that's a partner, a learning partner as compared to a hierarchical structure where you're meeting with the doctor, you know, whatever. And so there's less intimidation, but also an infinite amount of time and patience. You know,

Shanon Tysland (17:23)
Mm.

Jud Brewer MD PhD (17:23)
I'd like to say I have patience with my patients, but I don't have a lot of time. And so here in the program, we can build this so that people can progress at their own pace and then also have a digital version of how I would run things in my clinic, but one that they have access to twenty four seven.

Shanon Tysland (17:43)
That sounds very powerful to be gratitude to be grateful not just for the good things you have in life, but to be grateful for the mishaps in life, the frustrations. You know, what pops into my mind is, you know, as a parent, when one of our my four kiddos gets underneath my nerves and I start perseverating on something, slowing down and be like,

Thank you. I'm grateful that you're helping me teach patience right now. That's next level. So,

Jud Brewer MD PhD (18:16)
Yes. Yeah.

Shanon Tysland (18:17)
okay. So be grateful to everyone and yeah, I'm gonna work on that.

Jud Brewer MD PhD (18:23)
And you're highlighting w when we give people the foundation of knowing how their mind works, they can start with the easier steps as a way to build up the fortitude of gratitude. And then they can be leaning into the more challenging things as growth opportunities. I don't know if you've heard the term the FGO, the frickin' growth opportunity, right? We can we can run away from things that are challenging or we can run toward the challenges in life.

Shanon Tysland (18:52)
I love that. that's like Carol Dweck's mindset, growth opportunities, yes, or growth mindset. okay, Jud one thing I appreciated, I just finished your book, Unwinding Anxiety, is how broadly anxiety shows up, not just in panic attacks, but the subtle loops that so many high-functioning people just normalize.

Do you think many high achievers unknowingly build identities around anxiety-driven reinforcement loops?

Jud Brewer MD PhD (19:27)
I more than think I know this. I see this all the time. You know, a lot of people are very attached to worrying because they think that it's something that helps them solve problems or get ahead or,  keep family members safe. But in fact, this is the this is such a misconception that you know a lot of people just they they really struggle with letting go of it because they just feel like it's part of who they are.

You know, in I even wrote in the Unwinding Anxiety book about someone who described anxiety as deeply etched in her bones, right? That's how identified she was with her anxiety. So first we've got to recognize that we can become identified with anxiety. And once we recognize that, then we know we can learn how it's a habit and then we can learn to work with it. One of my favorite quotes is from Alan Watts, you know, the philosopher, where he talks about.

The the ego, if I've got this right, ego, he who believes himself to be is nothing but a pattern of habits. Right. So we are our habits, you know, full stop.

Shanon Tysland (20:37)
Absolutely. So can you help us unpack this anxiety itself can become a habit loop habit loop? Can you help us understand the framework that you're working with and how anxiety actually becomes reinforced in the brain?

Jud Brewer MD PhD (20:55)
I'd be happy to. So there you need three elements for any habit: a trigger, a behavior, and a reward or a result. And so the feeling of anxiety, this mental, restless, contracted, itchy-urgy quality of anxiety that says do something can lead to the mental behavior of worrying. And that mental behavior makes us feel like we're in control. It gives us the illusion of control, even though anxiety is about fear of the future. So we don't really have control over the future. But that worrying feels better than nothing. And that's rewarding enough to feed back and drive the loop. So the next time we feel anxious, we worry more. And then we become so habituated to it to the point where we just feel like, yeah, this is what I do. This is who I am.

Shanon Tysland (21:47)
So if I'm breaking that down and I have four kiddos, and so say there's a test coming up, and so the trigger, I want to get this straight. So it's the trigger, the behavior, the result. The trigger is I have a test. The behavior might be I should be studying, but I get nervous and I go to my phone and I start doom scrolling to procrastinate or whatever. And

The result that I get out of that is I'm more anxious because now I haven't been studying. Is that close?

