Coronavirus Special: How To Manage Anxiety In The Face Of A Global Pandemic with Dr Judson Brewer #103
Dr. Rangan Chatterjee speaks with behavioral neuroscientist and psychiatrist Judson Brewer about managing anxiety during the global pandemic. They discuss understanding fear vs. anxiety, how the brain reacts, and practical exercises like breathing, mindfulness, and physical activity to break the anxiety cycle.
Deep Dive Analysis
16 Topic Outline
Uncertainty and social media fuel anxiety
Distinguishing between healthy fear and unhelpful anxiety
Anxiety's impact on the prefrontal cortex
Practical techniques to break the anxiety cycle
Mindfulness app effectiveness for anxiety reduction
Children's anxiety and parental influence
The Five-Finger Breathing technique
Importance of connection, touch, and pets
Recognizing and addressing hidden anxiety in others
Understanding stress-related habit loops
News consumption as an addictive habit
Strategies for mindful news consumption
Physical activity for anxiety management
Practicing calmness: 'Short moments, many times'
Summary of practical tips for well-being
The 'Feel Better in Five' daily framework
7 Key Concepts
Fear vs. Anxiety
Fear is a healthy, adaptive survival response to immediate danger, helping us learn to avoid future threats. Anxiety, however, arises when fear combines with uncertainty and the need to plan, often hindering the prefrontal cortex and rational thought, making it less helpful.
Social Contagion
This refers to the passing of affect or emotion from one person to another. In the context of anxiety, it means that one person's worry or panic can easily spread to others, especially through platforms like social media, amplifying collective anxiety.
Prefrontal Cortex Going Offline
When anxiety or panic becomes overwhelming, the prefrontal cortex, the part of the brain responsible for logical thought and rational decision-making, can temporarily shut down. This impairs our ability to think clearly and make sound judgments.
Habit Loops
A fundamental learning mechanism consisting of a trigger, a behavior, and a reward. Our brains form these loops, and understanding them allows us to identify unhelpful behaviors (like stress eating) and replace them with more rewarding alternatives.
Intermittent Reinforcement
The strongest form of learning, where rewards are given randomly or unpredictably. This mechanism explains why checking the news can become addictive: the unpredictable nature of 'breaking news' acts like a slot machine, making us repeatedly check for a 'jackpot' of new information.
Bigger Better Offer (BBO)
A concept in behavior change where, once an unhelpful habit's reward value is diminished through awareness, a more rewarding alternative can naturally take its place. For anxiety, curiosity, calm, kindness, and connection can serve as BBOs.
Short Moments, Many Times
This phrase describes a strategy for creating new habits, including calmness. It emphasizes that consistent, brief practices throughout the day are more effective than infrequent, long sessions for developing new behaviors and skills.
14 Questions Answered
While fear is a healthy survival response, anxiety arises when that fear is combined with uncertainty and the need to plan, making it a common but not necessarily helpful response in such unprecedented times.
Fear is an adaptive response to immediate danger, helping us survive, whereas anxiety is a less helpful state that emerges when fear is coupled with uncertainty, often causing the thinking part of our brain to go offline.
Social media facilitates 'social contagion,' allowing emotions and worry to spread rapidly from person to person globally, amplifying collective anxiety and panic.
When anxiety passes a certain threshold, the prefrontal cortex (the logical, rational thinking part of the brain) goes offline, making it difficult to make sound decisions and leading to unthinking behaviors.
By grounding ourselves in direct physical experience, such as taking our own pulse, focusing on our breath, or feeling our feet on the ground, we can calm our nervous system and allow the prefrontal cortex to come back online.
Yes, studies have shown that app-based mindfulness training can significantly reduce clinically validated anxiety scores in populations like anxious physicians and individuals with generalized anxiety disorder.
Children are highly susceptible to social contagion but also tend to let go of stressful situations more quickly than adults, who often ruminate. Parents' calmness is crucial to avoid passing anxiety to their kids.
Parents can practice staying calm themselves, engage in simple mindfulness exercises like the Five-Finger Breathing, and schedule dedicated time for connection, hugs, and even cuddling with pets.
Instead of telling them to 'just relax,' which can exacerbate anxiety, try to be present, observe contributing factors (like hunger), and offer practical help or a hug, understanding that their rational brain might be offline.
