Lessons - Breaking Free From Bad Habits | Dr. Jud Brewer - Neuroscience of Addiction Expert

In this lessons episode, uncover the science behind habits and addictions, learn why automatic behaviors form to conserve energy and how reinforcement learning sets the stage for unhealthy addictions, understand how paying attention to the true rewards of a behavior can transform negative patterns into opportunities for healthier change. And actually I wanted to describe, so for people listening, what is the actual clinical definition of a habit? Because I think that setting the baseline to people understand what we're actually speaking about, because I think people also, I mean, I don't want to jump too deep in before they even understand how you understand a habit. Yeah, I'll actually give you a two-fer. Let's let's define habit and let's define addiction as well so that we can differentiate those two. So habit is basically something that we do automatically. That's a simple operational definition that generally holds pretty well. And habits are set up so that we can learn things and then have the energy the next day to not have to relearn that and learn something new. So most habits are extremely helpful and it's an efficiency process for our brain. Imagine waking up every morning and having to relearn everything from walking to making breakfast. You know, we'd be exhausted before we'd even relearned how to make coffee. So that's, you know, habit is automatic behavior. Something that we see a cue and that cues this process, this automated process to just do the thing. In contrast, addiction, I think of habit along a spectrum and at the far end of that spectrum is addiction. And the definition of addiction I learned in residency was continued use despite adverse consequences. And the reason I bring that forward as well is that often people think and they describe their addictions in terms of a habit on the habit of smoking in the habit of overeating or whatever. But if you look at that definition, continue use despite adverse consequences. We can see how, you know, they're the obvious ones like smoking, which aren't helpful for survival. But then the ones that are not so obvious where it overlaps between the survival mechanisms like eating, we all have to eat to survive. And doing that same behavior despite adverse consequences, where we, for example, overeating and clinical obesity has been linked to anti-survival. You know, a lot of a lot of negative health consequences from not being an ideal weight. So that's how we think of habit. And then that's how we think of its relationship. We can be in a habit of doing something where we're continuing to do it despite adverse consequences. So addiction, it can even fall into that addiction spectrum as well. Does that make sense? It does. And it's very interesting because something seems to be more black and white. So I think that most people in 2024 would agree that smoking is more of an addiction than a habit. But I'm curious about food in particular and maybe we can just extrapolate to other habits that maybe turn into addictions. And what is that bridge that we cross when we're not aware? Because I think that's where people predominantly get into trouble. I don't think people wake up and are like, hey, I want to be clinically obese or just out of shape or or eat more than I really need. People don't go into life thinking that. But that's the output after five, 10 years. So how does that happen in the brain? We try to have it into an addiction. Yes, let's, well, let's use eating as an example. The our brains learn to do behaviors based on how rewarding they are. And often we'll set up these habits early in life. So for example, if we were five years old and we go to a birthday party, you know, our parents aren't sending us to that birthday party saying, you know, why don't you go and get some nutritious food if this. You know, this is going to substitute for lunch. You know, they're sending us probably trying to have us eat some a healthy, you know, meal before we go. So we don't over indulge on the cake and ice cream. But the point there is that we're already starting to learn to associate ice cream cake, you know, things like that with celebrations with connection with people and all that. And you can see as we go through life, we start to learn to eat in the absence of hunger. So we set up these habitual behaviors, you know, celebrations that we're overindulging in ways that are not aligned with our physiology. Our brain and our body aren't saying, hey, you know, you're hungry. Go eat that cake, typically not right at it at an office party or whatever. It's like, oh, here's a celebration. Here's some cake. It looks good. And so we just go into the habit mood of eating. So these habits get set up in the way that we are, we're doing the thing because it's now associated not with a survival strategy like I need calories now, but with something else. And if that's something else is rewarding, we're going to keep doing it to the point where it is habitual. So with eating, it could be celebrations. It could also be consolations where we learn, you know, we're bored one day and we go into that we're rummaging around the kitchen, just looking for something we eat, you know, and that boredom gap is filled with some, typically some type of a comfort food. And so we learn, oh, if I'm bored, if I'm sad, if I'm mad, if I'm lonely, all these things, we learn that food becomes this consolation mechanism that can make us feel less bad. And it's rewarding enough that it gets set up as a habit. So we've got these two reinforcement learning processes, one it's called positive reinforcement where it's all the celebratory stuff. It's like, ooh, you know, we just had a good meal go have some dessert. And the other is this negative reinforcement loop where it says, oh, you feel bad, make yourself feel better. And this is just using food as an example. Almost every habit falls into the same category where if we're continuing the pleasant, the behavior gets reinforced through positive reinforcement, if we're making the unpleasant go away or avoiding it, we're reinforcing that habit through negative reinforcement. And this, you know, honestly, this process, not that sea slugs eat birthday cake, but this has been shown, you know, Ergindal got the Nobel Prize back in the year 2000 showing that this is a very evolutionarily conservative process all the way back to the most basic of nervous systems. Well, because I think that I mean, there's again, your work helps a wide spectrum of people, but I think that the people that I really want to tap into, especially with the audience listen