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

- Welcome to the Huberman Lab Podcast,

where we discuss science, and science-based tools

for everyday life.

I'm Andrew Huberman,

and I'm a professor of Neurobiology and Ophthalmology

at Stanford School of Medicine.

Today my guest is, Dr. 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.Crum works on all these things.

She's 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.

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And now, my conversation with Dr. Alia Crum.

Great to have you here.

- Great to be here.

- Yeah, for the record, it's Alia Crum,

but you go by Allie, correct?

- That is correct. - Right, Dr. Allie Crum.

- Or just Allie. - Okay, great.

Well, I've been looking forward

to talking to you for a long time.

Just to start off, you've talked a lot and worked a lot

on the science of mindsets.

Could you define for us what is a mindset,

and what sort of purpose does it serve.

- Of course, yeah.

Mindsets have been described or defined in a lot of ways.

We define mindsets as core beliefs

or assumptions that we have

about a domain or category of things,

that orient us to a particular set of expectations,

explanations and goals.

So that's kind of jargony, [chuckles], a little.

I can distill it down for you.

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

So take stress, for example.

The nature of stress.

What's your sort of core belief about that?

And mindsets that we've studied about stress,

or do you view stresses 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 in 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, 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.

- 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 as 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 over-simplified 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 the things.

But as humans, we need these simplifying systems

to help us understand a complex reality.

So those assumptions that we jumped to,

oh, intelligence is fixed or intelligence is malleable,

they help us to simplify this complex reality,

but they're not in consequential, 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,

you know, why work harder at math,

if you don't think you're good at it.

So, in retrospect, it's pretty clear

how these mindsets can affect our motivation.

What our work has and 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, it could be a variety of different foods.

You might have different thoughts

about different healthy foods.

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

have this view that, stress is debilitating,

healthy foods are disgusting and depriving.

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

right or wrong, they have an impact.

And they have an impact,

not just through the motivational mechanisms,

that Dweck and others have studied,

but as our lab has started to reveal,

they also shape physiological mechanisms

by changing what our bodies prioritize and prepare to do.

So those are just two examples.

Mindsets about stress, mindsets about food we've looked at.

Mindsets about exercise,

do you feel like you're getting enough,

or do you feel like you're getting an insufficient amount

to get the health benefits you're seeking.

Mindsets about illness.

Do you view cancer as an unmitigated catastrophe,

or do you view cancer as manageable

or perhaps even an opportunity.

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

Do you view side effects

as a sign that the treatment is harmful,

or do you view side effects

as a sign that the treatment is working?

Again, these are sort of core beliefs

or assumptions you have about these domains or categories,

but they matter because they're shaping,

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

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

what we're motivated to do,

and potentially even how our bodies respond.

- Yeah, I'd love to talk about this notion

of power of the 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 the 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 [mumbles]. - 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,

and was in this sort of food domain

and this emotions and food domain.

And it really occurred to me,

that there was a very simple question

that hadn't been probed yet.

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

change our body's physiological response to that food,

holding constant, the objective nutrients of that thing.

So that question might sound outrageous at first,

but it's really not outrageous

if you're coming from a place

of having studied in depth, placebo effects.

Placebo effects, in medicine, at least,

are these sort of a 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,

can lead to those physiological effects

even though there's no objective nutrients.

And we have more evidence on placebo effects

than we have for any other drug.

- Really?

- Because of the clinical trial process,

in which all new drugs and medications are required

to outperform a placebo effect.

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

Now, you know, we can get nuance 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 crisis

to behavioral medicine solving our health crisis,

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

To what degree are these things influenced by our mindsets

or beliefs about them.

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

This was done at the Yale center

for clinical and translational research.

And we brought people into our lab under the impression

that we were designing different milkshakes

with vastly different metabolic concentrations,

nutrient concentrations,

that were designed to meet different metabolic needs

of the patrons of the hospital, right?

So, you're going to come in,

you're going to taste these milkshakes,

and we're going to measure your body's physiological response

to them.

This was 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 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 are looking at the hormone ghrelin.

So as you know, ghrelin,

medical experts call it the hunger hormone,

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

And then theoretically,

in proportion, the amount of calories you consume,

ghrelin levels drops signaling to the brain.

Okay, you don't need to eat so much anymore,

you can stop eating,

and also revving up the metabolism

to burn the nutrients that were just ingested.

