Huberman Lab - Dr. Alia Crum: Science of Mindsets for Health & Performance

Welcome to the Huberman Lab Podcast,

where we discuss science

and science-based tools for everyday life.

I’m Andrew Huberman,

and I’m a professor of neurobiology and ophthalmology

at Stanford School of Medicine.

Today, my guest is Dr. Aliyah Crum.

Dr. Crum is a tenured professor of psychology

at Stanford University,

and the founder and director

of the Stanford Mind and Body Lab.

Her work focuses on mindsets,

how what we think and what we believe

shapes the way that our physiology, our biology,

reacts to things like what we eat or stress or exercise.

Indeed, as you will soon learn

from my discussion with Dr. Crum,

what you believe about the nutritional content of your food

changes the way that food impacts your brain and body

to a remarkable degree.

And the same is true for mindsets about exercise and stress

and even medication.

For instance, recent work from Dr. Crum’s laboratory

shows that what we believe about the side effect profiles

of different drug treatments

or different behavioral treatments

has a profound impact on how quickly those treatments work

and the effectiveness of those treatments.

I just want to mention one particular study

that just came out from a graduate student

in Dr. Crum’s laboratory, Lauren Howe, H-O-W-E,

showed that how kids react to a treatment

for peanut allergies can be profoundly shaped

by whether or not those kids were educated

about the side effects of the treatment,

such that if they learned that the side effects

were a by-product of a treatment

that would help them,

and they learned a little bit

about why those side effects arose

and that the side effects might even help them

in route to overcoming their peanut allergy,

had an enormous impact

on how quickly they move through the treatment

and indeed how much they suffered,

or in this case did not suffer from those side effects.

And that is but one example that you will learn about today

as we discuss what mindsets are,

the number of different mindsets that exist

and how we can adopt mindsets

that make us more adaptive, more effective,

allow us to suffer less

and to perform better in all aspects of life.

I personally find the work of Dr. Aaliyah Crum

to be among the most important work being done

in the fields of biology and psychology

and the interface of mind-body.

Everything that she’s done up until now and published,

and indeed the work that she continues to do,

has shaped everything within my daily routines,

within my work routines, within my athletic routines.

And we probably shouldn’t be surprised

by the fact that Dr. Crum works on all these things.

She was not only an incredibly accomplished

tenured research professor,

she’s also a clinical psychologist,

and she was also a division one athlete

and an elite gymnast at one period in her life.

So she really walks the walk

in terms of understanding what mindsets are

and applying them in different aspects of life.

I’m sure you’re going to learn a ton from this conversation,

as did I, and come away with many, many actionable items

that you can apply in your own life.

In fact, as we march into today’s conversation,

you might want to just put in the back of your mind

the question, what is my mindset about blank?

So for instance, ask yourself,

what is my mindset about stress?

What is my mindset about food?

What is my mindset about exercise?

What is my mindset about relationships of different kinds?

Because in doing that, you’ll be in a great position

to extract the best of the information

that Dr. Crum presents, and indeed to adapt those mindsets

in the way that is going to be most beneficial for you.

Before we begin, I’d like to emphasize

that this podcast is separate from my teaching

and research roles at Stanford.

It is, however, part of my desire and effort

to bring zero cost to consumer information about science

and science-related tools to the general public.

In keeping with that theme,

I’d like to thank the sponsors of today’s podcast.

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And now my conversation with Dr. Aliyah Crum.

Well, great to have you here.

Great to be here.

Yeah, for the record, it’s Aliyah Crum,

but you go by Ali, correct?

That is correct.

Dr. Ali Crum, I guess would be.

Or just Ali.

Okay, great.

Well, I’ve been looking forward

to talking to you for a long time.

Just to start off, you’ve talked a lot

and worked a lot on the science of mindsets.

Could you define for us what is a mindset

and what sort of purpose does it serve?

Of course, yeah, mindsets have been described

or defined in a lot of ways.

We define mindsets as core beliefs

or assumptions that we have about a domain

or category of things that orient us

to a particular set of expectations,

explanations, and goals.

So that’s kind of jargony.

I can distill it down for you.

So mindsets are an assumption that you make about a domain.

So take stress, for example, the nature of stress.

What’s your sort of core belief about that?

And mindsets that we’ve studied about stress are,

do you view stress as enhancing, good for you,

or do you view it as debilitating and bad for you?

Those mindsets, those core beliefs orient our thinking.

They change what we expect will happen to us

when we’re stressed, how we explain the occurrences

that happen or unfold when we’re stressed,

and also change our motivation

for what we engage in when we’re stressed.

So we have mindsets about many things,

mindsets about stress, mindsets about intelligence,

as Carol Dweck’s work has shown,

mindsets about food, mindsets about medicine, you name it.

It’s sort of distilling down those core assumptions

that really shape and orient our thinking and action.

I’ve heard you say before that mindsets simplify life

in some way by constraining the number of things

that we have to consider.

And it sounds to me like we can have mindsets

about many things, as you said.

What are some different mindsets?

I think many people are familiar

with our colleague Carol Dweck’s notion of growth mindset,

that if we’re not proficient at something

that we should think about not being proficient yet,

that we are on some path to proficiency.

But what are some examples of mindsets

and how early do these get laid down

or do we learn them from our parents?

Maybe if you could just flesh it out a bit for us

in terms of what you’ve observed in your own science

or your own life even.

Yeah, sure.

I think it’s important with Carol Dweck’s work,

a lot of people kind of get focused

on growth motivation and all these things.

But her work really originated from thinking

about what she called as implicit theories

or core beliefs about the nature

of intelligence or ability.

So do you believe that your baseline levels

of intelligence or your abilities are fixed, static,

set throughout the rest of your life?

Or do you believe that they can grow and change?

Now, those are oversimplified generalizations

about the nature of intelligence.

And the reality is, as it always is, complex

and it’s a bit of both and it’s all these things.

But as humans, we need these simplifying systems

to help us understand a complex reality.

So those assumptions that we jump to,

oh, intelligence is fixed or intelligence is malleable,

they help us to simplify this complex reality,

but they’re not inconsequential, right?

They matter in shaping our motivation.

And as she has shown, if you have the mindset

that intelligence is malleable,

you’re motivated to work harder, to grow your intelligence.

If you have a setback in your learning,

you think, okay, there’s something there

that I can grow and learn and build from.

If you have the mindset that it’s fixed,

why work harder at math

if you don’t think you’re good at it?

So in retrospect, it’s pretty clear

how these mindsets can affect our motivation.

What our work has aimed to do

is to expand the range of mindsets

that we are studying, focused on,

and also understand and expand the range of effects

that they have.

So by and large, we’ve focused on mindsets

in the domain of health and health behaviors.

So I mentioned mindsets about stress.

We’ve also looked at mindsets about food and healthy eating.

So do you have the mindset that foods

that are good for you, healthy foods,

are disgusting and depriving?

Or do you have the mindset that healthy foods

are indulgent and delicious?

Now, you know, it could be a variety of different foods.

You might have different thoughts

about different healthy foods,

but generally people, at least in our culture in the West,

have this view that stress is debilitating.

Healthy foods are disgusting and depriving.

And those mindsets, whether or not they’re true or false,

right or wrong, they have an impact.

And they have an impact

not just through the motivational mechanisms

that Dweck and others have studied,

but as our lab has started to reveal,

they also shape physiological mechanisms

by changing what our bodies prioritize and prepare to do.

So those are just two examples, mindsets about stress,

mindsets about food.

We’ve looked at mindsets about exercise.

Do you feel like you’re getting enough?

Or do you feel like you’re getting an insufficient amount

to get the health benefits you’re seeking?

Mindsets about illness.

Do you view cancer as an unmitigated catastrophe?

Or do you view cancer as manageable

or perhaps even an opportunity?

We’ve looked at mindsets about symptoms and side effects.

Do you view side effects as a sign

that the treatment is harmful?

Or do you view side effects as a sign

that the treatment is working?

Again, these are sort of core beliefs or assumptions

you have about these domains or categories,

but they matter because they’re shaping,

they’re synthesizing and simplifying the way we’re thinking,

but they’re also shaping what we’re paying attention to,

what we’re motivated to do,

and potentially even how our bodies respond.

Yeah, I’d love to talk about this notion

of mindset shaping, how our bodies respond.

And maybe as an example of this,

if you could share with us this now famous study

that you’ve done with a milkshake study,

if you wouldn’t mind sharing the major contours

of that study and the results,

because I think they’re extremely impressive

and they really speak to this interplay

between mindset and physiology.

Certainly, yeah, this was a study that I ran

as a graduate student at Yale University.

I was working with Kelly Brownell and Peter Salovey.

Peter Salovey had done a lot of work

on really coining the term emotional intelligence,

studying that.

He’s now the president of Yale, right?

He’s now the president of Yale, yes.

So he’s done well.

He’s done well for himself

and for the university and society.

