In this episode of the Feel Good Effect, we’re talking about how to unwind anxiety & stop worry in its tracks. Joining us, is renowned addiction psychiatrist & neuroscientist, Dr. Jud Brewer.
Listen to the episode or read the article to learn his tactical, science-backed tips that anyone can use to build awareness & get unstuck.
how to break the anxiety habit with dr. jud brewer
Anxiety can be defined as a feeling of worry, nervousness, or unease about something with an imminent or uncertain outcome. We all feel some sort of anxiety on a spectrum and it can vary in intensity and level of disruption of our life.
I hope this conversation helps you feel more hope & understanding around anxiety and how to approach it as a habit in your life.
“You do not have to be stuck in anxiety if it is not working for you”.Dr. Jud Brewer
starting to look at anxiety as a habit
As an addiction psychiatrist, Dr. Jud Brewer helped patients manage anxiety (typically with prescribed medications). When he began researching mindful eating, he started to look at anxiety and thinking of it as more of a habit.
Dr. Brewer and his team were studying how mindful eating might help change eating behaviors and habits while developing an app called Eat Right Now. With medications, there is a concept called ‘number needed to treat’ – which describes how typically five patients have to be treated before one shows a significant benefit. These success rates left him anxious about how to help the other 80% of patients who were likely not benefitting from their medication.
He started to look back at the literature, and realized that there was a lot of research looking at anxiety driven through the mental behavior of worrying as a habit loop. The concept just clicked and he wanted to test it.
Dr. Brewer was able to observe this phenomenon in several studies including one with anxious physicians – who showed a 57% reduction in clinically evaluated anxiety scores with this intervention. And among those with generalized anxiety disorder, there was a 67% reduction. Compared to the 5.15 people who would need to use a medication to effectively treat anxiety, this intervention only needed 1.6.
how accepted is this idea in the medical field?
In the medical field, it takes about 17 years for something to go from an idea to implementation stages. Understanding a concept and getting it out there can happen much quicker than getting something covered by insurance.
On a larger societal scale, it is about getting the word out there so people can understand it today.
Introducing the idea of anxiety being a habit seems to quickly click with people and the more it lands with people’s direct experiences, the more it can be taken on by them.
the myth of willpower
One of the barriers to the concept being widely accepted includes our collective attachment to the idea of willpower being the best way to approach new habits.
Our society has this individualist focus that encourages people to pull themselves up by their bootstraps. This self-made idea is one many of us have grown up with – one where we are taught to heavily value & rely on willpower to get things done.
But in reality, we know that our brains don’t work in a “just do it” mentality; brains do rely on habits and once we understand how habits are best formed, we can learn to tap into that. Including when it comes to anxiety and worrying.
“The more we can tap into habit formation, the more we will see willpower go to the wayside”.Dr. Jud Brewer
how habits are formed
We have thought so much about anxiety as a personality trait instead of something we can learn and unlearn. The more we worry and feel anxious, the more we take it on in our identity, but it can be unlearned through habit formation.
Any habit is formed through three elements: a trigger, a behavior, and a reward or result. Anxiety forms in the same way.
Our ancient ancestors had to learn where danger was when searching for food. Seeing a predator triggered the behavior to run away, which resulted in survival. Our brains work the same way today, even without danger. Anxiety itself can be the trigger that drives the mental behavior of worry.
We often think of behaviors as physical things we do, like smoking or exercising. But we can actually have mental behaviors as well, such as worry.
what worrying looks like as a habit loop
When we worry, we either feel like we have a sense of control or we distract ourselves from the unpleasant feeling of anxiety. This gives the brain a type of “reward” that is then fed back into the habit loop, and we find ourselves worrying again the next time we feel anxious.
Worrying becomes a “reward” – not because it feels good, but because we can avoid a potentially worse feeling. Or if we feel a sense of greater control as we think through various possible & worst-case scenarios.
The problem, though, is that the act of worrying does not truly solve the problem. Instead it makes it harder for us to think & plan. The part of the brain that has evolved to help us survive through thinking and planning actually goes offline when anxiety kicks in.
Here’s an example that may be helpful to illustrate this idea. Imagine a parent of a teenager who goes out with friends one night. The parent spends all evening worrying, unable to sleep until they hear the door open and finally know their child is home safe. The worrying itself doesn’t keep their child safe. But it does give them something to do to make them feel a little more in control. The consequence, though, is that this reinforces worry as a habit.
we only have a little bit of control over our context
We only have a little bit of control over our context. Certainly, it is great if you can avoid triggers, but that is not how much of life works.
We don’t have control over our genes, we have limited control over our environment, but we do have control over our own minds.
If we can learn how our mind works, we can work with that and work with context appropriately.
the first step is mapping your mind
Anyone can map out their triggers, behaviors, and results, and map out how they feed each other. Dr. Brewer and has a free downloadable Habit Mapper available to guide you with this process.
