Dr. Alia Crum: Science of Mindsets for Health & Performance

00:00:00.320 | - Welcome to the Huberman Lab Podcast,

00:00:02.280 | where we discuss science and science-based tools

00:00:04.880 | for everyday life.

00:00:05.900 | I'm Andrew Huberman,

00:00:10.200 | and I'm a professor of neurobiology and ophthalmology

00:00:12.900 | at Stanford School of Medicine.

00:00:14.880 | Today, my guest is Dr. Alia Crum.

00:00:17.360 | Dr. Crum is a tenured professor of psychology

00:00:19.680 | at Stanford University and the founder and director

00:00:22.420 | of the Stanford Mind and Body Lab.

00:00:24.600 | Her work focuses on mindsets,

00:00:26.840 | how what we think and what we believe

00:00:28.520 | shapes the way that our physiology,

00:00:30.360 | our biology reacts to things like what we eat

00:00:33.660 | or stress or exercise.

00:00:35.960 | Indeed, as you will soon learn

00:00:37.360 | from my discussion with Dr. Crum,

00:00:39.200 | what you believe about the nutritional content of your food

00:00:42.540 | changes the way that food impacts your brain and body

00:00:45.280 | to a remarkable degree.

00:00:46.720 | And the same is true for mindsets about exercise

00:00:49.240 | and stress and even medication.

00:00:51.600 | For instance, recent work from Dr. Crum's laboratory

00:00:54.120 | shows that what we believe about the side effect profiles

00:00:57.160 | of different drug treatments

00:00:58.720 | or different behavioral treatments

00:01:00.360 | has a profound impact on how quickly those treatments work

00:01:03.720 | and the effectiveness of those treatments.

00:01:05.920 | I just want to mention one particular study

00:01:07.580 | that just came out from a graduate student

00:01:09.880 | in Dr. Crum's laboratory, Lauren Howe, H-O-W-E,

00:01:13.540 | showed that how kids react to a treatment

00:01:15.940 | for peanut allergies can be profoundly shaped

00:01:19.100 | by whether or not those kids were educated

00:01:21.180 | about the side effects of the treatment,

00:01:23.260 | such that if they learned that the side effects

00:01:25.560 | were a by-product of a treatment that would help them,

00:01:27.740 | and they learned a little bit

00:01:28.800 | about why those side effects arose

00:01:30.400 | and that the side effects might even help them

00:01:32.200 | in route to overcoming their peanut allergy,

00:01:34.480 | had an enormous impact

00:01:36.320 | on how quickly they move through the treatment

00:01:38.160 | and indeed how much they suffered

00:01:39.760 | or in this case did not suffer from those side effects.

00:01:42.640 | And that is but one example that you will learn about today

00:01:45.620 | as we discuss what mindsets are,

00:01:48.160 | the number of different mindsets that exist,

00:01:50.520 | and how we can adopt mindsets

00:01:52.280 | that make us more adaptive, more effective,

00:01:55.080 | allow us to suffer less

00:01:56.640 | and to perform better in all aspects of life.

00:01:59.280 | I personally find the work of Dr. Alia Crum

00:02:01.640 | to be among the most important work

00:02:03.800 | being done in the fields of biology and psychology

00:02:06.120 | and the interface of mind-body.

00:02:08.680 | Everything that she's done up until now and published,

00:02:11.060 | and indeed the work that she continues to do,

00:02:13.180 | has shaped everything within my daily routines,

00:02:15.520 | within my work routines, within my athletic routines.

00:02:18.440 | And we probably shouldn't be surprised

00:02:19.940 | by the fact that Dr. Crum works on all these things.

00:02:22.160 | She was not only an incredibly accomplished

00:02:24.320 | tenured research professor,

00:02:25.960 | she's also a clinical psychologist,

00:02:27.840 | and she was also a division one athlete

00:02:29.500 | and an elite gymnast at one period in her life.

00:02:32.220 | So she really walks the walk

00:02:34.160 | in terms of understanding what mindsets are

00:02:36.380 | and applying them in different aspects of life.

00:02:38.640 | I'm sure you're going to learn a ton from this conversation

00:02:40.860 | as did I, and come away with many, many actionable items

00:02:45.200 | that you can apply in your own life.

00:02:47.560 | In fact, as we march into today's conversation,

00:02:50.080 | you might want to just put in the back of your mind

00:02:51.940 | the question, what is my mindset about blank?

00:02:55.600 | So for instance, ask yourself,

00:02:56.940 | what is my mindset about stress?

00:02:58.480 | What is my mindset about food?

00:02:59.820 | What is my mindset about exercise?

00:03:01.340 | What is my mindset about relationships of different kinds?

00:03:04.080 | Because in doing that, you'll be in a great position

00:03:06.980 | to extract the best of the information

00:03:09.160 | that Dr. Crum presents, and indeed to adapt those mindsets

00:03:12.600 | in the way that is going to be most beneficial for you.

00:03:15.460 | Before we begin, I'd like to emphasize that this podcast

00:03:18.060 | is separate from my teaching and research roles at Stanford.

00:03:20.800 | It is, however, part of my desire and effort

00:03:22.760 | to bring zero cost to consumer information about science

00:03:25.320 | and science-related tools to the general public.

00:03:27.880 | In keeping with that theme,

00:03:28.900 | I'd like to thank the sponsors of today's podcast.

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00:08:23.440 | And now my conversation with Dr. Alia Crum.

00:08:27.160 | Great to have you here.

00:08:28.680 | - Great to be here.

00:08:29.600 | - Yeah.

00:08:30.440 | For the record, it's Alia Crum, but you go by Ali, correct?

00:08:34.240 | - That is correct.

00:08:35.180 | - Dr. Ali Crum.

00:08:36.520 | - Or just Ali.

00:08:37.360 | - Okay, great.

00:08:38.600 | Well, I've been looking forward

00:08:40.520 | to talking to you for a long time.

00:08:42.840 | Just to start off, you've talked a lot

00:08:45.480 | and worked a lot on the science of mindsets.

00:08:48.600 | Could you define for us what is a mindset

00:08:51.600 | and what sort of purpose does it serve?

00:08:54.040 | - Of course, yeah.

00:08:54.960 | Mindsets have been described or defined in a lot of ways.

00:08:58.960 | We define mindsets as core beliefs

00:09:01.760 | or assumptions that we have about a domain

00:09:05.600 | or category of things that orient us

00:09:09.100 | to a particular set of expectations,

00:09:12.420 | explanations, and goals.

00:09:15.000 | So that's kind of jargon-y.

00:09:16.520 | I can distill it down for you.

00:09:19.640 | So mindsets are an assumption that you make about a domain.

00:09:23.080 | So take stress, for example, the nature of stress.

00:09:26.680 | What's your sort of core belief about that?

00:09:30.160 | And mindsets that we've studied about stress are,

00:09:32.760 | do you view stress as enhancing, good for you,

00:09:35.200 | or do you view it as debilitating and bad for you?

00:09:38.580 | Those mindsets, those core beliefs orient our thinking.

00:09:42.040 | They change what we expect will happen to us

00:09:44.740 | when we're stressed, how we explain the occurrences

00:09:48.360 | that happen or unfold when we're stressed,

00:09:50.640 | and also change our motivation

00:09:53.200 | for what we engage in when we're stressed.

00:09:55.780 | So we have mindsets about many things,

00:09:57.560 | mindsets about stress, mindsets about intelligence,

00:10:00.280 | as Carol Dweck's work has shown,

00:10:02.300 | mindsets about food, mindsets about medicine, you name it.

00:10:06.760 | It's sort of distilling down those core assumptions

00:10:09.060 | that really shape and orient our thinking and action.

00:10:12.560 | - I've heard you say before that mindsets simplify life

00:10:15.120 | in some way by constraining the number of things

00:10:17.640 | that we have to consider.

00:10:18.960 | And it sounds to me like we can have mindsets

00:10:22.020 | about many things, as you said.

00:10:23.880 | What are some different mindsets?

00:10:25.360 | I think many people are familiar with our colleague,

00:10:27.660 | Carol Dweck's notion of growth mindset,

00:10:30.260 | that if we're not proficient at something

00:10:32.560 | that we should think about not being proficient yet,

00:10:35.820 | that we are on some path to proficiency.

00:10:38.320 | But what are some examples of mindsets

00:10:41.800 | and how early do these get laid down

00:10:43.880 | or do we learn them from our parents?

00:10:45.800 | Maybe if you could just flesh it out a bit for us

00:10:49.360 | in terms of what you've observed in your own science

00:10:51.920 | or your own life even.

00:10:53.240 | - Yeah, sure, so I think it's important with Carol Dweck's

00:10:55.920 | work, a lot of people kind of get focused

00:10:57.520 | on growth motivation and all these things.

00:11:00.160 | But her work really originated from thinking about

00:11:04.400 | what she called as implicit theories or core beliefs

00:11:07.560 | about the nature of intelligence or ability, right?

00:11:11.440 | So do you believe that your baseline levels of intelligence

00:11:15.960 | or your abilities are fixed, static,

00:11:19.100 | set throughout the rest of your life?

00:11:21.280 | Or do you believe that they can grow and change?

00:11:24.680 | Now, those are oversimplified generalizations

00:11:29.640 | about the nature of intelligence.

00:11:31.640 | And the reality is as it always is complex

00:11:34.680 | and it's a bit of both and it's all these things.

00:11:36.920 | But as humans, we need these simplifying systems

00:11:39.660 | to help us understand a complex reality.

00:11:43.120 | So those assumptions that we jump to,

00:11:45.680 | oh, intelligence is fixed or intelligence is malleable,

00:11:50.040 | they help us to simplify this complex reality,

00:11:53.640 | but they're not inconsequential, right?

00:11:57.280 | They matter in shaping our motivation.

00:11:59.660 | And as she has shown, if you have the mindset

00:12:02.180 | that intelligence is malleable,

00:12:04.900 | you're motivated to work harder, to grow your intelligence.

00:12:08.360 | If you have a setback and you're learning, you think,

00:12:10.920 | okay, there's something there that I can grow

00:12:12.840 | and learn and build from.

00:12:14.360 | If you have the mindset that it's fixed,

00:12:17.260 | why work harder at math if you don't think you're good at it?

00:12:20.540 | So in retrospect, it's pretty clear

00:12:23.500 | how these mindsets can affect our motivation.

00:12:26.900 | What our work has aimed to do is to expand

00:12:30.180 | the range of mindsets that we are studying, focused on,

00:12:35.180 | and also understand and expand the range

00:12:38.620 | of effects that they have.

00:12:40.380 | So by and large, we focused on mindsets

00:12:42.900 | in the domain of health and health behaviors.

00:12:46.060 | So I mentioned mindsets about stress.

00:12:48.380 | We've also looked at mindsets about food and healthy eating.

00:12:52.200 | So do you have the mindset that foods that are good for you,

00:12:55.620 | healthy foods are disgusting and depriving,

00:12:59.700 | or do you have the mindset that healthy foods

00:13:01.940 | are indulgent and delicious?

00:13:04.700 | Now, you know, it could be a variety of different foods.

00:13:07.280 | You might have different thoughts

00:13:08.200 | about different healthy foods, but generally people,

00:13:11.780 | at least in our culture and in the West,

00:13:14.580 | have this view that stress is debilitating,

00:13:17.660 | healthy foods are disgusting and depriving,

00:13:20.140 | and those mindsets, whether or not they're true or false,

00:13:23.480 | right or wrong, they have an impact,

00:13:25.420 | and they have an impact not just

00:13:27.040 | through the motivational mechanisms

00:13:28.780 | that Dweck and others have studied,

00:13:30.440 | but as our lab has started to reveal,

00:13:32.600 | they also shape physiological mechanisms

00:13:36.380 | by changing what our bodies prioritize and prepare to do.

00:13:41.320 | So those are just two examples, mindsets about stress,

00:13:43.660 | mindsets about food.

00:13:44.920 | We've looked at mindsets about exercise.

00:13:47.660 | Do you feel like you're getting enough,

00:13:50.420 | or do you feel like you're getting an insufficient amount

00:13:52.940 | to get the health benefits you're seeking?

00:13:56.560 | Mindsets about illness.

00:13:58.940 | Do you view cancer as an unmitigated catastrophe,

00:14:03.940 | or do you view cancer as manageable,

00:14:06.440 | or perhaps even an opportunity?

00:14:09.520 | We've looked at mindsets about symptoms and side effects.

00:14:12.500 | Do you view side effects as a sign

00:14:15.620 | that the treatment is harmful,

00:14:18.120 | or do you view side effects

00:14:19.220 | as a sign that the treatment is working?

00:14:21.540 | Again, these are sort of core beliefs

00:14:23.580 | or assumptions you have about these domains or categories,

00:14:27.140 | but they matter because they're shaping,

00:14:29.300 | they're synthesizing and simplifying the way we're thinking,

00:14:32.540 | but they're also shaping what we're paying attention to,

00:14:34.980 | what we're motivated to do,

00:14:36.340 | and potentially even how our bodies respond.

00:14:39.080 | - I'd love to talk about this notion

00:14:41.740 | of mindset shaping, how our bodies respond.

00:14:45.500 | And maybe as an example of this,

00:14:47.540 | if you could share with us this now famous study

00:14:50.820 | that you've done with a milkshake study.

00:14:54.580 | If you wouldn't mind sharing the major contours

00:14:58.300 | of that study and the results,

00:14:59.500 | 'cause I think they're extremely impressive

00:15:01.580 | and they really speak to this interplay

00:15:03.100 | between mindset and physiology.

00:15:05.060 | - Certainly, yeah.

00:15:05.900 | This was a study that I ran as a graduate student

00:15:08.540 | at Yale University.

00:15:10.140 | I was working with Kelly Brownell and Peter Salovey.

00:15:13.300 | Peter Salovey had done a lot of work

00:15:14.780 | on really coining the term emotional intelligence,

00:15:17.420 | studying that. - He's now the president

00:15:18.260 | of Yale, right? - He's now the president

00:15:19.420 | of Yale, yes. - So he's done well.

00:15:21.060 | - He's done well for himself

00:15:22.220 | and for the university and society.

00:15:24.700 | And Kelly Brownell, who was doing a lot of research

00:15:27.100 | on food and obesity.

00:15:29.220 | And I had come in doing some previous work

00:15:31.660 | on mindsets about exercise and placebo effects and exercise

00:15:35.300 | and was in this sort of food domain

00:15:38.340 | and this emotions and food domain.

00:15:40.420 | And it really occurred to me

00:15:42.620 | that there was a very simple question

00:15:44.540 | that hadn't been probed yet.

