How to Break Your Anxiety Habit | Judson Brewer (2021)
This episode features Dr. Judson Brewer, a psychiatrist and deep dharma practitioner, discussing anxiety as a habit that can be unwound. He explains how mindfulness can be harnessed to deal with anxiety and debates if any level of stress is healthy.
Deep Dive Analysis
17 Topic Outline
Introduction: Anxiety as a Habit and Mindfulness
Defining Anxiety: Feelings vs. Mental Behavior (Worry)
Anxiety as a Habit Loop: Trigger, Behavior, Reward
How Worry Perpetuates Anxiety and Impairs Thinking
Patient Example: Mapping Anxiety-Driven Eating Habits
Goal: Changing Relationship to Anxiety, Not Eliminating Feelings
Distinguishing Clinical vs. Garden Variety Anxiety
Step 1: Mapping Anxiety Habit Loops
Step 2: Updating Reward Value Through Awareness (Rescorla-Wagner Model)
Step 3: Finding a Bigger, Better Offer (BBO) – Curiosity
Two Flavors of Curiosity: Deprivation vs. Interest
Love and Curiosity as Shared Experiences of Opening
The Role of Historical Context vs. Present Moment Awareness
Formal vs. Informal Meditation Practices for Anxiety
Debunking the Yerkes-Dodson Law: Is Any Anxiety Healthy?
Fear vs. Anxiety: Timescale and Evolutionary Adaptiveness
Comfort Zone vs. Growth Zone in Personal Development
7 Key Concepts
Anxiety as a Habit
Dr. Brewer views anxiety not just as a feeling, but as a mental habit that can be unwound. This perspective suggests that the cycle of anxiety, often driven by worry, operates like other habits with a trigger, a behavior, and a result, which can be identified and changed.
Worry as Mental Behavior
Worry is described as a mental behavior that can be negatively reinforced. It can either distract individuals from more unpleasant feelings of fear or anxiety, or provide a false sense of control, even if it doesn't actually solve problems, thereby perpetuating the anxiety habit loop.
Habit Loops
Habits are formed by three elements: a trigger, a behavior, and a result (or reward). This evolutionary process helps us remember beneficial actions and avoid danger. In the context of anxiety, a negative emotion (trigger) can lead to worry (behavior), which offers a temporary 'reward' of distraction or control, reinforcing the loop.
Reward Value Update
Based on the Rescorla-Wagner model, our brains store a composite reward value for behaviors. This value can be updated through 'prediction errors' (positive for better-than-expected, negative for worse-than-expected outcomes). Awareness is the key ingredient to see the true, often unrewarding, outcome of habitual behaviors like worrying or overeating, thereby updating their reward value.
Bigger, Better Offer (BBO)
Once the brain recognizes an old behavior as unrewarding, it seeks a 'bigger, better offer.' Ideally, this BBO is intrinsically rewarding, such as curiosity or awareness. These intrinsic rewards are not subject to habituation in the same way external rewards are, providing a sustainable alternative to old, unhelpful habits.
Interest Curiosity
This type of curiosity is about exploring the journey and the joy of discovery, rather than seeking a definitive answer (deprivation curiosity). It feels open and expansive, and is intrinsically more rewarding than anxiety or worry, making it a powerful tool for unwinding anxiety.
Yerkes-Dodson Law (Debunked)
Originally based on animal studies, this 'law' suggested an inverted U-shaped curve where a moderate level of arousal/anxiety optimizes performance. Dr. Brewer argues that research largely refutes this for humans, showing that more anxiety generally leads to worse performance, as it impairs the prefrontal cortex's ability to think and plan.
9 Questions Answered
Anxiety is defined as a feeling of nervousness, worry, or unease about something in the future or with an uncertain outcome. Dr. Brewer emphasizes differentiating the physical feeling from the mental behavior of worry itself.
The feelings of anxiety are physical sensations, often associated with thoughts, but worry is a mental behavior that can actively drive more worry and perpetuate anxiety habit loops. Understanding this distinction helps in addressing the behavioral component of anxiety.
For medications, the 'number needed to treat' is 5.15, meaning about 20% of patients show significant improvement. For cognitive behavioral therapies (CBT), the hit rate for response is about 50%.
