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

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. Alia 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. Alia 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. Crumb works on all these things.

She was not only an incredibly accomplished, tenured research professor, She's also a clinical psychologist and she was also a division one athlete and an elite gymnast at one period in her life.

So she really walks the walk in terms of understanding what mindsets are and applying them in different aspects of life.

I'm sure you're going to learn a ton from this conversation, as did I. and come away with many, many actionable items that you can apply in your own life.

In fact, as we march into today's conversation, you might want to just put in the back of your mind the question, what is my mindset about blank?

So for instance, ask yourself, what is my mindset about stress?

What is my mindset about food? What is my mindset about exercise?

What is my mindset about relationships of different kinds?

Because in doing that, you'll be in a great position to extract the best of the information that Dr. Crum presents and indeed to adapt those mindsets in the way that is going to be most beneficial for you.

Before we begin, I'd like to emphasize that this podcast is separate from my teaching and research roles at Stanford.

It is, however, part of my desire and effort to bring zero cost to consumer information about science and science-related tools to the general public.

In keeping with that theme, I'd like to thank the sponsors of today's podcast.

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And now my conversation with Dr. Aliyah Crum.

Great to have you here. Great to be here.

Yeah. For the record, it's Aaliyah Crum, but you go by Allie, correct?

That is correct. Dr. Allie Crum. Or just Allie.

Okay. 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?

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 of 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. So 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 those implicit theories or core beliefs about the nature of intelligence or ability.

Right, 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 and 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 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... you know, a sign that the treatment is harmful or do you view side effects as a sign that the treatment is working?

Again, these are 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.

I'd love to talk about this notion of how our 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 in exercise. 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's really not outrageous if you're coming from a place of having studied in depth placebo effects.

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, and boost your immune system, 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 medication our 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 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 systems. nutrient concentrations that were designed to meet different metabolic needs of the patrons of the hospital, right?

So you're going to come in, you're going to 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... medical experts call it the hunger hormone, rises in ghrelin, signal. seek out food.

And then theoretically, in proportion to the amount of calories you consume, ghrelin levels drop, signaling to the brain that 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 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 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 is that you're eating healthy, right?

Like, you know, 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 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, 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 faults. which is incredible.

But then again, there must be crossover between conscious thought and these subconscious or kind of autonomic pathways.

It's really remarkable. It raises a question that I just have to ask because it, 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, So 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 works for them, Each camp seems to tout all the health benefits and how great they feel.

Could it be that mindset effects are that people are finding the nutritional program that they feel brings them the most enrichment of life, but also nutrients 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.

I'm not going to weigh in on the debate, which is better.

What I will most certainly weigh in on is the notion that Look, going back to the placebo effect, right?

We have an 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 about that diet and what others around you and in our culture think about that diet. because those social contexts inform 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 or keto or whatever, 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, you know, 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? of their 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 a... 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...

In the milkshake study, we didn't give people a placebo milkshake.

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.

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 response one to three degree increase in body temperature, one to three degrees Fahrenheit increase in body temperature.

It's pretty impressive. And I guess plays into symptomology generally.

So I'm a believer in belief effects. I would just say that the term that we use in our field is nocebo effect for that, which is sort of the... placebo's ugly stepsister.

It's when negative beliefs cause negative consequences. you are told you will have... 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 the physiological symptoms.

You know, there's various debates. 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 this is a really good example of this – 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, you know, Eastern mind, you know, Buddhist sort of mindfulness based mindset.

And she actually was the one who said to me originally, 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? what does it mean to give a placebo exercise?

So 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 were women. working in hotels, who were on their feet all day long, pushing carts, changing linens, climbing stairs, 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 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 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 take, 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, I'm...

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, 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 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 use is helpful for us.

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

So I'm not saying 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 is 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 your listeners, you could all answer this.

And then in these data sets, what she did was she had 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.

Or, you know, who's to say it's misperceiving?

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

If you're 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 I feel like I'm not exercising much.

But if I think about compared to other people, given what I know about 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.

In one of the samples, it was a 71% higher risk of death rate if people rated themselves as feeling like they were getting less activity than others.

That's a big deal. It's a big deal. And again, that study is cross-sectional, longitudinal.

