Judson Brewer, author of The Craving Mind: From Cigarettes to Smartphones to Love – Why We Get Hooked, & How We Can Break Bad Habits – kept his meditation practice and medical career separate for a decade. Luckily for us, it eventually dawned on him to inform his research and clinical practice with the 2500-year-old insights of Buddhism.
As he dove deep into the dynamics of addiction, he noticed that the primary western model for understanding human learning – BF Skinner's operant conditioning – was simply another way of describing the Buddhist concept of dependent generation. That is, humans, like all organisms, survived because they learned to associate certain triggers with behaviors that produced a reward that conveyed survival benefit.
As in, see a fruit tree, eat the fruit, get a dopamine rush to the brain to signify, “This is good; let's remember it.” And repeat, with each loop reinforcing the lesson.
This was fine as long as our environment rewarded behaviors that increased our wellbeing: eating, mating, resting, finding warm and dry shelter, etc.
But along the way, we grew these big brains that complicated things. We remembered that high-calorie food made us feel good, so we turned to food to ease our bad moods even when we weren't hungry. And as we created new ways to get dopamine (drugs, alcohol, compelling technologies), our minds leveraged this learning loop into craving and addiction.
Once Brewer noticed the similarities between operant conditioning and the Buddhist model of human craving and suffering, he wondered if the Buddhist practice of mindfulness could be a tool to decouple craving from behavior. Armed with the latest real-time neurofeedback and fMRI technologies, his lab studied brains that craved and brains that had overcome cravings. Brains that had been meditating for years, and brains that had just started meditating. Brains that were struggling to meditate, and brains that received feedback on how well they were meditating.
And armed with this data, Brewer and his team at the Center for Mindfulness at the University of Massachusetts Medical School crafted interventions that were staggeringly effective in helping participants overcome their addictions.
Now Brewer is making these interventions widely available, convenient, and affordable via smartphone apps that target emotional eating, smoking, and anxiety.
In our thoroughly enjoyable (to me, at least) conversation, we covered:
- why he started meditating
- discovering a long list of personal addictions (including all the socially acceptable ones)
- the three components of habit
- why are brains are the same as sea slugs'
- traditional strategies of habit change, and their weaknesses
- the delay discounting disaster: why we don't care about future consequences
- how to hack the reward-based learning system through ancient wisdom
- why the pre-frontal cortex can't be trusted
- the blissful sensation of flow, and how we get in our own way
- the excitement paradox: why it feels kind of good and bad
- and much more…
Enjoy, add your voice to the conversation via the comment box below, and please share – that's how we spread our message and spread our roots.
The Craving Mind – on amazon
Big thanks to Ashley Corcoran for transcribing this episode. You can download the PDF here.
HOWARD: Judson Brewer, welcome to the Plant Yourself Podcast!
JUDSON: Thanks for having me.
HOWARD: I'm so excited to have this conversation about mindfulness, largely, as we were talking about before we started recording, for my own selfish purposes, but also because I think this set of techniques and understanding is really a huge missing link for people who are struggling to change their habits and behaviors. So, I'm really looking forward to this conversation.
HOWARD: Let's start with you and your background and how you got into this. On paper, you're a psychiatrist, which is, you know, I don't usually talk to psychiatrists, um..
JUDSON: [laughs] That’s a good thing.
HOWARD: It was just the imaginary ones... [laughs]. No, I mean, the psychiatric model of serotonin imbalances and all that doesn't really jive with my view of the world, but like-what's your trajectory to your own interests in addiction medicine and in applying mindfulness, and really, an ancient Buddhist wisdom to this topic. So how did you get to where you are?
JUDSON: Well it’s been a “long and winding road”, as the song goes. It really started when I had gone through a bad relationship breakup right before starting medical school, so you know, pretty "Type A" in college and I was brainwashed to, you know, marry someone from my university [laughs]. So, I was engaged to be married and then we broke up right before I started medical school and was having trouble sleeping for the first time, probably in my life. And this book, Full Catastrophe Living by Jon Kabat-Zinn landed in my lap and I read a little bit of that. More importantly, [I] started listening to the cassette tapes my first day of medical school, [and] I started meditating for the first time.
HOWARD: [Laughs] That's like, kind of interesting, that you were able to jump into both things at once. Do you think it was kind of the, blank slate of a whole new routine that allowed you to shoe horn the meditation in, or was actually harder?
JUDSON: It really felt like a new beginning. You know, I don't get many of those. So, it was like, okay, lets try a couple of things. I'm starting medical school, let's try something that can help me really... I didn’t know it at the time, but it was something that was going to really help me be better at being a student [laughs].
HOWARD: What was it that drew you to Jon Kabat-Zinn's work? Because I can remember, as a really stressed out parent, I was reading, I think he wrote a book on mindful parenting-
HOWARD: I can't remember the title. I was reading it one day and my toddler daughter came in and wanted attention, and I like, kicked her out because I was reading the book on mindful parenting [laughs]. It clearly did not stick. What about the "Full Catastrophe Living" really spoke to you as an intellectual, as a scientist, as someone who is you know, looking for the cold hard facts, like, what about that really caught your eye and made you think this could work?
