 So, wouldn't it be amazing if my patients walked into my office and they say, I don't regret smoking and I would just say, just stop it, it would be one visit, I could charge them a bunch of money because it would be one visit and they'd be done, right? Just stop overeating, just stop worrying, it's not how our brains work. So that's the first thing I want to highlight is that we've got to start by knowing how our brains work. 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. Well, I think the big issue with a lot of this and I can see it in my own family is culturally, the way we're raised, a lot of these habits we pick up from our family. Johnny's talking about smoking. I picked up worrying from my family. My grandma was like the biggest warrior of all time and then my dad was slightly less of a warrior, but still worry was that tool that he would grab whenever there was uncertainty and I find myself falling into those similar patterns. So if we're now noticing this and we're seeing that we have these habits that are creating anxiety in our lives and we're talking about food companies pushing us in a direction. We're talking about video games, social media, all of these outside inputs also pushing us in a direction. How do we start to take back our autonomy and override some of these biological processes to actually enjoy life? Yeah, it's a great question. So the first place I would start is by saying be careful of what you think might work and then just keep trying to do. So I want to highlight how there's just been such an emphasis placed on willpower and this is hundreds of years. It's not with the advent of advertising that suddenly willpower came to the fore. It's just that the companies, whether it's the weight loss companies that say, hey, the formula is right, you just take in fewer calories than you put out, which is correct and something I learned in medical school. But it's not just about the formula. It's about knowing that and also knowing how our brains work. Do you either of you remember Bob Newhart? Of course. Oh, yeah. Remember the Newhart show? Yeah. So did you there was a skit that is just hilarious called something like just just stop it. So basically so woman walks into a therapist's office. It's five minutes, but I won't go through the whole thing. Woman walks into a therapist's office, right? And says, you know, I have this fear and I won't say which one it is because it's worth watching the skit. And he basically says, just stop it, you know, just stop it. And that's the whole skit. And I say this because that was a skit from the 1970s that is just as relevant today as it was then. And it would have been relevant a hundred years ago. And hopefully it's not as relevant in a hundred years because we've learned a little more about how our brains work. So wouldn't it be amazing if my patients walked into my office and they say, I don't regret smoking, I would just say, just stop it. You know, it'd be one visit. I could charge them a bunch of money because it would be one visit and they'd be done, right? Just stop overeating, just stop worrying. It's not how our brains work. So that's the first thing I want to highlight is that we've got to start by knowing how our brains work. If we know how our brains work, then we can work with our brains. And so this is where this piece around, you know, anxiety, even we've done work with eating, we've done work with smoking. All of this comes together is just understanding the process. So if we know that habits are formed through this three step process, we also have to pay attention to how that how rewarding these behaviors are. And the reason for that is that the only way that our brains will change a habit is by seeing one of two things, either that the habit is really rewarding or that it's not. I'll give you an example. So for example, I have so our brains set up these reward hierarchies with different behaviors so that we can choose things very quickly. You know, it's like if I'm given a choice between broccoli and chocolate cake, guess what my brain is going to say? Dude, eat the cake, right? Goes back to the hunter-gatherer days where cake is more calorically dense. And our receptors in our mouths and even in our stomach say, hey, you know, cake over broccoli. So we have these preferences that are naturally aligned with survival. Those preferences get set down and then we just we don't have to relearn them. We just it's called set. I think of it as set and forget. You set the habit that cake is better than broccoli. And then you just you see the cake, you eat the cake. So that's important because the only way to update that reward value is to do something actually very simple, which is to pay attention. So then this goes back. There are some researchers back in the 1970s that developed this formula called they were Rascorla and Wagner, these two researchers. And they basically said you can get two things if you pay attention. One is called a positive prediction error. One's called a negative prediction error, positive prediction error. So let's use chocolate cake. If I walk into a bakery, a new bakery, let's say one opens up in my neighborhood. I walk into the bakery. I don't know how good their cake is. What do I have to do? I have to eat their cake. So I eat their cake and I'm like, oh, my God, this is my favorite, you know. And I started babbling because it's so good and post on social media how everybody should go to this bakery. That's what I just got a positive prediction error because it is better than expected, right? And my brain learned something. It said, hey, good bakery, you know, come back here again. Remember where this place is. Remember, it's set up for context dependent memory. The other thing that could happen is that my brain could eat the cake and my brain's like, I've had better and I get a negative prediction error where my brain says I expected to be at least this good and it's not as good as expected. And I learn, don't go back here, you know, post on social media. Not that great a bakery or whatever. Actually, there's a third thing that could happen. So those two depend on awareness. If I pay attention, cake's good, positive prediction error. If I pay attention and it tastes bad, negative prediction error. And I learn if I don't pay attention, let's say I walk into the bakery, I order some cake and then somebody calls me and they say, oh, you know, listen to this, something crazy happened. And I'm mindlessly eating the cake while I'm listening on the phone. And then I finish the cake and then I go home and my wife's like, hey, how's that bakery? I don't know. It couldn't be awesome because my brain would be like, hey, get off the phone. This is really good. Pay attention. And it couldn't have been terrible because my brain wouldn't be like, you know, spit that out. That's horrible. I would remember those things because my brain would have forced me to pay attention. It's like, hey, you know, the phone call is not as important as this cake for whatever reason. So if it's just if it falls within an expectancy range, my brain is like, yeah, whatever. It's good. It's cake. You know, just eat it. So if I don't pay attention, that reward value doesn't change. And that's critical because that's how habits keep getting perpetuated. If we don't pay attention, they keep we just keep doing the same thing. As an example, I had a patient who came in that wanted to quit smoking after 40 years. First, we calculated the number of times he had reinforced this habit. Are you ready? Two hundred and ninety three thousand times. Plus or minus, probably. Yeah, that's estimated. Yeah. Yeah. 