Jud Brewer MD PhD (22:27)
Yeah, that's a related habit loop. And I see this quite a bit, these distraction or procrastination habit loops where the feeling of anxiety drives that type of behavior. So the that's probably one of the most common ones I see. So the behaviors can be worrying, the behaviors can be doom scrolling, they can be scrolling on social media, they can even be, oh well, the bathroom needs cleaning, so I'm gonna clean the bathroom. And so if you know it's like, well, I need to clean the bathroom sometime.

But maybe not right now when you really need to be studying for the test or getting the project done.

Shanon Tysland (23:02)
That's so good. So for me, I'm I'm a physical therapist by trade. We have three performance centers out here in the Pacific Northwest. One of the goals people have is to improve their health or fitness. Can you break down that trigger behavior reward for someone who is like maybe exercise is yet to be a habit? Maybe they are nervous to go to the gym or work out, they don't want to get hurt. They don't want to think of themselves as the most deconditioned person in the gym. So the behavior of working out just really doesn't come to fruition. What does that trigger behavior result look like for someone in that case?

Jud Brewer MD PhD (23:50)
So we can leverage this in two ways. One is we can start to see all the habits that get in the way of say becoming physically fit or going to the gym. So if it's fear of others judging us, if it's feeling like we're,  we're comparing ourselves to others, if we, there are a lot of things that get in the way of going to the gym. I'm sure you've heard the joke the heaviest weight at the gym is the front door. Yeah.

Shanon Tysland (24:17)
Hundred percent.

Jud Brewer MD PhD (24:19)
So it's whatever it is that makes that front door seem very heavy. So we can recognize those things and we can ask ourselves. So the question I'll have my patients ask themselves is what am I getting from this? So when just like with worrying, what do I get from worrying? Oh, it makes me more anxious. They can also start asking, what do I get from avoiding, you know, becoming physically fit? well, yeah, I don't get much from this. And that helps our brains see that it's not very rewarding. And when something's not rewarding, we're less likely to do that thing. So the avoidance becomes we I think of this as becoming disenchanted with that old behavior. So we can become disenchanted with all the things that get in the way of working out. And then we can start to explore all the ways of what all the positive aspects of of working out. And so here we can start, you know, it's if we've even

Gone for a walk as compared to sat on our couch. We can start wherever somebody's at. And it doesn't take much to notice that actually just movement, you know, our bodies are are meant to move, right? So anytime somebody's sitting on a couch or a chair for a long time, we just naturally want to get up and stretch because our body's like, okay, too much sedentariness. This doesn't feel good. So when we get up and stretch, it feels good. And we can notice, okay, what does that feel like? So the

The trigger is feeling like I need to stretch the behaviors we stretch, and then we feel better, it feels good. And then we can ask, okay, what's it like when I go for a walk? What's it like when I go to the gym? And then we can reflect on these things after we do those behaviors. So we can leverage that same reinforcement learning where we learn, oh, it actually doesn't feel so bad to go to the gym. And then as we start to build some physical fitness or some strength or, or whatever.

And our body is just feeling a little bit better, we can reflect on that. And then that can be the impetus to go work out in the future. One of the biggest misconceptions that I see around exercise and any other building any other good habits is that people think that they just need more willpower. From a neuroscience perspective, willpower is a myth. And I'm not mincing words here. 

Shanon Tysland (26:37)
Say that again for our listeners out there. Say that one

more

time. That's pretty powerful.

Jud Brewer MD PhD (26:40)
Will

from a neuroscience perspective, willpower is a myth. There, there's no willpower built into the equations of forming habits or breaking bad habits. It's really about awareness. If you pay attention and you see that something is not helping you, then we get what's called a negative prediction error and we become disenchanted with it and our brain learns not to do it. Quick example of that is when I help patients to quit smoking, I have them pay attention as they smoke and they realize that cigarettes taste like crap.

So they become disenchanted. They get that negative prediction error. We can do the same thing by reflecting on the last time we went and worked out. How'd that feel? Generally after we work out, it feels good. Even when we're tired, there's a good tired, you know. So my my lab does workouts. We do hill workouts together on Wednesday mornings in Providence, Rhode Island. And I wrote a substack about this around building distress tolerance, right? So it actually

It at the time it can feel pretty challenging, but we can also bring awareness and curiosity to those moments and just see what it's like, step by step by step, as compared to looking to the top of a very steep hill and saying, oh no, I have to run another rep. You know, so that's how we can actually leverage this same process to actually build healthy habits that have,  just completely the opposite of willpower. It's it's really about awareness.