JUDSON: Honestly, I don't remember. You know, I joke with Jon, you know, cause now I work at the- we jokingly call it the house that Jon built - I work for the Center for Mindfulness at UMass Medical School. I don't really remember. I remember the meditations, well actually, I fell asleep for about the first six months when I started trying to meditate, but there was something about that, that really compelled me; the practices themselves more than the reading about them.
HOWARD: Uh huh. So, you fell asleep for the first six months; I've had that experience of just like being a crappy meditator and you know, just getting up worse than I sat down, at least mentally. What lead you to stick with it, especially with the stress of the first six months of medical school?
JUDSON: Yeah, I think I have a thick skull. I like to find challenges, and just keep pushing and pushing and pushing. That's how I got, you know, through college, I think. It was just- I don't know how true that is. But, you know, I find a challenge, and someone says, "Oh, you can't do that." You know, so I do it. Actually, yeah. That type of thing. So, it was like, “this is challenging, this is really hard. I’m going to see if I can do this”. But the funny thing is, you can't really "do" meditation. [Laughs] I sweated a lot, I gritted my teeth, I struggled a lot, and it took about 10 years of that struggle before I realized meditation isn't about struggling at all.
HOWARD: [Laughs] I hear that a lot from people who are sort of meditators and meditation teachers, that like, they basically did it wrong for ten years, and if we could understand what they didn't understand, we could be meditating really well from like, day one.
JUDSON: Yes! And that's something that, boy, I hope that I can convey to some of my students: that they don't need to struggle as much as I have. It was certainly a learning process, but I wouldn't necessary wish that on other people.
HOWARD: So, when was the first time you can remember meditating and saying, okay, I see the value here, not just as a "I can do this", not just as a sort of, pride or self-betterment, but something that really struck you as, "wow, this is really valuable."
JUDSON: I think for several years, it was a slow build. So, I remember, in medical school, during boring medical lectures, I would start paying attention to my breath. So, there was something about that, that, you know, made me, in those moments-and I can articulate it retrospectively-I was feeling more calm, or I was less caught up in stuff. It took me years to realize, to look back on that later, and say “Oh wow, that could have been a lot worse,” when there is the stress of medical school or whatever. It was a slow build, and it was actually after about ten years or so when I was, 1) realizing it isn't this grit your teeth, forced march, and 2), there was something when I was doing these sorts of meditation, concentration practices, I started to see so much more clearly how my mind worked. Those were some real moments where I was like, "Wow, this is crazy."
And, there was some point, I'm trying to pinpoint when that was, when I really just started to see, how my mind works. And it was probably somewhere towards the end of my MD/PHD program, so about 8 years into practice, where I was just seeing all these connections, and I was really able to see all of the various addictions that I had, which is actually what lead to me writing a whole book on this. So, it was probably, there was some slow build, there were some benefits in the first five years, but in the five and twelve years, there were just these huge "ah-ha's."
HOWARD: You know it reminds me when one year, back to my daughter, she was probably eight or nine, and it was my birthday, and she hadn't gotten me anything, so she like found a book somewhere, like on a shelf, some place was giving [it] away, called Meditations for Men. And she gave it to me, and I really, really enjoyed it. There were like, these one page meditations, [they were] really valuable for me. Like, they really spoke to me. And then I looked in the back, and I saw like, "oh, this part of the AA thing, this is meditation for men with addictions". And at that point, I really didn't think I had addictions, which is kind of hilarious. So, what were your addictions, because they weren't, you know, like alcohol or drugs, or things we typically think of as things needing treatment?
JUDSON: Yeah, I have a long list. And most of them were socially acceptable. So, I didn't realize I had really been addicted to running, you know, I fell in love with it in junior high school and you know, ran track and cross country, and still run, I still love it, but I didn't realize I was to the point where I would go through withdrawal if I couldn't run a certain day or I would spend my days planning when my next run was going to be, you know, all of these things you could tick off the boxes for meeting criteria for addiction in the psychiatric manual, so that's one. There were others; romantic love, I was so enamored with romantic love, to the point of where I'd have these elaborate schemes around romance, so that was certainly an addiction of mine.
HOWARD: And you, like I went to Princeton, the gender gap must have been a little better when you were there, because my dreams of romantic love were statically improbable.
JUDSON: I think it was about 50/50 when I was there [laughs].
HOWARD: Nice! [Laughs].
JUDSON: You know, addicted to thinking, addicted to distraction, I mean I could go on and on. The thinking piece, took a long time to really wake up to because it was just so seductive. And it’s not like thinking is bad, it’s just that when I would get totally caught up in it, or my points of view, that I started to realize it was causing some suffering for me and for others.
HOWARD: So, one of the definitions that I really like, I can't remember if this Jon Kabat-Zinn or sort of a standard, who said "addiction is continued use despite adverse consequences," and that just kind of sounds like most of our lives.
JUDSON: Yes, yeah, I learned that in residency training. And its just such a simple, yet, comprehensive description of addiction, right? And it shows how it moves from beyond the classic addictions to, like, you were saying, everything. Or it can, depending on how we relate to what we're doing.