What we found in this study was that,

when people thought they were consuming

the high fat high calorie indulgent milkshake,

in response to the shake,

their ghrelin levels dropped at a three-fold 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 tastes 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, a lie about how much something

these milkshakes contained affected a subconscious process,

because I have to imagine that the ghrelin pathway

is not one that I can decide,

oh, this particular piece of chocolate

is going to really reduce my ghrelin

'cause it's very nutrient rich,

as opposed to one,

if you told me that a different piece of chocolate,

for instance, is a low calories or sugar free chocolate

or something 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.

So, 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,

in 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 got people who are carnivores.

You have every variation.

You have intermittent fasting,

also called time restricted feeding.

And it seems like, once a group

and it 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 involved there?

That people are finding the nutritional program

that they feel brings them the most enrichment of life,

but also nutrients.

And that their health really is shifting

in a positive direction,

but not necessarily because of the food constituents,

but because of the community,

and the ideas and the reinforcement.

- Yeah, and the belief

that this is the right way of doing something.

I think, a hundred percent it has something to contribute.

I'm not going to weigh in on the debate.

What I will most certainly weigh in on,

is the notion that,

look going back to the placebo effect, right?

We have a outdated understanding of what that is,

which is based on this randomized controlled 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 over simplified.

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,

its beliefs, its social context,

and it's your body's natural ability

to respond to something.

So, that's in the placebo effect example.

The same is true for everything we do or consume.

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

both are true.

It does matter what it is

and it matters what you think about that diet

and what others around you

in our culture think about that diet.

Because those social contexts inform our mindsets,

our mindsets interact with our physiology

in ways that produce outcomes that are really important.

So let's not get dualistic

and say, it's either all in the mind or not in the mind.

Let's also not be unnecessarily combative

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

or keto or whatever.

It's all of those things are a combined product

of what you're actually doing,

and what you're thinking about.

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

or in some cases,

you think you should be eating a certain way

and then you don't live up to that.

It might have even an adverse effect because of the stress

and the anxiety associated with that.

- Very interesting.

Along the lines of belief effects,

could we call these belief effects or mindsets?

- Sure, yeah.

- 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 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 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, right?

We just changed what they believed about it.

So, how I like to think about it is that,

placebo effects, as they're traditionally construed

are made up of three things.

It's the social context, mindsets or beliefs,

and the natural physiological processes

in the brain and body that can produce the outcomes.

And so, we could just call them belief effects

because the beliefs are triggering

the physiological processes,

and the beliefs are shaped by the social context.

Does that make sense?

- It makes sense. - Yeah.

- 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 to think that they are sick,

you get a genuine one to three degree

increase in body temperature,

one to three degrees Fahrenheit increase in body temperature

is pretty impressive.

- Yeah.

- And I guess it plays into symptomology generally.

So, I'm a believer in belief effects.

- Just say that, you know,

the term that we use in our field

is nocebo effect for that,

which is sort of the placebo's ugly stepsister.

It's when negative beliefs cause negative consequences.

So, 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.

And there's various debates.

That it's not only that physiology changes,

it's also that your attention changes.

So we're experiencing things like fatigue and headache

and upset stomach all the time.

And then when you take a drug and somebody says,

you're going to feel fatigue and headache,

you start noticing that you're tired,

and that headaches attributed 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 just these results also amazing.

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

of this phenomenon, right?

That the total effect of anything

is a combined product of what you're doing

and what you think about what you're doing.

So this was a study that I ran with Ellen Langer

way back when I was an undergrad actually.

We started this study.

Ellen Langer is a professor of psychology at Harvard,

and she's done a lot of really fascinating work

on her flavor of mindfulness,

which is distinct from a more Eastern mind,

Buddhist sort of mindfulness-based work.

She actually was the one who said to me originally,

you know, I was an athlete at the time.

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

And one day I'll never forget it.

She said, you know the benefit of exercise

is just a placebo, right?

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

Ellen's known for saying very provocative,

but also very wise things.

And that statement really got me thinking about that.

So we designed this study together and that was to look at,

how would you study?

If the benefits of exercise were a placebo,

how would you even test that?

Because, 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 are 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,

or 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.

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 do we conceptualize that result

in light of all of our efforts

to get more out of exercise, right?

Because earlier you mentioned it from the milkshake study

and our perceptions about nutrient density,

that the right message

that is actually a little bit counterintuitive.

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

nutrient sparse, then it's good for me

in the context of losing weight for instance.

But it turns out the opposite is true,

because as you told us, the body responds differently

when you think something is nutrient dense

and can actually suppress hunger more.

So, in light of this result, if I were to say,

okay, my current understanding of the literature

is that getting somewhere

between 150 and 180 minutes per week

of cardiovascular exercise

is probably a good idea for most people.

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

but that it's extremely effective

in lowering my blood pressure

and maintaining healthy weight, et cetera, et cetera,

according to these results,

it will have an enhanced effect on those metrics.

