Huberman Lab - AMA #5: Intrusive Thoughts, CGMs, Behavioral Change, Naps & NSDR

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 is an Ask Me Anything episode, or AMA.

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And now without further ado,

I will answer your questions,

and as always, I will strive to be as thorough as possible,

as clear as possible, and as concise as possible.

Our first question is about abstaining from thoughts,

and in answering this question,

we’re going to skirt right up against a topic

that I’ve covered before on the podcast,

which is obsessive-compulsive disorder,

which is a very serious disorder.

I mean, it can have a range of severity,

but people with true OCD suffer a lot from obsessions,

these are intrusive thoughts, and compulsions,

which are the behaviors

typically associated with those thoughts.

I think it’s really important

that we define OCD really clearly

so that we can make sure

that we’re talking about intrusive thoughts

and the desire to abstain from thoughts versus OCD

and where there might be some overlap there.

The functional definition of OCD

that really pertains to the disorder,

obsessive-compulsive disorder,

OCD, as opposed to, you know, we call people neurotic,

or we say, you have OCD,

or I’m so OCD about this, or OCD about that,

that’s become kind of a common use of the acronym OCD.

But true OCD is a situation

in which the engaging in a particular compulsive behavior

does not serve to reduce the intensity

or the frequency of the obsessions.

In fact, it makes it worse, okay?

So the typical thing that we hear these days is,

oh, you’re so OCD, or he’s so OCD, or she’s so OCD,

or I’m so OCD.

Now, if someone is OCD in that sense, okay,

so not the clinical disorder,

but OCD in the sense that, you know, they’re really clean,

they’re really fastidious, they need everything perfect.

However, that person can achieve some level of calm

and comfort that’s fairly long lasting

if everything’s clean and perfect.

Well, then that’s not obsessive-compulsive disorder.

This is really important to understand

as we venture into answering the question

about intrusive thoughts

and the desire to abstain from certain thoughts.

A person with true OCD will keep cleaning and cleaning,

or washing their hands,

or arranging things at perfect right angles,

but the more they do it, the more their anxiety goes up.

A person who has more typical,

gosh, we don’t really even have a language

for this nowadays, unfortunately,

but the sort of person that’s extremely particular,

they need things a certain way,

and they’re very driven to resolve things and do things

to make sure that things are done in a certain way

or handled in a certain way.

Well, if that person can experience relief

from engaging in, let’s say, exercise or from cleaning,

you’d say, you’re so OCD about exercise.

Well, but if exercising for an hour

or even two hours in the morning

makes somebody really calm the rest of the day

and they don’t need to exercise,

well, then they’re not necessarily true OCD.

They don’t necessarily have a disorder related to exercise.

However, if they’re exercising for two hours in the morning

and then they find they can’t concentrate on other things

and their desire to exercise just increases and increases

and becomes intrusive for them,

disrupting their quality of life throughout the day,

well, then that’s falling under the umbrella

of what we would call a true disorder.

Okay, so we want to highlight that

because the question is about

a desire to abstain from thoughts.

And the question is,

in your discussion with Dr. Anna Lembke,

and I should just mention Dr. Anna Lembke

is the director of our Dual Diagnosis Addiction Clinic

at Stanford University School of Medicine.

She’s the author of this incredible book,

“‘Dopamine Nation,’ that I think everybody should read.

I do believe everyone should read that book.

So important for the addict and non-addict alike

because it deals with basically

the state of our life nowadays.

We’re living in this dopamine rich world

where we can quickly become dopamine depleted,

which is terrible, leads to depression,

in addition to things like addiction in some folks, et cetera.

Anna was a guest on the podcast.

You can find her episode at

Just put Anna.

I think she’s the only guest we’ve had thus far

whose name is Anna.

So it’ll just pop up there.

The entire website is searchable.

But if you want to listen to that episode

or watch that episode, you can access it

The question is, in your discussion with Dr. Anna Lembke,

you were talking about abstaining

from people’s drug of choice for 30 days

to reset the dopamine reward pathway.

And indeed that is the prescriptive

that Dr. Anna Lembke gives for most all addictions

and for people that are suffering from mild

or even severe depression related

to dopamine seeking behaviors,

social media, video games, sex, food, et cetera.

