 And then we assumed that it was the worrying that solved the problem, but that's, you know, correlation without causation. Another is that it's less by doing something by worrying, it distracts us from the worst feeling, feeling of anxiety. So it's negatively reinforced in the sense that it distracts us from something that feels worse. So relatively speaking, it feels better. What's up, everybody? And welcome to the show today. We drop great content each and every week, and we want to make sure that you guys get notified. And in order to do that, you're going to have to smash that subscribe button and hit that notification bell. And if you've gotten a lot of value out of this, make sure you give us a like and share our videos with your friends. Welcome to the show, Judd. We're so excited today to talk about your latest book, Unwinding Anxiety. Thanks for having me. Now, Johnny and I have talked to a lot of authors of books around anxiety over the last decade. Many of them titled Stop, Defeat, Beat, Anxiety. Unwinding Anxiety is a new perspective that Johnny and I hadn't heard before. So we'd love to just start with, you know, your definition of the book title. Yeah, it's well, it's a great place to start. So as a psychiatrist, you know, I've had patients who have tried to stop, tried to beat, tried to do everything to, to essentially end their anxiety and have come to me after, you know, 15 years or 20 years and saying, I'm exhausted. I've tried everything. So this title came out of my own anxiety around helping my patients, you know, about one in five patients shows a significant reduction in symptoms with medication. So my prescribing is basically me playing the medication lottery. And also, this serendipitously came together with some research that my lab had been doing around how to help change habits. And those two pieces came together that really changed the way that I view anxiety completely. And it's really about unwinding it rather than, you know, it's like you have this string and you pull on it and suddenly that knot is, you know, oops, you know, you cannot get that knot untied. It's not about pulling. It's about learning to see how the knot is tied and how to help it unwind itself. Something there that I want to dig into really quickly before we move forward, which is what were your preconceived notions that you had before this discovery and changing these? I would imagine a lot of people hold those same beliefs about anxiety as well. Yes. So some were and some of this was conditioned in medical school. So it was like, well, the only things that's going to help anxiety is giving them a medication. Another one that I saw a lot in my patients and I see this more generally as well is people just feel like, well, that's the way I am. It's always going to be like that. And in particular, you know, people thinking that they are an anxious person where they're so identified with the anxiety that they feel like they can't even imagine anything other than that. Now this link between habits and anxiety I had not heard before. And we don't often think about anxiety of basically being something that we could be doing to ourselves continuously through our behaviors and actions. We often think about it as something external that's happening. Some trigger or something is causing this anxiety in our life. So how are habits and anxiety playing together or not playing well together for causing anxiety? Yeah, they kind of feed off of each other. So any as any habit is formed through, you know, as three essential elements, like you mentioned, one of them already a trigger. So trigger behavior and results process from a brain standpoint or reward. So this was set up, you know, this is evolutionarily conserved all the way to sea slugs, right? We all have the same process and it's set up to help us remember where food is. You know, you see food, that's the trigger, you eat the food, that's the behavior. And then the reward is that your stomach sends this dopamine signal to your brain that says, remember what you ate and where you found it. So it's really this process, you know, it's called positive and negative reinforcement, it's helped us to eat and not be eaten, right? We can also learn, you know, through fear where danger is and to avoid it in the future. Anxiety, and this is, every time I think about this, it still blows my mind. I mean, I've been thinking about this for a long time now, but it still is amazing because I never thought of anxiety as being a trigger for, ready for this, the mental behavior of worrying. So the feeling of worry, which is part of the definition of anxiety, can trigger the mental behavior of worrying, right? So it can be a noun and a verb. So the trigger of anxiety triggers the mental behavior of worrying. And a lot of my patients say, well, I don't see anything rewarding about worrying, but at some point in the past, because as all habits are formed, and there's a fair amount of research going back to the 1980s showing that this is true, is that anxiety was rewarding in some way. And it can be real, I'm sorry, the worrying, the mental behavior of worrying can be rewarding in some way. Most often it's through one of a couple of things. One is it feels like we are solving problems. So occasionally we might solve a problem, although, and then we assume that it was the worrying that solved the problem, but that's correlation without causation. Another is that it's less by doing something, by worrying, it distracts us from the worst feeling of anxiety. So it's negatively reinforced in the sense that it distracts us from something that feels worse. So relatively speaking, it feels better. And the other way