Is that right?

- Definitely.

So this is a really important point,

because what this reveals

is that we have to be more thoughtful

in how we go about motivating people to exercise

or teaching people about the benefits.

Our current approach is just to basically tell people,

writ large, here's what you need to get.

Here's what you need to get good for.

To get enough exercise to receive the health benefit.

The problem with that approach is that,

most people aren't meeting those benefits yet,

they 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 makes people worse off

than they were without knowing about the guidelines.

So again, it's tricky.

I'm not saying that mindset is everything.

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

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

So I'm not saying, oh, exercises 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, 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, the audience, your listeners,

you could all answer this.

And then in these datasets, 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

as 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 who's to say, it's misperceiving,

everything's relative, right?

I used to do triathlons very seriously.

So if you were to ask me now,

I feel like I'm totally inactive, right?

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

And if that's my focus set, right?

I feel like I'm not exercising much.

But if I think about, you know, compared to other people,

given what I know about national representative statistics,

and I could feel like, oh, I'm getting a lot, right?

So you can see how these perceptions

are decoupled from objective reality.

And what we found in these studies,

is that, that one question mattered

in some cases, more than objective activity,

but in all cases controlling for objective activity

and predicting death rates.

And in one of the samples,

it was a 71% higher risk of death rate.

You know, if people rated themselves

as feeling like they were getting less activity than others.

- Wow.

That's a big deal.

- It's a big deal.

And again, that study is cross-sectional, longitudinal,

it was not experimental.

But combined, 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 one 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 come off a two hour practice

into a weightlifting session.

And then I would get on the elliptical for 30 minutes,

'cause 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 pay attention,

not just to what I was doing,

but also take care of my mindset about that.

And I think the essence is how do you get people

to feel like they're getting enough?

It's a sense of enoughness that really matters.

- Yeah, I can see the dilemma

because you don't want people thinking

that exercise and its positive effects are so potent

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

And that they're good because most likely they are not.

But again, you don't want them

to be so back on their heels psychologically

that they don't even do that or that they never exceed that

by very much.

But it seems like the message from the milkshake study

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

would be to really communicate to the general public

that food has a potency,

even healthy foods have a potency to give us energy,

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

And that exercise has a remarkable potency,

and that that potency can be enhanced

by believing in or understanding that potency.

- Exactly.

- Is that an accurate way to state it?

- 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 both matter, right?

Both exercise and what you think about it matter.

Both what you eat

and how you think about what you eat matter.

And so, we really, as individuals and as a society

need to work on, what is the right way to cultivate

both behaviors and mindsets

about those behaviors that serve us?

And in the food context, this--

Again, that milkshake study really changed me

on a personal level,

because I had been somebody

who was constantly trying to restrain my eating, right?

I wanted to maintain or lose weight, look fit.

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

and I should have low calorie, low carb.

Low this, low that.

But what that was doing,

was putting me into this constant mindset of restraint.

And what that study suggested,

was that that mindset was potentially counteracting

any benefit 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 'cause 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 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 the anti-public facing health communications,

this comes up again and again, you know,

how should we conceptualize our behavior?

How should we think about all these options

that are offered to us?

And I'm excited that the potency of mindsets

are coming through again and again.

So, I have a question about this.

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

but a lot of these mindset effects

are something that years ago,

I felt I did vis-a-vis sleep.

Because I was in graduate school, and as a postdoc,

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

that I decided I would sleep when I was "dead".

Not a good idea from what we know.

However, I found that a couple nights of minimal sleep

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

Eventually it would catch up with me.

Has there ever been a study

exploring whether or not the effects of sleep deprivation

can be impacted by these mindset effects?

Because over the years, I keep learning more and more

about how much sleep I need and I've really emphasized it,

but 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

find sometimes that they don't get a good night's sleep.

Would believing that we can tolerate that

and push through it and function just fine,

and that it's not 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.

[indistinct] 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 figure out how--

This was done a number of years ago.

Now we actually have devices to test this,

but there's was this sham test.

And then they gave people fake feedback

about the quality of their sleep

and 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 this sham feedback,

if they were told that they had gotten

and let lower quality sleep

led to deficits in variety of cognitive tasks.

And that was sort of decoupled

from their actual [laughs] qualities of sleep,

at least as self-reported.

So that's one study that attest to this, I think certainly,

I would bet a lot of money, I haven't run those myself,

but that your mindsets can push around

your cognitive functioning, physiological effects of sleep.

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

There are real important benefits of sleep,

and how far we can push around that through our mindset,

is an open question.