However, of course, in the instance of food

or in some other addictions,

you can’t abstain for 30 days, right?

That would be terrible to abstain for food for 30 days.

I’m sure people have done it, but it is not healthy to do.

Certain things like alcohol and drugs,

people can abstain for 30 days

in efforts to never go back to them again.

There are cases of severe alcohol or opiate dependence

where people can’t go cold turkey or they risk dying.

So there they need to really work with a physician.

But the 30 day reset of the dopamine system

is something that’s very real.

And that pertains to most people.

That is, it’s going to be very effective

for most people struggling with either behavioral,

what are sometimes called process addictions

or other types of addictions,

including substance abuse issues.

The question continues,

you said you were going to ask Anna how to abstain

if your drug of choice is a thought or narrative

as opposed to a substance or a behavior.

The question continues,

as far as I can tell your discussion with Anna moved on

before you asked her the question.

Would you be able to discuss strategies

for abstaining from addictive thoughts and narratives?

Okay, so let’s talk about intrusive thoughts

and let’s start off by asking ourselves,

what is a thought?

Okay, in the realm of neurobiology,

we have sensations,

which are the processes by which our neurons,

nerve cells convert light photons, sound waves,

touch, mechanical pressure, et cetera,

into electrical signals and chemical signals

that head into our nervous system, including our brain.

And then our brain, at least we think makes sense of them

and help us navigate the world that we’re in.

Okay, so the sensation part

is a pure transformation of mechanical information

or in some cases, chemical information, like smell,

chemicals, literally volatile chemicals

floating around in the world

are brought into your nose

and your neurons in your olfactory bulb

convert those into electrical and chemical signals

that your brain can understand.

Perceptions are your idea

of what those signals out in the world are,

either because you’re paying attention to them

or for some other reason,

you decide that a stop sign in front of you is red

and that the sign behind it is white

and that the sky is blue or cloudy.

Those are perceptions, okay?

So we have sensations and perceptions.

Then we have emotions,

which are these things that include the mind and body

that are related to neuromodulators

like dopamine, serotonin, et cetera,

although those chemicals do other things as well.

And then of course we have behaviors, actions,

everything from me moving my pen on a piece of paper

to walking, running, et cetera.

Thoughts are a fifth category of neural functioning

that we really need to define,

but that doesn’t have as strict a definition

as sensations, perceptions, or feeling, or action.

But thoughts are real, right?

We all know this, thoughts are real.

And one way that we can define thoughts

is that thoughts are perceptions

that include data from the past, present, or future, okay?

Or combinations of past and present

or present and future or future and past, okay?

I’m not trying to give

an overly complicated definition here,

but if we are going to answer a question

about how to abstain from thoughts

in a really direct and actionable way,

we really need to address what are thoughts.

So thoughts are perceptions

that are generated internally, right?

We don’t need any external sensation

in order to have a thought.

We can close our eyes.

We could be in sensory isolation for that matter.

We can be floating with no gravity,

and we can have a thought.

Thoughts tend to run pretty much automatically

in the background all the time.

Some people refer to this as chatter

in the back of our minds in a very unstructured way.

And then if we force our thoughts to be structured

because we decide they need to be,

or if something in our environment captures our perception,

then our thoughts tend to be structured.

Let me give you an example.

If I’m just walking around,

if there were a way in which we could broadcast my thoughts

onto a screen, I hope we wouldn’t do that,

but those thoughts would be a mixture

of semi-complete sentences and gibberish.

However, if somebody stops me and says,

hi, good to see you, what are you doing today?

And I start answering, well, then my thoughts

are suddenly being driven by an external stimulus,

their question, and some internal ideas,

memory of who I am and what I’m doing that day,

so past and present, and so on.

And so thoughts become structured.

So when we have a question

about how to abstain from thoughts,

we need to be additionally specific

and really pinpoint that what we’re trying to do

is to abstain from thoughts we don’t want, presumably,

either because they are too repetitive and distracting,

or because what’s contained in those thoughts is disturbing.