Dr. Brewer suggests there is no evidence that worrying is helpful; instead, it can perpetuate anxiety and make things worse by making the thinking and planning parts of the brain (prefrontal cortex) go offline, hindering effective problem-solving.
While questionnaires like the GAD-7 can indicate severity, a critical aspect is whether the anxiety is causing significant disturbance in one's life. If it disrupts daily functioning, it may be considered clinical, highlighting the importance of one's relationship to the anxiety rather than just its objective presence.
Based on historical precedent and research, formal meditation is not strictly required. Informal mindfulness practices, such as paying attention to specific activities or noting anxiety in the moment, can be highly effective, especially for beginners, and can augment formal practices.
Dr. Brewer argues against the Yerkes-Dodson Law, stating that research shows no evidence for a 'sweet spot' where anxiety improves performance. Instead, higher anxiety levels generally correlate with worse performance, as anxiety impairs the prefrontal cortex.
Fear tends to be a short-term, reflexive survival response, like jumping out of the way of a bus. Anxiety, in contrast, is the chronic, often optional, piece that arises from what we do with uncertainty and fear, such as persistent worrying about a past event or future threat.
While understanding past patterns can be helpful, Dr. Brewer emphasizes focusing energy on 'what is happening right now' rather than 'why' it's happening. This present-moment focus, combined with understanding basic brain biology, is more effective for changing habits and not feeding anxiety.
30 Actionable Insights
1. View Anxiety as a Habit
Understand that anxiety, like other habits, is formed by a trigger, a behavior (like worry), and a result (like temporary distraction or feeling of control), which can be unwound.
2. Map Your Anxiety Habit Loops
Identify and write down your specific anxiety or worry-related habit loops, noting the trigger, the behavior (e.g., worrying, avoiding), and the perceived result.
3. Differentiate Anxiety Feelings from Worry
Separate the physical sensations of anxiety from the mental behavior of worrying, as worry is a behavior that can perpetuate anxiety habit loops.
4. Stop Useless Worrying
Recognize that worrying is not helpful and can actually impair your ability to think and plan effectively, making things worse by shutting down the prefrontal cortex.
5. Update Reward Value with Awareness
Use awareness to clearly see the true reward value of a behavior; by paying attention to the actual outcome, your brain updates its perception of how rewarding that behavior truly is.
6. Question Worry’s Actual Reward
When you find yourself worrying, pause and ask yourself what you are truly gaining from this behavior in the present moment and if it’s genuinely solving the problem you intend it to.
7. Cultivate Curiosity as a Superpower
Choose to be curious about your anxiety and other experiences, as curiosity is an intrinsically rewarding mental state that feels better and opens you up, unlike anxiety which feels closed down.
8. Seek a Bigger, Better Offer
Once you recognize an old habit is unrewarding, actively seek out a ‘bigger, better offer’ – an intrinsically rewarding alternative that genuinely feels better.
9. Practice Interest Curiosity
Engage in ‘interest curiosity’ by exploring the present moment and the joy of discovery, rather than ‘deprivation curiosity’ which seeks to fill an information gap and can feel closed down.
10. Mindfulness as Intrinsic Reward
Recognize that simply being present and exploring sensations through mindfulness can be the ‘bigger, better offer’ compared to unrewarding habitual behaviors like binging, leading to a sense of ease and balance.
11. Stop Resisting Anxiety
Observe if you are resisting or trying to fix your anxiety; instead, try to simply be with and accept the feelings, as resistance can perpetuate them.
12. Be Comfortable with Discomfort
When facing challenges and discomfort, choose to be open and curious rather than locked down by anxiety and uncontrolled worry, monitoring when you lapse into unhelpful patterns.
13. Acknowledge Uncertainty, Then Let Go
Acknowledge uncertainty by seeking trusted information, but then practice letting go when answers are unavailable, becoming comfortable with being uncertain.
14. Work with Anxiety in Moment
When anxiety arises, prioritize bringing in mindfulness practices in that moment to work with the feeling, rather than trying to intellectually think your way out of it.
15. Prioritize Informal Mindfulness Practice
Begin with and prioritize informal mindfulness practices throughout your day (short moments many times) as research suggests they are highly effective, especially for those just starting.