HOWARD: Right, so if that's the case, if its this, despite adverse consequences.. I've just got to say, we are talking about your book The Craving Mind, I just finished reading it for the second time. So, I read it the first time, and my impression was, this is really complicated. There's all these fMRI graphs, and lots of different topics, and I was thinking, "I really have to go through this and take note to really get a handle on what he's talking about before we get on the phone together.”
And then I watched your TED talk, it was one of the short ones, the 11 minute one, not the 18 minute one, and I finished watching it and I go, "Oh, this is really, really simple!"
JUDSON: Simple. [laughs].
HOWARD: So, can you kind of go over, for people like me, who are also addicted to thinking and like to see things as complicated so we can rise to the occasion, what's the really, really simple idea that you have, you came to, and started studying, with these high-tech techniques around addiction.
JUDSON: Yeah, so, I started with, you know, just discovering my own mental processes, and then I started looking to see how this was described in literature. So, in modern day, B. F. Skinner is probably the most well-known one for this, for how we learn, around behavior, so positive and negative reinforcement are concepts that are taught in Psych 101 in most college-freshman-intro-psychology classes. But it turns out, that those processes were described 2500 years ago, before paper was even invented by the Buddhist psychologists.
And that’s what got me totally fascinated with this, because I could not only see that both of these were related to each other, and basically the same thing, but I could see how they directly played out in my own life, and also now in my patients lives, as I work as a researcher and a psychiatrist.
So, the simplest form of this is, you need three components: you need a trigger, you need a behavior, and you need a reward. With those three pieces, you could form any habitual behavior. So, a simple one, and this is actually evolutionarily conserved back to the sea slug. So, Eric Kandel got the Nobel prize for showing that this process is at play in the sea slug, where it only has 20,000 neurons in its entire nervous system. It is probably set up evolutionary so we would approach nutrients and we would avoid danger. So, if you think of it simply as, we see some food, so there's the trigger, the behavior is we eat it, and we get this dopamine signal to our brain that says, "Oh calories! Survival!"
That's the reward from a brain perspective, from a human perspective. I think of this as the outcome, or the result of the behavior. This is operant conditioning; this is positive and negative reinforcement from a Skinnerian standpoint.
The Buddhists described this as a "dependent origination", different word, same process. And they, whether its modern-day psychology or ancient Buddhist psychology or philosophy, it’s the same process. And that's really what drives much of our behavior, from eating to thinking, to distraction, to romantic love.
HOWARD: I mean, this is a circuit that was obviously, really, really useful.
JUDSON: It still is [laughs].
HOWARD: One thing that surprised me, when you started bringing up Skinner in the book, I was pretty sure you were kind of setting him up to take him down. And, you know, I think a lot of his studies were on animals, and you know he seems very, very mechanistic. I had been brought up as a sensitive person, but Skinner's stuff was kind of, you know, we're machines, and its not very enlightened, and you never took it down. You were kind of like, "Yeah, this is the basis of some very, very deep neural patterns that all creatures have and we can transcend them."
JUDSON: Yes, and this doesn't mean that we are machines, it means we are humans that learn the same way as many other animals. It can be a "both, and" right? I think a lot of people saw Skinner as reducing human behavior to robots, like you pointed out. No, we're human, we are just as sensitive and nuanced as we've ever been, and there may be a way that we learn that is very basic and simple that might shed a lot of information on that nuance. Now, I find that fascinating.
HOWARD: So, the simple idea that I got from your book and from the TED talk is that using mindfulness and curiosity, we can create an even stronger positive response than we could get from the addictive behavior or substance, which kind of blew my mind. It seems like a real act of advanced jiu-jitsu. Instead of all the ways I have been taught and I had learned and used with clients, to get them with a sort of, brute force attack.
Before you got to your mindfulness, what are the ways in which Western science has dealt with the problem of addiction, whether its substance, or habit, or thought, what have our tools been?
JUDSON: So, in one sense, you can think of the carrot and the stick, right? And that actually is operant conditioning. If you give someone a carrot, they are more likely to do the behavior because they've been rewarded or if you beat them for doing the behavior they are less likely to do it [laughs].
We don't exactly beat people for using drugs, there are other things that are out there. So, if you avoid certain cues, if there is something that cues people to drink, and they avoid those cues, they're less likely to drink. And there's this saying: People, places and things.
If you avoid people, places and things you're less likely to drink. So that's one strategy that's used to help people not drink alcohol, for example. Smoking-another addiction-little harder to avoid your front porch, your car, outside of work, you know, all the places that we smoke, so there, one of the most employed strategies is substitution.
So, if you have a craving to smoke, eat some candy, and you'll break that. So, you can treat around that behavior, substitute it with a different behavior. These work variably, and with smoking for example, the average amount of weight gain that someone gets when they quit smoking, is about 15 pounds and a lot of that often has to do with, you know, eating candy or eating something for that oral fixation. So, these are the standard strategies: avoid cues, or substitute a behavior. Or, distract yourself.
HOWARD: So, one of the questions is, if we are supposed to be rewarded, like we learn by getting rewarded, and then we do these behaviors that are anything but rewarding in the long term.. How did we get into that mess? When, again, these adverse consequences, like our brains aren't set up to evaluate all this like, future discounting...