Anxiety can act as a trigger for behaviors like stress eating, where the temporary 'reward' reinforces the loop. By bringing awareness to why, what, and how we eat, we can diminish the reward value of stress eating and find healthier coping strategies.
News consumption can act like a slot machine, providing intermittent reinforcement. The unpredictable timing of 'breaking news' (the jackpot) trains our brains to constantly check for updates, leading to a habit or addiction.
Set specific limits for checking the news (e.g., three times a day at set times) to avoid intermittent reinforcement. Also, reflect on whether checking the news actually provides a tangible benefit or just increases anxiety.
Physical activity, including walking in nature, yoga, or general exercise, can help match and release high energy levels associated with anxiety, boost the immune system, and improve overall well-being.
Yes, calmness is a skill that can be developed through 'short moments, many times' of conscious practice, such as brief breathing exercises or moments of gratitude. Reflecting on the positive feeling afterward helps the brain lock in the reward.
29 Actionable Insights
1. “Feel Better in Five” Framework
Dedicate five minutes daily to your mind (mental health like breathing, journaling, or getting outside), five minutes to your body (physical activity like dancing or skipping), and five minutes to your heart (human connection via calls, texts, or letters) to improve overall well-being and resilience.
2. Practice Calm, Kindness, Connection
Integrate “short moments, many times” of calm (taking breaths), kindness (looking loved ones in the eyes), and connection (calling a friend) throughout your day, as these are “bigger better offers” than anxiety and panic.
3. Learn How Mind Works
Understand the mechanisms of your own mind, including how anxiety and habits form, by utilizing accessible resources to gain insight and better manage your responses.
4. Map Out Habit Loops
Identify and map out your habit loops (trigger, behavior, reward) to bring conscious awareness to behaviors like stress eating, which helps reduce their perceived reward value and break the cycle.
5. Focus on Controllables
Actively focus your energy and attention on the aspects of your daily life that you can control, rather than dwelling on uncertainties, to reduce anxiety.
6. Unwind Anxiety with Curiosity
When feeling anxious, bring curiosity to the physical sensation of anxiety in your body (e.g., “where do I feel it? what does it feel like?”), which helps to let go and unwind the anxiety.
7. Practice Calm, Note Reward
Practice calming techniques (e.g., a few breaths, 5 minutes meditation) in “short moments, many times,” and crucially, reflect afterward on how it felt to reinforce the reward value and build new habits.
8. Calm with Deep Breaths
When feeling anxious, take your own pulse or a couple of deep breaths to literally calm your nervous system, allowing your prefrontal cortex (thinking brain) to come back online and make rational decisions.
9. “Feel Your Feet” Mantra
If breath focus is difficult due to anxiety, use the simple mantra “feel your feet” to ground your awareness in a tangible sensation, helping to break the anxiety cycle.
10. Five-Finger Breathing
Use the five-finger breathing technique (tracing fingers while coordinating with breath) to engage multiple senses and focus awareness, helping to quiet the mind and reduce anxiety.
11. Parents Stay Calm
As a parent, consciously strive to remain calm and relaxed so that you do not pass social contagion (anxiety) onto your children.
12. Be Present, Don’t Fix
When someone is anxious, recognize your “helper habit loop” of trying to fix it; instead, step back, be patient, try to understand their underlying needs, and simply be present with them, perhaps offering a hug.
13. Express Love & Hug
Purposefully look loved ones in the eyes, remind them you love them, and give them a big hug to foster connection and provide comfort.
14. Cuddle or Adopt Pets
Cuddle with existing pets or consider adopting/fostering a pet to gain the benefits of physical contact and connection, especially during times of social distancing.
15. Move Your Body Daily
Engage in physical activity every single day, even simple things like dancing or skipping at home, to boost immune function, improve health, and manage anxiety.
16. Match Energy with Movement
When anxiety is high, match your energy level with active forms of mindfulness like walking meditation in nature, yoga (with awareness), or vigorous exercise, which helps to engage the mind and body.
17. Mindful Eating: Why, What, How
Practice mindful eating by bringing awareness to three aspects: Why you’re eating (stress, anxiety, or actual hunger), What you’re choosing to eat, and How you’re eating (mindfully or mindlessly).