- You know what?

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 that they supplied us data

on how well people are sleeping,

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

When they see that score,

they might think based on these results,

oh, 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 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'd come off the heels

of doing some research in exercise and diet

and finding these provocative

and also counterintuitive effects

with respect to how we should try to motivate people, right?

And, as I was thinking about this,

and this grouping of going from medicines to saving us

to behaviors to saving us,

and how those behaviors might be influenced by mindsets.

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

Because it's like, okay,

well you want to be healthier and fix your diet,

fix your exercise and stress less.

And so I started doing some digging

into the nature of stress

and a couple things were clear.

One was that the public health message

was very clear, right?

That stress was bad, right?

Unmitigated and harmful on our health,

our productivity, our relationships, our fertility,

our cognition, you name it, right?

And the messages that were out there,

by and large over-simplified 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 literatures

is not so clear cut.

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

to support the fact that the experience of stress,

meaning encountering adversity or challenge

in one's goal related efforts,

does not have to be debilitating.

And in many cases, the body's response

was designed to enhance our ability

to manage at those moments, right?

So some research showing that stress narrows our focus,

increases our attention,

speeds up the rate

at which we're able to process information.

There was some research out there

showing this phenomenon of physiological toughening,

the process by which the release of catabolic hormones

and the stress response

recruit or activate anabolic hormones,

which help as you know build our muscles,

build our neurons, to help us grow and learn.

And there was a whole body of emerging research

on post-traumatic growth

or this phenomenon 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 some 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 heightens my vitality and growth, things like that.

And we found in a number of correlational studies

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's stress response

was designed to do this.

Did you know it could do that?

And we had empowering images

like LeBron James making the free-throw in the final minute

versus missing it, right?

So all of these things are true possibilities

but oriented to two different mindsets about stress.

- So either people saw a video that basically made it seem

like stress will diminish you, crush you, reduce you,

or a video very similar, stress will grow you,

bring out your best,

and maybe even take you to heightened levels of performance

that you've never experienced before.

- Exactly, exactly.

So, yeah, examples in the sports,

we also had 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 financial service company

that was undergoing pretty massive amounts of layoffs.

So these employees were stressed about being laid off.

They were taking on more pressure.

It was just a tough time.

And we randomized them into three conditions.

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

but the three different conditions, some watched no videos,

some watched the stressful crushy videos

and some watched the stress could enhance you videos.

And what we found was that just--

It was a total of nine minutes of videos

over the course of the week,

led to changes in their mindsets about stress,

which led to changes in their physiological symptoms

associated with stress.

So people who watched the enhancing films

had fewer backaches, muscle tension, insomnia,

racing heart, and so forth.

And they also reported performing better at work

compared to those who watched the debilitating videos.

Now interestingly, we didn't make anyone worse

with the debilitating videos.

- Wow, that's good. - Which was good.

We were told that 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 of this enhancing perspective

that turned out to be inspiring.

- I love that study, and I know

we both have friends and ties

in the special operations community

through just sort of happenstance

and maybe we'll get into that a little later,

but a good friend from that community always says,

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

which is either back on your heels,

flat-footed or forward center of mass.

And I said, well, well,

what's the key to forward center of mass?

And he said, "Stress is what places you

"in forward center of mass,"

meaning leaning forward and into challenge.

And I know that you've actually looked at that community

and it does really seem

like that's a mindset that either they have going in

or that they cultivate through the course of their training.

But this notion

that stress is what puts us in forward motion,

is true physiologically, right?

I mean, adrenaline's major role

is to place us into a moment of,

or bias us towards action, that's why we tremble.

It's the body trying to initiate action.

But actually this is probably a good opportunity.

If there was anything interesting

to extract from the study on SEAL teams, what was it?

- Yeah, no, I loved working with the SEALs.

And 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 have tested so far,

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

- People just saying stress is bad.

- Stress is bad, right?

Like with measures of growth and fixed mindsets

about intelligence, people are in the middle,

but oftentimes have a more positive mindsets

about intelligence.

That was not the case with stress, [chuckles].

It's still not the case.

I'm trying to get the message out there.

Except for this group of Navy SEALs.

When they were actually recruit,

so people who were going through basic training

in order to become Navy SEALs.

And we found that they on average

had stresses 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 buds training,

and then looked at how well they succeeded

through that program.

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

At the time it was only like 10 or 20% of trainees.

- Still is, the numbers have never shifted from about that.

No matter how hard pressures on the community change,

the numbers are still about on average, about 15%.

- Yeah, wow.

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

So people 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, again, let's break this down, right?

This doesn't mean, and people get this wrong sometimes.