JUDSON: That’s it, that's it. Our brains aren't set up to think like, "What's the likelihood that I'm going to get cancer in 30 years if I smoke now?" We just can't make that calculation. Our brains are not set up that way. So, this is the delayed discounting that you're taking about. We are more likely to discount future rewards in favor of immediate ones-and there are mathematical models for all of this-our brains are set up for immediate reward. Oh, see the candy, looks good, eat the candy. See the cigarette, jones for a cigarette, smoke the cigarette.
So, that immediate gratification, that's how we are set up, that's how we've evolved evolutionarily, and its really hard to take into account all future probabilities. Our brains are just not set up that way. So, we can't really trust that part of our brain to say, "Oh, I shouldn't smoke because I might get cancer" for example. But, this is where it gets really interesting, so we can do these things like, you know, force ourselves not to smoke, or create these substitution strategies, like eat some candy instead.
These are all depend on extrinsic or external rewards-and even that’s what sets up reward based learning- if I eat carrot sticks, I feel better, or if I’m stressed out and I eat cupcakes, I feel better, right? That’s an extrinsic motivator because its dependent on getting something outside of ourselves.
So, that’s where all those pieces are set up for the immediate gratification. If we can actually understand that system, we might even be able to hack it so that we can tap right into that reward based learning system but provide an intrinsic or internal reward rather than an extrinsic one. And if we can do that, we win the game.
HOWARD: So, what’s an example of an intrinsic reward and why’s it better than an extrinsic one?
JUDSON: So, the extrinsic ones, they’re always going to require that “out there”, we always need the carrot, right, to continue that behavior. If the carrot is no longer there, we’re going to lose the behavior. So, if we run out of carrot sticks or whatever our reward is, that behavior goes away. That’s a critical piece.
HOWARD: It’s fragile.
JUDSON: Yeah, its fragile. The intrinsic ones are always available. Yeah, so, there’s no limited resource there [laughs]. There’s no, “I need this in order to be happy” type thing. It’s like, “Oh, it’s always here, it’s always available.” That’s one of the downsides to extrinsic rewards. An example of an intrinsic reward is-let’s use an intrinsic rewarding behavior-let’s say we get stressed out, that’s a trigger, the behavior is we eat a cupcake, or eat chocolate, or eat ice cream, that’s the behavior, and the reward is we feel a little bit better.
We distract ourselves from whatever we’re stressed out about or you know, we are tasting the good taste of ice cream, there’s the extrinsic reward, we have to have ice cream to feel better. What if, instead, same trigger, stress, and we get curious about what that stress feels like in the moment, “What does this feel like in my body?” So, let me ask you this: does a craving feel pleasant or unpleasant? That urge to do something.
HOWARD: I would say it’s largely unpleasant.
JUDSON: Yeah. So, it’s like, “DO SOMETHING!” The cravings typically aren’t that pleasant. So, what does curiosity feel like? Pleasant or unpleasant?
HOWARD: Curiosity is pleasant.
JUDSON: Oh, wow! So, we’ve just flipped the valence of this system in that moment, from craving (unpleasant) to curiosity. That behavior flips the valence from something unpleasant to pleasant even in the moment we are exploring a craving. So, we’ve already decreased the discomfort that comes with the craving simply by injecting a good amount of curiosity. So that curiosity is that intrinsic behavior that itself has a different reward. And we can unpack specifically what that feels like in a minute, but I just want to make sure that makes sense.
HOWARD: Yeah, so but, you’re saying that curiosity is actually a tool that doesn’t coexist with the craving, in a certain sense. It’s like a three-way light switch or something. You can’t have the craving and the curiosity both going full blast?
JUDSON: I would say the unpleasant feeling tone of the craving is lessened in that moment. So maybe it’s a dimmer switch. The craving is still there. But as we dive into the sensations themselves, we start to see the components of craving, that themselves aren’t actually, you know, things that make our heads explode.
Like my patients say, “Oh, you know, my cravings are so strong my head’s gonna explode.” If we dive in and, [they say] “Oh it’s tightness. It’s tension. It’s heat.”
Well, heat isn’t going to make my head explode. Tightness isn’t going to make my head explode. So, in those moments, as we unpack what craving is experientially, one it’s not as terrible or terrifying and two, that curiosity changes that feeling tone. You know, we are curious, instead of running to make the craving go away or make it feel better. H
HOWARD: So, it sounds like a hack because again, it feels very much like ju-jitsu, where you’re doing kind of the opposite of what you would expect. What I learned was the gold standard for treating addiction and craving was some form of cognitive behavioral therapy, like ABCD model where D is you dispute, your rational brain is online, right, its blinking green, and you get to argue with the craving and say well, “I know I want this now, but I know I don’t want to put on five pounds over the next week.”
I was talking to a client today about why he spent the entire day in front of the refrigerator when he was working from home in his kitchen, even though he knew he shouldn’t be doing it. So, we were trying to get to like, what was your prefrontal cortex saying about all this? His prefrontal cortex was nowhere to be found.