18. Stop Eating When Full
Practice stopping eating when you are full, as this feels better than overeating and serves as a “bigger better offer” for your brain.
19. “How Little Is Enough?”
When eating, especially indulgent foods, consciously ask yourself with each bite, “how little is enough?” to prevent overeating and foster mindful consumption.
20. Pay Attention to Habits
Bring conscious awareness to habitual behaviors (e.g., smoking, stress eating) to evaluate their actual reward value; realizing they are not truly rewarding opens space for choosing “bigger better offers.”
21. Limit News Consumption
Set specific limits for checking the news, such as three times a day, to avoid intermittent reinforcement that leads to addiction and increased anxiety.
22. Evaluate News Checking
After checking the news, reflect on what you gained: Did it make you more anxious, or did it provide tangible, helpful information? This helps your brain recognize if the behavior is truly rewarding.
23. Avoid Morning News
Do not check the news first thing in the morning, as it can immediately raise anxiety levels and set a negative tone for the day.
24. Morning Calm Routine
Before checking the news, engage in a 5-10 minute calming routine like breathing, journaling, or a quick workout to establish a sense of calm and efficiency.
25. Mindful Coffee/Tea
Consciously drink your coffee or tea with no distractions, paying attention to the taste and experience, to find more satisfaction and potentially reduce overall consumption.
26. Avoid News Before Bed
Do not watch the news before going to bed, as it can negatively impact your subconscious mind and hinder deep, relaxing sleep.
27. Simple Physical Reset
Engage in simple, repetitive physical activities like tapping a ball to shift focus from anxious thoughts to bodily sensations, helping to reset your mind.
28. Stay Positive & Take Precautions
Take sensible precautions (like staying six feet away and washing hands) and actively try to stay as positive as you can, focusing on what you can control, as this time will pass.
29. Schedule Connection Time
Intentionally schedule dedicated time with loved ones, putting away technology and social media, to foster deeper connection and combat isolation.
6 Key Quotes
You can sneeze on somebody's brain from anywhere in the world.
Judson Brewer
Anxiety is not actually that helpful because it makes our prefrontal cortex our thinking part of our brain go offline.
Judson Brewer
Our brain only has a certain amount of random access memory right and so... if you use up all that ram so seeing feeling you know feeling your finger feeling your breath seeing your um seeing your finger that actually uses up that that memory in your brain so it it crowds out any of this background noise of our mind trying to freak out.
Judson Brewer
It's really important as parents for people to make sure that they're they are staying calm and relaxed so that they don't pass that social contagion onto their kids.
Judson Brewer
Calm, kind and connection those are all bigger better offers than anxiety and panic it's a no-brainer.
Judson Brewer
Short moments many times throughout the day that's how we develop this new habit and I hope that we come together as a world and collectively collectively see how much more rewarding connection is than division let's go through this together and let's come out the other end a more connected world.
Judson Brewer
4 Protocols
Breaking the Anxiety Cycle (Immediate)
Judson Brewer- Pause and take your own pulse (or focus on a tangible sensation like your feet).
- Take a couple of deep breaths to calm your nervous system.
- Get curious about the sensation (e.g., 'What does my pulse feel like?').
- Allow your prefrontal cortex to come back online, enabling rational thought.
Five-Finger Breathing for Calmness
Judson Brewer- Take one hand and your index finger from the other hand.
- Start at the outside base of your pinky finger.
- As you breathe in, trace up the side of your pinky.
- As you breathe out, trace down the other side of your pinky.
- Repeat this pattern for each finger (breathe in tracing up, breathe out tracing down) for your whole hand.
Managing News Consumption
Judson Brewer- Ask yourself when you last checked the news.
- Set a limit for checking the news (e.g., three times a day at set times).
- After checking, reflect on what you gained from it and if it was truly rewarding or just increased anxiety.
- If the news cycle calms down, dial back the frequency (e.g., twice a day, once a day).
Daily Well-being Framework (Feel Better in Five)
Rangan Chatterjee- Mind (5 minutes): Engage in mental health practices like breathing, journaling, spending time in nature, or creative pursuits.
- Body (5 minutes): Engage in physical activity such as dancing, skipping, gardening, or lifting weights.
- Heart (5 minutes): Focus on human connection, reaching out to friends and family via FaceTime, Skype, texts, or letters.