And Kelly Brownell, who was doing a lot of research

on food and obesity, and I had come in

doing some previous work on mindsets about exercise

and placebo effects and exercise,

and was in this sort of food domain

and this emotions and food domain.

And it really occurred to me

that there was a very simple question

that hadn’t been probed yet.

And that was, do our beliefs about what we’re eating

change our body’s physiological response to that food,

holding constant the objective nutrients of that thing?

So that question might sound outrageous at first,

but it was, it’s really not outrageous

if you’re coming from a place

of having studied in depth placebo effects.

So placebo effects are this, in medicine at least,

are this sort of robust demonstration

in which simply taking a sugar pill, taking nothing,

under the impression that it’s a real medication

that might relieve your asthma, reduce your blood pressure,

boost your immune system,

can lead to those physiological effects

even though there’s no objective nutrients.

And we have more evidence on placebo effects

than we have for any other drug

because of the clinical trial process

in which all new drugs and medications

are required to outperform a placebo effect.

So we have a lot of data on the placebo effect.

Now, we can get nuanced there.

We don’t have a lot of data comparing the placebo effect

to doing nothing, which is important

for distilling mindset effects or belief effects

from sort of natural occurring changes in the body.

But anyways, going back to this question,

it was like, all right, we’ve moved from, you know,

medications solving our health crises

to behavioral medicine solving our health crises,

increase people’s exercise, get them to eat better.

To what degree are these things influenced

by our mindsets or beliefs about them?

So to test this question, we ran a seemingly simple study.

This was done at the Yale Center

for Clinical and Translational Research.

And we brought people into our lab

under the impression that we were designing

different milkshakes with vastly different

metabolic concentrations, nutrient concentrations

that were designed to meet different metabolic needs

of the patrons of the hospital, right?

So you’re gonna come in,

you’re gonna taste these milkshakes,

and we’re gonna measure

your body’s physiological response to them.

This was a within-subjects design,

so it was the same people consuming two different milkshakes,

two different time points separated by a week.

And at one time point, they were told

that they were consuming this really high-fat,

high-caloric, indulgent milkshake.

It was like a 620 calorie, super high fat and sugar.

The other time point, they were told

that it was a low-fat, low-calorie,

sensible sort of diet shake.

In reality, it was the exact same shake.

It was right in the middle.

It was like 300 calories,

moderate amount of fats and sugars.

And we were measuring their body’s

gut peptide response to this shake.

And in particular, we were looking at the hormone ghrelin.

So as you know, ghrelin hunger,

medical experts call it the hunger hormone,

rises in ghrelin, signal, you know, seek out food.

And then theoretically,

in proportion to the amount of calories you consume,

ghrelin levels drop, signaling to the brain,

okay, you don’t need to eat so much anymore.

You can stop eating.

And also revving up the metabolism

to burn the nutrients that were just ingested.

What we found in this study was that

when people thought they were consuming

the high-fat, high-calorie, indulgent milkshake,

in response to the shake, their ghrelin levels dropped

at a threefold rate, stronger than when they thought

they were consuming the sensible shake.

So essentially, their bodies responded

as if they had consumed more food,

even though it was the exact same shake at both time points.

So this was really, you know,

interesting and important for two reasons, really.

One was that it was, to my knowledge,

one of the first studies to show any effects

of just believing that you’re eating something different

on your physiology.

Lots of studies have shown that

believing you’re eating different things changes your taste,

you know, and even your satisfaction and fullness after.

But this shows that it has a metabolic

or a physiological component.

But the second piece was really important as well.

And especially for me, this was one study

that really transformed the way I think about

how I approach eating.

And that was the manner in which it affected our physiology

was somewhat counterintuitive.

So I had gone in thinking,

the better mindset to be in when you eat

means that you’re eating healthy, right?

Like, you know, it just makes sense.

Like placebo effects, think you’re healthy,

you’ll be healthy, you know.

But that was a far too simplistic way of thinking about it.

And in fact, it was the exact opposite

because thinking that they were eating,

when these participants thought they were eating sensibly,

their bodies left them still feeling physiologically hungry,

right, not satiated,

which could potentially be corresponding

to slower metabolism and so forth.

So if you’re in the interest of maintaining or losing weight,

what’s the best mindset to be in?

It’s to be in a mindset that you’re eating indulgently,

that you’re having enough food, that you’re getting enough.

And at least in that study,

we showed that has a more adaptive effect

on ghrelin responses.

So interesting.

And especially interesting to me as a neuroscientist

who has worked on aspects of the nervous system

that are involved in conscious perception,

like vision and, you know,

motion and color perception and so forth.

But also our lab has worked

and is increasingly working on autonomic functions

that are below our conscious detection.

In this case, a lie about how much something

these milkshakes contain affected a subconscious process,

because I have to imagine that the ghrelin pathway

is not one that I can decide,

oh, you know, this particular piece of chocolate

is going to really reduce my ghrelin

because it’s very nutrient rich,

as opposed to one,

if you told me that a different piece of chocolate,

for instance, is low calorie or sugar-free chocolate

or something of that sort.

The ghrelin pathway, however, it seems based on your data

that the ghrelin pathway is susceptible to thoughts,

which is incredible.

But then again, there must be crossover

between conscious thought and these subconscious

or kind of autonomic pathways.

So it’s really remarkable.

It raises a question that I just have to ask

because increasingly so,

I’m involved in online discussions and social media.

And one of the most barbed wire topics out there,

and that’s being generous,

is this topic of which diet or nutrients are best.

You’ve got people who are strictly plant-based.

You’ve got people who are omnivores.

You’ve got people who are carnivores.

You have every variation.

You have intermittent fasting,

also called time-restricted feeding.

And it seems like once a group kind of plugs

into a particular mode of eating

that they feel works for them,

for whatever reason, energy-wise, mentally,

maybe they’re looking at their blood profiles,

maybe they’re not.

But once they feel that it sort of, it works for them,

each camp seems to tout all the health benefits

and how great they feel.

Could it be that mindset effects are involved there,

that people are finding the nutritional program

that they feel brings them the most enrichment of life,

but also nutrients,

and that their health really is shifting

in a positive direction,

but not necessarily because of the food constituents,

but because of the community and the ideas

and the reinforcement?

Yeah, and the belief that this is the right way

of doing something.

I think 100%, 100%, it has something to contribute.

You know, I don’t wanna,

I’m not gonna weigh in on the debate,

which is that what I will most certainly weigh in on

is the notion that,

look, going back to the placebo effect, right,

we have a outdated understanding of what that is,

which is based on this randomized control trial.

You compare a drug to a placebo.

If the drug works better than the placebo,

you say, great, the drug works.

If the drug doesn’t outperform the placebo,

you say the drug doesn’t work.

That’s really oversimplified.

It’s a good test for the specific efficacy of the drug.

It’s not a good test for understanding

the total impact of that drug.

Because in the reality of things,

if a drug outperforms a placebo,

then you start prescribing it,

but the reality is that the total effect of that drug

is a combined product of the specific chemical attributes

of that drug and whatever’s going on in the placebo effect,

which is, at least from our perspective,

it’s beliefs, it’s social context,

and it’s your body’s natural ability

to respond to something.

So that’s in the placebo effect example.

The same is true for everything we do or consume.

So when it comes to what diet you’re eating,

both are true.

It does matter what it is,

and it matters what you think about that diet,

and what others around you and in our culture

think about that diet,

because those social contexts inform our mindsets.

Our mindsets interact with our physiology

in ways that produce outcomes that are really important.

So let’s not get dualistic and say,

it’s either all in the mind or not in the mind.

Let’s also not be unnecessarily combative

and say, oh, it should be all plant-based

or keto or whatever.

It’s all of those things are a combined product

of what you’re actually doing

and what you’re thinking about.

If you believe in it, if you don’t, if you’re skeptical,

or in some cases you think you should be eating

a certain way and then you don’t live up to that,

it might have an adverse effect

because of the stress and the anxiety associated with that.

Very interesting.

Along the lines of belief effects,

can we call these belief effects or mindsets?

Is there a difference between these,

what I’m calling belief effects and placebo effects?

I mean, are placebo effects distinctly different

from mindset effects or are they more or less the same thing?

They’re related.

So I think placebo effects maybe should be reserved

for the conditions in which you’re actually taking a placebo

which is an inactive substance.

When you get out of that sort of placebo versus drug realm

and you start looking at placebo effects,

I use quotes with my hands here,

in behavioral health, the term kind of becomes confusing

because you’re not, you know, in the milkshake study,

we didn’t give people a placebo milkshake, right?

We just changed what they believed about it.

So how I like to think about it is that placebo effects

as they’re traditionally construed

are made up of three things.

It’s the social context, mindsets or beliefs,

and the natural physiological processes

in the brain and body that can produce the outcomes.

And so we could just call them belief effects

because the beliefs are triggering

the physiological processes

and the beliefs are shaped by the social context.

Does that make sense?

It makes sense.