that I think about that is even if worrying about something doesn't actually keep that person safe or prevent that thing from happening, at least it feels better than doing nothing. But there's a fallacy in that that you could probably already see, which is worrying itself doesn't feel very good. And in fact, it can feedback and trigger more anxiety. Therein lies the problem. I think that the mental behaviors and the warnings are, it's, you see it and certainly smoking. I'm 48. So I grew up in a time when you could go into the bank and get in line and have a smoke. And it was always portrayed that it was a stress reliever, that you're going to start worrying and then you have this cigarette and then you'll feel much better and want an actuality that all you're getting is relief from your nicotine addiction cravings. It has quite a different effect, but it was also personified and you would see it in movies as a stress reliever. I remember as a kid asking my parents why they smoked it was a stress reliever. And so you certainly see it there more than anything. And it changes the way you relate to that cigarette. It changes the way you relate to those chemicals. So the chemicals are now the relief from not having the chemicals. We drop great content each and every week and we want to make sure that you guys get notified. And in order to do that, you're going to have to smash that subscribe button and hit that notification bell. And if you've gotten a lot of value out of this, make sure you give us a like and share our videos with your friends. Yeah, it's crazy how we and with smoking, it's interesting because nicotine is created. It's very toxic actually. And so plants make nicotine so animals won't eat those plants. And as humans, I mean, this is how crazy smoking is, as humans, we are willing to push past the nausea that comes when we first start smoking. And that nausea is our body telling us, Hey, dude, you're ingesting a toxin. But we are willing to do that for the better reward of feeling cool, rebelling, whatever, because most people start smoking at the age of 13. They don't start smoking as adults. They start smoking because there's something that's really that they're willing to overcome, which is ingesting a toxin to have the bigger reward of, you know, being cool at school or, you know, imitating the Marlboro man or whatever. Well, I just I was just saying my parents for Thanksgiving. And on television, there was a Frankie Avalon series going on that afternoon. And in one of the scenes, and it was just blowing my mind of the world that was portrayed in the early sixties. And there was still so much innocence left on the in these movies. And there was a pivotal scene where Frankie Avalon just gets gets off of surfing expedition. He comes back and he and there was this whole dramatic scene of him pulling out the cigarette. And and I was marveling at how this was set up. Now, I don't know if the cigarette companies had paid for that the way that it worked out. But the way it was dramatized, and of course, he started singing while he's smoking. And it was this thing. And then she lights a cigarette to watch in in utter attraction and amazement. And I was utterly blown away. I mean, so I mean, the messaging certainly was all around all of us at all times back then. Oh, yeah, for sure. And today it's really heartbreaking to see in modern day where so many television shows also portray smoking, whether it's like mad men, you know, where everybody has a cigarette in their mouth at all times, you know, we're with that television show, or even more modern movies, etc. There's, you know, there's there's this whole thing where people are smoking. And it's just part of what they do. Setting up the whole, you know, messaging for kids, you know, if you want to be Don Draper, you got to have a cigarette in your mouth and a drink in your hand. You know, both of them. It's terrible. Some of your other work around eating and cravings and overeating is a very similar thing where many of us will over-indulge to the point of sickness, just to get that initial reward of the first slice of pizza or the first piece of candy. Yeah, isn't it amazing? Well, I mean, this is our brains. Our brains are kind of one-trick ponies where they know one thing, which is this positive and negative reinforcement. And they just basically, you know, they give it a rinse and repeat, they just, okay, learn to smoke this way, learn to overeat this way, you know, learn to worry this way. You know, it's the same process. And it's just amazing how much it can, you know, and in general, habits are helpful. I'm not saying that having habits isn't a good thing. Just imagine if we had to relearn how to, you know, put on our clothes to walk to make food. We wouldn't even make it past breakfast because we'd be so exhausted, you know, every day. So habits in general are really helpful. Yet this process can go awry, especially in modern day, where things are designed to be addictive, you know, whether it's the food-like items. And I say that because, you know, Doritos do not grow on trees. You know, they are specifically designed to be, and it's amazing how like Cheetos or the exact same color as Doritos, that's not a coincidence, right? So the perfect color, the perfect mouth feel, the perfect crunch, the fact that things will just dissolve in your mouth, all of that is designed to be addictive. Social media, same thing, from the tweets to the likes to the, even when you pull on your, you know, your phone to refresh a news feed or whatever, where that comes from, the casinos, right? And so it's all of this is very, very well and carefully designed to get us addicted.