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. But, you know, a pack a day times two, you know, so 20 cigarettes a day times three hundred sixty five times forty. That's a big number, regardless. And it's amazing how when somebody smokes a pack a day there, it's like clockwork, you know, they use it's a pack a day. So there I sent him home. I said, go ahead and smoke. And he looks at me like you're my doctor telling me to smoke. And I say, just pay attention as you smoke. And it comes back and he's like, how did I not notice how crappy this day is? So he got a negative prediction error because he paid attention. He hadn't been paying attention for years. And so he was just repeatedly smoking habitually. Now, for anybody that doesn't smoke, my lab just published a paper on this where we did this with our we have this eating app called eat right now. And what we did was we we embedded this basically paying attention tool into the app so that we could measure how quickly people's reward value changes in their brain. We could do this, you know, scientifically. You ready for this? It only takes 10 to 15 times of somebody really paying attention for that reward value to drop below zero. So if somebody's been habitually eating cake for 40 years or smoking for 40 years, it doesn't take 40 years to change that, which also makes sense from a survival standpoint. You can't be chased by the saber to Tiger like 20 times before your brain's like, dude, that's kind of dangerous, you know. We don't get that many off and that many chances. So we our brains are amazingly plastic and we will learn very, very quickly as long as we pay attention. That's the critical piece. We have to be aware of what's happening. I'm guessing that's where the curiosity aspect comes in, right? So we're getting curious about our addiction. We're getting curious about our habits and we're going to to dive in and start examining them and being aware. Absolutely. We've had guests on talking about the attention economy. We now have this space race to get as much human attention, distracting us to make these poor decisions as possible everywhere we look. And it's so fascinating because every time we talk to scientists, we always do go back to, well, when we were cavemen, saber tooth tigers, when there was no abundance, like these survival mechanisms were there because food was scarce. This reward was scarce. We are now bathing in rewards everywhere we look, whether it's food, whether it's technology. So it feels to me like we're losing this race at such a rapid pace that even if I had an ungodly amount of attention on some of these triggers, how do I beat back what's going on around me with abundance? Yeah, that's a really good question. So the nice thing here is to know that our brains and our bodies still know when something is too much, right? So if we never plateaued in the reward value when we ate sugar, we would just keep eating sugar forever. But there's a point where we just have to stop because we are overstuffed and our body says, dude, really four pieces of chocolate cake. And then when we really pay attention, our body says, wow, that feels really terrible. There, it doesn't matter how much distraction there is. If we pay attention in that moment, our body is going to say, I know exactly how much is enough and that was too much. If we pay attention when we are overindulging on social media and we really notice like, what was the result of that hour that I spent scrolling? Nobody says, wow, that was great. I want to do another hour. You know, they say, wow, I wasted all that time. I actually I teach a class in the fall at Brown and I have my students like pick a habit to work with over the semester. A lot of them pick social media and you wouldn't believe when at the beginning of the semester, their social media is like a part time job. You know, it's like really 20 hours a week or more on social media. When they pay attention, they can start to see, wow, I would rather spend time with my friends as compared to texting my friends or looking at their social media, you know, posts or whatever. And they start to see not only, you know, that our bodies and our minds know what's good for us through that awareness. It doesn't matter, you know, the attention economy is one thing. It's like if everything is equal, then you got to try to out compete everybody else, not everything is equal. Our bodies know our minds know. And that's not going to change. We're not going to evolve that quickly to suddenly, you know, where sugar is going to be the best thing for us from an evolutionary standpoint. So that old cave person brain, that old cave person body is still there saying, hey, if you pay attention, I can tell you exactly where to go. And the nice thing is if we do it a couple of times, we start to learn, wait a minute. Oh, wow, I do. Wow. And then we start to let go naturally. So that's actually why I set my The Unwinding Anxiety book up in three sections. The first section is we've got to see this stuff, but nobody is not interested in seeing how their mind works, especially if they're suffering, right? If they've got too much anxiety, they're going to pay attention. If they're overeating, they're paying attention. That's a pain point, right? That's the that's why ad people, you know, they look for pain points so they can sell us stuff. The second section is what we just talked about, seeing how rewarding or unrewarding something is. But the third section is, I think, what Johnny alluded to, which is if we can see that there is something that is more rewarding, we're going to naturally be inclined in that direction. So we don't have to force our attention, right? We don't have to try to compete with other elements to get our attention. We just have to pay attention a couple of times. You know, like I said, with this eating with our E Right Now program, it was 10 to 15 times and then our brain naturally moves in that direction, which is really good news, right? If we had to outcompete all these other things, man, they're being engineered so fast and at such, you know, with so many people behind these things, it would be impossible.