JUDSON: Right! Right! Our prefrontal cortex, as the youngest part of our brain from an evolutionary perspective, can’t be trusted. It’s the first part that goes offline when we get stressed. You probably know the “H.A.L.T.” acronym (hungry, angry, lonely, tired)? Right, those are all prime indicators that our prefrontal cortex is about to run out of battery.
HOWARD: So, which begs the question then, is curiosity coming from a different place?
JUDSON: Yes [laughs]. Sorry, I mean, let’s think about that for a little bit. But it is coming from a different place. Curiosity is coming from a place of awareness which is a pretty basic process, rather than a thinking process, right? Dispute, (of “ABCD”) dispute is a cognitive function, it’s a thinking function, it’s higher order. It’s actually much slower, if you think of it from a timeframe.
Awareness comes online just like that. Whereas, thinking, we have to ramp up the whole system, and you know, get it working, you’ve got to stoke the fire. So many differences in time frame, speed of response in brain function and in basic systems, it’s like awareness is something that’s always available. And that curiosity piece is something that is an added component of awareness.
We can be aware, you know, judging awareness, what’s happening, or we can be aware and just curious. But that curiosity is kind of that, flavor, that attitudinal component, that can come with awareness if that makes sense.
HOWARD: So, is it a decision, then? Does the prefrontal cortex have to do its last little gasp before it goes and takes a nap and goes, “Okay, I choose curiosity”? Or is it like, you know, I’ve heard some of the meditation teachers talking about awareness as something that is always there, fundamental, not requiring any effort, when in fact everything else we do to build our egos is effort.
HOWARD: And, but, I sit there, and I listen to you know, Tara Brach, Adyashanti, or Jack Kornfield, and I want that so bad, I want to identify with universal awareness, why do I have to be in this body dealing with bills, and fears, and sweat, and heat, right? It seems like the biggest effort in the world to get to this like, naturally default state.
JUDSON: [Laughs] This is the cosmic joke, right? This is what Yoda said. “Do or do not, there is no try”. The more we want to get somewhere, the farther we are from actually achieving it. Something that’s already available, that’s always been available, and the more we start tearing our hair out trying to figure out from a cognitive standpoint what that means, the farther we are away from it. And then we wake up and it’s like, “Oh, it’s here. I can be aware, I can be curious”. How much effort does it take for you to hear the sound of my voice? How much effort?
JUDSON: And, what if you have no idea what I’m going to say next. What does that feel like? What’s that curiosity that’s like, “Hmm, I wonder what he’s going to say next?” How much effort does that take?
HOWARD: Um, well, I want to say none, but I’m also here in my office filled with distractions, I’m sort of typing notes, I’m thinking ahead to the next question, it feels like there’s a certain amount of effort that goes into awareness, that, you know, I think it was Edward Hallowell called that “email voice,” when you’re talking to someone on the phone and they’re going, “uh-huh, uh-huh” and you realize, they’re typing an email. So, it does feel like listening to you with curiosity and awareness is taking some form of effort for me not to be distracted by something else.
JUDSON: If you’re curious about our conversation how much effort does it take?
JUDSON: Okay. And I’m guessing if you were really engaged in the conversation, neither of us is going to be using email voice.
HOWARD: Right, right, so now I’m going back to your example of sort of, your romantic stuff. When I was really into a girl, it didn’t take any effort to pay attention to her every gesture.
JUDSON: So that’s the key here, is, you know, our brains are constant- especially in the day of mass distraction- right, where we’ve got emails, we’ve got phones, we’ve got this, we’ve got that, if we can pay attention, if we can see how painful it is to be multi-tasking, compared to be “uni-tasking”, what’s it feel like when you’re totally engaged in that conversation or you’re totally engaged in that book? Its effortless, its joyful, right? So, if we can see how painful it is, it becomes a “Skinner box”; “Oh, when I multi-task, how great does that actually feel? Oh, not so great compared to uni-tasking.” Boom, there’s a “Skinner box” there that says, “Oh, this is more painful, than this.”
By “Skinner box”, you know, in case that’s not clear, [Skinner] would do these animal experiments where he would shock animals in one box versus the other and he realized that they had, what he called, a “conditioned place preference.”
He would condition them to prefer one color versus the other because they wouldn’t get shocked as much. And in the same way, if we pay attention to what it feels like when we’re multi-tasking, if we really pay attention, to when we are uni-tasking and really engaged in something, and at the far end of that extreme is “flow”-which, I haven’t heard anybody describe anything better than flow yet- there’s a beautiful, natural, Skinner box for us all.
And we start naturally inclining toward that which is less painful or more pleasant. “Oh, I can find components that help me drop into the direction of flow. Wow, that feels pretty good. Wow, my brain starts to do that more”. And then it says, “Why the heck would I ever multi-task?” This is abysmal compared to just really being with whatever I’m doing. And then, the “email voice” goes away.
HOWARD: So, I want to sort of get to, at some point, the tools that we can use to begin to approach this, but before we do, one of the things that really struck me was, in your book and your work, is how science-based it is, and how evidence based. I’ve been inclined to like the idea of meditation as a solution for lots of problems for many years and frankly, as I’ve looked at the meditation research, it hasn’t been very impressive. Tons of holes in it, you know, no controls, all sorts of…
JUDSON: Yes. It’s a very young field, absolutely.