Yeah, there was a paper a year or two ago

published in Science Magazine

about brain regions involved in psychogenic fever

that if people, or you can actually do this

in animal models too, think that they are sick,

you get a genuine one to three degree increase

in body temperature,

one to three degrees Fahrenheit increase in body temperature.

It’s pretty impressive.

Yeah.

And I guess it plays into, you know,

symptomology generally.

So I’m a believer in belief effects.

Well, it’s also, and I would just say that, you know,

the term that we use in our field is nocebo effect for that,

which is sort of the placebo’s ugly stepsister.

You know, it’s when negative beliefs

cause negative consequences.

So you are told you will have, you know,

it’s very well demonstrated that when people are told

about certain side effects,

they’re far more likely to experience those side effects.

When people think that they’re sick or going to get sick,

sometimes that can create, you know,

the physiological symptoms.

And, you know, there’s various debates

that it’s not only that physiology changes,

it’s also that your attention changes.

So we’re experiencing things like fatigue and headache

and upset stomach all the time.

And then when you take a drug and somebody says,

you’re going to feel fatigue and headache,

you start noticing that you’re tired and have headaches

and attribute it to the drug.

So some of the mechanisms are attention

and some of them are real changes in physiology.

I’d love for you to tell us about the hotel workers study.

Yeah, sure.

I know you get asked these questions all the time,

but I find these results also amazing.

Yeah, no, I think that this is a really good example

of this phenomenon, right?

That the total effect of anything is a combined product

of what you’re doing

and what you think about what you’re doing.

So this was a study that I ran with Ellen Langer

way back when I was an undergrad, actually.

We started this study.

Ellen Langer is a professor of psychology at Harvard

and she’s done a lot of really fascinating work

on her flavor of mindfulness,

which is distinct from a more Eastern,

Buddhist sort of mindfulness-based work.

And she actually was the one who said to me originally,

you know, I was an athlete at the time,

I was an ice hockey player and I was training constantly.

And one day, I’ll never forget it,

she said, you know the benefit of exercise

is just a placebo, right?

And I was like, well, that’s outrageous.

Ellen’s known for saying very provocative,

but also very wise things.

And that statement really got me thinking about that.

So we designed this study together

and that was to look at, you know, how would you study,

if the benefits of exercise were a placebo,

how would you even test that?

Because, you know, what does it mean

to give a placebo exercise?

And we sort of flipped it on its head

and we found a group of people

who were getting a lot of exercise,

but weren’t aware of it, that they were, right?

So this, we settled on a group of hotel housekeepers.

So these are women working in hotels

who were on their feet all day long,

pushing carts, changing linens, climbing stairs,

you know, cleaning bathrooms, vacuuming.

It was clear that they were getting above and beyond

at least the surgeon general’s requirements at that time,

which were to accumulate 30 minutes

of moderate physical activity per day.

But what was interesting was when we went in

and surveyed them and asked them,

hey, how much exercise do you think you’re getting?

A third of them said zero.

Like, I don’t get any exercise.

And the average response was like a three

on a scale of zero to 10.

So it’s clear that even though these women were active,

they didn’t have that mindset, right?

They had the mindset that their work was just work,

hard, maybe thankless work that led them to feel tired

and, you know, in pain at the end of the day,

but not that it was good for them,

that it was good exercise.

So what we did was we took these women

and we randomized them into two groups,

and we told half of them that their work was good exercise.

In this case, it was true, factual information.

We oriented them to the surgeon general’s guidelines.

We oriented them to the benefits

that they should be receiving.

And then we had measured them previously

on their physiological metrics like weight

and body fat and blood pressure.

And we came back four weeks later and we tested them again.

And what we found was that these women,

even though they hadn’t changed anything in their behavior,

at least that was detectable to us,

they didn’t work more rooms.

They didn’t start, you know, doing pull-ups or push-ups

in between cleaning hotel rooms, as far as I’m concerned.

They didn’t report any changes in their diet,

but they had benefits to their health.

So they lost weight.

They decreased their systolic blood pressure

by about 10 points on average.

And they started feeling better about themselves,

their bodies, and their work, not surprisingly.

That’s amazing.

How should we conceptualize that result

in light of all of our efforts

to get more out of exercise, right?

Because earlier you mentioned it from the milkshake study

and our perceptions about nutrient density,

that, you know, it’s a little bit the right message

that actually a little bit counterintuitive,

that if you think, oh, this is very low calorie,

nutrient sparse, then it’s good for me

in the context of losing weight, for instance.

But it turns out the opposite is true,

because as you told us, the body responds differently

when you think something is nutrient dense

and can actually suppress hunger more.

So in light of this result,

if I were to say, okay,

my current understanding of the literature

is that getting somewhere between 150 and 180 minutes

per week of cardiovascular exercise

is probably a good idea for most people.

If I tell myself that it’s not just a good idea,

but that it’s extremely effective

in lowering my blood pressure

and maintaining healthy weight, et cetera, et cetera,

according to these results,

it will have an enhanced effect on those metrics.

Is that right?

Definitely.

So this is a really important point,

because what this reveals

is that we have to be more thoughtful

in how we go about motivating people to exercise

or teaching people about the benefits.

Our current approach is just to basically tell people

writ large, you know, here’s what you need to get.

Here’s what you need to get good for, you know,

to get enough benefits to receive the,

enough exercise to receive the health benefits.

The problem with that approach is that

most people aren’t meeting those benefits yet

or aren’t meeting those requirements yet.

And the risk with that is that,

well, the intention with that is to motivate them

because, you know, public health officials think,

well, if I just tell people you need to get more exercise

because it’s good for you, they’ll do it.

We know now that that doesn’t work,

that these guidelines are not motivational.

They don’t change our behavior.

And what our work adds to that

is that not only is it not motivational,

it also creates potentially a mindset

that, you know, makes people worse off

than they were without knowing about the guidelines.

So again, it’s tricky.

I’m not saying that mindset is everything.

Certainly exercise is good for us and is helpful for us.

It’s one of the things we have the best data on.

So I’m not saying, oh, exercise is all a placebo.

What I am saying is that we need to be more mindful

about how do we motivate people to exercise,

but how do we help people to actually reap the benefits

of the exercise they are already doing?

Now, Octavia Zart, who’s a grad student in my lab,

ran a number of interesting studies along these lines,

one in which she looked at

three nationally representative data sets,

which had this interesting question in them,

which was how much exercise do you get relative to others?

Do you get about the same, a little more, a lot more?

Do you get a little less or a lot less, right?

So, you know, the audience, your listeners,

you could all answer this.

And then in these data sets,

what she did was she had, you know,

pulled from data that tracked death rates

over the next 21 years.

And a couple interesting things revealed themselves.

One was that the correlations

between these perceptions of exercise relative to others

and people’s actual exercise

is measured through accelerometer data,

as well as more rigorous sort of

what did you do today kind of data.

Those don’t correlate much at all.

People lie.

Well, people lie, but also-

Or misperceive.

They misperceive.

And, or, you know, who’s to say it’s misperceiving?

There’s just, everything’s relative, right?

I used to do triathlons very seriously.

So if you were to ask me now,

I feel like I’m totally inactive, right?

Because I’m not doing anything near what I used to.

And if that’s my focus set, right,

I feel like I’m not exercising much.

But if I think about, you know,

compared to other people,

given what I know about, you know,

national representative statistics,

then I could feel like, oh, I’m getting a lot, right?

So you can see how these perceptions

are decoupled from objective reality.

And what we found in these studies

is that that one question mattered,

in some cases, more than objective activity,

but in all cases, controlling for objective activity

and predicting death rates.

And in one of those samples,

it was a 71% higher risk of death rate,

you know, if people rated themselves

as feeling like they were getting less activity than others.

Wow, that’s a big deal.

It’s a big deal.

And again, you know, that study is cross-sectional,

longitudinal, it was not experimental,

but, you know, combined these really sort of,

you know, coalesce to say, hey, this is important too, right?

Like, let’s figure out ways to be active

and get people active,

but let’s also not make people feel horrible

about themselves when they’re not getting enough.

And going back to the hotel study,

again, I mentioned that I did that at a time

when I was a Division I ice hockey player at the time.

We were training all the time,

and I was in an unhealthy mindset about that.

I never felt like I was getting enough.

I would, you know, come off a two-hour practice

into a weightlifting session,

and then I would get on the elliptical for 30 minutes

because I thought I had to do that also, you know?

My teammates who were with me at the time

could attest to that.

And so that study was really helpful for me

to realize that I needed to pay attention,

not just to what I was doing,

but also take care of my mindset about that.

And I think the essence is how do you get people

to feel like they’re getting enough?

It’s a sense of enoughness that really matters.

Yeah, I can see the dilemma

because you don’t want people thinking

that exercise and its positive effects are so potent

that they can get away with a three-minute walk each day

and that they’re good,

because most likely they are not.

But again, you don’t want them

to be so back on their heels psychologically

that they don’t even do that

or that they never exceed that by very much.