00:15:46.100 | And that was, do our beliefs about what we're eating

00:15:50.540 | change our body's physiological response to that food,

00:15:54.700 | holding constant the objective nutrients of that thing?

00:15:59.140 | So that question might sound outrageous at first,

00:16:02.380 | but it's really not outrageous

00:16:04.860 | if you're coming from a place of having studied

00:16:07.100 | in depth placebo effects.

00:16:09.700 | Placebo effects are this row, in medicine at least,

00:16:12.740 | are this sort of robust demonstration

00:16:15.820 | in which simply taking a sugar pill, taking nothing,

00:16:20.260 | under the impression that it's a real medication

00:16:22.820 | that might relieve your asthma, reduce your blood pressure,

00:16:26.660 | boost your immune system,

00:16:28.340 | can lead to those physiological effects

00:16:31.460 | even though there's no objective nutrients.

00:16:33.660 | And we have more evidence on placebo effects

00:16:36.220 | than we have for any other drug

00:16:37.980 | because of the clinical trial process

00:16:40.860 | in which all new drugs and medications are required

00:16:45.740 | to outperform a placebo effect.

00:16:47.860 | So we have a lot of data on the placebo effect.

00:16:50.300 | Now, we can get nuance there.

00:16:53.820 | We don't have a lot of data comparing the placebo effect

00:16:56.620 | to doing nothing,

00:16:58.620 | which is important for distilling mindset effects

00:17:01.660 | or belief effects from sort of natural occurring changes

00:17:05.100 | in the body.

00:17:06.140 | But anyways, going back to this question,

00:17:07.660 | it was like, all right, we've moved from medications

00:17:11.020 | solving our health crises

00:17:12.940 | to behavioral medicine solving our health crises,

00:17:16.980 | increase people's exercise, get them to eat better.

00:17:20.460 | To what degree are these things influenced

00:17:22.660 | by our mindsets or beliefs about them?

00:17:25.180 | So to test this question,

00:17:26.860 | we ran a seemingly simple study.

00:17:30.340 | This was done at the Yale Center

00:17:31.860 | for Clinical and Translational Research.

00:17:35.060 | And we brought people into our lab

00:17:38.340 | under the impression that we were designing

00:17:40.660 | different milkshakes

00:17:42.140 | with vastly different metabolic concentrations,

00:17:45.460 | nutrient concentrations

00:17:47.540 | that were designed to meet different metabolic needs

00:17:49.780 | of the patrons of the hospital, right?

00:17:51.460 | So you're gonna come in,

00:17:52.580 | you're gonna taste these milkshakes,

00:17:54.220 | and we're gonna measure

00:17:55.220 | your body's physiological response to them.

00:17:58.100 | This was a within-subjects design.

00:18:00.220 | So it was the same people

00:18:02.620 | consuming two different milkshakes,

00:18:05.340 | two different time points separated by a week.

00:18:07.940 | And at one time point,

00:18:09.100 | they were told that they were consuming

00:18:10.740 | this really high-fat, high-caloric, indulgent milkshake.

00:18:15.020 | It was like a 620-calorie, super high-fat and sugar.

00:18:19.820 | The other time point,

00:18:20.740 | they were told that it was a low-fat,

00:18:22.620 | low-calorie, sensible sort of diet shake.

00:18:25.980 | In reality, it was the exact same shake.

00:18:28.060 | It was right in the middle.

00:18:29.100 | It was like 300 calories,

00:18:30.860 | moderate amount of fats and sugars.

00:18:32.980 | And we were measuring their body's gut peptide response

00:18:36.300 | to this shake.

00:18:37.140 | And in particular,

00:18:37.980 | we were looking at the hormone ghrelin.

00:18:40.100 | So as you know,

00:18:41.020 | ghrelin hunger,

00:18:43.340 | medical experts call it the hunger hormone,

00:18:45.740 | rises in ghrelin,

00:18:47.260 | signal, you know, seek out food.

00:18:50.260 | And then theoretically,

00:18:51.980 | in proportion to the amount of calories you consume,

00:18:54.580 | ghrelin levels drop,

00:18:55.700 | signaling to the brain,

00:18:57.220 | okay, you don't need to eat so much anymore.

00:18:59.900 | You can stop eating.

00:19:00.780 | And also revving up the metabolism

00:19:02.700 | to burn the nutrients that were just ingested.

00:19:05.780 | What we found in this study was that

00:19:07.740 | when people thought they were consuming

00:19:10.460 | the high-fat, high-calorie, indulgent milkshake,

00:19:14.180 | in response to the shake,

00:19:16.020 | their ghrelin levels dropped

00:19:17.620 | at a threefold rate stronger than when they thought

00:19:20.860 | they were consuming the sensible shake.

00:19:23.660 | So essentially, their bodies responded

00:19:26.460 | as if they had consumed more food,

00:19:29.380 | even though it was the exact same shake

00:19:31.620 | at both time points.

00:19:33.500 | So this was really, you know,

00:19:36.060 | interesting and important for two reasons, really.

00:19:39.220 | One was that it was, to my knowledge,

00:19:41.700 | one of the first studies to show any effects

00:19:44.620 | of just believing that you're eating something different

00:19:47.380 | on your physiology.

00:19:48.780 | Lots of studies have shown that

00:19:51.140 | believing you're eating different things

00:19:52.980 | changes your taste, you know,

00:19:54.540 | and even your satisfaction and fullness after.

00:19:57.140 | But this shows that it has a metabolic

00:19:59.020 | or a physiological component.

00:20:01.420 | But the second piece was really important as well,

00:20:04.660 | and especially for me,

00:20:06.420 | this was one study that really transformed

00:20:08.820 | the way I think about how I approach eating,

00:20:11.260 | and that was the manner in which it affected our physiology

00:20:16.260 | was somewhat counterintuitive.

00:20:18.620 | So I had gone in thinking,

00:20:21.180 | the better mindset to be in when you eat

00:20:23.220 | is that you're eating healthy, right?

00:20:24.940 | Like, you know, it just makes sense.

00:20:26.220 | Like, placebo effects, think you're healthy,

00:20:27.780 | you'll be healthy, you know?

00:20:28.620 | But that was a far too simplistic way of thinking about it,

00:20:32.300 | and in fact, it was the exact opposite,

00:20:34.660 | because thinking that they were eating

00:20:37.260 | when these participants thought they were eating sensibly,

00:20:40.980 | their bodies left them

00:20:43.100 | still feeling physiologically hungry, right?

00:20:46.140 | Not satiated, which could potentially be corresponding

00:20:49.820 | to slower metabolism and so forth.

00:20:52.740 | So if you're in the interest of maintaining

00:20:55.180 | or losing weight, what's the best mindset to be in?

00:20:58.260 | It's to be in a mindset that you're eating indulgently,

00:21:01.060 | that you're having enough food, that you're getting enough.

00:21:04.500 | And at least in that study,

00:21:06.140 | we showed that has a more adaptive effect

00:21:08.660 | on ghrelin responses.

00:21:10.620 | - So interesting, and especially interesting to me

00:21:13.460 | as a neuroscientist who has worked on

00:21:17.020 | aspects of the nervous system

00:21:18.540 | that are involved in conscious perception,

00:21:20.060 | like vision and motion and color perception and so forth,

00:21:23.900 | but also our lab has worked

00:21:26.620 | and is increasingly working on autonomic functions

00:21:29.420 | that are below our conscious detection.

00:21:31.180 | In this case, a lie about how much something,

00:21:36.020 | these milkshakes contain, affected a subconscious process,

00:21:39.860 | because I have to imagine that the ghrelin pathway

00:21:42.540 | is not one that I can decide,

00:21:43.820 | oh, you know, this particular piece of chocolate

00:21:46.180 | is going to really reduce my ghrelin

00:21:47.940 | 'cause it's very nutrient rich,

00:21:49.580 | as opposed to one if you told me

00:21:51.500 | that a different piece of chocolate, for instance,

00:21:52.940 | is low calorie or sugar-free chocolate

00:21:56.140 | or something of that sort.

00:21:57.140 | The ghrelin pathway, however, it seems, based on your data,

00:22:01.740 | that the ghrelin pathway is susceptible to thoughts,

00:22:06.340 | which is incredible.

00:22:07.700 | But then again, there must be crossover

00:22:09.860 | between conscious thought and these subconscious

00:22:13.060 | or kind of autonomic pathways.

00:22:14.820 | So it's really remarkable.

00:22:16.520 | It raises a question that I just have to ask

00:22:21.140 | because increasingly, so I'm involved in online discussions

00:22:26.100 | and social media.

00:22:27.100 | And one of the most barbed wire topics out there,

00:22:30.360 | and that's being generous,

00:22:31.980 | is this topic of which diet or nutrients are best.

00:22:35.020 | You've got people who are strictly plant-based.

00:22:38.740 | You've got people who are omnivores.

00:22:40.420 | You've got people who are carnivores.

00:22:41.940 | You have every variation.

00:22:43.460 | You have intermittent fasting,

00:22:44.740 | also called time restricted feeding.

00:22:46.300 | And it seems like once a group kind of plugs into

00:22:50.600 | a particular mode of eating that they feel works for them,

00:22:53.500 | for whatever reason, energy-wise, mentally,

00:22:55.800 | maybe they're looking at their blood profiles,

00:22:57.340 | maybe they're not.

00:22:58.700 | But once they feel that it sort of, it works for them,

00:23:02.940 | each camp seems to tout all the health benefits

00:23:05.940 | and how great they feel.

00:23:07.340 | Could it be that mindset effects are involved there?

00:23:11.260 | That people are finding the nutritional program

00:23:13.940 | that they feel brings them the most enrichment of life,

00:23:17.660 | but also nutrients and that their health really is shifting

00:23:21.480 | in a positive direction,

00:23:22.400 | but not necessarily because of the food constituents,

00:23:24.740 | but because of the community and the ideas

00:23:27.020 | and the reinforcement.

00:23:28.020 | - Yeah, and the belief that this is the right way

00:23:30.420 | of doing something.

00:23:31.900 | I think 100%, 100% it has something to contribute.

00:23:36.900 | You know, I don't want to,

00:23:38.380 | I'm not going to weigh in on the debate.

00:23:40.220 | What I will most certainly weigh in on is the notion that,

00:23:46.540 | look, going back to the placebo effect, right,

00:23:48.660 | we have a outdated understanding of what that is,

00:23:51.820 | which is based on this randomized control trial.

00:23:54.420 | You compare a drug to a placebo.

00:23:57.300 | If the drug works better than the placebo,

00:23:59.380 | you say great, the drug works.

00:24:01.340 | If the drug doesn't outperform the placebo,

00:24:03.380 | you say the drug doesn't work.

00:24:05.340 | That's really oversimplified.

00:24:07.100 | It's a good test for the specific efficacy of the drug.

00:24:09.840 | It's not a good test for understanding

00:24:12.400 | the total impact of that drug.

00:24:15.020 | Because in the reality of things, you know,

00:24:17.300 | if a drug outperforms a placebo,

00:24:20.300 | then, you know, you start prescribing it,

00:24:22.940 | but the reality is that the total effect of that drug

00:24:27.180 | is a combined product of the specific chemical,

00:24:31.740 | you know, attributes of that drug

00:24:33.740 | and whatever's going on in the placebo effect,

00:24:36.580 | which is, you know, at least from our perspective,

00:24:39.140 | it's beliefs, it's social context,

00:24:42.220 | and it's your body's natural ability

00:24:44.220 | to respond to something.

00:24:46.040 | So, you know, that's in the placebo effect example.

00:24:48.940 | The same is true for everything we do or consume.

00:24:53.180 | So when it comes to what diet you're eating,

00:24:56.380 | both are true.

00:24:58.740 | It does matter what it is,

00:25:01.380 | and it matters what you think about that diet

00:25:05.380 | and what others around you in our culture

00:25:08.540 | think about that diet,

00:25:09.620 | because those social contexts inform our mindsets.

00:25:13.420 | Our mindsets interact with our physiology

00:25:17.580 | in ways that produce outcomes that are really important.

00:25:20.920 | So let's not get dualistic and say, you know,

00:25:24.100 | it's either all in the mind or not in the mind.

00:25:26.440 | Let's also not be unnecessarily combative

00:25:29.260 | and say, oh, it should be all plant-based

00:25:31.280 | or, you know, keto or whatever.

00:25:33.820 | It's all of those things are a combined product

00:25:36.780 | of what you're actually doing

00:25:38.660 | and what you're thinking about if you believe in it,

00:25:41.500 | if you don't, if you're skeptical or, you know,

00:25:43.840 | in some cases you think you should be eating a certain way

00:25:47.300 | and then you don't live up to that,

00:25:49.620 | it might have an adverse effect

00:25:52.260 | because of the stress and the anxiety associated with that.

00:25:55.940 | - Very interesting.

00:25:57.360 | Along the lines of belief effects,

00:26:00.100 | can we call these belief effects or mindsets?

00:26:02.820 | Is there a difference between these,

00:26:06.220 | what I'm calling belief effects and placebo effects?

00:26:09.560 | I mean, are placebo effects distinctly different

00:26:11.460 | from mindset effects or are they more or less the same?

00:26:14.260 | - They're related.

00:26:15.340 | So I think placebo effects, you know,

00:26:18.780 | maybe should be reserved for the, you know,

00:26:21.460 | conditions in which you're actually taking a placebo,

00:26:24.060 | which is a inactive substance.

00:26:27.260 | When you get out of that sort of placebo versus drug,

00:26:30.760 | you know, realm and you start looking at, you know,

00:26:34.020 | placebo effects, I use quotes with my hands here,

00:26:37.300 | in behavioral health, the term kind of becomes confusing

00:26:40.700 | because you're not, you know, in the milkshake study,

00:26:43.100 | we didn't give people a placebo milkshake, right?

00:26:45.860 | We just changed what they believed about it.

00:26:48.340 | So how I like to think about it is that placebo effects,

00:26:52.220 | as they're traditionally construed,

00:26:54.260 | are made up of three things.

00:26:55.580 | It's the social context, mindsets or beliefs,

00:26:59.540 | and the natural physiological processes in the brain and body

00:27:04.060 | that can produce the outcomes.

00:27:06.540 | And so we could just call them belief effects

00:27:10.840 | because the beliefs are triggering

00:27:12.760 | the physiological processes and the beliefs are shaped

00:27:16.600 | by the social context.

00:27:18.460 | Does that make sense?

00:27:19.300 | - It makes sense.