HOWARD: That’s a very kind… yeah [laughs]. So, you’ve done stuff with fMRIs, like, I was looking at it and thinking, “That’s exactly how an fMRI should be used.” As opposed to some of the, you know, I think flights of fancy that we are trying to extrapolate. Can you describe, sort of, all the pictures in the book, all the little bar graphs, and the significance of the work you did and real-time meditation and collating that with people’s described experience.
JUDSON: Yeah. So, the first thing I’ll say is, this was completely by accident, but we’ll call it a blessing, it was a blessing that I never went into getting my PhD thinking I was going to study meditation.
My PhD is actually in immunology [laughs] and I did conditional knock out mouse models of stress. I was curious about stress and how that affects functioning, like why do we get sick when we get stressed; but I was in molecular biology, I was an immunologist. I was just practicing, to you know, better my own life.
So, I spent about ten years before I shifted from doing animal work to doing human work and started retooling to learn neuro-imaging and to learn clinical trials and clinical studies. So, I had this opportunity for ten years to really explore meditation from a direct experience, and that was such a gift because I wasn’t thinking about “Oh, how am I going to study this?” it was like, “What the heck is this stuff? Is it good, does it suck, does it do anything?”
And, from that perspective, then I could start, when I shifted my research, I could start actually designing trials that were based on, “What are the essential questions that we need to be asking right now?” from direct experience, not coming in from a, “Let me study meditation from a psychology perspective” or “Let me study meditation from a neuroscience perspective” and not really understand the inner workings of it from an experiential perspective.
So, I’ll start there and say, it was really helpful to practice a lot first, and then, we did just the fundamental studies first. We took very novice and very experienced meditators, and we compared their brain activity when we had them do different types of meditation. One thing that I wanted to look for specifically was, “What are commonalities across or amongst different meditation practices?” because that might tell us more about how the brain works and how meditation works.
So, we started there, and then we found brain regions that lined up pretty well, and a lot of serendipitous discoveries, like we were looking for brain regions that were activated during meditation, we found, in fact, that the biggest findings were that there were deactivations during meditations and certain brain regions like these default mode networks, these self-preferential networks, and so if you think of it, it’s like, we are constantly going throughout our day evaluating whether something applies to us or not, right? Past, future, “Oh, am I going to get something from you?”
There’s a lot of “self”, when we go through the day and there’s a lot of brain networks that are implicated in that. We found that these brain networks were decidedly decreased in activity, but then we wanted -
HOWARD: I wanted to re-read that section of the book, because I realized it didn’t occur to me there was a part of the brain that wouldn’t do that, it just seemed like, that’s thinking. And to realize that that’s not the core of cognition, or thinking, or awareness, this sort of creation of the ego-self and the evaluating everything-past, present, future- in terms of how it serves us, that was kind of a shock to me that that’s not synonymous with thinking.
JUDSON: [laughs] Yeah, there’s a lot more that goes into it, right? Because we can be thinking, we can be in flow, like we are working through a math problem, or we are doing something, we are writing a book, or whatever-I actually used writing my book as a flow exercise, we can talk about that later- but the idea is, letting our brains do their work.
The default network actually gets in the way, this self-preferential network, it’s like driving your car with one foot on the brake. And that foot on the brake is the “self” coming in and saying, “Oh, did I do that right, is someone else coming in and going to do it better than I am, am I going to lose my job, am I going to blah, blah, blah” until we’ve thought ourselves ten years into the future where we are homeless and on the side of the street, you know, that type of thing.
HOWARD: Like driving your car while reading the owner’s manual.
JUDSON: Right, right. So its much easier if you just use the brake and the gas to drive your car. Yeah, so, those pieces actually, those parts of the brain, get in the way during much of waking life. And if we can get out of our way, we can actually move more in the direction of flow where really, everything is just humming, singing, working very seamlessly.
With our studies, I didn’t really believe our data at first. It was kind of different than what other people had found, so we turned to these techniques called “real time neuro-feedback” where we could actually give people feedback from their minds in real time while they are meditating, and this is what you’re talking about, where we are linking up their subjective experience with their brain activity.
This is a really critical piece in cognitive neuroscience in general, because there’s this big gap between subjective experience and brain activity that hasn’t really been crossed much, and this is a new technique, and a pretty new technology. Fortunately, one of my friends at Yale had developed it, and we could be one of the first to test it out, and we could actually bridge that cognitive gap, that “first person, third person” gap.
First person, subjective experience, third person, brain activity. And we used meditation to test that, and we learned something about meditation. The big fascinating take home from that was there’s a brain region that’s involved in self-preferential processing, but it actually seems to be involved in the experiential components of self. So, if you think of fear, right, and if I asked you, does fear feel contracting or expanding, what would you say? In your experience.
HOWARD: It’s contracting.
JUDSON: So, there’s this brain region that gets activated when we contract around things, whether its craving, feeling guilty, ruminating when we’re depressed, feeling anxious, there’s all these different studies that were showing this brain region called the posterior singular cortex was getting activated. And people didn’t have a granular idea, on a granular level, what was happening.