But it seems like the message from the milkshake study

and what we’re talking about now in terms of exercise

would be to really communicate to the general public

that food has a potency,

even healthy foods have a potency to give us energy,

to fuel our immune system and endocrine system, et cetera,

and that exercise has a remarkable potency

and that that potency can be enhanced

by believing in or understanding that potency.

Exactly.

Is that an accurate way to state it?

Total, that’s exactly right.

And that’s where I really feel like we need to push

and what I try to do in our research

is to not just show, oh, mindset matters.

Isn’t that interesting?

But it’s both matter, right?

Both exercise and what you think about it matter.

Both what you eat and how you think about what you eat matter

and so we really as individuals and as a society

need to work on what is the right way to cultivate

both behaviors and mindsets about those behaviors

that serve us.

And in the food context, this, again,

that milkshake study really changed me on a personal level

because I had been somebody who was constantly

trying to restrain my eating, right?

I wanted to maintain or lose weight, look fit

and so I was like, well, I should diet,

I should have low calorie, low carb, low this, low that,

but what that was doing was putting me

into this constant mindset of restraint

and what that study suggested was that that mindset

was potentially counteracting any benefit, right?

Or any objective effects of the restrained diet

because my brain was saying, okay, you’re restraining,

maybe my body was responding to that,

but the brain was also saying, eat more food,

stay hungry because you need to survive.

And so the answer isn’t, oh, we’ll throw everything

into the wind and just drink indulgent milkshakes

all day long.

The answer is eat healthy foods, right?

Based on the latest science and what we know to be true

about nutrients and our body’s response to them,

but try to do so in a mindset of indulgence,

a mindset of satisfaction, a mindset of enjoyment, right?

That is really the trick and that’s what I at least try

to do in my own life.

I love that and as I get more involved

in public-facing health communications,

this comes up again and again.

How should we conceptualize our behavior?

How should we think about all these options

that are offered to us?

And I’m excited that the potency of mindsets

are coming through again and again.

So I have a question about this.

I don’t know if this study has ever been done,

but a lot of these mindset effects are something

that years ago I felt I did vis-a-vis sleep

because I was in graduate school and as a postdoc

and even as an undergraduate, I had so much work to do

that I decided I would sleep when I was dead, in quotes.

Not a good idea from what we know.

However, I found that a couple nights of minimal sleep

or even an all-nighter and I could do pretty well.

Eventually it would catch up with me.

Has there ever been a study exploring whether or not

the effects of sleep deprivation can be impacted

by these mindset effects?

Because over the years I keep learning more and more

about how much sleep I need and I’ve really emphasized sleep

and I do feel much better when I’m getting it.

But as new parents know or students know or athletes know

or anyone that lives a normal life finds sometimes

that they don’t get a good night’s sleep.

Would believing that we can tolerate that

and push through it and function just fine

and that it’s not gonna kill us or give us Alzheimer’s,

could that help us deal with a poor night’s sleep

or even two or chronic sleep deprivation?

Certainly, I would guess.

There’s been one study to my knowledge that’s tested that,

Dragunov and colleagues.

And they looked at, they had people come in

and they gave them sort of, I think it was a sham

sort of EEG test to sort of figure out how, you know,

this was done a number of years ago.

Now we actually have devices to test this,

but theirs was this sham test.

And they gave people fake feedback

about the quality of their sleep

and, you know, how it had been the night before.

And they also asked the participants

how they felt about their sleep.

And essentially what they found was that the sham feedback,

if they were told that they had gotten lower quality sleep

led to deficits in a variety of cognitive tasks.

And that was sort of decoupled from their actual,

you know, qualities of sleep, at least as self-reported.

So that’s one study that attests to this.

I think certainly, I mean, I would, you know,

I would bet a lot of money, I haven’t run this myself,

but that your mindsets can push around your, you know,

cognitive functioning, physiological effects of sleep.

But once again, it’s not all or nothing, right?

There are real important benefits of sleep

and how far we can push around that through our mindset

is an open question.

You know, the result that you mentioned

is really interesting

because a lot of people use these sleep trackers now.

They’re using rings or wristbands.

In fact, my lab has worked pretty closely with a company

and they supplied us data on how well people are sleeping.

And you get a score, people get the score back.

And when they see that score,

they might think based on these results,

oh, my sleep, my recovery score, my sleep score was poor.

I shouldn’t expect much from myself today.

It makes sense that my memory would be going.

For this reason,

and I’ll probably lose a few friends for saying this,

but hopefully I’ll gain a few as well.

That’s why I like to just do a subjective score for myself.

If I wake up in the morning, I just decide,

okay, did I sleep well or not?

I don’t like seeing a number.

I don’t like getting a readout from a device.

That’s me, I know a lot of people like it

and they can be very useful,

but gosh, it seems that these belief effects

are weaving in at all levels.

I’d love for us to talk about stress

because your lab has worked extensively on this.

And if you would,

could you tell us at some point about the study

that you’ve done about informing people

about the different effects of stress,

but also if there’s an opportunity,

some takeaways about how we could each conceptualize stress

in ways that would make it serve us better

as opposed to harm us

and our mental and physical performance.

Great, yeah, so I had come off the heels

of doing some research in exercise and diet

and finding these provocative

and also counterintuitive effects

with respect to how we should try to motivate people.

And I was thinking about this

and this grouping of going from medicines

to saving us to behaviors to saving us

and how those behaviors might be influenced by mindsets.

The obvious next thing to think about was stress, right?

Because it’s like, okay, well, you want to be healthier,

fix your diet, fix your exercise and stress less.

And, you know, so I started doing some digging

into the nature of stress and a couple of things were clear.

One was that the public health message was very clear, right?

That stress was bad, right?

Unmitigated and harmful on our health,

our productivity, our relationships,

our fertility, our cognition, you name it, right?

The messages that were out there,

by and large oversimplified messages

focused on the damaging consequences of stress.

But as you know, if you actually dive deeper

into the literature on stress and the origins of stress,

what you find is that, you know, the literature,

like most literatures is not so clear cut.

And in fact, there’s a large amount of evidence

to support the fact that the experience of stress,

meaning encountering adversity or challenge

in one’s goal-related efforts

does not have to be debilitating.

And in many cases, the body’s response was designed

to enhance our ability to manage at those moments, right?

So some research showing that stress narrows our focus,

increases our attention, speeds up the rate

at which we’re able to process information.

There was some research out there showing this phenomenon

of physiological toughening,

the process by which the release of catabolic hormones

and the stress response recruit

or activate anabolic hormones,

which help, as you know, build our muscles,

build our neurons to help us grow and learn.

And there was a whole body of emerging research

on post-traumatic growth or this phenomenon

which even the experience of the most traumatic stressors,

the most chronic and enduring stressors

could lead not to destruction,

but in fact to the exact opposite,

to an enhanced sense of connection with our values,

connection to others, sense of joy and passion for living.

And so, you know, I found that to be interesting.

And, you know, my work since then

has been not to try to argue that stress is enhancing

and not debilitating, but try to point out

that the true nature of stress is a paradox.

The true nature of stress is manifold and complex

and lots of things can happen.

But to question what’s the role of our mindset about stress

in shaping our response to stress.

So some work had already been done

looking at your perception of the stressor, right?

So do you view a stressor like a challenging exam

or a health diagnosis as a challenge or a threat?

And that had shown pretty convincingly

that when you view stressors more as a challenge,

less as a threat, that your brain and body

responds more adaptively.

What our question was was to take

the sort of psychological construal

one step higher in abstraction.

So not just the stressor, but the nature of stress, right?

At that core level, do you view stress

as something that’s bad, is going to kill us,

and therefore should be avoided?

Or do you view stress as natural and something

that’s going to enhance us?

And so we set out to design a series of studies

to test the extent to which these mindsets about stress

mattered.

We first, this again was with Peter Salovey and Sean Aker

originally, we designed a measure

to test people’s mindsets about stress.

Simple questions like, what extent

do you believe or agree or disagree

with statements like, stress enhances my performance

and productivity, stress heightens my vitality

and growth, things like that.

And we found in a number of correlational studies

that that more enhancing stress mindset

was linked to better health outcomes, better well-being,

and higher performance.

So then we set out to see if we could

change people’s mindsets.

And in our first test of this, we

decided to do so by creating these multimedia films that

showcased research, anecdotes, facts about stress, all true,

but oriented towards one mindset or the other, right?

So you can imagine one set of films

showed basically the messages that were out there

in the public health context.

The other showed, hey, stress has

been linked to these things, but in fact, the body stress

response was designed to do this.

Did you know it could do that?

And we had empowering images like LeBron James

making the free throw in the final minute

versus missing it, right?

So all of these things are true, possibilities,

but oriented to two different mindsets about stress.

So either people saw a video that basically

made it seem like stress will diminish you, crush you,

reduce you, or a video very similar,

stress will grow you, bring out your best,

and maybe even take you to heightened levels of performance

that you’ve never experienced before.

