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,
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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 there I teach neuroscience in short form,
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Some of that information overlaps
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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.