It was not experimental. But... these really sort of coalesced 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 break 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.

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.

I can see the dilemma because you don't want people thinking that 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 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.

Is that an accurate way to state it? Totally, 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 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 balance both behaviors and mindsets about those behaviors that serve us.

And in the food context, 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 her, lose weight, look fit.

And so I was like, well, I should diet. I should have low calorie, low fat. 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 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 a 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?

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, 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, 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 then it's not going to 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. and colleagues and they looked at, they had people come in and they gave them sort of a, 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.

Theirs was this sham test and then 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 qualities of sleep, at least as self-reported.

So that's one study that attests to this.

I think certainly, I mean, 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. how far we can push around that through our mindset is an open question.

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 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 is poor.

I shouldn't expect much from myself today, or 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 analysis 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 like how we should try to motivate people, right?

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 step 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 so I started doing some digging into the nature of stress. a couple things were clear.

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

That stress was bad, right? Unmitigated and... 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 The literature, like most literature, 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 in 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 I found that to be interesting. And 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 Shawn Achor 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 my vitality and growth, things like that.

And we found in a number of correlational studies that that A more enhancing stress mindset was linked to better health outcomes, better wellbeing 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, you know, 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, you know, 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 like true leaders emerge in the moments of greatest stress, you know, Churchill and 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. 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 the stress will crush you videos and some watched the stress could enhance you videos.

And what we found was that 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 watch 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 watch 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, you know, 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.

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, so 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 just saying stress is bad. Stress is bad, right?

And you know, You know, it's like with measures of growth and fixed mindsets about intelligence, people... are in the middle, but oftentimes have a more positive mindset about intelligence.

That was not the case with stress. still not the case.

I'm trying to get the message out there.

Except for this group of Navy SEALs when they were actually so people who were going through basic training in order to become Navy SEALs.

And we found that they, on average, had stress as 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. 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- Still is.

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%.

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

So people who even within that range had a more stresses 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-enhancing mindset means you should like stress.

Well, maybe SEALs do. But that's not what we're saying, right?

Having a stress is 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, how does that work? 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, you know, 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 going to deal with it. You're basically in denial.

People who have a stress and 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 is enhancing mindset, the motivation changes, right?

Then 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. have better science and treatments for the future, deepen my relationships with others, improve my priorities and so forth.

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 stresses 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 inspired to adopt more enhancing mindsets, have more moderate cortisol response, and they have higher levels of DHEA levels in response to stress.

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 Yukon stores was very interesting.

It was in exercise science and physiology.

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, although of course there's estrogen, testosterone, 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 animalism as opposed to cannibalism, which is not saying cannibalism as in eating other people, 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 our ability to flip a switch and turn them on or off.

And yet mindset seemed 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...

We should do that. We should do that. We should collaborate.

We've got common friends in both departments, so we should do it.

But I did want to mention, you know, the way... 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? if sort of programmed in there, you have stress equals bad, right?

That is going to... you know, that's going to 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, 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 subconscious physiological processes, But it can also be accessed through our consciousness.

So just talking about this 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 better. 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.

That doesn't work that way. 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. it clearly is the case that the mindset, they sort of act as heuristics, right?

And as we talked about earlier, 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 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?

Or 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, 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?

Right? Fight against it. Vacation massages, yoga classes.

Yeah. against an orange checkout product, 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, right? 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. 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, 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.

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 that 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 going to 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.

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? And I love it as somebody who's laboratory studies, the physiological effects of stress, the effects that impressed 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 than 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, 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 non-specific response, right?

So it's, 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.

Our colleague Anna Lembke, who also we had the good fortune of having as a guest on this podcast, talked a lot about this, and 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 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 in 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, a landscape now where I'm constantly bombarded with health information and influencers, a term I didn't even know until a couple months ago.

Well, one could argue one way or the other, but the, 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.

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?

And 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, you know, things like when we're stressed or food or other things.

Second is culture and media, so movies, TV. you know, 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 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 food, 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, you know, depending on the study, 70 to 90% of those movies or influencers would fail the legal standards for advertising in the UK.

They're putting out their nutrition contents that are, maybe not surprisingly, but undeniably unhealthy.