Exactly.

Exactly.

So yeah, examples in the sports.

We also had true leaders emerge in the moments of greatest

stress, you know, Churchill.

So all those examples are out there

for both the enhancing nature and the debilitating nature.

And our question was, does orienting people

to different mindsets change how they respond to stress?

So this study was done in the wake

of the 2008 financial crisis.

We worked with UBS, a company, a financial service company

that was undergoing pretty massive amounts of layoffs.

So these employees were stressed about being laid off.

They were taking on more pressure.

It was just a tough time.

And we randomized them into three conditions.

And this was all pre-work before getting a training on stress.

But the three different conditions,

some watched no videos, some watched the stress

will crush you videos, and some watched the stress

could enhance you videos.

And what we found was that just, you know,

it was a total of nine minutes of videos

over the course of the week led to changes in their mindsets

about stress, which led to changes

in their physiological symptoms associated with stress.

So people who watched the enhancing films

had fewer backaches, muscle tension, insomnia,

racing heart, and so forth.

And they also reported performing better at work

compared to those who watched the debilitating videos.

Now, interestingly, we didn’t make anyone worse

with the debilitating videos, which was good.

We had told the IRB we didn’t expect that

because that message was already out there.

That’s what they were already seeing.

That wasn’t new to them.

It was more this enhancing perspective

that turned out to be inspiring.

I love that study.

And I know we both have friends and ties

in the special operations community

through just sort of happenstance.

And maybe we’ll get into that a little later.

But a good friend from that community always says,

there are only three ways to go through life at any moment,

which is either back on your heels,

flat-footed, or forward center of mass.

And I said, well, what’s the key to forward center of mass?

And he said, stress is what places you

in forward center of mass,

meaning leaning forward and into challenge.

And I know that you’ve actually looked at that community,

and it does really seem like that’s a mindset

that either they have going in or that they cultivate

through the course of their training.

But this notion that stress is what puts us

in forward motion is true physiologically, right?

I mean, adrenaline’s major role is to place us

into a moment of, or bias us towards action.

That’s why we tremble.

It’s the body trying to initiate action.

But actually, this is probably a good opportunity.

If there’s anything interesting to extract

from the study on SEAL teams, what was it?

Yeah, no, I loved working with the SEALs.

One of the interesting things we found,

we’ve studied this, measured this mindset

in several different populations.

And in every single one that we had tested so far,

the average had been on the debilitating side of the scale.

People were just saying stress is bad.

Stress is bad, right?

And it’s like with measures of growth

and fixed mindsets about intelligence,

people are in the middle,

but oftentimes have a more positive mindsets

about intelligence.

That was not the case with stress.

It’s still not the case.

I’m trying to get the message out there.

Except for this group of Navy SEALs,

when they were actually recruits,

so people who were going through basic training

in order to become Navy SEALs.

And we found that they, on average,

had stress’s enhancing mindset,

perhaps not surprisingly, right?

If you’re going in to devote your whole life

to being a Navy SEAL, you must have some inclination

that stress is a source of strength for you.

But what we found with them,

we measured this at the beginning of their basic training,

of Bud’s training, and then looked at

how well they succeeded through that program.

So as you know, this is an extremely rigorous program.

You know, at the time, it was only like 10 or 20%

of trainees make it through.

The numbers have never shifted.

No matter how hard pressures on the community change,

the numbers are still on average about 15%.

Yeah, wow.

So what we found was that our measure predicted that rate.

So people who, even within that range,

had a more stress’s enhancing mindset

were more likely to complete training, become a SEAL.

They also had faster obstacle course times,

and they were rated by their peers more positively.

So, you know, again, let’s break this down, right?

This doesn’t mean, and people get me,

people get this wrong sometimes.

They think that I’m saying

that a stress’s enhancing mindset

means you should like stress, right?

Well, maybe SEALs do.

But that’s not what we’re saying, right?

Having a stress’s enhancing mindset

doesn’t mean the stressor is a good thing, right?

It doesn’t mean it’s a good thing

that you have to go into combat and it’s not pretty, right?

It doesn’t mean that getting a cancer diagnosis

is a good thing, or being in abject poverty is a good thing.

These are not good things.

But the experience of the stress associated with that,

the challenge, the adversity,

that experience can lead to enhancing outcomes

with respect to not just our cognition,

but our health, our performance, and our wellbeing.

So that mindset, right?

How does that work, right?

Well, it works through a number of different pathways.

One is that it changes fundamentally

what we’re motivated to do.

So if you just imagine we’re stressed about something,

maybe a global pandemic, for example,

for instance, and you think that stress is bad,

then what’s your motivation, right?

Your motivation is to, well,

first you get worried about the stress, right?

Now, not only do you have the pandemic,

you’re stressed about the stress of the pandemic.

But second is your reaction is typically

to do one of two things.

It’s either to freak out and do everything you can

to make sure that this doesn’t affect you negatively,

or to check out and say, oh, it’s not a big deal.

I’m not gonna deal with it.

You’re basically in denial.

So people who have a stress-debilitating mindset,

and we’ve shown this in our research,

tend to go to one or the other of those extremes.

They freak out or they check out.

Why?

Because if stress is bad,

you need to either get rid of it and deal with it,

or it needs to not exist, right?

If you have a stress-enhancing mindset,

the motivation changes, right?

And the motivation is how do I utilize the stress

to realize the enhancing outcomes?

What can we do here, right,

to learn from this experience to make us stronger, fitter,

you know, have better science and treatments for the future,

deepen my relationships with others,

improve, you know, my priorities and so forth, right?

So the motivation changes.

The affect around it changes.

It doesn’t make it easy to deal with.

But what we’ve shown in our research

is that people who have a stress-enhancing mindset

have more positive affect,

not necessarily less negative affect.

And it potentially changes physiology.

We have a few studies that show that people who are,

you know, inspired to adopt more enhancing mindsets

have more moderate cortisol response,

and they have higher levels of DHEA levels

in response to stress.

So more work needs to be done on the physiology,

but I’d love your take on the mechanisms

through which that’s possible.

Yes, and DHEA, of course,

has an anabolic hormone in both men and women.

Very interesting, because we had a guest on this podcast.

He actually is a PhD scientist

who runs the UFC Performance Training Institute.

His name is Duncan French.

And his graduate work at UConn stores was very interesting.

It was in exercise science and physiology.

And what he showed was that

if you could spike the adrenaline response,

I think they did this through first-time skydive

or something like that,

that testosterone went up.

Now, this spits in the face of everything

that we’re told about stress and testosterone levels, right?

And this has also been looked at in females with estrogen,

although, of course, there’s estrogen and testosterone

in both males and females,

but that’s how they designed the study.

So it turns out that at least in the short term

that a very stressful event can raise anabolic hormones.

And I think that people forget at a mechanistic level

that adrenaline is epinephrine,

and epinephrine is biochemically derived

from the molecule dopamine.

If you look at the pathway

and even just Google it and go images,

you’ll see that adrenaline is made from dopamine.

And dopamine and these anabolic hormones,

they’re sort of close cousins.

They work together in the pituitary and hypothalamus.

So it makes sense that one could leverage stress

toward growth and towards anabolism

as opposed to cannibalism,

which is not saying cannibalism as in eating other people,

but catabolic processes is, I guess,

the right way to refer to it.

But what’s, again, remarkable to me

is that all of these brain structures

that control dopamine, epinephrine,

testosterone, and estrogen,

they’re all thought to be in the subconscious,

meaning below our ability to flip a switch

and turn them on or off,

and yet mindsets seem to impact them.

So all that to say that there’s a clear mechanistic basis

by which this could all work.

And so on the one hand, I’m surprised

because these are incredible results.

On the other hand, I’m not surprised

because there’s a physiological substrate there

that could readily explain them.

Yeah, and I think figuring out exactly how it works

is really, you know-

We should do that.

We should do that, let’s do it.

We’ve got common friends in both departments,

so we should do it, why not?

But I did want to mention, you know,

the way I think about mindset,

and again, I think we need to study this.

I’m not a neuroscientist, so I haven’t looked at this,

but this is something we could do.

But the way I think about mindset

is that mindsets are kind of a portal

between conscious and subconscious processes.

They operate as a default setting of the mind, right?

So if, you know, if sort of programmed in there,

you have stress equals bad, right?

That is gonna, you know,

that’s gonna be something maybe conscious, right?

But it doesn’t have to be conscious, right?

People don’t have to know their mindsets about stress

until they’re asked, really.

That’s been programmed in through our upbringing,

through public health messages,

and through media and other things.

And it kind of sits there as an assumption in the brain.

And the brain is then figuring out

how should it respond to this situation.

And if the assumption, the default,

the programming is stress is bad,

that’s gonna, through our subconscious,

trigger all the things that’s like,

okay, well, I need to like, you know,

rev up the things that protect me

versus rev up the things that help me grow.