00:27:20.280 | Yeah, there was a paper a year or two ago

00:27:22.220 | published in Science Magazine about brain regions

00:27:26.700 | involved in psychogenic fever that if people,

00:27:30.180 | or you can actually do this in animal models too,

00:27:32.920 | think that they are sick,

00:27:33.760 | you get a genuine one to three degree increase

00:27:36.680 | in body temperature.

00:27:37.680 | One to three degrees Fahrenheit increase in body temperature.

00:27:39.840 | It was pretty impressive.

00:27:41.400 | - Yeah.

00:27:42.240 | - And I guess it plays into, you know,

00:27:43.700 | symptomology generally.

00:27:45.000 | So I'm a believer in belief effects.

00:27:47.720 | - Well, it's also, and I would just say that, you know,

00:27:50.520 | the term that we use in our field is nocebo effect for that,

00:27:54.560 | which is sort of the placebo's ugly step-sister.

00:27:58.280 | You know, it's when negative beliefs

00:28:00.400 | cause negative consequences.

00:28:02.220 | So you are told you will have, you know,

00:28:05.300 | it's very well demonstrated that when people are told

00:28:08.540 | about certain side effects,

00:28:09.880 | they're far more likely to experience those side effects.

00:28:14.360 | When people think that they're sick or going to get sick,

00:28:17.840 | sometimes that can create, you know,

00:28:19.780 | the physiological symptoms.

00:28:22.220 | And, you know, there's, you know, various debates.

00:28:25.580 | It's not only that physiology changes,

00:28:28.300 | it's also that your attention changes.

00:28:31.120 | So we're experiencing things like fatigue and headache

00:28:35.200 | and upset stomach all the time.

00:28:37.980 | And then when you take a drug and somebody says,

00:28:40.380 | you're going to feel fatigue and headache,

00:28:42.660 | you start noticing that you're tired and have headaches

00:28:45.280 | and attribute it to the drug.

00:28:46.520 | So some of the mechanisms are attention

00:28:49.580 | and some of them are real changes in physiology.

00:28:53.200 | - Love for you to tell us about the hotel worker study.

00:28:59.020 | - Yeah, sure.

00:28:59.860 | - I know you get asked these questions all the time,

00:29:01.440 | but I find these, just these results also amazing.

00:29:04.860 | - Yeah, no, I think that this is a really good example

00:29:08.340 | of this phenomenon, right?

00:29:11.780 | That the total effect of anything is a combined product

00:29:14.540 | of what you're doing and what you think about

00:29:16.960 | what you're doing.

00:29:18.180 | So this was a study that I ran with Ellen Langer way back

00:29:21.780 | when I was an undergrad, actually, we started this study.

00:29:24.760 | Ellen Langer is a professor of psychology at Harvard

00:29:27.540 | and she's done a lot of really fascinating work

00:29:30.260 | on her flavor of mindfulness,

00:29:32.980 | which is distinct from a more Eastern mind,

00:29:37.420 | Buddhist sort of mindfulness based work.

00:29:41.300 | And she actually was the one who said to me originally,

00:29:46.300 | I was an athlete at the time, I was a ice hockey player

00:29:49.820 | and I was training constantly.

00:29:52.860 | And one day I'll never forget it, she said,

00:29:55.140 | you know, the benefit of exercise is just a placebo, right?

00:29:59.260 | And I was like, well, that's outrageous.

00:30:00.660 | Ellen's known for saying very provocative,

00:30:04.420 | but also very wise things.

00:30:06.580 | And that statement really got me thinking about that.

00:30:09.380 | So we designed this study together and that was to look at,

00:30:12.980 | you know, how would you study if exercise,

00:30:15.900 | the benefits of exercise were a placebo,

00:30:17.720 | how would you even test that?

00:30:19.180 | Because, you know, what does it mean

00:30:20.920 | to give a placebo exercise?

00:30:22.620 | So we sort of flipped it on its head

00:30:23.980 | and we found a group of people

00:30:25.860 | who were getting a lot of exercise,

00:30:28.520 | but weren't aware of it, that they were, right?

00:30:31.140 | So this, we settled on a group of hotel housekeepers.

00:30:34.780 | So these were women working in hotels

00:30:38.060 | who were on their feet all day long,

00:30:40.580 | pushing carts, changing linens, climbing stairs,

00:30:44.740 | you know, cleaning bathrooms, vacuuming.

00:30:47.900 | It was clear that they were getting above and beyond

00:30:50.060 | at least the surgeon general's requirements at that time,

00:30:53.140 | which were to accumulate 30 minutes

00:30:55.580 | of moderate physical activity per day.

00:30:57.780 | But what was interesting was when we went in

00:31:00.700 | and surveyed them and asked them,

00:31:02.540 | hey, how much exercise do you think you're getting?

00:31:05.340 | A third of them said zero, like I don't get any exercise.

00:31:09.900 | And the average response was like a three

00:31:12.340 | on a scale of zero to 10.

00:31:14.220 | So it's clear that even though these women were active,

00:31:18.440 | they didn't have that mindset, right?

00:31:20.200 | They had the mindset that their work was just work,

00:31:23.760 | hard, maybe thankless work that led them to feel tired

00:31:26.980 | and, you know, in pain at the end of the day,

00:31:30.360 | but not that it was good for them,

00:31:31.960 | that it was good exercise.

00:31:33.660 | So what we did was we took these women

00:31:35.300 | and we randomized them into two groups

00:31:37.540 | and we told half of them that their work was good exercise.

00:31:42.540 | In this case, it was true factual information.

00:31:45.580 | We oriented them to the surgeon general's guidelines.

00:31:48.340 | We oriented them to the benefits that they should

00:31:50.460 | be receiving and then we had measured them previously

00:31:54.100 | on their physiological metrics like weight and body fat

00:31:58.600 | and blood pressure and we came back four weeks later

00:32:01.740 | and we tested them again.

00:32:02.980 | And what we found was that these women,

00:32:05.120 | even though they hadn't changed anything in their behavior,

00:32:08.660 | at least that was detectable to us,

00:32:10.360 | they didn't work more rooms, they didn't start, you know,

00:32:14.000 | doing pull-ups or push-ups in between cleaning hotel rooms

00:32:17.020 | as far as I'm concerned.

00:32:18.300 | They didn't report any changes in their diet,

00:32:20.640 | but they had benefits to their health.

00:32:23.740 | So they lost weight, they decreased their systolic

00:32:27.140 | blood pressure by about 10 points on average

00:32:30.100 | and they started feeling better about themselves,

00:32:33.960 | their bodies and their work, not surprisingly.

00:32:37.420 | - That's amazing.

00:32:38.620 | How should we conceptualize that result in light

00:32:42.980 | of all of our efforts to get more out of exercise, right?

00:32:47.880 | 'Cause earlier you mentioned it from the milkshake study

00:32:50.020 | and our perceptions about nutrient density that, you know,

00:32:54.120 | it's a little bit, the right message that actually

00:32:56.420 | a little bit counterintuitive that if you think,

00:32:58.640 | oh, this is very low calorie, nutrient sparse,

00:33:03.640 | then it's good for me in the context of losing weight,

00:33:05.940 | for instance, but it turns out the opposite is true

00:33:07.600 | because as you told us, the body responds differently

00:33:11.620 | when you think something is nutrient dense

00:33:13.340 | and can actually suppress hunger more.

00:33:15.080 | So in light of this result, if I were to say,

00:33:18.360 | okay, my current understanding of the literature

00:33:22.920 | is that getting somewhere between 150 and 180 minutes

00:33:26.120 | per week of cardiovascular exercise

00:33:27.780 | is probably a good idea for most people.

00:33:30.060 | If I tell myself that it's not just a good idea,

00:33:32.700 | but that it's extremely effective

00:33:34.100 | in lowering my blood pressure and maintaining healthy weight,

00:33:37.220 | et cetera, et cetera, according to these results,

00:33:39.900 | it will have an enhanced effect on those metrics.

00:33:42.460 | Is that right?

00:33:43.300 | - Definitely, so this is a really important point

00:33:45.960 | because what this reveals is that we have to be

00:33:50.020 | more thoughtful in how we go about motivating people

00:33:55.020 | to exercise or teaching people about the benefits.

00:33:58.420 | Our current approach is just to basically tell people

00:34:02.740 | writ large, you know, here's what you need to get.

00:34:05.320 | Here's what you need to get good for, you know,

00:34:06.900 | to get enough benefits to receive the, enough exercise

00:34:10.260 | to receive the health benefits.

00:34:12.000 | The problem with that approach is that most people

00:34:16.180 | aren't meeting those benefits yet

00:34:18.700 | or aren't meeting those requirements yet.

00:34:21.240 | And the risk with that is that, well,

00:34:26.240 | the intention with that is to motivate them

00:34:29.120 | 'cause, you know, public health officials think,

00:34:31.000 | well, if I just tell people you need to get more exercise

00:34:33.260 | 'cause it's good for you, they'll do it.

00:34:35.100 | We know now that that doesn't work,

00:34:36.780 | that these guidelines are not motivational.

00:34:39.560 | They don't change our behavior.

00:34:40.820 | And what our work adds to that is that not only

00:34:43.980 | is it not motivational, it also creates potentially

00:34:47.340 | a mindset that, you know, makes people worse off

00:34:52.340 | than they were without knowing about the guidelines.

00:34:55.700 | So again, it's tricky.

00:34:57.420 | I'm not saying that mindset is everything.

00:35:00.580 | Certainly exercise is good for us and use is helpful for us.

00:35:04.900 | It's one of the things we have the best data on.

00:35:07.780 | So I'm not saying, oh, exercise is all a placebo.

00:35:11.020 | What I am saying is that we need to be more mindful

00:35:13.880 | about how do we motivate people to exercise,

00:35:17.100 | but how do we help people to actually reap the benefits

00:35:19.700 | of the exercise they are already doing?

00:35:22.860 | Now, Octavia Zart, who is a grad student in my lab,

00:35:26.520 | ran a number of interesting studies along these lines.

00:35:30.780 | One in which she looked at three nationally representative

00:35:34.620 | data sets, which had this interesting question in them,

00:35:38.660 | which was how much exercise do you get relative to others?

00:35:43.580 | Do you get about the same, a little more, a lot more?

00:35:47.740 | Do you get a little less or a lot less, right?

00:35:49.860 | So, you know, the audience, your listeners,

00:35:52.040 | you could all answer this.

00:35:53.780 | And then in these data sets, what she did was she had,

00:35:57.300 | you know, pulled from data that tracked death rates

00:36:00.000 | over the next 21 years.

00:36:02.100 | And a couple of interesting things revealed themselves.

00:36:05.460 | One was that the correlations between these perceptions

00:36:09.140 | of exercise relative to others and people's actual exercise

00:36:13.120 | is measured through accelerometer data,

00:36:16.580 | as well as more rigorous sort of,

00:36:18.740 | what did you do today kind of data.

00:36:21.420 | Those don't correlate much at all.

00:36:24.060 | - People lie.

00:36:25.060 | - Well, people lie, but also-

00:36:26.060 | - Or misperceive.

00:36:27.060 | - They misperceive and, or, you know,

00:36:29.360 | who's to say it's misperceiving.

00:36:31.020 | There's just, everything's relative, right?

00:36:32.980 | If you're, I used to do triathlons very seriously.

00:36:37.100 | So if you were to ask me now,

00:36:38.320 | I feel like I'm totally inactive, right?

00:36:40.900 | 'Cause I'm not doing anything near what I used to.

00:36:42.860 | And if that's my focus set, right,

00:36:46.020 | I feel like I'm not exercising much.

00:36:49.000 | But if I think about, you know, compared to other people,

00:36:52.100 | given what I know about, you know,

00:36:53.540 | national representative statistics,

00:36:56.700 | then I could feel like, oh, I'm getting a lot, right?

00:36:59.700 | So you can see how these perceptions

00:37:02.300 | are decoupled from objective reality.

00:37:07.300 | And what we found in these studies

00:37:10.020 | is that that one question mattered,

00:37:14.220 | in some cases more than objective activity,

00:37:18.040 | but in all cases controlling for objective activity

00:37:21.020 | and predicting death rates.

00:37:22.260 | And in some, in one of those samples,

00:37:24.340 | it was a 71% higher risk of death rate, you know,

00:37:28.820 | if people rated themselves as feeling

00:37:30.620 | like they were getting less activity than others.

00:37:33.460 | - Wow.

00:37:34.300 | - So yeah. - That's a big deal.

00:37:36.380 | - It's a big deal.

00:37:37.220 | And again, you know, that study is cross-sectional,

00:37:39.700 | longitudinal, it was not experimental,

00:37:41.940 | but, you know, combined these really sort of, you know,

00:37:47.580 | coalesced to say, hey, this is important too, right?

00:37:51.780 | Like let's figure out ways to be active

00:37:54.380 | and get people active,

00:37:55.500 | but let's also not make people feel horrible

00:37:57.660 | about themselves when they're not getting enough.

00:38:00.620 | And going back to the hotel study, again,

00:38:03.180 | I mentioned that I did that at a time when I was a,

00:38:05.420 | I was a division one ice hockey player at the time.

00:38:08.100 | We were training all the time

00:38:09.860 | and I was in an unhealthy mindset about that.

00:38:13.340 | I never felt like I was getting enough.

00:38:15.160 | I would, you know, come off a two-hour practice

00:38:19.140 | into a weightlifting session

00:38:20.780 | and then I would get on the elliptical for 30 minutes

00:38:23.840 | 'cause I thought I had to do that also.

00:38:26.940 | My teammates who were with me at the time

00:38:29.060 | could attest to that.

00:38:30.380 | And so that study was really helpful for me

00:38:33.140 | to realize that I needed to pay attention

00:38:35.820 | not just to what I was doing,

00:38:37.180 | but also take care of my mindset about that.

00:38:40.300 | And I think the essence is how do you get people

00:38:43.540 | to feel like they're getting enough?

00:38:45.140 | It's a sense of enoughness that really matters.

00:38:48.060 | - Yeah, I can see the dilemma

00:38:49.100 | because you don't want people thinking that exercise

00:38:54.100 | and its positive effects are so potent

00:38:56.900 | that they can get away with a three-minute walk each day

00:39:00.560 | and that they're good because most likely they are not.

00:39:04.260 | But again, you don't want them to be so back on their heels

00:39:10.500 | psychologically that they don't even do that

00:39:12.880 | or that they never exceed that by very much.

00:39:16.480 | But it seems like the message from the milkshake study

00:39:20.180 | and what we're talking about now in terms of exercise

00:39:22.180 | would be to really communicate to the general public

00:39:25.180 | that food has a potency,

00:39:28.120 | even healthy foods have a potency to give us energy,

00:39:31.940 | to fuel our immune system and endocrine system, et cetera.