Okay, this is important because it gives us two answers

to the questions that are highly divergent.

One answer to the question of how to abstain

from intrusive thoughts, you know,

thoughts that we’re addicted to,

is if those thoughts are merely on loop all the time,

and we can’t stop them,

but the thoughts themselves aren’t particularly disturbing,

so think about a song you can’t get out of your head,

or you keep recounting some event,

but the event itself isn’t very disturbing,

it’s just intrusive because it’s there.

Well, in that case, the data really point

to trying to anchor your thoughts

to some external stimulus.

So getting into action, getting into activities

that really draw your attention away from that thought.

Now, you may still hear it scrolling in the background,

so you might be sitting in class

still hearing that loop of thoughts in the background.

That’s something that over time ought to wane,

it ought to disappear.

If we try and bring more and more attention

to whatever it is that’s in our environment,

whatever it is that we happen to be learning

or doing physically, et cetera.

Things like mindful meditation,

doing a 10 or even just five-minute-a-day practice

of sitting with eyes closed or lying down with eyes closed

and really focusing on one’s breath,

focusing one’s attention on the,

sometimes it’s called the third eye center,

but in science, we’d say just the region

right behind the forehead,

you’re directing your attention there,

has been shown to increase focus for singular topics

and can improve memory

and do a bunch of other things as well.

Those are data from Dr. Wendy Suzuki’s lab

at New York University.

She was a guest on the podcast as well.

My laboratory has run studies on mindful meditation

as well.

So what you’re really trying to do

is learn how to focus better on one thing

and by focusing on that one thing,

you focus off these repetitive thoughts.

Now, I have a feeling that this question was asked

and that many people upvoted this question

because the issue isn’t just thoughts that are intrusive

because they’re there and on repeat,

but because the thoughts themselves are actually troubling.

This could be recounting a trauma, someone harmed you,

you observed something that was disturbing,

you felt wronged, you felt someone else was wronged,

you can’t seem to get your mind off of something

and your emotions tend to follow.

And so it’s uncomfortable.

I have a feeling this is the root of the question.

In that case, the approach is very different.

What we know from essentially all of the quality scientific

and clinical studies is that those sorts

of intrusive thoughts are very much like a trauma.

Now we have to be clear in defining what trauma is.

I’ll use the definition that Dr. Paul Conti,

another incredible guest that was on our podcast,

a psychiatrist, Stanford Harvard trained psychiatrist,

I think one of the world’s foremost leaders

on the issue of trauma and psychiatry

and psychology generally.

He defines trauma as an event or something

that fundamentally changes the way

that your nervous system works

such that you function less adaptively going forward

from that event.

So not every bad occurrence in your life is a trauma.

That’s good news.

The bad news is many people have traumas

and traumas change the way that our nervous system works

so that we don’t function as well as we could.

So in that sense, intrusive thoughts that are disturbing

are in many ways traumas and are reinforcing that trauma.

Now we know that almost counterintuitively

in order to deal with trauma,

you have to get very close to that trauma.

You don’t have to re-expose

and I would hope you would not re-expose yourself

to the very same trauma,

but we know that one of the best ways to deal with traumas

is to get very clear about the narrative

around those traumas.

Now this can be done with a therapist ideally,

but not everyone has access to therapy

or can afford therapy.

There’s a range of quality of therapists for that matter.

So we’re always referring to the desire for people

to do great therapy with really great,

meaning excellently trained people.

But it turns out that if you want to extinguish

an intrusive thought, one of the best ways to do that

is to journal about that particular thought extensively.

So rather than the earlier strategy for intrusive thoughts

where they’re just on loop and intrusive

because they’re on loop and present,

but their content isn’t disturbing,

when a thought is disturbing and intrusive,

we know that it’s very useful to script out

as much detail about that particular thought

and the things around it as possible.

Obviously you want to do this in a way

that is fairly structured.

So you ideally would use complete sentences.

So the reason for doing that is that thoughts,

as I mentioned earlier, can often be fragmentary.

So they pop up in our mind almost seemingly spontaneously.

They’re inhibiting our ability to focus

or be present to work or family or other things or sleep.