And so that’s at least how I think about it.

And what’s cool about it is that

because it operates as a sort of portal,

it communicates with more, you know,

subconscious physiological processes,

but it can also be accessed through our consciousness,

right, so just talking about this, right,

for your listeners, they’re now invited

to bring their stress mindsets up to the consciousness

and say, what is my stress mindset?

How am I thinking about stress?

Can I reprogram that?

Can I start to think about it as more enhancing?

That takes a little bit of a conscious work, potentially,

but then once you do that,

that can kind of operate in the background,

influencing how your body responds

and you don’t have to say, okay, I’m stressed,

I better tell my, you know, anabolic hormones.

Right.

That doesn’t work that way.

No.

But these mindsets can help with the translational process.

I love the idea that mindsets are at the interface

between the conscious and subconscious.

And I think there’s a lot to unpack there,

but it clearly is the case that the mindset,

they sort of act as heuristics, right?

And as we talked about earlier,

they can limit what the number of things to focus on,

because one thing that is really stressful

is trying to focus on everything all the time.

I mean, trying to navigate the public health

around anything, the public health information

around anything is kind of overwhelming.

As you mentioned, for stress,

you see a lot in the stresses will crush you,

and then you can also find evidence

that stress will grow you.

How should we, the listeners, think about stress?

I mean, what’s the most adaptive way to think about stress?

And should we talk about our stress?

Should we not talk about our stress?

Is there a short list of ways

that we can cope with stress better?

Yeah.

Or maybe I should be careful with the word cope.

Is there a way that we can leverage stress to our advantage?

Great, yeah, and that’s an important nuance

in your language, which is people have, by and large,

come from a place of how do you manage stress?

How do you cope with it?

Which implies, how do you fight against it?

Vacation massages, yoga classes.

Fight against it or check out from it, right?

And yeah, the real challenge is how do we leverage it?

How do we utilize it?

How do we work with it?

And I have a lot of thoughts on this.

The first and most important thing

is to clarify our definition of stress.

So I think people often associate,

the negative stress mindset is so insidious

that now people define stress

with its negative consequences.

So the first step is to decouple that

and to realize that stress is a neutral, right,

yet to be determined effect of experiencing

or anticipating adversity in your goal-related efforts.

So let me unpack that a little more.

You can be in the midst of it

or you could just be worried about something happening.

That’s one aspect.

Second is adversity or challenge,

so something that’s working against you.

But the third piece is critical

and that is in your goal-related efforts.

What that means is that we only stress

about things we care about, things that matter to us.

So this is really important, right,

because stress is linked with,

it’s the other side of the coin of things we care about.

And so I think that’s the first thing to realize, right,

that as humans, we stress because we care

and we don’t stress about things we don’t care about.

So the simplified example I like to use is,

if Johnny was failing school,

that wouldn’t stress you out unless Johnny was your son

or you were Johnny or you really cared

about educating the Johnnies of the world, right?

It only becomes stressful

to the extent that you care about it.

So why are we trying to fight or run away or hide

or merely cope with our stress

or overcome it through our massages

when the stress is connected to the things we care about?

So then the question becomes, okay, if that’s true,

how can I better utilize or leverage

or respond to the inevitable stresses

that we’re going to experience?

I’m not saying go out and seek out more stress.

What I am saying is that you’re gonna experience stress

if you have any cares or values or passions

and most all of us do.

And so then what do you do?

And we’ve developed a three-step approach

to adopting a stresses-enhancing mindset.

And briefly, the first step is to just acknowledge

that you’re stressed, to own it, see it, be mindful of it.

The second step is to welcome it.

Why would you welcome it?

You welcome it because inherently in that stress

is something you care about.

So you’re using it as an opportunity

to reconnect to what is it that I care about here?

And then the third step is to utilize the stress response

to achieve the thing that you care about,

not spend your time, money, effort, energy

trying to get rid of the stress.

Does that make sense?

Makes sense, and I love it.

As somebody who’s laboratory studies

the physiological effects of stress,

the effects that impress me the most are, for instance,

the narrowing of visual attention

that then drives a capacity to parse time more finely,

which then drives the capacity

to process information faster.

It’s almost like a superpower.

And yes, it can feel uncomfortable often,

but I love the idea that acknowledging it, embracing it,

and then understanding its power and leveraging that power,

I think what I like so much about that framework

is that the stress response is very generic.

Unlike the relaxation response,

we don’t actually have to train up the stress response.

So we all kind of get this as a freebie.

And then it sounds like it’s a question

of what we end up doing with that.

Right, and Hans Selye, father of stress,

said himself it’s a nonspecific response, right?

So it occurs, it’s what you’re doing with it.

It’s how you’re channeling it.

And yeah, like we talked about before,

what most people do is they stress about the stress,

which then over exacerbates it,

or they check out from the stress,

which leads to depression and anhedonia,

because by checking out from stress,

you’re also checking out from the things we care about.

And substance abuse.

Exactly.

Our colleague, Anna Lembke, who also,

we had the good fortune of having as a guest

on this podcast, talked a lot about this,

that so much of substance abuse,

because she runs the addiction clinic

over on the med side of campus,

it takes over people’s lives

because of this increased ability

to find a solution to the stress

that then eventually becomes its own stressor

and its own problem.

Well, I love that mindset and framework.

I’d love for you to tell us just a bit

about what you’re up to right now,

and what’s most exciting to you now.

If you are able or willing to talk about

some of the work that’s on the way,

I saw a brief mention of something

on your publication’s website of a paper

about influencers, online influencers and nutrition.

That might not be the main thrust of what you’re up to,

but if you’re able to tell us about it,

sort of interesting,

given that a lot of the communication

in and around this podcast

takes place through social media.

And I’ve kind of launched into this landscape now

where I’m constantly bombarded with health information

and influencers, a term I didn’t even know

until a couple of weeks ago.

You are one.

One could argue one way or the other,

but so what is the deal with influencers?

Are they doing something good for health information

or are they ruining the landscape?

And don’t try and protect my feelings

because I now know that stress is actually an asset.

Yes, well, that work is part of a body of work

that we’ve been sort of venturing into,

which is to understand

where do these mindsets come from, right?

I mentioned sort of public health entities

as one source of, say, our mindsets about stress,

but I think that our mindsets are influenced

by four different sources.

First is our upbringing,

how our parents talked about things

like when we’re stressed or food or other things.

Second is culture and media,

so movies, podcasts,

and now social media.

Third is influential others,

so what doctors say to us or close friends or peers.

And fourth is your conscious choice.

So we talked about that a little.

You do have, we have, as humans,

have the ability to be mindful of

and to change our mindsets.

But the social media and influencer stuff

has been in part an attempt to understand

where do our mindsets about things

like healthy foods come from?

And Brad Turnwald, who is a former grad student in my lab,

has done a series of really interesting studies on this,

showing that if you rate the nutritional quality

of the top-grossing movies in the last 20 years,

or you look at the Instagram accounts

of all the most influential people on Instagram,

and you analyze the nutrition content

of what they’re eating,

what he’s shown is that, depending on the study,

70 to 90% of those movies or influencers

would fail the legal standards for advertising in the UK.

So they’re putting out there nutrition contents

that are, maybe not surprisingly,

but undeniably unhealthy.

And to me, that’s interesting and important,

and it shows that where are we getting this mindset

that those unhealthy foods are pleasurable, desirable?

What’s maybe even more interesting than that

is some of the work that he and others in our lab

have done to show that the ways people are talking

about the foods they’re eating really matter too.

So generally, what we’ve found is that

when people talk about unhealthy foods,

they use language that connotes a sense of excitement,

fun, sexiness, danger, indulgence,

basically anything good and desirable, right?

This would be like cookies, cakes, high sugar,

just really unhealthy.

Truly unhealthy foods, or yeah, that’s actually,

the objective of what health means is challenging,

but yeah, high fat, high sugar.

I think there’s pretty good agreement now

that excessive sugar isn’t good.

And highly processed.

Yeah, highly processed, excessive sugar.

I think there’s general consensus.

I’m sure someone will,

if you’re going to come after anyone, come after me.

I’ll stand behind that statement.

But on the other hand, when people are talking about,

if they do, which healthy foods aren’t portrayed in media,

they aren’t portrayed by influencers, rarely ever.

And when they are, they’re often talked about

with language that conveys a sense of deprivation.

It’s nutritious, but it’s sort of boring.

It’s bland.

It’s less tasty. Recovery from the holidays.

Sort of the post-holiday reset, right.

And this is really important because,

you’re doing all this work,

and others are doing all this work trying to inform people

about what actually is good for them.

And meanwhile, there’s this hurricane of other force

that’s telling people, that’s seeping into our minds

that sure, those might be good for you,

but those foods are not fun or sexy or indulgent

or desirable in any way, shape, or form, right.

And it’s also paid advertising for fast foods

and sugary beverages and other things.

