In this episode of the Making Sense podcast, Sam Harris speaks with Judson Brewer about addiction, craving, and mindfulness. They discuss the nature of reward-based learning, the role of subjective bias in addiction, the neuroscience of craving, the neural correlates of the sense of self, real-time neuroimaging, effort and effortlessness in meditation, smoking cessation through mindfulness, the difference between dopamine-driven reward and happiness, how to make meditation a habit, working with anxiety, and other topics.
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This is an unofficial transcript meant for reference. Accuracy is not guaranteed.
Welcome to the maidens Asthma against SAM Harris
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and today's conversations is appearing both on the app and the podcast. That doesn't usually happen, but sometimes as a conversation that seems relevant to both audiences- and this is one of those times too. Damn speaking with Judson.
Brewer job is the director of research and innovation at the mindful a centre and associate professor and psychiatry at the School of medicine. At Brown university
he's also research affiliate at MIT and before that he held research.
Teaching positions at Yale University and at the University of Massachusetts Centre for mindfulness jet, as also the founder of additional therapeutics platform, Mine Sciences and the author of the book, the craving mind from cigarettes to smart phones to love. Why we get hooked and
We can break bad habits and in this episode we talk about mindfulness and addiction
the nature of reward based learning the Neuroscience of Craven
real time: Neuro Imaging Smokin cessation through mindfulness the difference but
when dopamine, driven reward and real happiness, working with anxiety and other topics.
And now without further delay? I bring you judge and brewer
I am here would Jed Brewer Chad thanks are thanks for having me so give us, Sir, the
potted biography of your intellectual interests and what you're doing professionally now before we die than I am
an addiction psychiatrist and inert scientist and the director of research and innovation at Brown, universities, mindfulness centre and the founder of mind sciences, which makes apis mindfulness training programmes for habit change.
So what is your background in meditation? How did you get interested in it and what sort of training have you done? I started meditating my first day of medical school, three, the background of suffering mechanism. You know.
That ten thousand hours Roy. I certainly achieved that early on in my life with regard to ten thousand hours of suffering. So I an expert there
but started meditating isles really struggling beginning medical school figured, it was said he knows.
Putting something new. In my life and I started meditating to see what that would be likened to see if it could help us some of the stress and started
practicing? I didn't know that there were different traditions. I joined a local
Son Guide in Saint Louis, where I was going to medical school, which turned out to be led by first by air as in practice now and then a terawatt in practitioner, and then I found it a teacher in the MID West and start practising the turnout in the turnout in tradition and have largely focused their over the last twenty plus years. Most recent I've been sitting with Joseph Goldstein, who has an eclectic style, is studied with a bunch of different teachers and have also been doing some collaboration with Dan Brown is more in the term, and then the tibetan lineage
and learning a fair amount of Zog Chin, both free from practice perspective, but also to help make sure that the research that we do is accurate, nice and when you wanted to medical school, did you know immediately that you wanted to go into psychiatry or was that at a later, a picnic.
Let's say later as in it is the last thing that I thought I was gonna do when it was in the sandy beach deeper.
I'm where you do a couple of years of medical school, and then you do your Phd for long enough to forget everything that you have learned in medical school and then you go back
to the words, and so when I
back into the words for that, my thirty of medical school. I I figured I would,
Psychiatry is way too remember how to interview patients.