Shanon Tysland (28:08)
Let's unpack that a little bit. And you've said awareness, attention, reflection, and being curious all in the last minute.

Jud Brewer MD PhD (28:18)
Yes.

Shanon Tysland (28:18)
And to have that pause after you do something, or the example you just said with smoking. I want to be curious of what I'm experiencing while I'm smoking. Oh this tastes like crap.

What I feel like that's almost a habit in and of itself is pausing to stay curious to, and I'm thinking of eating. How many times I eat a meal and I'm like, what did that food even taste like? Right. I was just wolfing it down to get to the next thing. And am I curious and present to how the food tastes, how I feel afterwards? I think that curiosity is so important.

And yet in our go, go, go society to slow down to reflect and stay curious, it's quite challenging.

Jud Brewer MD PhD (29:12)
It certainly can be. And we teach curiosity probably is the main technique in our going beyond anxiety program. As you're highlighting, it can be very challenging for people to be able to tap into curiosity, especially if they're feeling anxious or they have some injury and there's pain and things like that. So when we have life circumstances, whether we're anxious or or anything else.

We tend to have this reaction of oh no. Right. So what we can start to learn is to see if we are resisting our experience. And what do we get from the resistance in itself? Right. So this is resistance itself as a habit. So we can learn, what do I get from the habit of resistance? And then what happens when I start to bring curiosity in? So flip that oh no to, Oh! And instead of saying, you know, oh no, is this gonna last forever? I'm gonna

Whatever, as we're running off into the future, we can bring it back to the present moment. And instead of the, why am I anxious or why is this happening? We can ask, what is happening right now? And what does this feel like in my body? And we can even start to zoom in and notice what we what resistance feels like. It also tends to feel like this contracted quality of experience, and what we get from resisting, which is nothing because this is happening, and we can either

accept that it's happening or we can resist it. And the resistance is just extra energy that we're wasting that we could redirect toward working with our experience, whatever it is in the moment.

Shanon Tysland (30:50)
That is fantastic. Staying curious. That's something I want to be more attuned to. So, Jud, where do people most confuse maybe the the loops with their identity? And what I mean by that is do you hear people say, "This is just who I am," when in reality it might be a learned pattern that they've been repeating for years? Thoughts on that?

Jud Brewer MD PhD (31:17)
Yes.

I would say we can and this is something I would throw this out. It might sound controversial, but then when we really start looking, we see that it's actually probably relatively true. Most of the things that we think are just who we are, are habits. You know, back to Alan Watts, where he says basically everything is a pattern of habits. So if we think of our identities, we can start naming those, right? I'm a psychiatrist, I'm a neuroscientist, I'm a husband, I'm a, you know, I'm this, I'm that. And all of those are habits. Right. So I'm in the habit of going to work and working in my lab. I'm in the habit of going to my clinic, but all of those are identities that I hold and I can hold them, you know, with a very tight fist, like this is who I am, or I can hold them loosely, like, yeah, this is what I do. And so I would say almost everything

that we take ourselves to be, these identities, almost everything's a habit.

Shanon Tysland (32:22)
Wow, that potentially gives a lot of hope for people that want to make a change, right? If it all boils back down to habits. And how can we do that? So most of us were taught that change comes from the discipline, the grit, the pushing harder, just using that gym example, like I gotta go to the gym, and if I do that, and if I don't, I'm a complete failure. Where are we missing or what are we misunderstanding about behavior change?

Jud Brewer MD PhD (32:56)
Yes. So grit is more a correlation than causation. So it's it falls into the same category as willpower, where we think, I just need to clench my teeth and do this thing. Well, we think we associate clenching our teeth and forcing ourselves to do something with getting something done. But there's a there's a common fallacy, and this is this is critical for any type of scientific pursuit, is being able to differentiate.