They think that I'm saying,

that a stresses enhancing mindset

means you should stress, right?

Well, maybe SEALs do.

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

Having a stresses 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 an 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 and enhancing outcomes

with respect to not just our cognition,

but our health, our performance and our wellbeing.

So that mindset, right?

How does that work, right?

Well, it works through a number of different pathways.

One is that it changes fundamentally

what we're motivated to do.

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

maybe a global pandemic, for example.

- For instance.

- For instance.

And you think that stress is bad,

then what's your motivation, right?

Your motivation is to,

well, first you get worried about the stress, right?

Now not only do you have the pandemic,

you're stressed about the stress of the pandemic.

But second is,

your reaction is typically to do one of two things.

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

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

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

I'm not going to deal with that.

You're basically in denial.

So, people who have a stresses debilitating mindset

and we've shown this in our research,

tend to go to one of 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 stressors 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, right?

So the motivation changes, the affect around it changes,

it doesn't make it easy to deal with.

But what we've shown in our research is that,

people who have a stresses enhancing mindset

have more positive effect,

not necessarily less negative effect,

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 DHA levels

in response to stress.

So, more work needs to be done on the physiology,

but I'd love your take on the mechanisms

through which that's possible.

- Yes, and DHA of course is an anabolic hormone

in both men and women.

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

He actually he's 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 with estrogen.

Although of course, there's estrogen and testosterone,

both males and females,

but that's how they had 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 epinephrin,

and epinephrin 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 anibalism as opposed to cannibalism,

which is not saying cannibalism as in eating other people,

but catabolic processes,

is I guess, the right way to refer to it.

But what's again remarkable to me,

is that all of these brain structures

that control dopamine, epinephrin,

testosterone and estrogen,

they're all thought to be in the subconscious,

meaning below our ability to flip a switch

and turn them on or off. - [Alia] Right.

- And yet mindset seemed to impact them.

So I've all that to say,

that there's a clear mechanistic basis

by which this could all work.

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, [chuckles].

- We should do that. - We should do that.

- We should collaborate. - Let's do it.

- We've got common friends in both departments,

so we should do it.

- But I did want to mention,

the way I think about mindset,

and again, I think we need to study this.

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

but this is something we could do.

But the way I think about mindset,

is that mindsets are kind of a portal

between conscious and subconscious processes.

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

So, if sort of programmed in there,

you have stress equals bad, right?

That is 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,

through public health messages and through media

and other things.

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

and the brain is then figuring out

how should it respond to this situation?

And if the assumption, the default,

the programming is, stress is bad,

that's going to, through our subconscious trigger,

all the things that's like,

okay, well, I need to 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, right?

So just talking about this, right?

For your listeners, they're now invited

to bring their stress mindsets up to the consciousness

and say, what is my stress mindset?

How am I thinking about stress?

Can I reprogram that?

Can I start to think about it as more enhancing?

That takes a little bit of a conscious work potentially,

but then once you do that,

that can kind of operate in the background,

influencing how your body responds

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

I better tell my anabolic hormones.

- Right, right. - That doesn't work that way.

- No.

- But these mindsets can help

with the translational process.

- I love the idea that mindsets are at the interface

between the conscious and subconscious.

And I think there's a lot to unpack there.

But it clearly is the case, that the mindset,

they sort of act as heuristics, right?

And as we talked about earlier,

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

Because one thing that is really stressful

is trying to focus on everything all the time.

I've been trying to navigate the public health

around anything.

The public health information around anything

it's 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

and what's the most adaptive way to think about stress?

And should we talk about our stress?

Should we not talk about our stress?

Is there a short list

of ways that we can cope with stress better?

- Yeah.

- I should be careful with the word cope.

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

- Great, yeah, and that's an important nuance

in your language, which 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?

- Vacation, massages, yoga classes.

- Fight against or check out from it, right?

- Exactly, exactly.

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

How do we utilize it?

How do we work with it?

And yeah, I have a lot of thoughts on this.

The first and most important thing

is to clarify our definition of stress.

So I think people often associate--

The negative stress mindset is so insidious,

that now people define stress

with its negative consequences.

So the first step is to decouple that,

and to realize that stress is a neutral, right?

Yet to be determined effect

of experiencing or anticipating adversity

in your goal related efforts.

So let me unpack that a little more,

you can be in the midst of it,

or you could just be worried about something happening.

That's one aspect.

Second is, adversity or challenge,

or 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, right?

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

That as humans, we stress because we care,

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

So the simplified example I like to use is,

you know, 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 Johnny's of the world, right?

It only becomes stressful

to the extent that you care about it.