to this show, people that overwork and get addicted to work. And then it actually has averse impacts, even though it starts off as just a very, a very healthy habit, right? You're motivated. You're putting in the hours. You're waking up every morning and you're going to the office or you're building your thing. But then there's like you just mentioned, people lose track of that habit turning into some some addiction. And I think that's really where a lot of people look back and they're like, shit, what have I become? And that's really, that's really a scary, at the very scary space and a very scary place to find yourself in. And I want to, we'll talk about sort of how to overcome that. But I still want to stick on hunger and food and eating because you speak about hedonic hunger. And I want to speak about that. I want to understand it and how it relates to emotional eating because that's a very big, so this is, if we're looking at the spectrum of, or the sort of the journey of the person that has all these reinforcement mechanisms that eventually turn into an addiction, where does hedonic hunger fit into that journey? Yeah, it's a great question. So scientists, we scientists, I'll let you in on a secret. We make up new terms so that we can sound smart, okay? So relatively recently, a scientist came up with a term called hedonic hunger, which interestingly is a misnomer. So hedonic is about, you know, emotion, basically, pleasure. Yeah, pleasure, right. And so we're eating, it's a misnomer because it's about emotional eating. And so it's not about hunger itself. It's not physiologic hunger. That's called homeostatic hunger. But this hedonic hunger basically relates to what you're talking about, which is we're eating due to an emotion, whether it's a positive emotion or a negative emotion, rather than direct physiologic hunger itself. And that's where these habits come into play because then it bypasses our physiologic mechanisms that are putting on the brakes and saying, hey, you're not actually hungry. Why are you putting stuff in your mouth? That turns into the emotional eating. So help me understand, help me understand, what is the, what is this strategy to start to reverse this process once you've developed this addition? And we'll use food as an example. But then I know you work with, you work with Olympic athlete to work with business leaders. So I want to start to unpack other addictions. I want to even understand what an Olympic athlete is addicted to or what a business leader is addicted to. I can speak from experience is probably working too much. And maybe, you know, I see a lot of people that have been very successful. They have broken in families and divorces. And I think that's probably the end result of addiction. But you tell me, so how do we start to reverse, you know, this, this progression into addition? What we found over the last couple of decades, and it, and it spans every habit and addiction that we've studied. So we studied alcohol, cocaine, you're smoking, eating, anxiety, you know, all of these. And the, the basic, there seems to be a, you can break it down into three steps. The first is just understanding how habits form. If we don't know how our mind works, there's no way that we can work with it. And so that's the first, the simplest and the most basic piece to start with. So, you know, you can break it down to, you know, what's the behavior and what's the result of the behavior. We can also map out what's queuing the behavior, what's triggering it. But that's actually the least important part of the equation. So that's the first step is just recognizing that we're doing something and that it is a habit. Does that make sense? Yeah, yeah, yeah. So with eating, it's not the, you know, we're eating because we're hungry. That's not a habit. That's helpful. But it's that we're reaching for food when we're bored, lonely, sad, celebrating, you know, as we talked about earlier, often because of emotions, we're emotionally eating rather than eating because we're at a collard deficit. So being able to recognize the behavior then helps us shift into this second step, which really highlights the how our brains learn to differentiate behaviors, which is all about how rewarding a behavior is. So I have people start paying attention to the results of the behavior. And it's interesting. This goes all the way back to ancient Buddhist psychology where they talk about cause and effect. If you look at modern psychology, this is really about reinforcement learning, which highlights that if a behavior, a cause is rewarding effect, we're going to keep doing it. If it's not rewarding, we're going to stop doing it. So the key here with a habit is we've already established a reward value of a behavior to the point where it's automatic. And so we're not even paying attention to how rewarding it is. So for example, if we have learned to overeats or stress eats a long time ago, we're just going to do that automatically. And we're not going to be asking ourselves, hey, you know, what what am I getting from this? So that's really what the second step is all about is asking this simple question, what am I getting from this? And for example, my lab did a study within app that we'd felt called E right now, where we help people pay attention to the results of eating. And we found that within 10 to 15 times of somebody paying attention when they're overeating, for example, that reward value dropped below zero, meaning that they were updating the reward value to the present day. Like what are they getting from overeating? Typically, it doesn't feel good. They feel bloated. They feel lethargic. They're they feel guilty. All these things that are not rewarding, they're anti rewarding. Almost you think of it as punishing is not the best term for it. But is that college just like to use that term? So there when people see very clearly that something is not rewarding, it makes it much easier to stop doing the behavior. Ancient Buddhist psychologists describe this as disenchantment. We become disenchanted with the behavior. So it's actually pretty straightforward. And you can we could talk, you know, if you want, we can talk for a long time about the brain mechanisms, but they're that's not actually as pragmatically important as understanding the psychological process, which is, you know, asking ourselves this question, what am I getting from this behavior? So if it's overeating, asking, what am I getting when I over you? How does it feel in my body and letting our body tell us the answer, which typically is, this doesn't feel very good. And that's enough. It typically pretty quickly to start shifting that behavior.