00:39:36.200 | And that exercise has a remarkable potency

00:39:38.660 | and that that potency can be enhanced

00:39:41.000 | by believing in or understanding that potency.

00:39:45.000 | Is that an accurate way to state it?

00:39:47.660 | - Totally, that's exactly right.

00:39:49.140 | And that's where I really feel like we need to push.

00:39:52.940 | And what I try to do in our research

00:39:54.760 | is to not just show, oh, mindset matters,

00:39:56.740 | isn't that interesting?

00:39:57.580 | But it's both matter, right?

00:40:01.880 | Both exercise and what you think about it matter.

00:40:04.100 | Both what you eat

00:40:05.020 | and how you think about what you eat matter.

00:40:07.540 | And so we really as individuals and as a society

00:40:10.780 | need to work on what is the right way to cultivate

00:40:15.440 | both behaviors and mindsets about those behaviors

00:40:18.700 | that serve us.

00:40:19.700 | And in the food context, this again,

00:40:22.820 | that milkshake study really changed me on a personal level

00:40:26.000 | because I had been somebody

00:40:28.580 | who was constantly trying to restrain my eating, right?

00:40:32.180 | I wanted to maintain or lose weight, look fit.

00:40:37.180 | And so I was like, well, I should diet,

00:40:39.380 | I should have low calorie, low carb, low this, low that.

00:40:42.280 | But what that was doing was putting me

00:40:44.200 | into this constant mindset of restraint.

00:40:47.640 | And what that study suggested was that that mindset

00:40:51.500 | was potentially counteracting any benefit, right?

00:40:56.500 | Or any objective effects of the restrained diet.

00:41:01.520 | 'Cause my brain was saying, okay, you're restraining,

00:41:03.940 | maybe my body was responding to that.

00:41:06.860 | But the brain was also saying, eat more food, stay hungry,

00:41:11.340 | 'cause you need to survive.

00:41:13.340 | And so the answer isn't, oh, we'll throw everything

00:41:17.240 | into the wind and just drink indulgent milkshakes

00:41:19.860 | all day long.

00:41:20.700 | The answer is eat healthy foods, right?

00:41:25.700 | Based on the latest science and what we know to be true

00:41:28.560 | about nutrients and our body's response to them.

00:41:31.340 | But try to do so in a mindset of indulgence,

00:41:34.620 | a mindset of satisfaction, a mindset of enjoyment, right?

00:41:38.300 | That is really the trick.

00:41:40.040 | And that's what I at least try to do in my own life.

00:41:43.040 | - I love that.

00:41:43.880 | And as I get more involved in the kind of public facing

00:41:46.060 | health communications, this comes up again and again.

00:41:49.900 | How should we conceptualize our behavior?

00:41:51.900 | How should we think about all these options

00:41:54.140 | that are offered to us?

00:41:55.020 | And I'm excited that the potency of mindsets

00:41:58.780 | are coming through again and again.

00:42:01.260 | So I have a question about this.

00:42:02.400 | I don't know if this study has ever been done,

00:42:04.580 | but a lot of these mindset effects

00:42:06.940 | are something that years ago I felt I did vis-a-vis sleep

00:42:11.900 | because I was in graduate school and as a postdoc,

00:42:15.220 | and even as an undergraduate, I had so much work to do

00:42:17.540 | that I decided I would sleep when I was dead in quotes.

00:42:20.920 | Not a good idea from what we know.

00:42:23.280 | However, I found that a couple nights of minimal sleep

00:42:28.220 | or even an all-nighter and I could do pretty well.

00:42:30.440 | Eventually it would catch up with me.

00:42:32.300 | Has there ever been a study exploring whether or not

00:42:34.240 | the effects of sleep deprivation can be impacted

00:42:37.460 | by these mindset effects?

00:42:39.140 | Because over the years I keep learning more and more

00:42:42.140 | about how much sleep I need and I've really emphasized sleep

00:42:44.300 | and I do feel much better when I'm getting it.

00:42:46.400 | But as new parents know, or students know,

00:42:50.780 | or athletes know, or anyone that lives a normal life

00:42:53.300 | finds sometimes that they don't get a good night's sleep.

00:42:56.740 | Would believing that we can tolerate that

00:42:58.740 | and push through it and function just fine

00:43:00.900 | and then it's not going to kill us or give us Alzheimer's,

00:43:03.660 | could that help us deal with a poor night's sleep

00:43:07.340 | or even two or chronic sleep deprivation?

00:43:10.380 | - Certainly I would guess.

00:43:12.280 | There's been one study to my knowledge that's tested

00:43:14.900 | that Dragana and colleagues and they looked at,

00:43:19.780 | they had people come in and they gave them sort of a,

00:43:22.900 | I think it was a sham sort of EEG test

00:43:26.540 | to sort of figure out how,

00:43:29.720 | this was done a number of years ago,

00:43:31.140 | now we actually have devices to test this,

00:43:33.720 | but theirs was this sham test and then they gave people

00:43:37.000 | fake feedback about the quality of their sleep

00:43:40.720 | and how it had been the night before.

00:43:43.540 | And they also asked the participants

00:43:46.880 | how they felt about their sleep.

00:43:48.500 | And essentially what they found was that the sham feedback,

00:43:53.500 | if they were told that they had gotten lower quality sleep

00:43:57.820 | led to deficits in a variety of cognitive tasks

00:44:02.300 | and that was sort of decoupled

00:44:04.940 | from their actual qualities of sleep,

00:44:07.640 | at least as self-reported.

00:44:09.280 | So that's one study that attest to this.

00:44:11.500 | I think certainly, I mean, I would bet a lot of money,

00:44:16.340 | I haven't run this myself,

00:44:17.780 | but that your mindsets can push around

00:44:20.780 | your cognitive functioning, physiological effects of sleep.

00:44:25.540 | But once again, it's not all or nothing, right?

00:44:28.540 | There are real important benefits of sleep

00:44:31.500 | and how far we can push around that through our mindset

00:44:35.360 | is an open question.

00:44:36.860 | - The result that you mentioned is really interesting

00:44:39.820 | 'cause a lot of people use these sleep trackers now,

00:44:42.100 | they're using rings or wristbands.

00:44:43.860 | In fact, my lab has worked pretty closely with a company

00:44:46.180 | they supply us data on how well people are sleeping

00:44:48.580 | and you get a score, people get the score back

00:44:51.340 | and when they see that score,

00:44:52.880 | they might think based on these results,

00:44:54.540 | oh, my sleep, my recovery score, my sleep score was poor,

00:44:57.620 | I shouldn't expect much for myself today

00:44:59.500 | or it makes sense that my memory would be going.

00:45:02.660 | For this reason,

00:45:03.500 | and I'll probably lose a few friends for saying this,

00:45:05.220 | but hopefully I'll gain a few as well.

00:45:06.620 | That's why I like to just do a subjective score for myself.

00:45:11.100 | If I wake up in the morning, I just decide,

00:45:13.020 | okay, did I sleep well or not?

00:45:14.580 | I don't like seeing a number.

00:45:15.980 | I don't like getting a readout from a device.

00:45:18.980 | That's me, I know a lot of people like it

00:45:20.660 | and they can be very useful, but gosh,

00:45:23.380 | it seems that these belief effects

00:45:24.580 | are weaving in at all levels.

00:45:26.440 | I'd love for us to talk about stress

00:45:30.100 | because your lab has worked extensively on this

00:45:33.580 | and if you would, could you tell us at some point

00:45:38.440 | about the study that you've done about informing people

00:45:40.540 | about the different effects of stress,

00:45:42.660 | but also if there's an opportunity,

00:45:45.460 | some takeaways about how we could each conceptualize stress

00:45:49.320 | in ways that would make it serve us better

00:45:52.340 | as opposed to harm us

00:45:53.580 | and our mental and physical performance.

00:45:55.660 | - Great, yeah, so I had come off the heels

00:45:58.380 | of doing some research in exercise and diet

00:46:03.700 | and finding these provocative

00:46:06.260 | and also counterintuitive effects with respect

00:46:09.580 | to how we should try to motivate people, right?

00:46:13.100 | And as I was thinking about this

00:46:16.540 | and this grouping of going from medicines to saving us,

00:46:21.540 | to behaviors to saving us

00:46:23.660 | and how those behaviors might be influenced by mindsets,

00:46:27.740 | the obvious next thing to think about was stress, right?

00:46:31.780 | 'Cause it's like, okay, well, you wanna be healthier,

00:46:33.500 | fix your diet, fix your exercise and stress less.

00:46:37.260 | And so I started doing some digging

00:46:40.140 | into the nature of stress and a couple of things were clear.

00:46:43.780 | One was that the public health message was very clear, right?

00:46:48.060 | That stress was bad, right?

00:46:50.180 | Unmitigated and harmful on our health,

00:46:55.180 | our productivity, our relationships, our fertility,

00:46:58.560 | our cognition, you name it, right?

00:47:01.860 | The messages that were out there,

00:47:04.600 | by and large oversimplified messages

00:47:07.380 | focused on the damaging consequences of stress.

00:47:11.260 | But as you know, if you actually dive deeper

00:47:13.900 | into the literature on stress and the origins of stress,

00:47:16.860 | what you find is that the literature,

00:47:19.520 | like most literatures is not so clear cut.

00:47:21.760 | And in fact, there's a large amount of evidence

00:47:24.740 | to support the fact that the experience of stress,

00:47:28.580 | meaning encountering adversity or challenge

00:47:31.240 | in one's goal-related efforts

00:47:33.360 | does not have to be debilitating.

00:47:37.320 | And in many cases, the body's response was designed

00:47:40.460 | to enhance our ability to manage at those moments, right?

00:47:44.560 | So some research showing that stress narrows our focus,

00:47:48.700 | increases our attention, speeds up the rate

00:47:51.200 | at which we're able to process information.

00:47:53.400 | There was some research out there showing this phenomenon

00:47:56.600 | of physiological toughening, the process by which

00:48:00.800 | the release of catabolic hormones and the stress response

00:48:03.680 | recruit or activate anabolic hormones,

00:48:06.120 | which help, as you know, build our muscles,

00:48:08.780 | build our neurons to help us grow and learn.

00:48:12.400 | And there was a whole body of emerging research

00:48:14.600 | on post-traumatic growth or this phenomenon

00:48:17.800 | in which even the experience of the most traumatic stressors

00:48:21.520 | and the most chronic and enduring stressors

00:48:24.420 | could lead not to destruction,

00:48:26.480 | but in fact, to the exact opposite,

00:48:28.300 | to an enhanced sense of connection with our values,

00:48:32.960 | connection to others, sense of joy and passion for living.

00:48:37.960 | And so, you know, I found that to be interesting.

00:48:42.780 | And you know, my work since then has been not to try

00:48:47.080 | to argue that stress is enhancing and not debilitating,

00:48:49.840 | but try to point out that the true nature of stress

00:48:54.040 | is a paradox.

00:48:55.040 | The true nature of stress is manifold and complex

00:48:58.680 | and lots of things can happen.

00:49:01.200 | But to question what's the role of our mindset about stress

00:49:05.240 | in shaping our response to stress.

00:49:08.240 | So some work had already been done looking at

00:49:11.700 | your perception of the stressor, right?

00:49:14.020 | So do you view a stressor like a challenging exam

00:49:17.780 | or a health diagnosis as a challenge or a threat?

00:49:20.940 | And that had shown pretty convincingly

00:49:23.800 | that when you view stressors more as a challenge,

00:49:26.280 | less as a threat, that your brain and body

00:49:29.260 | responds more adaptively.

00:49:32.680 | What our question was was to take the sort of

00:49:35.000 | psychological construal one step higher in abstraction.

00:49:38.560 | So not just the stressor, but the nature of stress, right?

00:49:42.340 | Do you, you know, at that core level,

00:49:45.140 | do you view stress as something that's bad,

00:49:48.160 | is going to kill us and therefore should be avoided?

00:49:50.760 | Or do you view stress as natural

00:49:54.080 | and something that's going to enhance us?

00:49:56.780 | And so we set out to design a series of studies

00:50:00.040 | to test the extent to which these mindsets

00:50:02.920 | about stress mattered.

00:50:04.460 | We first, this again was with Peter Salovey

00:50:08.280 | and Sean Aker originally, we designed a measure

00:50:12.080 | to test people's mindsets about stress.

00:50:14.360 | Simple questions like, what extent do you believe

00:50:18.120 | or agree or disagree with statements like,

00:50:21.020 | stress enhances my performance and productivity,

00:50:23.900 | stress heightens my vitality and growth, things like that.

00:50:28.900 | And we found in a number of correlational studies

00:50:32.000 | that that more enhancing stress mindset

00:50:34.560 | was linked to better health outcomes,

00:50:38.760 | better wellbeing and higher performance.

00:50:41.340 | So then we set out to see if we could

00:50:43.240 | change people's mindsets.

00:50:45.240 | And in our first test of this,

00:50:46.720 | we decided to do so by creating these multimedia films

00:50:50.600 | that showcased research, anecdotes, facts about stress,

00:50:55.600 | all true, but oriented towards one mindset or the other.

00:51:01.680 | So you can imagine one set of films

00:51:03.400 | showed basically the messages that were out there

00:51:06.360 | in the public health context.

00:51:07.980 | The other showed, hey, you know, stress, you know,

00:51:11.320 | stress has been linked to these things,

00:51:14.080 | but in fact, the body stress response

00:51:15.680 | was designed to do this.

00:51:16.800 | Did you know it could do that?

00:51:17.840 | And we had empowering images like LeBron James

00:51:22.080 | making the free throw in the final minute

00:51:23.960 | versus missing it, right?

00:51:25.440 | So all of these things are true, you know, possibilities,

00:51:28.720 | but oriented to two different mindsets about stress.

00:51:32.720 | - So either people saw a video that basically made it seem

00:51:35.400 | like stress will diminish you, crush you, reduce you,

00:51:38.680 | or a video, very similar, stress will grow you,

00:51:42.920 | bring out your best and maybe even take you

00:51:45.440 | to heightened levels of performance

00:51:46.960 | that you've never experienced before.

00:51:48.600 | - Exactly, exactly.

00:51:49.960 | So yeah, examples in the sports.

00:51:51.820 | We also had like true leaders emerge

00:51:54.080 | in the moments of greatest stress, you know, Churchill.

00:51:57.000 | And so all those examples are out there

00:51:59.440 | for both the enhancing nature and the debilitating nature.