So, why are we trying to fight or run away

or hide or merely cope with our stress

or overcome it through our massages,

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

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

how can I better utilize or leverage

or respond to the inevitable stresses

that we're going to experience?

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

What I am saying is that, you're 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,

and briefly, the first step

is to just acknowledge that you're stressed,

to own it, see it, be mindful of it.

The second step is to welcome it.

Why would you welcome it?

You welcome it because inherently in that stress

is something you care about.

So you're using it as an opportunity

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

And then the third step is to utilize the stress response,

to achieve the thing that you care about,

not spend your time, money, effort, energy,

trying to get rid of the stress.

Does that make sense?

- Makes sense and I love it.

As somebody who's laboratory studies,

the physiological effects of stress,

the effects that impressed me the most

are for instance, the narrowing of visual attention,

that it then drives a capacity to pass time more finely,

which then drives the capacity

to process information faster.

It's almost like a superpower.

- Right.

- And yes, it can feel uncomfortable often,

but I love the idea that, acknowledging it,

embracing it and then understanding its power

and leveraging that power.

I think what I like so much about that framework

is that the stress response is very generic.

Unlike the relaxation response,

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

So we all kind of get this as a freebie.

And then it sounds like it's a question

of what we end up doing with that.

- Right, and Hans Selye, father of stress said himself,

it's a nonspecific response, right?

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

It's how you're channeling it.

And yeah, like we talked about before,

what most people do is they stress about the stress,

which then over exacerbates it,

or they check out from the stress,

which leads to depression and anhedonia.

Because by checking out from stress,

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

- And substance abuse. - Exactly.

- Our colleague Anna Lembke, who also we had

the good fortune

of having as a guest on this podcast,

talked a lot about this.

I mean, 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 stability

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 publications website

of a paper about influencers,

online influencers and nutrition.

Now, that might not be the main thrust of what you're up to,

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

sort of interesting given that a lot of the communication

in and around this podcast takes place through social media.

And I've kind of launched into this landscape now

where constantly bombarded with health information

and influencers, right?

At the time I didn't even know

until couple of [mumbles].

- You are one.

- One could argue one way or the other,

but 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.

'Cause I now know that stress is actually an asset.

- Yeah, well, that work is part of a body of work

that we've been sort of venturing into,

which is to understand

where do these mindsets come from, right?

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,

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

Second is culture and media.

So movies, podcasts, and now social media.

Third is influential others.

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

And fourth is your conscious choice.

So, we talked about that a little.

We have as humans have the ability to be mindful of,

and to change our mindsets.

But the social media and influencer stuff

has been in part in attempt to understand

where do our mindsets

about things like healthy foods come from.

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

has done a series of really interesting studies on this,

showing that, if you rate the nutritional quality

of the top grossing movies in the last 20 years,

or you look at the Instagram accounts

of all the most influential people on Instagram,

and you analyze the nutrition content

of what they're eating, what he's shown is that,

depending on the study,

70 to 90% of those movies or influencers

would fail the legal standards for advertising in the UK.

So they're putting out their nutrition contents

that are, maybe not surprisingly, but undeniably unhealthy.

And to me, that's interesting and important.

It shows that where are we getting this mindset

that those unhealthy foods are pleasurable, desirable.

What's maybe even more interesting than that

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

to show that the ways people are talking

about the foods they're eating really matter too.

So generally what we've found is that

when people talk about unhealthy foods,

they use a language that connotes a sense of excitement,

fun, sexiness, danger, indulgence,

basically anything good and desirable, right?

- These should be cookies, cakes, high sugar.

- Exactly, like truly unhealthy foods.

That's actually--

The objective, what?

Helped me is it's challenging,

but yeah, high fat, high sugar.

- Yeah, I think there's pretty good agreement now

that excessive sugar isn't good.

- Yeah, and highly processed.

- Yeah, highly processed, et cetera, et cetera.

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 [mumbles].

- 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 not tasty. - Recovering

from the holidays.

Sort of the post-holiday reset, right?

- Exactly, and this is really important

because you're doing all this work trying,

and others are doing all this work,

trying to inform people

about what actually is good for them.

And meanwhile, there's this hurricane of other force

that's telling people, that seeping in our minds,

sure, those might be good for you,

but those foods are not fun or sexy or indulgent

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

And it's also paid advertising for fast foods

and sugary beverages and other things.

So it's not surprising that we have this mindset,

that healthy foods are the less desirable thing to eat

because of those cultural and social forces.

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

quantify it, as a way to say,

all right, let's maybe be a little bit more mindful

about how we talk about healthy foods.