If we are looking at an anxiety habit, we can start by looking at behaviors like worry and mapping back to what triggered it. And then to what resulted from the behavior, the results being the critical piece for changing behavior.
the second step is about awareness & updating the reward-value
If something is rewarding and habitual, we are going to keep doing it. If we want to change that behavior we have to update the reward-value, which requires awareness so that our brains can see clearly that something is outdated or not working anymore.
Dr. Brewer’s lab just finished a study with the Eat Right Now app, where they measure the reward value of overeating. They asked people to pay attention as they overate. It took about 10-15 times of bringing awareness to their overeating for the reward value to drop below zero, meaning that they shifted their eating behavior.
These findings highlight the plasticity of our brains; it doesn’t take years to overcome a habit, it takes awareness. With awareness, we can actually change the reward value in a meaningful way. When worrying, we can shift to ask ourselves, “what am I getting from this?”, to see that worrying is not solving the problem. This helps our brains update the reward value to a bigger, better offer, something that we are naturally wired for. Two of Dr. Brewer’s favorite bigger, better offers: kindness and curiosity.
“It doesn’t take years to overcome a habit, it takes awareness. With awareness we can change a lot.”Dr. Jud Brewer
breaking mindfulness down into two elements: kindness & curiosity
Kindness and curiosity together make up the attitudinal component of awareness that is key for any habit change.
It helps us sustain attention without judgment for what is happening. Curiosity helps us see what is actually happening so that our brain is getting accurate, unbiased, information. Not only is curiosity free and inherent, but it is much more rewarding than things like anxiety.
Dr. Brewer’s lab did a study with several hundred people looking to see which mental states were most rewarding. Anxiety, frustration, anger, and similar states were found to be less rewarding than things like curiosity and kindness. The other thing, is that kindness and curiosity share a feeling of openness and extension, in contrast to anxiety or frustration, whichfeel closed down or contracted. You cannot be closed and open at the same time. So if you can tap into something that is open and naturally more rewarding to the brain, especially when stuck in a habit that makes us feel closed down, that helps open up the closed states because it feels better.
There are different types of curiosity. Deprivation curiosity is not knowing some type of information, and the deprivation drives us through an itchy, antsy urge to go get that information. Just like our stomachs rumble when we are hungry to go get food, our brains rumble when we don’t have information; information is food for our brain. Deprivation curiosity is really more of a closed down, restless quality that is about the destination. There is also interest curiosity, which is more of an open, joy of discovery that comes with learning, more about the journey than the destination.
Dr. Brewer’s lab has done some testing in the brain. In one neuroimaging study, they observed that the brain regions that activate with anxiety and deactivate with meditation, also deactivated with curiosity. This neural network may be a marker of getting caught up or closed down in an experience with activation. Another study found that feelings of awe can deactivate the same network.
“Curiosity is a superpower”.Dr. Jud Brewer
how to bring about more curious awareness & natural kindness
The beauty and simplicity of how our brains work is that to change any habit only takes awareness. Mapping habit loops, measuring how rewarding something is, stepping out of these loops with curiosity, and knowing that our brains are naturally inclined for bigger, better offers all require a level of awareness. Using awareness, our brains will naturally want to move toward more positive directions.
Curious awareness overlaps with self-compassion in regard to how they feel, which is open. We can bring awareness to the way we treat ourselves, which can help bring natural kindness to ourselves. The awareness of how painful it is to beat ourselves up helps us flip into self-compassion. The capacity to be kind to ourselves naturally arises with curious awareness.
practicing shorter moments of micro mindfulness
Habits are formed in a particular context so that we can learn something in context (e.g., learn where food or danger are).
For example, clinically, Dr. Brewer knows that his patients don’t learn to smoke cigarettes in his office, so helping them practice mindfulness in his office is out of context. So, we need to look at how to help people become aware in context – so that they can apply these micro-moments of mindfulness throughout the day. Which is how you form any new habit.
We bring short moments of awareness and kindness into our lives, in context when we are getting caught up in anxiety or a self-judgmental loop, so we can efficiently unlearn the old habits. These shorter moments of mindfulness in context are strongly related to greater wellbeing, shown in smoking cessation research.
Additionally, doing a behavior mindfully, like smoking with awareness versus mindlessly, is what updates the reward value in the brain. Keeping the rewards immediate and accessible, our brains will want to do it again.
what does it really mean to be healthy?
“When I am exercising daily, not because I need to but because it feels good. When I eat food that is nourishing, my body feels content. That goes along with a healthy mind, which is around finding things that help open us and connect us, which ultimately lead us to contentment… Those two super foods for the mind are curiosity and kindness.”Dr. Jud Brewer
Dr. Jud Brewer is an internationally renowned addiction psychiatrist and neuroscientist. His TED Talk ”A Simple Way to Break a Bad Habit” has over 16 million views on YouTube. Dr. Jud is an associate professor at Brown University and executive medical director at Sharecare. His new book is called Unwinding Anxiety: New Science Shows How to Break the Cycles of Worry and Fear to Heal Your Mind
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