And then I realized that these you know what my patients we're talking about with
really using the same language as well as the protests, and also that psychiatry was in tremendous need of good treatments, especially for addictions. Man, that was at seems to be a sweet spot of the Buddha. You know
craving clinging her, the other. The the lens through which the Buddha looked at the whole problem of on enlightenment is really
of Craven and its consequences and end there's a very helpful analogy drawn here between addiction and these ancient methods of practice. Then you do this in your book, the craving mine,
Tell us talk about that. Maybe that's the the right way in before we get to the the esoteric of how mindfulness can help what is addiction and how should we be thinking about it. I, like the simple definition of continued use, despite adverse consequences. I learned that and residency training and the moroccan side of addiction, medicine just came out within it, a definition that very much parallels that unit teenagers, despite adverse consequences, which not only points out that we can be addicted to chemicals, but we can be addicted to behaviors, ranging from you know our cell phones, these weapons of mass destruction to thinking we can be addicted to our own thoughts or our own views rhetoric
Since that many people will balk at that definition, it seemed somehow or can seemed somehow to capacious. Are we really saying or do we want to say that addiction to something like cigarettes is precisely on the same continuum as a dick
to smart phones or think Aigner Shop, Aigner, gambling limited it. Isn't there some significance to the fact that in one case, someone could be using a chemical necessary
of which would lead to withdraw or is there a biochemistry that holds people hostage in a way that behavioral addictions, dont quite
Where is it really does want to get in? There is just narrow physiology whether you have an eggs on
and on board or not and really is the same mechanism. I think there are two asked:
ex here one is that we can look at physical dependence where we know certain in a few jack, the brain with doping mean which every known drug abuse has been shown to do. You know it's gonna led to receptor modulation and that, for example, with alcohol word, nicotine nerdy opiates or whatever you can see in a receptor up and down regulation and that take can take a while to normalize setting that peace hasn't been new. Is that that physical dependents pieces can be separated from us?
They continued use, despite adverse consequences, and so I think that's where the plank feel gets levelled. Somebody can be drinking alcohol. I not have consequences. Somebody else can be drinking alcohol and can be having severe consequences. Somebody grubby using their smartphone same thing. You know they could be texting while driving and get into an accident. Well, somebody else uses their smartphone.
Spawned. Simply, let's say right right: I guess it's a little wiggle room in the definition or or in the who is defining the adverse consequences, write them in their probably people who, by any outside estimation, are addicted to whatever their smartphones or gambling, and yet they have a problem. Admitting the day,
have a problem here, and I think we see this in psychiatry where its helpful to get information not only from the person who might be referred to as her come in, to see me as a psychiatrist, but also from a collateral where, in its family, friends coworkers. What knight and like your pointing out, somebody might not think they have a problem, no matter what whatever the substance or the behaviour is, but it might be causing significant adverse consequences to all the people around them, and so I think, of despite adverse consequences, meaning not just what somebody thinks is happening, but really having as much of an objective perspective as possible- and that includes many points of view here and perhaps the most subtle addiction here and and and many people again will find it strange to be
can join in these concepts of addiction and thinking. But you mentioned one been addicted to thinking, and this is really something that you encounter when you you and you try to meditate especially intensively on silent retreat. You just the autumn activity of being lost in discursive thought the fact that it is hard to false state despite arm most hurrah.
Efforts to pay attention. In this case, we ve deranged our lives and and gone into silence with the goal of paying attention
moment to moment, and yet the thoughts don't stop. How do you think about thinking in light of
This sort of addiction framing and undertake a sea underline mechanics of reward, based, learning and processing.
I guess I should say hi. My name is John demand. Think a hologram
May day, soberly and Mama Day with my
you know I remember my first seven days- silent, meditation retreat. This is when I was in medical school and by day three. I was crying uncontrollably on the shoulder of the treatment the retreat manager, because I didn't think I could do
this, I could pay attention and my breath. You know because I thought that's always encouraging psychiatrist to weep openly
holder of a stranger. Yes. So I think in terms of near what,
seen from my own experience and also what now,
begun to understand scientifically, and this is also is how much
what's comes in others. This idea that we can just just control ourselves and thinking as a great exam
or of really not having any control. We can't just stop our thoughts. Are we might be able to create conditions where the mind is quiet,
but if we just get up there- and you know, hold up to stop sign and say: oh ok, thoughts, you know, take a break, they come out ass. You can
like some base innovated near and it becomes the thought apocalypse? So that's one I think in terms of addiction. I also remember, being on a month on retreating
it took me a full day or so to realise that I would be having these thoughts and they be saying all this is. This is a great experience,
if you do not write this down, you know you will forget it and then it'll be lost in, and I would you know, get up from the cushion.
And then write it down and then you know, sit down again and then the next in the world's greatest thought, came up and then do the same thing. An ethic wait a minute. This is this is my mind not just not wanting to meditate. So I think in terms of thee. Looking at this from an addictive perspective, it might be helpful just even think of
What the general framework of ruler based learning is because that can also explain where addiction can move not just from alcohol in the typical ones, but to even to thinking and views, and things like this, so there's a beer there's a very simple framework that has three components trigger a behavior and a reward in this framework is set up to help us remember where food is and how to avoid danger.