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 packaging

can be sold as, can be woven into a film

or promoted by a celebrity influencer,

not a health influencer per se,

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

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

and it feeds back on sales to the company.

Whereas things that can't be commoditized,

it's more difficult, right?

It's hard to the 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.

That 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 was some of that certainly,

and yeah, all of the promoted and branded content

is usually for processed high sugar foods.

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

were not promoted or branded.

And so, there's a lot of flexibility

in what these producers or influencers

could show on their media.

Although it goes both ways, right?

It's not just the producers and the influencers

responsibility, the public is reacting to this.

And we showed too that people respond more positively,

there are more likes on posts about unhealthy foods.

So it's a sort of distasteful and in neck it,

you know, it's a distasteful culture around healthy eating

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

- Yeah, it's dopamine circuits through and through,

just the site of some very calorie dense,

extremely tasty food drives those dopamine circuits.

And I realized that there are people out there

who derive the same sort of,

or similar levels of pleasure from healthy foods.

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

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

- Yeah, exactly.

And that's what's really inspiring.

To me at least, is that, it is possible, right?

I mean, people think, oh, well,

vegetables are just inherently less tasty than ice cream.

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

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

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

in order for it her 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.

- So, it's a really interesting study.

When it's published, let me know and all.

- Yeah, I think it was actually released this week, yeah.

In JAMA Internal Medicine.

- JAMA Internal, okay, great journal.

I will definitely talk about it on social media

and elsewhere, sounds very interesting.

What else are you up to lately?

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 [mumbles],

well, I guess there's so many things.

The thing that I'm most into right now,

we're doing the most work in is, you know,

I started by getting inspired by placebo effects

in medicine.

I did a long stint in placebo or belief like effects

in behavioral health.

And now we're moving back into medicine.

So I'm really interested

in looking at how we can work with active drugs

and treatments, to make them better

and make the experience of them better

by instilling different mindsets.

So, one study we did along those lines,

we worked with kids

or 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 the 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 by-product of this treatment,

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

But what we found in our conversation with Kari,

was that the reality of those side effects

was not so negative.

In fact, they were mechanistically linked

to the body learning how to tolerate peanuts

or the allergen.

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

They were all getting the treatment,

but half of them were helped to see

this more positive mindsets.

That symptoms and side effects from this treatment,

were a positive signal that the treatment was working

and their bodies were getting stronger.

And what we found was that

that mindset led to reductions in anxiety, fewer symptoms,

when at the highest doses and most interestingly of all,

they had better outcomes.

So based on immune markers,

that were assign 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,

you know, 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.

- It's incredible.

I can't wait to read that study.

Is that one out or on the way?

- Yes.

- 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.

I find this issue of side effects really interesting.

I don't take a lot of prescription drugs,

but recently I was prescribed a few,

and the list of side effects is, it's incredible

and 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 expecting anyone to read those

because you need a high powered microscope to read this,

print is truly fine print.

But I did realize that in reading over the side effects

that one prime is themselves,

to experience those side effects.

And so now I just rip up the side effects thing

or the sheet, and just throw it away.

I just take it as recommended.

Do you think it works in the other direction

to where if an effective medication

is supposed to have result A, B or C,

and you are told again and again,

how effective it is for that treatment,

that it could amplify the effect.

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

It's not nocebo, as you described before.

But that perhaps at a lower dose,

a given medication could have a amplified effect

or at a appropriate dose, if you will,

it could have a super physiological effect.

Has that ever been demonstrated?

- To some degree.

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

people thought the effects of placebos

were expectancy based.

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

There's certainly some, some truth to that,

but I think the mindset approach is more powerful

because it helps us understand the mechanisms, right?

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

what are the mechanisms

through which that expectation

would lead to your blood pressure going down way?

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, right?

That you're being treated well.

Then you can start to unpack the mechanisms

through which blood pressure could be relieved.

Maybe it's anxiety reduction,

maybe it's changing the sort of anticipation

of what are the prioritization

of what the body needs to focus on.

And so, I really think that, the work of the future

needs to be on getting more sophisticated about

what is the mindset that we're instilling

when we say something will work or it won't work.

And how do we understand the mechanisms

through which that changes physiology?

So to answer your question,

I think that that could be true,

but it depends on what actually is the mindset

you're evoking.

- I know you're a parent,

and to the other parents out there,

but also the 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 will be a much better place.

- Yes.

- How does one go about that?

Given that there were kids and we are all being bombarded

with conflicting information all the time,

how do we anchor to a mindset?

- Yeah, and you're getting at my other major passion

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

meta mindset.

I'm working on this with Chris Evans and others.