Whether things are correlated, like I grit my teeth and I get something done, or causative. Like I I the only way I can get something done is by gritting my teeth. So the willpower and the grit is a story that we tell ourselves in identity that that some people take on. And you can see this in social media influencers where like, I just do this every day, right? Well, if they look and ask themselves,

How rewarding it is to do whatever they do every day is, they'll see probably what the causative agent is. And the causative agent is if they do something like eat healthy food and it feels good, they're gonna do it again. And so they don't actually, they can say, it's because of my grit. But the truth is it's probably because it's rewarding. And so that's the, that's the biggest thing that that people can start to explore is asking, you know, what is actually causing this to happen versus what's the story that I tell myself? 

Which is actually really freeing because then for the people that aren't social media influencers and feel like, well, they can do it and I can't, that's not true. The truth is that anytime we pay attention and see how rewarding something is, we're more likely to repeat it.

Shanon Tysland (34:39)
Hmm, I like that. So let's make this really practical. Someone is listening right now in the middle of a stressful season of their life. What's their first step?

Jud Brewer MD PhD (34:52)
The first step is to recognize any habits that are contributing to that. So for example, stress. And then we've already talked about the key elements here is being able to map out those habit loops. What's the trigger, what's the behavior, and what's the result? And the even if they want to simplify it, they can just really focus on the behavior. Like, what's the behavior? I'm getting stressed. I'm worrying. I'm doom scrolling. I'm doing whatever.

Shanon Tysland (35:21)
Love it. So are there some simple practices after that? Like I'm doing the doom scrolling and where do I go from there?

Jud Brewer MD PhD (35:30)
Yeah, let's use anxiety and worry as an example. So if somebody is anxious and they tend they notice that they're doom scrolling, they can then ask a simple question, what am I getting from doom scrolling? Right. It might be this momentary distraction, but is it actually helping me be with and work with this anxiety? No, it's just a distraction. So this is where they can become disenchanted with the old behavior and repurpose that energy. So

Take the doom scrolling, take the worrying. And the simple question is, what am I getting from this? When they see that it's not rewarding, then they become disenchanted. And then they can move to the third step. We've touched on this a tiny bit, but this is where we can leverage curiosity. So instead of the oh no or the numb out of distraction, we can go, Oh! What does this feel like in my body? And instead of running away from the unpleasant sensations, we can run toward them.

Which also has the side benefit of helping us develop distress tolerance, right? So we can learn to be with unpleasant sensations instead of doing something to distract ourselves or taking a pill to numb ourselves. Or a lot of my patients will eat, they've come to me because they've developed the habit of stress eating. So they eat to numb or distract themselves as well. They're all sorts of different habits that people form as a way to.

get this brief relief from the anxiety when in fact they're just perpetuating it.

Shanon Tysland (37:03)
I have two questions on this. One, could curiosity itself be thought of as a form of nervous system regulation?

Jud Brewer MD PhD (37:14)
Say that one more time. Curiosity?

Shanon Tysland (37:15)
Could curiosity itself be thought of as a form of nervous system regulation?

Jud Brewer MD PhD (37:22)
I would say yes. I think that's an interesting way of putting that. So if let's talk about dysregulation, right? So that our bodies are always trying to maintain homeostasis. And anxiety is this strange evolutionary bottleneck where fear is helpful in the moment, right? There's something that we needed to to get back to homeostasis. So we do it. We run away from the danger. And then planning is something that helps us.

Plan for the future. But if you mix those two together, fear plus future, you get anxiety. And so we can be afraid of the future, but we can't do anything about it right now. So we get into this evolutionary bottleneck that makes us feel like we're out of balance, that that restless, itchy urge of fear that says, do something, do something, but there's nothing we can do right now because we're worried about the future. And so the curiosity can help us step out of that dysregulatory pattern where we're stuck spinning our wheels and revving up our brain's energy and our body too. It's really tremendously taxing to be anxious. And the curiosity can help us turn toward that experience and disengage that process. You know, in the brain, there's a network of brain regions called the Default Mode Network. My lab just finished a three-year study where we looked at people with high anxiety, low anxiety, and meditators.