Writing things down in a lot of detail

does seem to have this quality

of both reducing the emotional load

of whatever it is that that thought is about,

as well as diminishing the frequency

of those intrusive thoughts over time.

So this is far and away different

than the strategy I mentioned

for the other types of intrusive thoughts.

And really it’s far and away different

from the 30-day abstinence approach

that Dr. Anna Lembke was talking about

for substance or behavioral addictions.

Now, of course, this process of abstaining from thoughts

or removing the addictive nature of certain thoughts

can definitely take some time.

So a good example there would be superstitions.

You know, I’ll come clean here.

And I’ve talked about this before on a few podcasts

that when I was in college,

I developed a sort of knock on wood superstition.

Anytime I’d say something that I didn’t want to happen

or did want to happen,

I’d say knock on wood and I’d knock on wood.

And then I started suppressing the behavior

mostly because it was a little embarrassing.

And then I started just telling myself in my head,

knock on wood, knock on wood, knock on wood.

And it was clearly a little bit of an OCD type thing.

But again, OCD in air quotes here.

I think it qualified as OCD in the sense

that the more I did it, the more I wanted to do it.

So I needed to go cold turkey on the thinking,

but how can you go cold turkey on a thought?

You couldn’t.

What I was told to do and what worked very well for me

was to just write down the worst possible outcome

that I was concerned about.

So to really get close to the nature

or the underlying basis of that intrusive thought.

And I raised this because a lot of times

the intrusive thought is not,

okay, I’m thinking about a car accident

or I’m thinking about a breakup

or I’m thinking about an exam that I have.

That can be intrusive, but a lot of times

it’s some kind of nebulous, abstract set of words

or ideas or images around something that happened

that we saw or heard or experienced.

And by putting a lot of clear structure

to what the thought is exactly

and to putting some thought and structure onto paper

about what that pattern of not healthy thinking relates to,

people often achieve tremendous relief

in a fairly short amount of time.

Sometimes just in one session of writing it down,

sometimes they need to write it down multiple times.

What you’re essentially trying to do

with a intrusive thought or a trauma of any kind

is you’re trying to turn a disturbing story,

that is a story that evokes a lot of emotion

and captures, it kind of hijacks your nervous system

into what is essentially a known but repetitive

and kind of old, boring story

where the emotional load has been depleted.

And there, of course, I have to highlight the fact

that getting sufficient rapid eye movement sleep,

we also know is very important

for removing the emotional load of traumatic experiences

and intrusive thoughts.

So you really want to strive

to get the best possible sleep you can

that includes sufficient rapid eye movement sleep.

And we have multiple zero cost resources

for that at

We have the episode on master your sleep.

We have the episode on perfect your sleep.

We have the toolkit for sleep, all of which are timestamped

and all of which can be accessed completely zero cost

to try and get your sleep as good as possible,

including lots of rapid eye movement sleep.

So in order to remove intrusive and addictive thoughts,

ask yourself, is this OCD of the classic sense?

If it is, you should see a psychiatrist.

They won’t necessarily prescribe medication,

but there are tools for true OCD

that are very effective in many cases.

And we did the episode on OCD,

which I invite you to listen to as well.

You want to ask yourself, are the thoughts disturbing

or merely intrusive and repetitive?

If they’re merely intrusive and repetitive,

well, then learning to focus your attention

on other things and getting better at focusing

on single things through an exercise

like mindfulness meditation can really help.

And indeed, perhaps the best use of mindfulness meditation

is to improve your level of focus.

It does have other benefits as well,

but that’s going to be the major one

that one will experience even with these very short

five or 10 minute day meditations.

Great data on that from the scientific literature.

And then if those intrusive thoughts are not only intrusive,

but they’re also disturbing, in that case,

you really want to put as much structure

and thought, believe it or not,

into what those thoughts are really about.

Write them out on paper in complete sentences

and maybe do that multiple times

until the underlying emotions related to those thoughts

really start to diminish.

And by doing that,

you’re essentially doing your own form of trauma therapy,

for lack of a better way to put it.

And again, the data really point to the fact

that getting close to the specific details

around those intrusive thoughts

is going to be the best way to extinguish them.

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