00:52:02.360 | And our question was, does orienting people

00:52:05.760 | to different mindsets change how they respond to stress?

00:52:09.600 | So this study was done in the wake

00:52:11.320 | of the 2008 financial crisis.

00:52:14.460 | We worked with UBS, a company, a financial service company

00:52:19.240 | that was undergoing pretty massive amounts of layoffs.

00:52:22.320 | So these employees were stressed about being laid off.

00:52:25.660 | They were taking on more pressure.

00:52:27.480 | It was just a tough time.

00:52:29.200 | And we randomized them into three conditions.

00:52:32.760 | And this was all pre-work before getting a training

00:52:36.240 | on stress, but the three different conditions,

00:52:39.380 | some watched no videos,

00:52:41.000 | some watched the stress will crush you videos,

00:52:43.520 | and some watched the stress could enhance you videos.

00:52:47.160 | And what we found was that just, you know,

00:52:49.500 | it was a total of nine minutes of videos

00:52:51.800 | over the course of the week led to changes

00:52:54.140 | in their mindsets about stress,

00:52:56.040 | which led to changes in their physiological symptoms

00:53:00.240 | associated with stress.

00:53:01.560 | So people who watched the enhancing films

00:53:03.920 | had fewer backaches, muscle tension,

00:53:06.480 | insomnia, racing heart, and so forth.

00:53:09.920 | And they also reported performing better at work

00:53:14.020 | compared to those who watched the debilitating videos.

00:53:16.900 | Now, interestingly, we didn't make anyone worse

00:53:19.240 | with the debilitating videos, which was good.

00:53:21.960 | We had told that the IRB, we didn't expect that

00:53:25.600 | because that message was already out there.

00:53:27.960 | That's what they were already seeing.

00:53:29.280 | That wasn't new to them.

00:53:31.080 | It was more this enhancing perspective

00:53:34.000 | that turned out to be inspiring.

00:53:37.240 | - I love that study.

00:53:38.080 | And I know we both have friends and ties

00:53:41.600 | in the special operations community

00:53:43.200 | through just sort of happenstance.

00:53:45.360 | And we can, maybe we'll get into that a little later,

00:53:47.840 | but a good friend from that community always says,

00:53:50.760 | "You know, there are only three ways to go through life

00:53:53.480 | at any moment, which is either back on your heels,

00:53:55.520 | flat-footed, or forward center of mass."

00:53:57.680 | And I said, "Well, what's the key

00:53:59.040 | to forward center of mass?"

00:54:00.160 | And he said, "Stress is what places you

00:54:01.900 | in forward center of mass."

00:54:03.400 | Meaning leaning forward and into challenge.

00:54:05.480 | And I know that you've actually looked at that community

00:54:07.840 | and it does really seem like that's a mindset

00:54:10.040 | that either they have going in or that they cultivate

00:54:12.840 | through the course of their training.

00:54:15.200 | But this notion that stress is what puts us

00:54:18.260 | in forward motion is true physiologically, right?

00:54:21.760 | I mean, adrenaline's major role is to place us

00:54:23.920 | into a moment of, or bias us towards action.

00:54:26.880 | That's why we tremble.

00:54:27.700 | That's the body trying to initiate action.

00:54:30.420 | But actually, this is probably a good opportunity.

00:54:33.180 | If there's anything interesting to extract

00:54:34.780 | from the study on seal teams, what was it?

00:54:38.860 | - Yeah, no, I loved working with the seals.

00:54:41.860 | One of the interesting things we found,

00:54:45.060 | so we've studied this, measured this mindset

00:54:49.580 | in several different populations.

00:54:51.180 | And in every single one that we had tested so far,

00:54:55.340 | the average had been on the debilitating side of the scale.

00:54:58.520 | - People just saying stress is bad.

00:54:59.800 | - Stress is bad, right?

00:55:01.080 | And you know, it's like with measures of growth

00:55:05.240 | and fixed mindsets about intelligence,

00:55:07.560 | people are in the middle,

00:55:09.240 | but oftentimes have a more positive mindsets

00:55:11.480 | about intelligence.

00:55:13.040 | That was not the case with stress.

00:55:14.600 | It's still not the case.

00:55:15.900 | I'm trying to get the message out there,

00:55:17.560 | except for this group of Navy Seals

00:55:20.320 | where they were actually recruits.

00:55:22.440 | So people who were going through basic training

00:55:24.680 | in order to become Navy Seals.

00:55:26.920 | And we found that they, on average,

00:55:30.520 | had stress as enhancing mindset,

00:55:33.160 | perhaps not surprisingly, right?

00:55:34.640 | If you're going in to devote your whole life

00:55:36.600 | to being a Navy Seal, you must have some inclination

00:55:40.380 | that stress is a source of strength for you.

00:55:44.360 | But what we found with them,

00:55:45.460 | we measured this at the beginning of their basic training,

00:55:48.500 | of Bud's training, and then looked at how well they succeeded

00:55:52.760 | through that program.

00:55:53.720 | So as you know, this is an extremely rigorous program.

00:55:57.480 | You know, at the time it was only like 10 or 20%

00:56:00.320 | of trainees make it through. - It still is.

00:56:02.440 | The numbers have never shifted from about that.

00:56:05.260 | No matter how hard pressures on the community change,

00:56:08.840 | the numbers are still, on average, about 15%.

00:56:11.720 | - Yeah, wow.

00:56:12.560 | So what we found was that our measure predicted that rate.

00:56:17.080 | So people who even within that range

00:56:19.260 | had a more stress as enhancing mindset

00:56:21.040 | were more likely to complete training,

00:56:23.440 | become a Seal, they also had faster obstacle course times,

00:56:26.920 | and they were rated by their peers more positively.

00:56:30.560 | So, you know, again, let's break this down, right?

00:56:34.360 | This doesn't mean, and other people get me,

00:56:37.200 | people get this wrong sometimes.

00:56:38.640 | They think that I'm saying

00:56:40.040 | that a stress as enhancing mindset

00:56:42.520 | means you should like stress, right?

00:56:44.680 | Well, maybe Seals do. (laughs)

00:56:46.860 | But that's not what we're saying, right?

00:56:48.620 | Having a stress as enhancing mindset

00:56:50.440 | doesn't mean the stressor is a good thing, right?

00:56:53.680 | It doesn't mean it's a good thing

00:56:55.060 | that you have to go into combat and it's not pretty, right?

00:56:59.380 | It doesn't mean that getting a cancer diagnosis

00:57:02.720 | is a good thing or being in abject poverty is a good thing.

00:57:05.560 | These are not good things.

00:57:07.480 | But the experience of the stress associated with that,

00:57:10.520 | the challenge, the adversity,

00:57:12.520 | that experience can lead to enhancing outcomes

00:57:17.600 | with respect to not just our cognition,

00:57:21.040 | but our health, our performance, and our wellbeing.

00:57:24.040 | So that mindset, right, how does that work, right?

00:57:27.560 | Well, it works through a number of different pathways.

00:57:30.760 | One is that it changes fundamentally

00:57:32.940 | what we're motivated to do.

00:57:34.780 | So if you just imagine we're stressed about something,

00:57:39.000 | maybe a global pandemic, for example, for instance,

00:57:44.440 | and you think that stress is bad,

00:57:48.140 | then what's your motivation, right?

00:57:50.160 | Your motivation is to,

00:57:51.800 | well, first you get worried about the stress, right?

00:57:54.200 | Now, not only do you have the pandemic,

00:57:55.680 | you're stressed about the stress of the pandemic.

00:57:58.040 | But second is your reaction

00:57:59.480 | is typically to do one of two things.

00:58:01.000 | It's either to freak out and do everything you can

00:58:04.480 | to make sure that this doesn't affect you negatively,

00:58:07.520 | or to check out and say, oh, it's not a big deal,

00:58:10.280 | I'm not gonna deal with it.

00:58:11.480 | You're basically in denial.

00:58:12.800 | So people who have a stress-indebilitating mindset,

00:58:15.740 | and we've shown this in our research,

00:58:17.400 | tend to go to one or the other of those extremes.

00:58:19.760 | They freak out or they check out.

00:58:22.000 | Why, because if stress is bad,

00:58:23.240 | you need to either get rid of it and deal with it,

00:58:26.000 | or it needs to not exist, right?

00:58:28.240 | If you have a stress-enhancing mindset,

00:58:30.800 | the motivation changes, right?

00:58:32.400 | Then the motivation is how do I utilize the stress

00:58:36.400 | to realize the enhancing outcomes?

00:58:38.700 | What can we do here, right,

00:58:40.660 | to learn from this experience to make us stronger,

00:58:45.140 | fitter, have better science and treatments for the future,

00:58:50.000 | deepen my relationships with others,

00:58:53.000 | improve my priorities and so forth, right?

00:58:55.580 | So the motivation changes.

00:58:57.820 | The affect around it changes.

00:58:59.580 | It doesn't make it easy to deal with.

00:59:01.580 | But what we've shown in our research

00:59:03.060 | is that people who have a stress-enhancing mindset

00:59:05.740 | have more positive affect,

00:59:07.500 | not necessarily less negative affect.

00:59:11.040 | And it potentially changes physiology.

00:59:13.240 | We have a few studies that show that people

00:59:16.860 | who are inspired to adopt more enhancing mindsets

00:59:21.560 | have more moderate cortisol response,

00:59:24.240 | and they have higher levels of DHEA levels

00:59:28.060 | in response to stress.

00:59:29.280 | So more work needs to be done on the physiology,

00:59:32.080 | but I'd love your take on the mechanisms

00:59:35.600 | through which that's possible.

00:59:37.120 | - Yes, and DHEA, of course, has an anabolic hormone

00:59:40.880 | in both men and women.

00:59:42.400 | Very interesting because we had a guest on this podcast.

00:59:46.360 | He actually is a PhD scientist

00:59:48.540 | who runs the UFC Performance Training Institute.

00:59:51.800 | His name is Duncan French.

00:59:53.320 | And his graduate work at UConn Storrs was very interesting.

00:59:56.560 | It was in exercise science and physiology.

00:59:58.840 | What he showed was that

01:00:00.640 | if you could spike the adrenaline response,

01:00:03.000 | I think they did this through first-time skydive

01:00:05.000 | or something like that,

01:00:06.200 | that testosterone went up.

01:00:09.240 | Now, this spits in the face of everything

01:00:11.220 | that we're told about stress and testosterone levels, right?

01:00:15.820 | And this has also been looked at in females with estrogen,

01:00:19.640 | although, of course, there's estrogen and testosterone

01:00:22.400 | in both males and females,

01:00:23.300 | but that's how they designed the study.

01:00:24.880 | So it turns out that at least in the short term,

01:00:27.880 | that a very stressful event can raise anabolic hormones.

01:00:32.800 | And I think that people forget at a mechanistic level

01:00:35.980 | that adrenaline is epinephrine,

01:00:37.880 | and epinephrine is derived,

01:00:39.960 | biochemically derived from the molecule dopamine.

01:00:42.680 | If you look at the pathway and even just Google it

01:00:44.660 | and go images, you'll see that

01:00:46.420 | adrenaline is made from dopamine.

01:00:49.100 | And dopamine and these anabolic hormones have a very close,

01:00:52.080 | they're sort of close cousins.

01:00:53.140 | They work together in the pituitary and hypothalamus.

01:00:55.480 | So it makes sense that one could leverage stress

01:00:59.960 | toward growth and towards anabolism

01:01:03.060 | as opposed to cannibalism,

01:01:04.720 | which is not saying cannibalism as in eating other people,

01:01:07.380 | but catabolic processes is, I guess,

01:01:10.280 | the right way to refer to it.

01:01:11.760 | But what's again, remarkable to me is that

01:01:13.620 | all of these brain structures that control dopamine,

01:01:15.700 | epinephrine, testosterone, and estrogen,

01:01:18.260 | they're all thought to be in the subconscious,

01:01:19.940 | meaning below our ability to flip a switch

01:01:24.280 | and turn them on or off.

01:01:25.840 | And yet mindset seemed to impact them.

01:01:28.280 | So all that to say that there's a clear mechanistic basis

01:01:34.000 | by which this could all work.

01:01:35.800 | And so on the one hand, I'm surprised

01:01:38.760 | because these are incredible results.

01:01:40.440 | On the other hand, I'm not surprised

01:01:41.560 | because there's a physiological substrate there

01:01:43.400 | that could readily explain them.

01:01:45.300 | - Yeah, and I think figuring out exactly how it works

01:01:49.040 | is really, you know.

01:01:50.960 | - We should do that.

01:01:51.800 | - We should do that, let's do it.

01:01:53.040 | - We've got common friends in both departments,

01:01:54.800 | so we should do it, why not?

01:01:56.240 | - But I did want to mention the way I think about mindset,

01:02:00.700 | and again, I think we need to study this.

01:02:03.180 | I'm not a neuroscientist, so I haven't looked at this,

01:02:05.240 | but this is something we could do.

01:02:07.140 | But the way I think about mindset

01:02:08.880 | is that mindsets are kind of a portal

01:02:11.800 | between conscious and subconscious processes.

01:02:16.360 | They operate as a default setting of the mind, right?

01:02:20.940 | So if sort of programmed in there,

01:02:25.720 | you have stress equals bad, right?

01:02:29.500 | That is gonna be something maybe conscious, right?

01:02:34.500 | But it doesn't have to be conscious, right?

01:02:38.800 | People don't have to know their mindsets about stress

01:02:40.880 | until they're asked, really.

01:02:42.460 | That's been programmed in through our upbringing,

01:02:46.240 | through public health messages,

01:02:48.180 | and through media and other things,

01:02:50.480 | and it kind of sits there as an assumption in the brain,

01:02:53.360 | and the brain is then figuring out

01:02:56.600 | how should it respond to this situation,

01:02:59.320 | and if the assumption, the default,

01:03:01.040 | the programming is stress is bad,

01:03:04.260 | that's gonna, through our subconscious,

01:03:06.840 | trigger all the things that's like,

01:03:08.260 | okay, well, I need to rev up the things that protect me

01:03:13.260 | versus rev up the things that help me grow.

01:03:16.340 | And so that's at least how I think about it,

01:03:19.280 | and what's cool about it is that

01:03:22.020 | because it operates as a sort of portal,

01:03:24.240 | it communicates with more

01:03:26.520 | subconscious physiological processes,

01:03:28.960 | but it can also be accessed through our consciousness, right?

01:03:32.080 | So just talking about this, right, for your listeners,

01:03:36.560 | they're now invited to bring their stress mindsets

01:03:40.720 | up to the consciousness and say,

01:03:42.440 | what is my stress mindset?