And we induced these worry scenarios and we found that they activate this network called the Default Mode Network, which is a self-referential network, which makes complete sense. That's what we actually hypothesized and we found that that that was true. But it's only true when people engage in these personalized worry scenarios. It only gets activated, it gets activated most in people with high anxiety. It gets activated to some degree in people with low anxiety.

And it doesn't activate at all. It's nothing more than baseline in experienced meditator. So they can recall these scenarios, but they don't get caught up in the scenarios. And so here that this highlights out training and curiosity, which is basically what meditation and mindfulness is about, is like learning to be curious about our present moment experience. We can learn to actually not activate that. And on top of it, we did we taught people this very basic mindfulness practice called noting practice. And the experienced meditators generally already know how to do some version of this. So we found that within with a single training in how measuring people's brain activity, that the novice the people with high anxiety and low anxiety could deactivate that network below baseline. With one training. And of course the experienced meditators act deactivate it even more below baseline than the other groups. So this suggests that it doesn't take a lot of training. And so we actually emphasize this noting practice in our going beyond anxiety program. We've got now we have really good neurobiologic data on the mechanism here. But also it suggests that, and this is a cross-sectional study, so I can't say this for certain. But when what we see is with the people that have practiced this type of thing for a while, they do a they do even better.

Shanon Tysland (40:34)
Hmm. So I want to unpack that a little bit just for our listeners. anxiety comes from something in the future, a thought that I might have. That thought is something that I cannot control, and it starts to make me nervous. My nervous system now kicks on. What is happening physiologically in my body when I have that thought about the future. Like what's going on that now I'm anxious? Talk us through that a little bit.

Jud Brewer MD PhD (41:12)
Yes. So there's a there's a little there's a very underappreciated part of the brain called the the BNST, the the bed nucleus of the stria terminalis. And that is part of the extended amygdala. So often people hear about the amygdala, fear. So you know, and the amygdala is basically about you know, orienting us to something that's dangerous right now, so that we can do something about it.

Once the danger has is moved beyond our vicinity, then we need to be hyper-vigilant to see if that danger comes back, at least for a little while. And this is where the BNST comes in. So it's kind of this hypervigilance mode, so to speak, where it's correlated with that. And what has been suggested is that the default mode network, these stories that went with worrying, that kind of keeps the BNST on, kind of feeds it so that we stay hypervigilant even when there's no danger, right? That's what anxiety and worry is. And so when we're keeping those modes, that hypervigilant mode on, we're keeping all the physiologic, you know, machinery revved up that prepares us, you know, for the fight flight free, freeze reaction. And so this is where,  we get all these heart rate goes up, blood pressure goes up, all these things.

that are helpful in the moment, but not helpful if we keep those systems running all the time. It's like revving your engine when you're in neutral. You know, you're gonna waste your gas and you're gonna burn up your engine.

Shanon Tysland (42:52)
So the pairing that with the meditators in your study who had no response with a future thought, what happens for them is that BNST is not activated.

Jud Brewer MD PhD (43:06)
We didn't look at the BNST, we looked at the default mode network. So we found that the network that's functionally connected to the BNST is less active. So we can that suggests that it's less likely to feed that hypervigilant signal.

Shanon Tysland (43:24)
Okay, so the key meditating mindfulness keeps us more curious. It keeps us in the present moment to avoid the future thoughts, patterns. Is would is that a simplistic way to use that say that?

Jud Brewer MD PhD (43:40)
Yeah, I think that's fair to say another way of putting it is that it helps us notice when these stories start to spin up and helps us not get caught up in the stories. Right. So that caught upness, that contraction, that marker of you know, contraction is a good marker of hypervigilance. It's kind of like coiling us up to spring into action. We can notice that. And instead of going, no, I need to, you know, be on high alert, we can go,

Oh! What does this feel like in my body? And what that does is help us kind of uncoil so that we can, when we look around and and I I have my patients do this, like ask themselves, am I actually in danger right now? And they see that they're not in danger. It can help them take a deep breath and regulate so that they can, they can turn that hypervigilant signal down.

Shanon Tysland (44:31)
Love that. Okay. So I'm curious, how do you think technology and the constant stimulation are affecting our habit loops?