16. Practice Short Moments of Mindfulness
Integrate brief moments of mindfulness throughout your day, such as noting physical sensations of anxiety or taking a mindful breath, rather than needing to stop for formal meditation.
17. Understand Basic Brain Biology
Learn about basic brain biology and psychology, such as the comfort zone versus growth zone, to help identify and work with habitual patterns as they arise in the moment.
18. Focus on ‘What’ Not ‘Why’
When dealing with current issues, direct your energy towards observing ‘what’ is happening in the present moment rather than getting caught up in ‘why’ it’s happening, as the present is where change can occur.
19. Play the Tape Forward
When faced with a craving or old habit, mentally project the full consequences of engaging in that behavior, drawing on past experiences to see its true unrewarding nature.
20. Use Awareness to Avoid Reactivity
Employ awareness to clearly perceive the unrewarding nature of habitual reactions, allowing you to navigate life without constantly being driven by desires or aversions.
21. Orient Brain Towards What Feels Good
Understand that mindfulness and awareness are not about forcing ‘good’ behaviors, but rather about orienting your brain to recognize and choose what genuinely feels better and is intrinsically rewarding.
22. Embrace Love and Kindness
Cultivate love, kindness, and compassion, as these practices share the core quality of opening up and expansion, which is a key aspect of mindfulness and helps move away from contraction.
23. Practice Self-Compassion for Brain
When experiencing anxiety, remind yourself, ‘Oh, that’s how my brain works,’ to foster compassion for your brain’s protective mechanisms and help it relax out of its rut.
24. Anxiety Impairs Performance
Recognize that anxiety does not improve performance; instead, it hinders the optimal functioning of your prefrontal cortex, which is essential for thinking and planning.
25. Aim for Flow State
Strive for a ‘flow’ state for optimal performance, characterized by effortlessness and freedom from worries, as this is where peak performance occurs without anxiety.
26. Move Along the Flow Continuum
View flow as a continuum and actively engage in practices that help you open up, as this moves you towards the flow state, away from contracted or closed-down experiences.
27. Understand Meditation’s Purpose First
Before engaging in formal meditation, understand its purpose by mapping out mental loops and observing push-and-pull dynamics in everyday contexts, which will enhance awareness during formal practice.
28. Formal Practice Deepens Mindfulness
While not strictly required, formal meditation practices can significantly deepen your mindfulness and awareness over time.
29. Apply Habit Mapping Broadly
Extend the practice of mapping habit loops (trigger, behavior, result) to other behaviors like overeating, drinking, or excessive Netflix use, especially those used as distractions from anxiety.
30. Shake Off Acute Stress
After experiencing acute stress or fear, learn from animals to ‘shake it off’ physically or mentally, allowing the experience to pass without leading to chronic anxiety.
7 Key Quotes
Worry can be both a feeling, but it can also be a mental behavior.
Dr. Judson Brewer
I haven't found any evidence to suggest that worrying is actually helpful.
Dr. Judson Brewer
We think that we're doing the right thing because we're gaming everything out. But in fact, we're driving ourselves into a hole where actually the quality of our thinking is going down because we're activating the reptilian folds of the brain, the amygdala, the stress and fear center of the brain. And that actually just shuts down the more advanced parts of the brain, the prefrontal cortex.
Dan Harris
It's not about not having thoughts or emotions or sensations. It's about changing our relationship to them.
Dr. Judson Brewer
What we resist persists.
Dr. Judson Brewer
Curiosity feels better.
Dr. Judson Brewer
Forgiveness is giving up hope of a better past.
Dr. Judson Brewer
1 Protocols
Unwinding Anxiety Protocol
Dr. Judson Brewer- Map out anxiety or worry-related habit loops by identifying the trigger, behavior (e.g., worrying), and the result (e.g., temporary distraction or false sense of control).
- Update the reward value of the old behavior (e.g., worrying) through awareness. Pay attention to what you are truly getting from the behavior in the moment, noticing if it actually makes you more anxious or solves the problem.
- Find a 'Bigger, Better Offer' (BBO) that is intrinsically rewarding, such as curiosity, kindness, or connection. When anxiety arises, shift attention to being curious about the sensations or thoughts, which feels more open and rewarding than being anxious or worrying.