01:03:44.520 | Am I thinking about stress?

01:03:46.000 | Can I reprogram that?

01:03:47.640 | Can I start to think about it as more enhancing?

01:03:51.040 | That takes a little bit of a conscious work, potentially,

01:03:54.240 | but then once you do that,

01:03:56.640 | that can kind of operate in the background,

01:03:59.080 | influencing how your body responds,

01:04:00.920 | and you don't have to say, okay, I'm stressed.

01:04:02.560 | I better tell my, you know, anabolic hormones.

01:04:05.880 | That doesn't work that way.

01:04:07.560 | - No.

01:04:08.440 | - But these mindsets can help with the translational process.

01:04:12.560 | - I love the idea that mindsets are at the interface

01:04:14.680 | between the conscious and subconscious,

01:04:16.760 | and I think there's a lot to unpack there,

01:04:20.140 | but it clearly is the case that the mindsets,

01:04:25.560 | they sort of act as heuristics, right?

01:04:27.100 | And as we talked about earlier,

01:04:29.040 | they can limit what the number of things to focus on,

01:04:31.640 | because one thing that is really stressful

01:04:33.440 | is trying to focus on everything all the time.

01:04:35.240 | I mean, trying to navigate the public health

01:04:37.000 | around anything, the public health information

01:04:39.560 | around anything is kind of overwhelming.

01:04:40.920 | As you mentioned, for stress,

01:04:42.000 | you see a lot in the stresses will crush you,

01:04:44.060 | and then you can also find evidence

01:04:45.940 | that stress will grow you.

01:04:47.360 | How should we, the listeners, think about stress?

01:04:53.480 | I mean, what's the most adaptive way to think about stress?

01:04:57.240 | And should we talk about our stress?

01:04:59.280 | Should we not talk about our stress?

01:05:01.220 | Is there a short list of ways

01:05:04.640 | that we can cope with stress better?

01:05:07.000 | Or I should be careful with the word cope.

01:05:09.140 | Is there a way that we can leverage stress to our advantage?

01:05:12.440 | - Great, yeah, and that's an important nuance

01:05:15.880 | in your language, which is people have, by and large,

01:05:19.320 | come from a place of how do you manage stress?

01:05:21.720 | How do you cope with it, which implies

01:05:24.320 | how do you fight against it?

01:05:26.280 | - Vacation, massages, yoga classes.

01:05:29.320 | - Fight against it or check out from it, right?

01:05:32.080 | And yeah, the real challenge is how do we leverage it?

01:05:35.320 | How do we utilize it?

01:05:36.640 | How do we work with it?

01:05:38.680 | And I have a lot of thoughts on this.

01:05:40.620 | The first and most important thing

01:05:42.760 | is to clarify our definition of stress.

01:05:47.320 | So I think people often associate,

01:05:50.240 | the stress mind, negative stress mindset

01:05:52.120 | is so insidious that now people define stress

01:05:57.120 | with its negative consequences.

01:06:00.560 | So the first step is to decouple that

01:06:02.660 | and to realize that stress is a neutral, right,

01:06:06.860 | yet to be determined effect of experiencing

01:06:11.960 | or anticipating adversity in your goal-related efforts.

01:06:16.880 | So let me unpack that a little more.

01:06:18.520 | You can be in the midst of it

01:06:20.520 | or you could just be worried about something happening.

01:06:23.480 | That's one aspect.

01:06:24.920 | Second is adversity or challenge,

01:06:27.200 | so something that's working against you.

01:06:29.920 | But the third piece is critical

01:06:31.520 | and that is in your goal-related efforts.

01:06:34.760 | What that means is that we only stress

01:06:37.280 | about things we care about, things that matter to us.

01:06:41.740 | So this is really important, right,

01:06:44.840 | because stress is linked with,

01:06:49.040 | it's the other side of the coin of things we care about.

01:06:53.520 | And so I think that's the first thing to realize, right,

01:06:56.960 | that as humans, we stress because we care

01:07:01.960 | and we don't stress about things we don't care about.

01:07:06.360 | So the simplified example I like to use is,

01:07:09.220 | you know, if Johnny was failing school,

01:07:12.700 | that wouldn't stress you out unless Johnny was your son

01:07:17.600 | or you were Johnny or you really cared

01:07:19.900 | about educating the Johnnies of the world, right?

01:07:22.300 | It only becomes stressful

01:07:23.700 | to the extent that you care about it.

01:07:25.860 | So why are we trying to fight or run away or hide

01:07:30.420 | or merely cope with our stress

01:07:32.100 | or, you know, overcome it through our massages

01:07:34.940 | when the stress is connected to the things we care about?

01:07:40.200 | So then the question becomes, okay, if that's true,

01:07:43.320 | how can I better utilize or leverage

01:07:47.380 | or respond to the inevitable stresses

01:07:50.780 | that we're going to experience?

01:07:52.880 | I'm not saying go out and seek out more stress.

01:07:55.560 | What I am saying is that you're gonna experience stress

01:07:57.880 | if you have any cares or values or passions

01:08:00.120 | and most all of us do.

01:08:02.160 | And so then what do you do?

01:08:05.240 | And we've developed a three-step approach

01:08:08.120 | to adopting a stress-enhancing mindset.

01:08:10.540 | And briefly, the first step is to just acknowledge

01:08:14.300 | that you're stressed, to own it, see it, be mindful of it.

01:08:19.300 | The second step is to welcome it.

01:08:22.960 | Why would you welcome it?

01:08:25.240 | You welcome it because inherently in that stress

01:08:28.760 | is something you care about.

01:08:30.300 | So you're using it as an opportunity to reconnect

01:08:32.980 | to what is it that I care about here?

01:08:35.760 | And then the third step is to utilize the stress response

01:08:39.720 | to achieve the thing that you care about,

01:08:43.120 | not spend your time, money, effort, energy

01:08:45.940 | trying to get rid of the stress.

01:08:48.740 | Does that make sense?

01:08:49.580 | - Makes sense and I love it.

01:08:51.000 | As somebody who's laboratory studies

01:08:52.360 | the physiological effects of stress,

01:08:54.260 | the effects that impress me the most are, for instance,

01:08:57.820 | the narrowing of visual attention

01:08:59.980 | that then drives a capacity to parse time more finely,

01:09:05.560 | which then drives the capacity to process information faster.

01:09:09.020 | It's almost like a superpower.

01:09:10.600 | And yes, it can feel uncomfortable often,

01:09:16.440 | but I love the idea that acknowledging it, embracing it,

01:09:21.560 | and then understanding its power and leveraging that power,

01:09:26.440 | I think is in, what I like so much about that framework

01:09:29.720 | is that the stress response is very generic.

01:09:32.520 | Unlike the relaxation response,

01:09:33.920 | we don't actually have to train up the stress response.

01:09:36.080 | So we all kind of get this as a freebie.

01:09:39.080 | And then it sounds like it's a question

01:09:40.320 | of what we end up doing with that.

01:09:41.780 | - Right, and Hans Selye, father of stress,

01:09:44.160 | said himself it's a nonspecific response, right?

01:09:47.040 | So it occurs, it's what you're doing with it.

01:09:50.100 | It's how you're channeling it.

01:09:51.720 | And yeah, like we talked about before,

01:09:53.920 | what most people do is they stress about the stress,

01:09:57.600 | which then over-exacerbates it,

01:09:59.600 | or they check out from the stress,

01:10:01.320 | which leads to depression and anhedonia,

01:10:04.080 | because by checking out from stress,

01:10:05.980 | you're also checking out from the things we care about.

01:10:08.460 | - And substance abuse. - Exactly.

01:10:09.960 | - Our colleague, Anna Lemke, who also,

01:10:11.720 | we had the good fortune of having as a guest

01:10:13.120 | on this podcast, talked a lot about this,

01:10:15.000 | that so much of substance abuse,

01:10:18.760 | because she runs the addiction clinic

01:10:20.080 | over on the med side of campus,

01:10:22.720 | it takes over people's lives

01:10:26.080 | because of this increased ability

01:10:28.920 | to find a solution to the stress

01:10:31.760 | that then eventually becomes its own stressor

01:10:33.480 | and its own problem.

01:10:34.660 | Well, I love that mindset and framework.

01:10:40.200 | I'd love for you to tell us just a bit

01:10:42.800 | about what you're up to right now

01:10:45.320 | and what's most exciting to you now.

01:10:47.120 | If you are able or willing to talk about

01:10:50.900 | some of the work that's on the way,

01:10:52.440 | I saw a brief mention of something

01:10:54.200 | on your publication's website of a paper

01:10:57.120 | about influencers, online influencers and nutrition.

01:11:00.760 | That might not be the main thrust of what you're up to,

01:11:02.560 | but if you're able to tell us about it,

01:11:04.060 | sort of interesting, given that a lot of the communication

01:11:06.520 | in and around this podcast takes place through social media,

01:11:09.440 | and I've kind of launched into this landscape now

01:11:12.800 | where I'm constantly bombarded with health information

01:11:16.440 | and influencers, a term I didn't even know until a couple-

01:11:21.440 | - You are one.

01:11:22.520 | - Well, one could argue one way or the other,

01:11:24.740 | but so what is the deal with influencers?

01:11:28.620 | Are they doing something good for health information

01:11:31.040 | or are they ruining the landscape?

01:11:33.820 | And don't try and protect my feelings.

01:11:36.180 | 'Cause I now know that stress is actually an asset.

01:11:39.800 | - Yes, well, that work is part of a body of work

01:11:44.500 | that we've been sort of venturing into,

01:11:47.420 | which is to understand where do these mindsets come from?

01:11:51.560 | Right, and I mentioned sort of public health entities

01:11:54.080 | as one source of, say, our mindsets about stress,

01:11:58.600 | but I think that our mindsets are influenced

01:12:01.340 | by four different sources.

01:12:04.320 | First is our upbringing, how our parents talked about,

01:12:08.420 | you know, things like when we're stressed

01:12:10.400 | or food or other things.

01:12:12.860 | Second is culture and media.

01:12:15.840 | So movies, you know, podcasts, and now social media.

01:12:24.000 | Third is influential others.

01:12:26.480 | So what doctors say to us or close friends or peers.

01:12:29.920 | And fourth is your conscious choice.

01:12:32.680 | So, you know, we talked about that a little.

01:12:34.920 | You do have, we have, as humans,

01:12:37.720 | have the ability to be mindful of

01:12:40.400 | and to change our mindsets.

01:12:43.140 | But, you know, the social media and influencer stuff

01:12:46.620 | has been in part an attempt to understand

01:12:49.760 | where do our mindsets about things like healthy foods

01:12:52.420 | come from, and Brad Turnwald,

01:12:54.760 | who was a former grad student in my lab,

01:12:56.560 | has done a series of really interesting studies on this,

01:12:59.340 | showing that, you know, if you rate the nutritional quality

01:13:02.800 | of the, you know, top grossing movies in the last 20 years,

01:13:07.800 | or you look at the Instagram accounts

01:13:10.180 | of all the most influential people on Instagram,

01:13:14.360 | what you, and you analyze the nutrition content

01:13:17.240 | of what they're eating.

01:13:18.800 | What he's shown is that, you know,

01:13:20.920 | depending on the study, 70 to 90% of those movies

01:13:25.440 | or influencers would fail the legal standards

01:13:29.340 | for advertising in the UK.

01:13:31.740 | So they're putting out their nutrition contents

01:13:35.400 | that are, you know, maybe not surprisingly,

01:13:37.580 | but undeniably unhealthy.

01:13:40.500 | And, you know, to me, that's interesting and important.

01:13:44.320 | It shows that where are we getting this mindset

01:13:48.280 | that, you know, those unhealthy foods

01:13:51.000 | are pleasurable, desirable.

01:13:53.400 | What's maybe even more interesting than that

01:13:55.600 | is some of the work that he and others in our lab

01:13:58.520 | have done to show that the ways people are talking

01:14:01.720 | about the foods they're eating really matter too.

01:14:04.360 | So generally what we found is that when people talk

01:14:07.980 | about unhealthy foods, they use language

01:14:12.320 | that connotes a sense of excitement, fun, sexiness,

01:14:17.800 | danger, indulgence, basically anything good and desirable.

01:14:22.560 | - This would be like cookies, cakes, high sugar.

01:14:24.760 | - Sorry, yeah.

01:14:25.600 | - Just really unhealthy.

01:14:26.440 | - Like truly unhealthy foods or, yeah,

01:14:29.320 | that's actually the objective.

01:14:32.520 | What health means is challenging,

01:14:33.980 | but yeah, high fat, high sugar.

01:14:35.600 | - I think there's pretty good agreement now

01:14:37.240 | that excessive sugar isn't good.

01:14:39.720 | - And highly processed.

01:14:40.960 | - Yeah, highly processed excessive sugar.

01:14:42.360 | I think there's general consensus.

01:14:43.720 | I'm sure someone will, if you're going to come after,

01:14:45.200 | anyone come after me, I'll stand behind that statement.

01:14:47.760 | - But on the other hand, when people are talking about,

01:14:50.600 | if they do, which, you know, healthy foods

01:14:53.160 | aren't portrayed in media, they aren't portrayed

01:14:55.400 | by influencers, rarely ever.

01:14:57.900 | And when they are, they're often talked about

01:15:00.120 | with language that conveys a sense of deprivation.

01:15:04.160 | It's, you know, it's nutritious, but it's sort of boring.

01:15:07.800 | It's bland.

01:15:08.640 | It's less tasty. - Recovery from the holidays.

01:15:10.520 | Sort of the post-holiday reset, right.

01:15:12.720 | And this is really important because, you know,

01:15:16.480 | you're doing all this work trying, you know,

01:15:18.020 | and others are doing all this work trying to inform people

01:15:21.080 | about what actually is good for them.

01:15:23.160 | And meanwhile, there's this, you know, hurricane

01:15:26.520 | of other, you know, a force that's telling people,

01:15:31.320 | that's seeping into our minds that sure,

01:15:34.380 | those might be good for you, but those foods are not fun

01:15:37.040 | or sexy or indulgent or desirable

01:15:39.340 | in any way, shape or form, right.

01:15:41.440 | And it's also paid advertising for fast foods

01:15:45.680 | and sugary beverages and other things.

01:15:47.640 | So, it's not surprising that we have this mindset

01:15:52.080 | that healthy foods are the less desirable thing to eat

01:15:55.120 | because of those cultural and social forces.

01:15:58.140 | What our work has just tried to do is to reveal that,

01:16:01.780 | you know, quantify it as a way to say,

01:16:04.720 | all right, let's maybe be a little bit more mindful

01:16:06.880 | about how we talk about healthy foods.