And that is, how do we consciously and deliberately

change our mindsets?

And the first step is really simple,

and that's just to be aware that you have them.

That the world, your beliefs,

aren't sort of an unmitigated reflection of reality

as it objectively is.

They are filtered through our interpretations,

our expectations, our frameworks,

and simplifications of that reality.

And as you know, your work and then you're as you know,

so well that 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 her 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 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.

- Your child real, real child.

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.

It's like, no, you need - Or you're negotiating.

- 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 parent is forcing me to do it, right?

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

the objective reality,

and really thinking about the subjective reality

and focusing on adaptive mindsets.

So my goal as a parent

has been to try to help her instill a healthy mindset

about eating,

that healthy foods are indulgent and delicious.

That the experience of stress is inevitable,

that it's natural.

And that going through stressful experience

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 [laughs] we will with time.

- Yeah, that'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

that 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 really urge against people getting dogmatic

about their mindset also, right?

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

Or, and if I don't have the right mind--

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 a puzzle.

So treat yourself like a scientist, look at your life,

look at your mindsets, see what's serving you,

see what isn't.

Find more useful, adaptive, and empowering mindsets

and live by those.

- I love it.

Now, in one version of this kind of discussion,

I would have asked

the question I'm going to ask next at the beginning,

but I'm going to ask it now close to the end,

which is, you're 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?

- I was trained as a clinical psychologist.

So my PhD is in clinical psychology.

And I did all my pre and post internships

that dealt 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.

So what are the mindsets that you try and adopt

on a regular basis in 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's good,

or do you have any kind of central mindsets

that help you navigate through,

you know, it was passed

to be a pretty complex set of daily routines

given everything that you juggle.

But I think that people like you are unique,

in that you have the inside knowledge

of how this stuff works,

and you've also existed in these different domains.

And I know a lot of listeners

have a more athletic slant to their life

or a more cognitive or some are raising kids,

or some people are doing any number of things.

So, this is where I think it would be useful

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

This is what I'm asking.

- Yeah, well, it's certainly true in my case,

that research is me search.

Everything that I study as an intellectual

has come from my own experience or my own failings, right?

And when I was 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.

I decided to do my dissertation on stress, right?

Now I think we're in the midst of a global pandemic.

How can our mindsets be useful here?

I don't think there's a 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.

I know many of you 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

then you have no chance

when you get up there on the balance beam, right?

And also, my father was a martial artist,

a teacher of meditation.

So this kind of mind body work

was baked into me from an early age.

And I think what I've done recently,

is to try to understand it scientifically,

and more importantly,

to figure out how can we do better with this, right?

We're all talking about AI taking over the world,

and technology this and all the personalized medicine that,

and it's like, we have done so little, relatively,

so little with the human resource, our human brains,

that the potential for which is so great.

And we've done almost nothing.

Take the placebo effect, we know a lot about what it is.

We've done almost nothing to leverage that in medicine

consciously and deliberately.

So, what keeps me going, what gets me through the hard times

is just that burning question of, what is going on here

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

- Well, I and millions of other people are so grateful

that you do this work.

It's so important and it's truly unique.

Tell us where people can learn more about your research,

where they can find you online.

I'm 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, it's been such an honor getting to chat with you

and just you have such an impact on the world.

And I look forward.

I hope we can do some science together also.

- Absolutely, absolutely.

- Yeah, all our papers and materials and interventions

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

We also have a link there too,

that takes you to Stanford SPARK,

which stands for social psychological answers

to real world questions.

We have a lot of toolkits on that website,

including a toolkit for this rethink stress approach

of acknowledging, welcoming, and utilizing your stress.

And then I guess I'm on Twitter, Alia Crum, [chuckles],

I don't do much there, but maybe I will start to.

- Well, those are all great resources.

We will provide links to all of those

for our listeners and viewers.

And I also hope to convince you

to write a book or many books in the future.

The world needs to know about this,

but thank you so much for taking time

out of your exceedingly busy schedule

to talk to us about these ideas.

I learned so much.

I'm going to definitely think about

what is the effect of my mindset about blank

in every category of life

and really, on behalf of everybody and myself.

Thank you so much.

- Yeah, thank you.

And I guess I just want to end by saying,

I think this work is really the tip of the iceberg

of what can and should be done.

And so, I really invite you, your listeners,

and anybody who's inspired by this work.

If they want to share stories

or want to partner on a collaboration to please reach out.

- Great, well, and the comments section on YouTube

is a great place to do that as well.

You will hear from them.

- Great, [laughs]. - All right.

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,

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in one of their upcoming studies on mindsets,

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