So it’s not surprising that we have this mindset

that healthy foods are the less desirable thing to eat

because of those cultural and social forces.

What our work has just tried to do is to reveal that,

quantify it as a way to say, all right,

let’s maybe be a little bit more mindful

about how we talk about healthy foods.

And could, if you’re a movie producer,

can you be a little bit more mindful to showcase

healthy and delicious foods

and have the characters talk about them

in ways that are more appealing?

There’s a lot of room for people who produce this content

to have an impact, not just on what people do,

but what they think about the foods they’re eating.

It’s really interesting.

I hadn’t thought about it until now,

but it makes sense that any food that’s packaged

and can be sold can be woven into a film

or promoted by a celebrity influencer,

not a health influencer per se,

but a celebrity influencer because they’ll get paid, right?

It’s part of the ecosystem that allows them an income

and it feeds back on sales to the company.

And whereas things that can’t be commoditized,

it’s more difficult, right?

It’s hard to, whoever makes oranges and sells oranges

is unlikely to promote oranges in a celebrity post

or in a movie because oranges can be purchased

from many, many sources.

There’s no identifiable source of oranges

as there is with a packaged food, for instance.

Yeah, but the interesting thing we found in those studies

is that it wasn’t driven by promoted content

or branded content.

There’s some of that certainly.

And yeah, all of the promoted and branded content

is usually for processed high sugar foods,

but 90% or more of these foods that they were showing

were not promoted or branded.

And so there’s a lot of flexibility

in what these producers or influencers

could show on their media.

Although it goes both ways, right?

It’s not just the producers

and the influencers’ responsibility.

The public is reacting to this.

And we showed too that people respond more positively.

There are more likes on posts about unhealthy foods.

So it’s a, yeah, it’s a sort of distasteful

and in that, you know, it’s a distasteful culture

around healthy eating.

And we really have a lot to do to change it.

Yeah, well, it’s dopamine circuits through and through.

Just that the sight of some-

Exactly.

Very calorie-dense, extremely tasty food

drives those dopamine circuits, you know?

And I realize that there are people out there

who derive the same sort of,

or similar levels of pleasure from healthy foods.

And that’s a wonderful thing if one can accomplish that.

So we just need more of that is what it sounds like.

Yeah, exactly.

And that’s what’s really inspiring to me at least

is that it is possible, right?

I mean, people think, oh,

well, vegetables are just inherently less tasty

than ice cream.

And it’s like, well, that’s not necessarily true.

Also, it doesn’t have to be a competition, right?

I don’t have to get my three-year-old to hate ice cream

in order for it to like broccoli.

There’s a lot more I can be doing to help shape

a more positive approach-oriented, indulgent mindset

around healthy, nutritious vegetables and fruits

and other foods, right?

In addition to having her like ice cream, right?

And that’s totally fine.

Sounds like a really interesting study.

When it’s published, please let me know.

Yeah, I think it was actually released this week.

Oh, great.

I will be sure to-

JAMA Internal Medicine.

JAMA Internal, okay.

Great journal.

I will definitely talk about it on social media

and elsewhere.

Sounds very interesting.

What else are you up to lately that’s,

my favorite question to ask any scientist or colleague,

by the way, is what are you most excited about lately?

What are you up late thinking about

and getting up early thinking about?

Yeah, so hands down, the thing I’m most excited,

well, I guess there’s so many things.

The thing that I’m most into right now,

we’re doing the most work in is,

you know, I started by getting inspired

by placebo effects in medicine.

I did a long stint in placebo or belief-like effects

in behavioral health,

and now we’re moving back into medicine.

So I’m really interested in looking at how we can work

with active drugs and treatments to make them better

and make the experience of them better,

by instilling different mindsets.

So one study we did along those lines,

we worked with kids who are undergoing treatment

for food allergies, so allergies to peanuts, for example.

This was with Kari Nadeau,

who’s the head of the Stanford Allergy Center here.

She has a great treatment for food allergies.

Basically, kids take gradually increasing doses

of the thing they’re allergic to, like peanuts,

and over the course of six or seven months,

these kids become, you know, less reactive to peanuts.

And the problem with that treatment

is it’s really difficult

because they’re having all sorts

of negative symptoms and side effects.

These kids are getting itchy mouths and upset stomach,

they’re puking, and it’s scary

because they’re literally eating the thing

that they’ve been told might kill them, right?

And what we did in this study was we attempted

to improve the experience and outcomes of that

by reframing mindsets about the symptoms

and the side effects.

So as it was being conducted before,

the kids were told, look, these side effects

are just an unfortunate byproduct of this treatment,

and you have to sort of endure them to get through it.

But what we found in our conversation with Kari

was that the reality of those side effects

was not so negative.

In fact, they were mechanistically linked

to the body learning how to tolerate peanuts or the allergen.

And so what we did was we worked within a trial,

they were all getting the treatment,

but half of them were helped

to see this more positive mindsets,

that symptoms and side effects from this treatment

were a positive signal that the treatment was working

and their bodies were getting stronger.

And what we found was that that mindset

led to reductions in anxiety,

fewer symptoms when at the highest doses,

and most interestingly of all, they had better outcomes.

So based on immune markers

that were a sign of the allergic tolerance,

those who had this mindset throughout

had better outcomes to the treatment.

So that’s just one example.

I think my goal is really to move us

beyond the placebo versus drug,

mindset versus behavior,

to get to a place where we can blend them together

and maximize the benefit of these treatments.

So we’re doing a lot of studies like that.

How can we improve treatment for cancer

with different mindsets?

We’ve done some work recently with the COVID-19 vaccine

and symptoms and side effects.

So that’s what I’m really passionate about right now.

Incredible.

I can’t wait to read that study.

Is that one out or on the way?

Okay, well then I will also read and communicate with you

and then about that study.

Who knows, maybe you would come on Instagram

and do a little Instagram Live

to make sure that I don’t screw up the delivery

and that we can hear it direct

from the person who ran the study.

I find this issue of side effects really interesting.

I don’t take a lot of prescription drugs,

but recently I was prescribed a few

and the list of side effects is incredible.

And it just goes on and on and on.

I realized some of that is legal protections.

It’s hard for me to believe

that they’re actually expecting anyone to read those

because you need a high-powered microscope

to read this print.

It’s truly fine print.

But I did realize that in reading over the side effects

that one primes themselves to experience those side effects.

And so now I just rip up the side effects thing

or the sheet and just throw it away.

I just take it as recommended.

Do you think it works in the other direction too?

Where if an effective medication

is supposed to have result A, B, or C

and you are told again and again

how effective it is for that treatment,

that it could amplify the effect.

So in other words, it’s strictly a placebo.

It’s not nocebo as you described before,

but that perhaps at a lower dose,

given medication could have a amplified effect

or at a appropriate dose, if you will,

it could have a super physiological effect.

Has that ever been demonstrated?

To some degree.

I think where it gets tricky is for a long time,

people thought the effects of placebos

were expectancy based.

So you expect to get a benefit and that benefit occurs.

There’s certainly some truth to that.

But I think the mindset approach is more powerful

because it helps us understand the mechanisms.

So if you just expect that your blood pressure will go down,

what are the mechanisms through which that expectation

would lead to your blood pressure going down?

It’s hard to even understand that.

But if you have the mindset that you’re in good hands,

that this is being taken care of,

that this illness is not going to kill you,

that you’re being treated well,

then you can start to unpack the mechanisms

through which blood pressure could be relieved.

Maybe it’s anxiety reduction.

Maybe it’s changing the sort of anticipation

of what are the prioritization

of what the body needs to focus on.

And so I really think that the work of the future

needs to be on getting more sophisticated

about what is the mindset that we’re instilling

when we say something will work or it won’t work

and how do we understand the mechanisms

through which that changes physiology?

So to answer your question,

I think that that could be true,

but it depends on what actually

is the mindset you’re evoking.

I know you’re a parent and to the other parents out there,

but also to kids and people who don’t have kids,

what is the best way to learn and teach mindsets?

I mean, clearly a conversation like this informs me

and many other people out there about mindsets

and how we can adopt them.

But it also seems to me that if we have the opportunity

to teach mindsets and really cultivate certain mindsets,

that the world would be a much better place.

Yes.

How does one go about that?

Given that there were kids and we are all being bombarded

with conflicting information all the time,

how do we anchor to a mindset?

Yeah, and you’re getting at my other major passion

right now, which is what we’re calling in our lab,

meta mindset.

I’m working on this with Chris Evans and others,

and that is how do we consciously

and deliberately change our mindsets?

And the first step is really simple,

and that’s just to be aware that you have them,

that the world, your beliefs

aren’t sort of an unmitigated reflection of reality

as it objectively is.

They are filtered through our interpretations,

our expectations, our frameworks,

and simplifications of that reality.

And as you know your work and as you know so well,

all of, most of what goes on in our brain

is an interpretation of reality.

Mindsets are just the simplified core assumptions

about things.

And the first step is to realize that we have them.