So basically, if you see food, that's the trigger, you eat the food, that's the behaviour, and then your stomach sends this dopamine signal to your brain. That says: remember what you ate, where he found it. There's the reward or quoting what reward it's from a brain perspective its basically, it lays down context dependent memory,
same fur awaiting danger, you see the danger you run away and then the reward is that Europe will have to tell your buddies Doug over there. That's kind of dangerous. So that's the basic frame
four reward based learning. Neither a couple of important components that
really explain a lot of
modern day, maladies that we dont quite understand with this Roer based learning is based on rewards not on the behaviour itself,
and I mention that, because in modern day we try everything from dieting to trying to make our minds silence, Wentworth meditating, but we use the brute Force brute force method. Where words like. Ok, just stop! That's what I was trying to do. I used to
wet through tee shirts in the middle of winter, at this centre at the insight meditation society up in Massachusetts, your words where cold I'd sweat through tee shirts, trying to force myself not to think and to just stay content.
My breath well, this is the same thing that people do in their trying to lose weight and they use a traditional diet, which just says you know makes her. You eat salad instead of cake. Well, it makes sense. Is it the formula is correct, but that's not how our minds work so
did based learning reminds us that it's not the behaviour, it's the wrong.
Lord- how rewarding a behavior is an that's. What's gonna drive future behaviour and understanding this risk really
key, not only for my lab in developing in owed outpace, my fullest training programmes, for example, but also under
banning dead, the underlying neural mechanisms of what work is going on and also
Personally, it really helped me dictators
my breath or pays attention to an object of meditation rather than trying to force it, and it's also more the anticipation of reward than it is
actual landing on the object of desire right. It's both actually so that doping fires the first time
get a reward, and if it happened for immediately that dopamine firing and that's that anticipation, peace that that feels
The Dublin in firing shifts from receipt of reward to anticipation of reward, so it actually start
firing when we have a trigger or when we have it, a thought can be a trigger where we start thinking about getting that thing it. It motivates us to get off the couch and go do that behaviour because remember this is all set up to motivate us to eat and to motivate us to run away from danger so that anticipation pieces go. Do something so you're saying that its initially encoded by the actual reward, but
In future instances it starts prior to the aurora, just one the one were actually engaging the routine. That would reliably
deliver the reward. Yes, so, for example, we know the first, if I in
Thirdly, this has to do with an anticipated reward self
I'm in a walking down the street, and suddenly I find you know a chocolate bar. That's even my favorite chocolate,
my brain says a wild. I was surprised and that oh well surprise says: oh you just just one the chocolate lottery,
and so the next time I walked down the street. My brain will say: oh, I wonder if there's another chocolate bar there and so the trigger of the context that walking down the street says: oh, go: look for chocolate,
in your book. You draw an analogy between the cycle of learning, which is in the behaviour of literature. Goin back to Skinner was called
went conditioning theirs, it amounted to draw their between that met.
And, as an end, the buddhist framing of dependent origination. If you want to unpack that, for us, the I'd be happy to
so dependent origination is
Reportedly, what the bureau is contemplating on the night of his enlightenment. Now that sounds kind of important this. This is what the deed was.
Was contemplating, and then he became awaken. Then we get it became enlighten. So I work with that,
holly scholar, Jake Davis, because
as I was studying, dependent origination. Personally, I was
eddying behavior change professionally as an addiction psychiatrist and was starting to see the importance of opera conditioning, which is basically that reward based learning cycle that I talked about.
And we looked at the parallels and it was striking how similar these two frameworks were. There were slight differences in terminal lodging in terms of some language that the Buddhist were using in some language that the behaviors were using, but basically it with the same process in what it suggested was that the unit
the Buddha. Basically, he discovered what we now think of in modern day, as your roared based learning before paper had even been invented
in this discovery and modern science? Just to put it in perspective with so huge that Eric
Dell won the Nobel Prize in the year two thousand, showing that this process is, can evolution early conserved, although it back to the sea slugs so critically, important concept, whether it
is the Buddha becoming awakened or air candy
Getting his Nobel Prize, showing that this is a very very fond
learning process. So in the buddhist framework there's this
Capacity the mind to notice.