Jud Brewer MD PhD (44:43)
Well we only have a few minutes, but I could talk for hours on this because they are the short answer is they're doing all sorts of things to jack that system, right? So you pair the intermittent reinforcement where you don't know when you're gonna get an alert on your phone that says, tells our curiosity, our brain to say, what is that? That's the deprivation curiosity kicking in. And then we pair that with our brains being looking for ways to distract ourselves when we're

In unpleasant situations or not feeling good, whether boredom or frustration or anxiety or whatever. So now we have, as Cornelas puts it, our weapons of mass distraction. That's what he describes our phones to be, which is perfect, right? So we learn to go and soothe ourselves on our phones whenever we are not feeling comfortable, instead of learning to just be with that discomfort. This is where you know the distress tolerance is at an all-time low, I would say, in humanity.

Shanon Tysland (45:41)
That's so good. And so our social media and phones essentially habit loop amplification devices.

Jud Brewer MD PhD (45:50)
Yes, yes, because they give us easy access to distractors.

Shanon Tysland (45:57)
All right, Jud, we're gonna jump into just a rapid fire question. whatever pops to your mind, I want you to let it fly. how about this? Anxiety is trying to help us by fill in the blank

Jud Brewer MD PhD (46:13)
Well, it's trying to help us be safe now about things in the future. And I say that because it's not actually helping us do anything.

Shanon Tysland (46:23)
Hmm, love that. What is a habit loop almost everyone has but rarely notices?

Jud Brewer MD PhD (46:31)
Oh that's a great question. I would say distraction.

Shanon Tysland (46:37)
What is one mindfulness misconception you'd love to retire?

Jud Brewer MD PhD (46:43)
That that meditation is about clearing your mind of your thoughts.

Shanon Tysland (46:48)
Say more on that.

Jud Brewer MD PhD (46:50)
Well, often people think, you know, I need to stop these thoughts. And I say, good luck. That's not what it's about. It's about changing a relationship to our thoughts. So instead of pushing them away or trying to distract ourselves or holding on to the pleasant ones, the idea is to just notice those thoughts come up and not get caught up in them or not get caught up in a tussle with them. It's really just to notice them and watch that they're going to go away on their own. We don't actually have to do anything but be aware of them.

Shanon Tysland (47:18)
That's so great. I the I saw a research article that said there are somewhere between 6,000 and 60,000 thoughts a day. Is that what what is the research showing on your end on?

Jud Brewer MD PhD (47:32)
I have no idea. I think that's really hard to study. But either way, whether it's six or sixty, that's still a lot.

Shanon Tysland (47:38)
It's a lot. Yeah. Okay. What is something you Jud are personally working on?

Jud Brewer MD PhD (47:44)
Patience. Yes.

Shanon Tysland (47:46)
Mm.

Forever.

And Jud, what does redefining what's possible mean to you?

Jud Brewer MD PhD (47:56)
I think it means to me that we can really step back and look at all the ways that we limit ourselves and that we put the we're constantly carrying around these anchors that slow us down. And so when we start to see, you know, we've even talked about this, all of the identities that we have, then when we can see those  identities, we can let go of them. And that totally redefines what's possible. When we and it helps us redefine who we are.

Shanon Tysland (48:26)
That's so powerful. Thank you for that. Jud this was great. I think one of the biggest takeaways for me, well, I have a couple, is one, curiosity. I want to sit with more curiosity. And two, that we're not fixed. I'm not fixed in the identity that I carry, that I'm more patterned and I want to become aware of that. And when we understand our our habit loop, we create the possibility for change.

Jud, where can people best connect with you, follow your work, and learn more about all the things you're up to?

Jud Brewer MD PhD (49:03)
Probably the easiest thing is my website. It's just drjud.com, drjud.com. I also write a free weekly Substack newsletter. Just judbrewer.substack.com. And then the program I mentioned is just goingbeyondanxiety.com.

Shanon Tysland (49:20)
Yeah. So for all of our listeners out there, check that out. And if this conversation resonated with you, share it with someone who may feel stuck in a loop right now. And maybe the goal today isn't to fix yourself, maybe it's simply to get curious. And until next time, keep redefining what's possible. And thanks for joining, y'all.