The second step is to start to think about

what the effects of those mindsets are on your life

to sort of play out the story, right?

Okay, I have this mindset that stress is debilitating.

How is that making me feel?

What is that leading me to do?

Is this mindset helpful or harmful?

The question isn’t is the mindset right or wrong

because you can find evidence for or against it,

and we can fight about it till we’re exhausted.

The question is, is it helpful or harmful?

And then you can go about seeking out ways

to adopt more useful mindsets.

So we’ve been doing a lot of work

on how to actually do that.

How do you consciously change it?

Sometimes it’s really simple.

I think in cases where we don’t have

a lot of prior experience,

like the kids with allergies who are getting treatment,

they didn’t have any other mindsets about symptoms.

So we just had the luxury of setting it, right?

When it comes to healthy food,

I think it’s harder to change people’s mindsets

because we have a lot of baggage weighing us down.

As a parent, for me, I guess my number one piece of advice

is to lighten up trying to get your kids

to do certain things and focus more on helping them

to adopt more adaptive mindsets.

So, you know, I’m by no means an expert at this,

but I’m testing it with my own child.

In real time, the real kind of experiment.

Yeah, it’s how do I, you know, how do I resist the urge

to force my child to eat her dinner

so that she can have her dessert, right?

Because that’s the real urge.

No, you need to do that. Negotiating.

Because when you start thinking about it

in terms of mindset, you realize,

oh, that’s just reinforcing to her

that the dessert is the exciting, fun thing to have.

And this thing that I have to do must be horrible.

So horrible that my, you know,

my parent is forcing me to do it, right?

So it’s letting go a little bit of the behavior,

the objective reality, and really thinking

about the subjective reality

and focusing on adaptive mindsets.

So my goal as a parent has been to try to help her

instill a healthy mindset about eating,

that healthy foods are indulgent and delicious,

that the experience of stress is inevitable,

that it’s natural, and that it can help,

going through stressful experience can help her learn,

grow, and become a more connected and happier individual.

And, you know, with exercise and physical activity,

we haven’t really gotten to that yet,

but we will with time.

Yeah, it’s great.

I wrote down, and I’m going to keep this

in the front of my mind going forward,

to continually ask,

what is the effect of my mindset about X?

And just to evaluate that about exercise,

about food, about school, about stress,

about relationships, about relationship to self, et cetera,

and to really think about that in a series of layers.

You think that would be a useful exercise?

Definitely, and you know, and your work speaks to this,

I mean, the mindful, it’s not,

I would, yeah, really urge against

people getting dogmatic about their mindset also, right?

Like, oh, I need to have the right mindset,

or, and if I don’t have the right mind, you know,

it’s like, okay, mindset is a piece of the puzzle.

It’s a piece of the puzzle that’s really empowering

because we have access to it and we can change it,

but it is just one piece of the puzzle.

So treat yourself like a scientist.

Look at your life, look at your mindsets,

see what’s serving you, see what isn’t.

Find more useful, adaptive, and empowering mindsets

and live by those.

I love it.

Now, in one version of this kind of discussion,

I would have asked the question I’m gonna ask next

at the beginning, but I’m going to ask it now

close to the end, which is,

you’re a unique constellation of accomplishments

and attributes, and I only know a subset of them,

but I’m curious, I’m curious,

I want to know, what were you doing

when you first started your career?

And then, of course, because today’s the first time

that we’ve met in person, even though I’ve known your work

for a long time and we’re colleagues across campus.

So you run your laboratory where you do research.

You were also an athlete in university, a serious athlete.

And then you’re also a clinical psychologist,

is that right?

So-

I was trained as a clinical psychologist,

so my PhD is in clinical psychology,

so I was closely-connected to the disease

of Alzheimer’s and trauma.

Do you see patients or did you see patients

at that time?

I did, yes, I don’t anymore.

Okay, that’s a very unique constellation

of practitioner and researcher.

So what are the mindsets that you try and adopt

on a regular basis as a consequence

or in relation to those things,

or athlete, researcher, clinician?

You know, for yourself, as you move through life,

that all challenge is good,

or do you have any kind of central mindsets

that help you navigate through,

has to be a pretty complex set of daily routines

given everything that you juggle.

But I think that people like you are unique

in that you have the inside knowledge

of how this stuff works,

and you’ve also existed in these different domains.

And I know a lot of listeners

have a more athletic slant to their life

or a more cognitive, or some are raising kids,

or some people are just, you know,

are doing any number of things.

So this is where I think it would be useful

for people to hear, kind of, what do you do?

This is what I’m asking.

Yeah, well, it’s certainly true in my case

that research is me-search.

Everything that I study as an intellectual

has come from my own experience

or my own failings, right?

And when I was, you know, really intensely exercising

and training, those were the questions I asked.

When I was dealing with eating

and, you know, concerns about my weight,

those were the questions I asked.

When I was stressed about my dissertation,

I decided to do my dissertation on stress, right?

You know, now I think we’re in the midst

of a global pandemic.

It’s, you know, how can our mindsets be useful here?

You know, so I, you know, I don’t think

there’s an obvious answer to your question

other than the guiding light for me

has been an undercurrent of understanding

that our mindsets matter.

I think I got that very clearly and deeply as a child,

both through my experiences as an athlete.

You know, I know many of your listeners are athletes.

Any athlete knows that you can be the same physical being

from one day to the next, one moment to the next,

and perform completely differently

just depending on what you’re thinking.

I was a gymnast growing up, and if you can’t visualize,

if you can’t see something in your mind,

you have no chance when you get up there

on the balance beam, right?

And I also, my father was a martial artist,

a teacher of meditation, so this kind of mind-body work

was baked into me from an early age.

And I think what I’ve done recently

is to try to understand it scientifically

and, more importantly, to figure out

how can we do better with this, right?

We’re all talking about AI taking over the world

and technology, this, and personalized medicine, that,

and it’s like we have done so little,

relatively so little with the human resource,

our human brains, that the potential

for which is so great, and we’ve done almost nothing.

Take the placebo effect.

We know a lot about what it is.

We’ve done almost nothing to leverage that in medicine,

consciously and deliberately.

So my, what keeps me going,

what gets me through the hard times

is just that burning question of what is going on here

and what more can I do with the power of my mind?

Well, I and millions of other people

are so grateful that you do this work.

It’s so important, and it’s truly unique.

Tell us where people can learn more about your research,

where they can find you online.

I’m gonna try and persuade you

to take more of a social media presence going forward,

but whether or not I succeed in that effort or not,

where can people find you?

Ask questions, find your papers, learn more.

I’d love to have you back for a conversation in the future,

but in the meantime.

Yeah, no, it’s really, it’s been such an honor

getting to chat with you.

I’m just, you have such an impact on the world,

and I look forward,

I hope we can do some science together also.

Absolutely, absolutely.

Yeah, all our papers and materials and interventions

are housed on our website, mbl.stanford.edu.

We also have a link there too

that takes you to Stanford SPARK,

which stands for Social Psychological Answers

to Real-World Questions.

We have a lot of toolkits on that website,

including a toolkit for this Rethink Stress approach

of acknowledging, welcoming, and utilizing your stress.

And then I guess I’m on Twitter,

Aaliyah Crump, I don’t do much there,

but maybe I will start to.

Well, those are all great resources.

We will provide links to all of those

for our listeners and viewers.

And I also hope to convince you to write a book

or many books in the future.

The world needs to know about this,

but thank you so much for taking time

out of your exceedingly busy schedule

to talk to us about these ideas.

I learned so much.

I’m going to definitely think about

what is the effect of my mindset about blank

in every category of life,

and really just on behalf of everybody and myself.

Thank you so much.

Yeah, thank you.

And I guess I just want to end by saying,

I think this work is really the tip of the iceberg

of what can and should be done.

And so I really invite you, your listeners,

and anybody who’s inspired by this work,

if they want to share stories

or want to partner on a collaboration

please reach out.

Great.

Well, and the comment section on YouTube

is a great place to do that as well.

You will hear from them.

Great.

Thank you so much, Allie.

Thank you.

Thank you for joining me

for my conversation with Dr. Aaliyah Crum.

I’m guessing by now you can appreciate

the enormous impact that mindsets have

on our biology and our psychology

and how those interact at the level of mind and body.

If you’d like to learn more about Dr. Crum’s work

and perhaps even be a research subject

in one of their upcoming studies on mindsets,

you can go to mbl.stanford.edu.

There, you will also see a tab for support

where if you like, you can make a tax deductible donation

to support the incredible research

that Dr. Crum and her colleagues are doing.

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and or enjoying the Huberman Lab podcast,

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And there I teach neuroscience in short form,

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Some of that information overlaps

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And as mentioned at the beginning of today’s episode,

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In closing, I’d like to thank you once again

for joining me for my discussion

about mindsets with Dr. Aaliyah Crum.

And as always, thank you for your interest in science.

And as always, thank you for your interest in science.

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