And, you know, 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. 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.

This would be like cookies, cakes, high sugar, just really unhealthy.

Like truly unhealthy foods or... Yeah, that's actually the objective.

What health means is challenging, but yeah, high fat, high sugar.

Pretty good agreement now that excessive sugar isn't good.

And highly processed. Yeah, highly processed excesses.

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, you know, 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.

Sort of the post-holiday reset. And this is really important because 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 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.

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, you know, 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 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. Yeah, all of the promoted and branded content is usually for processed high sugar foods.

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, 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 the sight of some very calorie dense, extremely tasty food. drives those dopamine circuits.

And I realize that there are people out there who derive the same sort of or similar levels of 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... 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. And JAMA Internal Medicine.

JAMA internal, okay. Great journal. I will definitely talk about it on social media and elsewhere.

That sounds very interesting. What else are you up to lately?

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 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 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 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 mindset, 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.

So 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. 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, you know, It's incredible.

I mean, it just goes on and on and on. I realize some of that is legal protections.

It's hard for me to believe that they're actually I'm not expecting anyone to read those because you need a high-powered microscope to read this print.

It's truly fine print. I did realize that in reading over the side effects that you prime, one primes themselves to experience those side effects.

And so now I just rip up the side effects thing and- 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 not strictly a placebo.

It's not nocebo, as you described before. but that perhaps at a lower dose, a given medication could have a amplified effect. or at an appropriate dose, if you will, it could have a supraphysiological effect.

Has that ever been demonstrated? Um, 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, right? 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, right?

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 or 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?

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 we're 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, 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.

We can fight about it until 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... 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 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.

It's 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.

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?

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 going through stressful experiences can help her learn, grow, and become a more connected and happier individual.

And with exercise and physical activity, we haven't really gotten to that yet, but we will with time.

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.

Do 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.

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, and live by those.

I love it. Now, in one version of this kind of discussion, I would have asked the question I'm going to 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, 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? Yeah. I was trained as a clinical psychologist.

So my PhD is in clinical psychology and I did you know, all my pre and post internships with stress 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.

What are the mindsets that you try and adopt on a regular basis as a consequence or in relation to those things, sort of athlete, researcher, clinician.

For yourself, as you move through life, do you have an overarching mindset? that all challenge is good?

Or do you have any kind of central mindsets that help you navigate through it has to be a pretty complex set of daily routines given everything that you juggle.

But I think that people, 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, 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? when I was really intensely exercising and training, Those were the questions I asked when I was dealing with eating and concerns about my weight.

Those were the questions I asked when I was stressed about my dissertation. decided to do my dissertation on stress.

You know, now I think we're in the midst of a global pandemic.

It's how can our mindsets be useful here?

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? better with this right how can we you know we're all talking about AI taking over the world and technology this and all personalized medicine that and it's like We have done so little, relatively so little, with the human resource, our human brains.

That the, you know, the potential for which is so great.

And we've done almost nothing. you know, 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 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?

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 going to 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 been such an honor getting to chat with you.

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 that takes you to Stanford SPARK, which stands for Social Psychological Answers to Real-World Qualifications.

We have a lot of toolkits on that website, including a toolkit for this rethink stress approach. acknowledging, welcoming, and utilizing your stress.

And then I guess I'm on Twitter, Aaliyah Cross.

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.

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 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 your... you, your listeners, and anybody who's inspired by this work, if they want to share stories or want to partner on a collaboration to 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. Alia 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, sometimes videos, sometimes text slides.

Some of that information overlaps with what you find on the podcast.

Some of it is distinct from what you find on the podcast. on the podcast.

In closing, I'd like to thank you once again for joining me for my discussion about mindsets with Dr. Alia Crum.

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

[마인드셋의 과학: 당신의 생각이 생물학적 반응을 어떻게 변화시키는가]-[Dr. Alia Crum: Science of Mindsets for Health & Performance]

📋 Summary

마인드셋의 정의와 힘

생리학을 바꾸는 마인드셋: 밀크셰이크 연구

운동과 건강에 대한 마인드셋

스트레스를 활용하는 법: 3단계 접근법

결론: 의식과 무의식의 인터페이스

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📖 Transcript