01:16:09.480 | And could, you know, if you're a movie producer,

01:16:12.280 | can you be a little bit more mindful to showcase

01:16:15.440 | healthy and delicious foods and have the characters

01:16:17.840 | talk about them in ways that are more appealing?

01:16:20.540 | There's a lot of room for people who produce this content

01:16:25.360 | to have an impact, not just on, you know, what people do,

01:16:28.900 | but what they think about the foods they're eating.

01:16:31.820 | - It's really interesting.

01:16:32.700 | I hadn't thought about it until now,

01:16:35.340 | but it makes sense that any food that's packaged

01:16:37.400 | and can be sold can be woven into a film

01:16:40.560 | or promoted by a celebrity influencer,

01:16:44.340 | not a health influencer per se,

01:16:46.940 | but a celebrity influencer because they'll get paid, right?

01:16:49.680 | It's part of the ecosystem that allows them an income

01:16:53.200 | and it feeds back on sales to the company.

01:16:55.680 | And whereas things that can't be commoditized,

01:16:59.940 | it's more difficult, right?

01:17:02.200 | It's hard to, whoever makes oranges and sells oranges

01:17:07.120 | is unlikely to promote oranges in a celebrity post

01:17:11.480 | or in a movie because oranges can be purchased

01:17:13.600 | from many, many sources.

01:17:15.040 | There's no identifiable source of oranges

01:17:18.380 | as there is with a packaged food, for instance.

01:17:20.960 | - Yeah, but the interesting thing we found in those studies

01:17:23.360 | is that it wasn't driven by promoted content

01:17:27.480 | or branded content.

01:17:29.040 | There's some of that, certainly.

01:17:30.560 | And yeah, all of the promoted and branded content

01:17:34.420 | is usually for processed high-sugar foods.

01:17:37.180 | But 90% or more of these foods that they were showing

01:17:41.340 | were not promoted or branded.

01:17:43.240 | And so there's a lot of flexibility in what, you know,

01:17:48.240 | these producers or influencers could show on their media.

01:17:52.580 | Although it goes both ways, right?

01:17:54.120 | It's not just the producers

01:17:56.200 | and the influencers' responsibility.

01:17:58.980 | The public is reacting to this.

01:18:00.660 | And we showed, too, that people respond more positively.

01:18:05.520 | There are more likes on posts about unhealthy foods.

01:18:10.080 | So it's a, yeah, it's a sort of a distasteful

01:18:15.080 | and, you know, it's a distasteful culture

01:18:19.480 | around healthy eating.

01:18:20.560 | And we really have a lot to do to change it.

01:18:23.160 | - Yeah, well, it's dopamine circuits through and through.

01:18:25.640 | Just the sight of some very calorie-dense,

01:18:28.880 | extremely tasty food drives those dopamine circuits.

01:18:33.880 | And I realize that there are people out there

01:18:38.240 | who derive the same sort of or similar levels of pleasure

01:18:42.040 | from healthy foods.

01:18:42.880 | And that's a wonderful thing if one can accomplish that.

01:18:44.640 | So we just need more of that is what it sounds like.

01:18:46.960 | - Yeah, exactly.

01:18:47.800 | And that's what's really inspiring to me, at least,

01:18:49.760 | is that it is possible, right?

01:18:53.200 | I mean, people think, oh, well,

01:18:54.200 | vegetables are just inherently less tasty than ice cream.

01:18:57.240 | And it's like, well, that's not necessarily true.

01:18:59.600 | Also, it doesn't have to be a competition, right?

01:19:01.640 | I don't have to get my three-year-old to hate ice cream

01:19:05.200 | in order for her to like broccoli.

01:19:07.640 | There's a lot more I can be doing to help shape

01:19:10.040 | a more positive approach-oriented, indulgent mindset

01:19:14.120 | around healthy, nutritious vegetables and fruits

01:19:18.640 | and other foods, right?

01:19:20.440 | In addition to having her like ice cream, right?

01:19:22.600 | And that's totally fine.

01:19:23.840 | - Sounds like a really interesting study.

01:19:25.120 | When it's published, will you let me know and I'll-

01:19:27.000 | - Yeah, I think it was actually released this week.

01:19:28.920 | - Oh, great.

01:19:29.760 | I will be sure to-

01:19:30.600 | - In JAMA Internal Medicine.

01:19:31.960 | - JAMA Internal, okay.

01:19:33.840 | Great journal.

01:19:34.680 | I will definitely talk about it on social media

01:19:37.960 | and elsewhere.

01:19:40.000 | Sounds very interesting.

01:19:41.040 | What else are you up to lately that's,

01:19:42.980 | my favorite question to ask any scientist or colleague,

01:19:45.240 | by the way, is what are you most excited about lately?

01:19:47.920 | What are you up late thinking about

01:19:51.520 | and getting up early thinking about?

01:19:53.360 | - Yeah, so hands down the thing I'm most excited,

01:19:56.160 | well, I guess there's so many things.

01:19:58.520 | The thing that I'm most into right now,

01:20:01.120 | we're doing the most work in,

01:20:02.160 | is I started by getting inspired

01:20:04.840 | by placebo effects in medicine.

01:20:07.160 | I did a long stint in placebo or belief-like effects

01:20:11.240 | in behavioral health.

01:20:12.680 | And now we're moving back into medicine.

01:20:15.480 | So I'm really interested in looking at how we can work

01:20:18.960 | with active drugs and treatments to make them better

01:20:24.000 | and make the experience of them better

01:20:26.200 | by instilling different mindsets.

01:20:29.200 | So one study we did along those lines,

01:20:31.360 | we worked with kids undergoing treatment for food allergies,

01:20:36.360 | so allergies to peanuts, for example.

01:20:38.760 | This was with Kari Nadeau,

01:20:40.140 | who's the head of the Stanford Allergy Center here.

01:20:42.640 | She has a great treatment for food allergies.

01:20:45.520 | Basically, kids take gradually increasing doses

01:20:48.600 | of the thing they're allergic to, like peanuts.

01:20:51.880 | And over the course of six or seven months,

01:20:54.560 | these kids become less reactive to peanuts.

01:20:59.560 | And the problem with that treatment

01:21:01.800 | is it's really difficult

01:21:05.200 | because they're having all sorts of negative symptoms

01:21:08.160 | and side effects.

01:21:09.420 | These kids are getting itchy mouths and upset stomach,

01:21:12.800 | they're puking, and it's scary

01:21:14.940 | because they're literally eating the thing

01:21:17.640 | that they've been told might kill them, right?

01:21:20.200 | And what we did in the study

01:21:21.960 | was we attempted to improve the experience

01:21:24.560 | and outcomes of that by reframing mindsets

01:21:28.880 | about the symptoms and the side effects.

01:21:31.560 | So as it was being conducted before,

01:21:34.200 | the kids were told, "Look, these side effects

01:21:36.940 | "are just an unfortunate byproduct of this treatment,

01:21:40.800 | "and you have to sort of endure them to get through it."

01:21:44.000 | But what we found in our conversation with Kari

01:21:46.280 | was that the reality of those side effects

01:21:49.120 | was not so negative.

01:21:50.640 | In fact, they were mechanistically linked

01:21:54.760 | to the body learning how to tolerate peanuts

01:21:57.980 | or the allergen.

01:21:59.280 | And so what we did was we worked within a trial,

01:22:02.740 | they were all getting the treatment,

01:22:04.640 | but half of them helped to see this more positive mindset,

01:22:09.240 | that symptoms and side effects from this treatment

01:22:12.240 | were a positive signal that the treatment was working

01:22:15.480 | and their bodies were getting stronger.

01:22:17.840 | And what we found was that that mindset led to reductions

01:22:21.240 | in anxiety, fewer symptoms when at the highest doses,

01:22:25.960 | and most interestingly of all, they had better outcomes.

01:22:30.080 | So based on immune markers

01:22:32.260 | that were a sign of the allergic tolerance,

01:22:34.640 | those who had this mindset throughout

01:22:36.280 | had better outcomes to the treatment.

01:22:38.640 | So that's just one example.

01:22:40.120 | I think my goal is really to move us

01:22:42.960 | beyond the placebo versus drug mindset,

01:22:47.760 | versus behavior to get to a place

01:22:51.380 | where we can blend them together

01:22:53.160 | and maximize the benefit of these treatments.

01:22:56.040 | So we're doing a lot of studies like that,

01:22:59.040 | how can we improve treatment for cancer

01:23:01.800 | with different mindsets.

01:23:03.480 | We've done some work recently with the COVID-19 vaccine

01:23:07.600 | and symptoms and side effects.

01:23:10.320 | So that's what I'm really passionate about right now.

01:23:13.320 | - Incredible.

01:23:15.640 | I can't wait to read that study.

01:23:16.800 | Is that one out or on the way?

01:23:18.960 | Okay, well then I will also read and communicate with you

01:23:22.760 | and then about that study.

01:23:23.760 | Who knows, maybe you would come on Instagram

01:23:25.320 | and do a little Instagram live

01:23:27.620 | to make sure that I don't screw up the delivery

01:23:31.000 | and that we can hear it direct

01:23:32.560 | from the person who ran the study.

01:23:34.380 | I find this issue of side effects really interesting.

01:23:38.400 | I don't take a lot of prescription drugs,

01:23:40.160 | but recently I was prescribed a few

01:23:42.900 | and the list of side effects is, it's incredible.

01:23:47.700 | And it just goes on and on and on.

01:23:49.260 | I realized some of that is legal protections.

01:23:51.340 | It's hard for me to believe

01:23:52.180 | that they're actually expecting anyone to read those

01:23:54.460 | because you need a high powered microscope

01:23:57.000 | to read this print, it's truly fine print.

01:23:59.480 | But I did realize that in reading over the side effects

01:24:02.640 | that you prime, one primes themselves

01:24:05.620 | to experience those side effects.

01:24:07.300 | And so now I just rip up the side effects thing

01:24:09.420 | and or the sheet and just throw it away.

01:24:11.380 | I just take it as recommended.

01:24:12.900 | Do you think it works in the other direction too?

01:24:16.460 | Where if an effective medication

01:24:19.860 | is supposed to have result A, B, or C,

01:24:23.700 | and you are told again and again

01:24:26.020 | how effective it is for that treatment,

01:24:27.980 | that it could amplify the effect.

01:24:29.860 | So in other words, it's not strictly a placebo.

01:24:33.080 | It's not nocebo as you described before,

01:24:35.580 | but that perhaps at a lower dose,

01:24:38.100 | a given medication could have a amplified effect.

01:24:41.340 | Or at a appropriate dose, if you will,

01:24:44.220 | it could have a super physiological effect.

01:24:46.620 | Has that ever been demonstrated?

01:24:48.220 | To some degree.

01:24:50.580 | I think where it gets tricky is for a long time,

01:24:53.300 | people thought the effects of placebos

01:24:55.260 | were expectancy based.

01:24:57.060 | So you expect to get a benefit and that benefit occurs.

01:25:02.060 | There's certainly some truth to that.

01:25:04.940 | But I think the mindset approach is more powerful

01:25:08.060 | because it helps us understand the mechanisms, right?

01:25:10.960 | So if you just expect that your blood pressure will go down,

01:25:15.720 | what are the mechanisms through which that expectation

01:25:21.100 | would lead to your blood pressure going down?

01:25:23.220 | It's hard to even understand that, right?

01:25:26.280 | But if you have the mindset that you're in good hands,

01:25:31.280 | that this is being taken care of,

01:25:34.760 | that this illness is not going to kill you, right?

01:25:39.460 | That you're being treated well.

01:25:41.880 | Then you can start to unpack the mechanisms

01:25:45.280 | through which blood pressure could be relieved.

01:25:47.020 | Maybe it's anxiety reduction.

01:25:49.560 | Maybe it's changing the sort of anticipation

01:25:53.920 | or the prioritization of what the body needs to focus on.

01:25:57.820 | And so I really think that the work of the future

01:26:01.920 | needs to be on getting more sophisticated

01:26:04.340 | about what is the mindset that we're instilling

01:26:07.500 | when we say something will work or it won't work?

01:26:09.580 | And how do we understand the mechanisms

01:26:12.260 | through which that changes physiology?

01:26:14.740 | So to answer your question, I think that that could be true,

01:26:17.500 | but it depends on what actually is the mindset

01:26:20.160 | you're evoking.

01:26:21.000 | - I know you're a parent and to the other parents out there,

01:26:25.940 | but also to kids and people who don't have kids,

01:26:28.700 | what is the best way to learn and teach mindsets?

01:26:32.040 | I mean, clearly a conversation like this informs me

01:26:34.980 | and many other people out there about mindsets

01:26:37.700 | and how we can adopt them.

01:26:39.260 | But it also seems to me that if we have the opportunity

01:26:43.780 | to teach mindsets and really cultivate certain mindsets,

01:26:47.240 | that the world would be a much better place.

01:26:50.260 | How does one go about that?

01:26:51.860 | Given that we're kids and we are all being bombarded

01:26:54.900 | with conflicting information all the time,

01:26:56.580 | how do we anchor to a mindset?

01:26:58.460 | - Yeah, and you're getting at my other major passion

01:27:04.340 | right now, which is what we're calling in our lab,

01:27:07.060 | meta mindset, I'm working on this with Chris Evans

01:27:10.420 | and others, and that is how do we consciously

01:27:14.260 | and deliberately change our mindsets?

01:27:17.120 | And the first step is really simple,

01:27:20.060 | and that's just to be aware that you have them,

01:27:22.800 | that the world, your beliefs aren't sort of

01:27:25.980 | an unmitigated reflection of reality as it objectively is.

01:27:30.260 | They are filtered through our interpretations,

01:27:32.860 | our expectations, our frameworks,

01:27:36.100 | and simplifications of that reality.

01:27:38.540 | And as your work and as you know so well,

01:27:42.420 | most of what goes on in our brain

01:27:45.080 | is an interpretation of reality.

01:27:47.700 | Mindsets are just the simplified core assumptions

01:27:50.560 | about things, and the first step

01:27:53.980 | is to realize that we have them.

01:27:56.180 | The second step is to start to think about

01:27:59.260 | what the effects of those mindsets are on your life

01:28:02.300 | to sort of play out the story, right?

01:28:04.220 | Okay, I have this mindset that stress is debilitating.

01:28:07.580 | How is that making me feel?

01:28:10.100 | What is that leading me to do?

01:28:11.700 | Is this mindset helpful or harmful?

01:28:15.000 | The question isn't is the mindset right or wrong,

01:28:17.260 | 'cause you can find evidence for or against it.