So, we could line up this brain activity in real time with subjective experience and what we were finding was that people were actually reporting that they were getting contracted, caught up in their experience, when they were activating this brain region. So, if fear feels contracting, what does joy feel like? Contracting, or expanding?
JUDSON: Yeah. What does curiosity feel like?
JUDSON: And what does meditation help us do? Not get caught up in ourselves, right? There’s this expanding quality that comes, whether we are doing compassion, or love and kindness mediation, or even concentration meditation, we are out of the way. We are not contracting, trying, doing, we are simply, being.
So that’s what our real-time neuro-feedback studies were starting to show, is we could get these neuro-phenomenologic correlates of brain activity. Like, oh, this subjective experience of contraction lines up with this brain region getting activated, and this subjective experience of expansion, whether it’s being concentrated or having a loss of a sense of self, correlates with brain activity being deactivated.
We had somebody report getting into flow while they were doing our real-time neuro-feedback study, so we kind of got a picture of that expanding quality on film. If you think of expanding, so if you experience expanse to infinity, where are you? Where’s that boundary between you and the universe? It’s not there!
HOWARD: You’re where all the meditators say we can be. Universal awareness.
JUDSON: So that’s what these experiments really helped us hone in on; not on the experiential quality, which is described so much as getting caught up, or taking things personally, there’s that experiential self, there are now neuro-correlates that line up with that.
And then we see the opposite, when there’s joy, when there’s curiosity, but the beautiful thing here is, if you take it back to reward based learning, you can see how all of these line up. So, when you get excited about, if you just won something or you’re about to eat a cupcake, or you’re about to have sex, is that contracted or expanded, when you’re really excited?
HOWARD: That’s a tough one.
JUDSON: It is, that’s a trick question. When we look at our experience, we now compare excitement, which has this restless quality that says, “Do something,” there are a lot of shared qualities between that and wanting and craving. Does craving feeling contracted or expanded?
HOWARD: Very contracted.
JUDSON: Yeah. So, it probably falls on the continuum of contracted, whereas joy or curiosity are clearly expansive. So, we can take this same reward based learning system and move from a contracted, externally driven reward to an expansive, internally driven one that is always available. All we have to do is find out how to hack into it. How do we hack into it? By practicing, getting curious.
HOWARD: Right, so, I’m curious, about the fact that you go for curiosity rather than joy. I think about times in my life where I was really pissy, and my wife would try to say something helpful like, “what are you grateful for right now?” and I’d just want to like, poke her in the eye [laughs]. I don’t want to be brought there.
I want to hold on to my pissy-ness and, like, telling someone to be joyful, you know, seems like a very dangerous thing to do, but asking people to be curious, is somehow, easier to access. What’s the deal?
JUDSON: Yeah. If I say, “Oh, you should be more joyful” that’s when you poke me in the eye, right?
So, the “shoulds” come in and that’s a cognitive like, “If only you were in some different place you would be happier”. That’s an extrinsic motivator, “Oh, if this, then this.” Well, curiosity is always available.
So, if you’re pissy, you can be like, “Oh, what’s it feel like to be pissy?” because you’ve got that right there to play with. Or if you’re not curious, you can ask yourself, “Why am I not curious right now?” So, it’s always available.
I find it one that is easier to tap into; it doesn’t rely on the “shoulds,” you know, “we ‘should’ all over ourselves” as some people say. And the other piece is, it fits beautifully with the Buddhist psychology. They described seven factors of awakening 2500 years ago and they taught these in a particular order. The first two were awareness or mindfulness, and interest, or curiosity.
And if you think of those as rubbing two sticks together, you start to generate the heat, “Oh, if I’m aware and I’m curious about something, then suddenly all these other factors come along”. I like to use reading a book as an example. If I open a book and I’m interested, then suddenly the energy to read that book arises, and that’s actually the third factor of awakening.
All of this goes down the line where I naturally become concentrated in that book without having to force anything, simply because I’m interested. Joy arises out of curiosity, but joy in itself can be more difficult to tap into, like you beautifully pointed out.
HOWARD: I’m wondering, like, do sea-slugs experience infinite bliss? As they’re going through their life? Is it basically humans that have developed this neurological capacity to make ourselves miserable that we have to transcend?
JUDSON: That’s a great question; I have no idea. But I do know that sea-slugs approach and avoid things in similar ways that humans do, but beyond that, I don’t know [laughs].
HOWARD: There’s nothing wrong with approaching and avoiding things, right?
JUDSON: Nope, not at all, it’s how we survive. It’s just a matter of if we get caught up in that and make that our every day, or every moment obsession. That can be problematic at that point.
HOWARD: So, you did a study on smoking cessation, where you were experimenting with these ideas compared to the American Lung Association’s sort of standard practice. So, bottom line, this stuff works. Can you kind of describe the study and when you knew that this was a really powerful technique, a better tool than we’ve had previously?
JUDSON: In short, we did a randomized controlled trial and found that mindfulness training was five times better than gold standard treatment at our four-month time point. So, it worked pretty well, we were pleasantly surprised by that.
And mechanistically we found that it was decoupling craving and smoking, just like we had hypothesized, or actually, just like Buddhists had hypothesized a long time ago.
We even did a study, we started making, you know, App based training out of this so we could have high fidelity and make these things accessible and available to the public, and in a study, we have this eating program to help people with stress and emotional eating called the “Eat Right Now” and we found that there was a 40% reduction in craving related eating when people used this program for about three months.
So, we see now, convergent data and different behaviors showing the same mechanism of mindfulness decouples the cravings for a certain behavior. And it fits beautifully with the operant conditioning paradigm, it explains it very, very nicely.
HOWARD: And that really struck me; you’re not saying it de-fangs the craving or de-claws it, or reduces the intensity, it breaks the link. You can have the craving, and I love the metaphor you use, sort of “surfing the wave” of the craving, like, “Oh, here it comes,” and you get to experience the whole craving without having to give in to it.
JUDSON: Yes. Yup. Absolutely. And honestly, if you think of craving as a fire, as you stop fueling that fire, as you stop feeding it through behaviors, it starts to die down on its own. So, it’s not like it goes away, we can surf them, those waves, but we become the master surfer so even if they are big, we can ride them, and also, they don’t come as hot and heavy down the road.
HOWARD: You know, five times better, that seems like it would be hard to predict that. You must have had much more “N” than you needed to get a standard deviation like that.
JUDSON: Yeah, we were surprised. It was a moderate size study, so we had recruited 90 to 100 I think, for that study. And the effect size was large enough, you know, with clinical trials you typically need hundreds of people, but with that size study we got statistically significant results because it was such a big difference.
HOWARD: I know right now it’s an App, I downloaded it and I went through “day one”, so what’s the, can you describe that for people? You have two, the “Eat Right Now” and the smoking one?
JUDSON: Yeah, the “Craving to Quit” program is for smoking cessation.
We actually have a third one we are in final stages of development; we do a bunch of pilot testing so it takes a while to develop them, but it’s for anxiety. It’s going to be called “Unwinding Anxiety.”
But the idea with the “Eat Right Now” program is that, you know, we often fall into these habitual stress and emotional eating habit loops, it’s the “eat because we are stressed” type of thing. So, we can help people change their relationship to eating simply by paying attention to it. And its daily, bite sized pieces of information where they get videos and animations and most importantly, in the moment exercises where they can really use eating-because we all have to eat anyway- to really learn mindfulness.
And we pair this, we have an online community that I moderate, weekly, live, web-based check in group where people can join us from all over the world and ask questions. We eat all the time because we are stressed out or because we are sad or angry, and through these bite-sized trainings people can really dive into their own experience, and by simply paying attention, learn how to change their relationship to eating.
It’s a beautiful thing to witness and be part of as people start to change their eating behavior. You know, I’ve had some people lose 55 pounds just using our program, but the other beautiful piece is, they start to wake up to all the moments where they can start to wake up and be aware.
And so, this mindfulness starts to become their new habit, and so it extends not just to eating but to their relationships, you know, to other things as well. We aimed to design this as a comprehensive program and it seems to be working pretty well so far.
HOWARD: That’s great. I know you have another thing you have to get back to, we are just past the hour, so I really appreciate the time you’ve taken today, and the work, and so if people want to find out more about you or download the Apps and give them a try, where can they follow?
JUDSON: The best way, I think, my website is just “judsonbrewer.com”. It should have links to everything from the Centre for Mindfulness, to the Apps, to my book, but people can find the eating program, for example, at the website GoEatRightNow.com and then the book can be found on Amazon, The Craving Mind. I think the subtitle is “From cigarettes to smartphones to love, why we get hooked in and how we can break bad habits.” And then the TED talk, you can just see that on the TED site under Judson Brewer, “A Simple Way to Break a Bad Habit.”
HOWARD: Great, I’ll get all those things in the show notes as well.
HOWARD: Last question, what are you working on now? Just sort of operationalizing these Apps and testing them out, or is there new stuff on the horizon?
JUDSON: We like to do clinical studies on everything we do, so not only doing more clinical studies with the Apps but developing these “flip classroom models” where we can pair Apps with in-person facilitation.
And then, we are doing a bunch of neuro-biology research to see how the Apps change people’s brains, and then also develop neuro-feedback procedures from the studies that we’ve learned, so that we can actually give people this mental mirror through neuro-feedback so that they can, let’s say, acquire mediation practices or skills more efficiently as compared to not getting this type of feedback.
So, a bunch of different types of projects that we’re doing and all the future is looking forward bridging the gap between App-based delivery and neuro-feedback, and then in-person facilitation and finding the best ways to help people change their habits.
HOWARD: Wow, I wonder if your friend from Yale could invent like a $20 plug in to the iPhone to give really accurate neuro-feedback.
JUDSON: [Laughs] I’m guessing in five years there will be something like that.
HOWARD: That sounds like a pretty cool gadget. So, Jud Brewer, thank you so much for taking the time, thank you so much for writing the book The Craving Mind and I’m going through it, and I encourage anyone, if you have any cravings, if you have any addictions left, if you have not yet reached enlightenment this is really a fascinating marriage of ancient philosophy and practice and modern neuroscience. So, thank you, so much.
JUDSON: Thanks for having me, this was really fun.
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