01:28:20.220 | We can fight about it 'til we're exhausted.

01:28:23.220 | The question is is it helpful or harmful?

01:28:26.980 | And then you can go about seeking out ways

01:28:31.080 | to adopt more useful mindsets.

01:28:34.900 | So we've been doing a lot of work

01:28:36.960 | on how to actually do that.

01:28:38.300 | How do you consciously change it?

01:28:39.980 | Sometimes it's really simple, I think,

01:28:42.740 | in cases where we don't have a lot of prior experience,

01:28:45.220 | like the kids with allergies who are getting treatment.

01:28:50.220 | They didn't have any other mindsets about symptoms,

01:28:53.900 | so we just had the luxury of setting it, right?

01:28:57.080 | When it comes to healthy food,

01:28:58.700 | I think it's harder to change people's mindsets

01:29:01.500 | 'cause we have a lot of baggage weighing us down.

01:29:04.140 | As a parent, for me, I guess my number one piece of advice

01:29:09.960 | is to lighten up trying to get your kids

01:29:14.300 | to do certain things and focus more on helping them

01:29:18.980 | to adopt more adaptive mindsets.

01:29:22.080 | So I'm by no means an expert at this,

01:29:25.480 | but I'm testing it with my own child.

01:29:27.820 | - In real time, the real kind of experiment.

01:29:31.460 | - It's how do I resist the urge

01:29:34.900 | to force my child to eat her dinner

01:29:37.280 | so that she can have her dessert, right?

01:29:39.740 | 'Cause that's the real urge.

01:29:40.940 | It's like, no, you need to do that.

01:29:42.960 | Because when you start thinking about it

01:29:44.980 | in terms of mindset, you realize,

01:29:47.760 | oh, that's just reinforcing to her

01:29:50.300 | that the dessert is the exciting, fun thing to have.

01:29:53.560 | And this thing that I have to do must be horrible,

01:29:56.300 | so horrible that my parent is forcing me to do it, right?

01:30:00.420 | So it's letting go a little bit of the behavior,

01:30:04.620 | the objective reality,

01:30:05.940 | and really thinking about the subjective reality

01:30:09.420 | and focusing on adaptive mindsets.

01:30:12.800 | So my goal as a parent has been to try to help her

01:30:16.660 | instill a healthy mindset about eating,

01:30:19.620 | that healthy foods are indulgent and delicious,

01:30:22.620 | that the experience of stress is inevitable,

01:30:25.580 | that it's natural and that it can help,

01:30:29.220 | going through stressful experience can help her learn, grow,

01:30:32.540 | and become a more connected and happier individual.

01:30:36.100 | And with exercise and physical activity,

01:30:39.380 | we haven't really gotten to that yet,

01:30:40.740 | but we will with time.

01:30:43.140 | - Yeah, it's great.

01:30:44.260 | I wrote down, and I'm going to keep this

01:30:45.920 | in the front of my mind going forward,

01:30:48.580 | to continually ask what is the effect

01:30:50.740 | of my mindset about X?

01:30:52.620 | And just to evaluate that about exercise,

01:30:54.820 | about food, about school, about stress, about relationships,

01:30:57.540 | about relationship to self, et cetera,

01:31:00.060 | and to really think about that in a series of layers.

01:31:03.180 | You think that would be a useful exercise?

01:31:05.180 | - Definitely.

01:31:06.020 | And you know, and your work speaks to the,

01:31:08.020 | I mean, the mindful, it's not, I would, yeah,

01:31:11.420 | really urge against people getting dogmatic

01:31:15.340 | about their mindset also, right?

01:31:16.780 | Like, oh, I need to have the right mindset.

01:31:18.380 | Or, and if I don't have the right mind, you know,

01:31:19.740 | it's like, okay, mindset is a piece of the puzzle.

01:31:22.980 | It's a piece of the puzzle that's really empowering

01:31:26.380 | because we have access to it and we can change it.

01:31:29.340 | But it is just one piece of a puzzle.

01:31:31.180 | So treat yourself like a scientist.

01:31:33.180 | Look at your life, look at your mindsets,

01:31:35.420 | see what's serving you, see what isn't.

01:31:38.420 | Find more useful, adaptive, and empowering mindsets

01:31:42.260 | and live by those.

01:31:45.700 | - I love it.

01:31:46.700 | Now, in one version of this kind of discussion,

01:31:50.740 | I would have asked the question I'm gonna ask next

01:31:53.420 | at the beginning, but I'm going to ask it now close

01:31:57.180 | to the end, which is you're a unique constellation

01:32:00.260 | of accomplishments and attributes.

01:32:03.620 | And I only know a subset of them, of course,

01:32:06.100 | 'cause today's the first time that we've met in person,

01:32:08.260 | even though I've known your work for a long time

01:32:09.780 | and we're colleagues across campus.

01:32:11.740 | So you run your laboratory where you do research.

01:32:15.860 | You were also an athlete in university, a serious athlete.

01:32:20.420 | And then you're also a clinical psychologist.

01:32:22.580 | Is that right?

01:32:23.860 | - I was trained as a clinical psychologist.

01:32:25.580 | So my PhD is in clinical psychology and I did, you know,

01:32:29.820 | all my pre and post internships with stress and trauma.

01:32:34.820 | - Do you see patients or did you see patients at that time?

01:32:37.340 | - I did, yes, I don't anymore.

01:32:39.300 | - Okay, that's a very unique constellation

01:32:41.500 | of practitioner and researcher.

01:32:43.580 | So what are the mindsets that you try and adopt

01:32:49.020 | on a regular basis as a consequence

01:32:51.940 | or in relation to those things,

01:32:53.460 | sort of athlete, researcher, clinician?

01:32:56.180 | You know, for yourself, as you move through life,

01:32:58.420 | do you have an overarching mindset

01:33:01.500 | that all challenge is good,

01:33:04.140 | or do you have any kind of central mindsets

01:33:06.820 | that help you navigate through, you know,

01:33:09.860 | has to be a pretty complex set of daily routines

01:33:12.900 | given everything that you juggle.

01:33:14.500 | But I think that people like you are unique

01:33:17.420 | in that you have the inside knowledge

01:33:20.180 | of how this stuff works,

01:33:22.060 | and you've also existed in these different domains.

01:33:24.300 | And I know a lot of listeners have a more athletic slant

01:33:28.900 | to their life or a more cognitive,

01:33:30.940 | or some are raising kids, or some people are just,

01:33:32.740 | you know, are doing any number of things.

01:33:34.980 | So this is where I think it would be useful

01:33:36.460 | for people to hear, what do you do?

01:33:38.540 | This is what I'm asking.

01:33:39.980 | - Yeah, well, it's certainly true in my case

01:33:42.380 | that research is me-search, right?

01:33:45.260 | Everything that I study as an intellectual

01:33:48.980 | has come from my own experience or my own failings, right?

01:33:53.260 | And when I was, you know,

01:33:55.620 | really intensely exercising and training,

01:33:59.820 | those were the questions I asked

01:34:01.820 | when I was dealing with eating

01:34:03.780 | and, you know, concerns about my weight.

01:34:06.260 | Those were the questions I asked

01:34:07.700 | when I was stressed about my dissertation.

01:34:10.940 | I decided to do my dissertation on stress, right?

01:34:13.580 | You know, now I think we're in the midst

01:34:15.580 | of a global pandemic.

01:34:17.260 | It's, you know, how can our mindsets be useful here?

01:34:22.260 | You know, so I don't think there's a obvious answer

01:34:26.500 | to your question other than the guiding light for me

01:34:30.700 | has been an undercurrent of understanding

01:34:35.140 | that our mindsets matter.

01:34:36.140 | I think I got that very clearly and deeply as a child,

01:34:40.060 | both through my experiences as an athlete, you know,

01:34:43.980 | I know many of your listeners are athletes.

01:34:45.940 | Any athlete knows that you can be the same physical being

01:34:49.540 | from one day to the next, one moment to the next,

01:34:52.060 | and perform completely differently

01:34:54.940 | just depending on what you're thinking.

01:34:57.020 | I was a gymnast growing up, and if you can't visualize,

01:35:00.980 | if you can't see something in your mind,

01:35:02.580 | you have no chance when you get up there

01:35:04.520 | on the balance beam, right?

01:35:05.860 | And I also, my father was a martial artist,

01:35:08.540 | a teacher of meditation,

01:35:09.740 | so this kind of mind-body work was baked into me

01:35:13.740 | from an early age, and I think what I've done recently

01:35:17.020 | is to try to understand it scientifically,

01:35:19.960 | and more importantly, to figure out

01:35:23.340 | how can we do better with this, right?

01:35:26.540 | How can we, you know, we're all talking about AI

01:35:29.380 | taking over the world, and technology this,

01:35:31.640 | and personalized medicine that, and it's like,

01:35:34.240 | we have done so little, relatively so little,

01:35:38.580 | with the human resource, our human brains,

01:35:43.340 | that the, you know, the potential for which is so great,

01:35:48.340 | and we've done almost nothing, you know?

01:35:51.380 | Take the placebo effect, we know a lot about what it is,

01:35:55.460 | we've done almost nothing to leverage that in medicine,

01:35:59.060 | consciously and deliberately.

01:36:00.800 | So my, what keeps me going,

01:36:04.540 | what gets me through the hard times

01:36:06.080 | is just that burning question of what is going on here,

01:36:09.680 | and what more can I do with the power of my mind?

01:36:13.080 | - Well, I and millions of other people

01:36:16.120 | are so grateful that you do this work.

01:36:17.640 | It's so important, and it's truly unique.

01:36:20.160 | Tell us where people can learn more about your research,

01:36:22.940 | where they can find you online.

01:36:24.500 | I'm gonna try and persuade you

01:36:25.600 | to take more of a social media presence going forward,

01:36:29.380 | but whether or not I succeed in that effort or not,

01:36:32.160 | where can people find you?

01:36:34.040 | Ask questions, find your papers, learn more.

01:36:37.360 | I'd love to have you back for a conversation in the future,

01:36:39.700 | but in the meantime.

01:36:41.060 | - Yeah, no, it's really,

01:36:42.120 | it's been such an honor getting to chat with you.

01:36:44.300 | I'm just, you have such an impact on the world,

01:36:47.240 | and I look forward,

01:36:48.080 | I hope we can do some science together also.

01:36:49.900 | - Absolutely, absolutely.

01:36:51.040 | - Yeah, all our papers and materials and interventions

01:36:55.540 | are housed on our website, mbl.stanford.edu.

01:37:01.480 | We also have a link there that takes you to Stanford SPARK,

01:37:04.800 | which stands for social psychological answers

01:37:07.520 | to real world questions.

01:37:08.920 | We have a lot of toolkits on that website,

01:37:12.640 | including a toolkit for this rethink stress approach

01:37:16.140 | of acknowledging, welcoming, and utilizing your stress.

01:37:20.480 | And then I guess I'm on Twitter, oleacross.

01:37:24.840 | I don't do much there, but maybe I will start too.

01:37:28.080 | - Well, those are all great resources.

01:37:29.280 | We will provide links to all of those

01:37:31.080 | for our listeners and viewers.

01:37:32.920 | And I also hope to convince you to write a book

01:37:37.020 | or many books in the future.

01:37:38.760 | The world needs to know about this,

01:37:40.100 | but thank you so much for taking time

01:37:42.800 | out of your exceedingly busy schedule

01:37:44.680 | to talk to us about these ideas.

01:37:46.600 | I learned so much.

01:37:47.480 | I'm going to definitely think about

01:37:49.600 | what is the effect of my mindset about blank

01:37:52.280 | in every category of life,

01:37:54.340 | and really just on behalf of everybody and myself.

01:37:57.940 | Thank you so much.

01:37:59.280 | - Yeah, thank you.

01:38:00.120 | And I guess I just want to end by saying,

01:38:01.960 | I think this work is really the tip of the iceberg

01:38:04.960 | of what can and should be done.

01:38:07.080 | And so I really invite you, your listeners,

01:38:10.780 | and anybody who's inspired by this work,

01:38:13.760 | if they want to share stories

01:38:15.540 | or want to partner on a collaboration to please reach out.

01:38:20.360 | - Great, well, and the comments section on YouTube

01:38:22.200 | is a great place to do that as well.

01:38:24.680 | You will hear from them.

01:38:25.760 | - Great.

01:38:26.600 | - All right, great.

01:38:27.420 | Thank you so much, Allie.

01:38:28.320 | - Thank you.

01:38:30.080 | - Thank you for joining me

01:38:30.940 | for my conversation with Dr. Alia Crum.

01:38:33.020 | I'm guessing by now you can appreciate the enormous impact

01:38:37.400 | that mindsets have on our biology and our psychology

01:38:40.720 | and how those interact at the level of mind and body.

01:38:44.520 | If you'd like to learn more about Dr. Crum's work

01:38:46.760 | and perhaps even be a research subject

01:38:48.960 | in one of their upcoming studies on mindsets,

01:38:51.520 | you can go to mbl.stanford.edu.

01:38:55.080 | There you will also see a tab for support

01:38:57.960 | where if you like, you can make a tax deductible donation

01:39:01.080 | to support the incredible research

01:39:02.800 | that Dr. Crum and her colleagues are doing.

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01:39:50.440 | And there I teach neuroscience in short form,

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01:40:01.380 | On previous episodes of the Huberman Lab Podcast,

01:40:03.860 | I often discuss supplements.

01:40:05.380 | While supplements aren't necessary or used by everybody,

01:40:08.380 | many people derive tremendous benefit from them.

01:40:11.180 | An important consideration when using supplements

01:40:13.140 | is that they be sourced from the highest quality sources.

01:40:16.440 | For that reason, we partner with Thorne, T-H-O-R-N-E,

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01:40:21.980 | and the greatest degree of precision

01:40:23.680 | in terms of what's listed on the bottle

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01:40:27.800 | And that is not true for all supplement companies.

01:40:29.640 | If you'd like to see the supplements that I take,

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01:40:36.180 | and you can get 20% off any of those supplements.

01:40:39.640 | In addition, if you navigate into the Thorne site

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01:40:45.120 | you can also get 20% off any of the other supplements

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01:40:49.000 | In closing, I'd like to thank you once again

01:40:50.640 | for joining me for my discussion about mindsets

01:40:52.960 | with Dr. Alia Crum.

01:40:54.680 | And as always, thank you for your interest in science.

01:40:57.480 | [upbeat music]

01:41:00.060 | (upbeat music)

Dr. Alia Crum: Science of Mindsets for Health & Performance | Huberman Lab Podcast #56

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