Feeling valence of a stimulus. So you were you what you can notice? What disappoints pleasanter, unpleasant and craving follows from that,
there's craven and identification with it, and I think we
now know something about the neural correlates of these processes. What is your work? Tell you about
what the brain is doing when, where field
for a stimulus and that desires made actionable because there's no distance between attention and the desire of self the US. So we are what we started. The debate at the pleasant and unpleasant aspect in business terms, vade an unpleasant, unpaid
maiden: unpleasant unpleasantly, sometimes neutral in opera conditioning modernist. Psychology terms, you pretty similar terms are used. You know something feels pleasant, something feels unpleasant and what the what both frameworks
show, is that, whether its pleasant or unpleasant, both of them lead to a craving
We want more of the pleasant and we want less of the unpleasant, so you can think of an anti craving it a version you ever craving aversion and then that leads in in the Buddhist terminology to
clinging Arup Madonna, which can be also suggest a translation, can be sustenance where were were fuelling that fire of craving end by behaving we start to become identified with that behaviour. So, if its eating chocolate, I can start to become identified with eating certain types of chocolate like dark Chocolate, verses, milk, chocolate or if I have a certain political propensity, I could start becoming I d
to fight with a certain type of you are set of views. Were you know? I am this verses, not that and the more we perform their behaviour, whether its eating chocolate or thinking. You know this is the right you, the more we become identified with that
no interesting Lee in ancient buddhist terms, they called they said that the cycle is perpetuated through ignorance.
And then in modern day I think of this. As that cycle is perpetuated through I e our, I used the term subjective bias, and so the term ignorance and subjective bias. I would suggest you basically the same thing
meaning that we become biased based on our previous behaviour. So
not seeing the world clearly we're seeing it through these lenses of our previous behaviour. So if I see chocolate, I'm gonna see
through the lens of oh, I like, or I dont like- that type of chocolate based on my previous behaviour, so this objective bias the Buddhist would suggest, is ignorance because we're not
actually seen clearly in I fed interpretation of the term,
Bosnia, which literally means seeing clearly its though we're taking off those subjective, biased classes here, there's mentioning connection here between the more creature,
levels of craving and wanting and identification, and something that seems you know far more recent than acquisition. In evolutionary terms, are you you're talking about political views right so that the fact that one's sense of identification to the sense of self can be
an emergent property of contracting within the domain of either of these things weathered the taste of chocolate, the wanting of it, the preference for one form or another and just hold into an opinion that one has entertained and become attached to. This can sound surprising, but
just an evolutionary terms. We didn't add entirely new modules to the ape brain to become human rights, mood
Only way we acquire new abilities is by extending the processing reach of structures that we know already there and so
the same circuitry? That's encoding and discussed over be confronted by something toxic here that you want to get into your mouth. Is that same process
that is underwriting moral.
Intuitions and even judgments of fear, the truth or falsity of ideas from the side of experience in meditation. This really isn't surprising means you can feel in yourself the difference between identification, attachment
cramp of self around any of these things in a want in another bite of cake and that we will have this experience of your head in some dessert, which you're you're very happy to debating, and someone usually, your spouse will ask for a bye,
of it when you down to the last by frighten you, you know, you feel viscerally late, something in you, some homunculus in you has not budgeted for the possibility of having to give up. At last. By to hear your pleasure extended to the remaining bite, you would have happily perhaps given an earlier bite, but surely at the last one that feeling of
emotional impediment that that is tied in the middle of virtually everything that feels like me. Do we know much at this point
Lee, underline Neuro anatomy of of these processes. I'm glad you brought in these terms around you, know, contraction and and basically clinging that they take the closed down quality of experience, because that something that my lab has kind of serendipitous Lee fallen into studying and if you think about it from a from an evolutionary perspective in a fear, for example, feels contract
doing right and the ideas did make ourselves a small, an object as possible, protect our vital organs from where
However, it is that's about to eat us now, that's very different than the feeling of say, joy or connection which feels much more expansive or even curiosity,
So just just anchoring us on that. On that framework on the feeling of contraction, verses, expansion,
My lab was studying experience meditated. This is back two thousand nine ten eleven. He almost a decade ago, where we were just trying to understand what the basic brain activity looked like inexperience versus novice meditated knew. We are actually looking for convergence, so we studied a bunch of different types of practices, so we had people practice like concentration, practice, breath awareness, a loving kindness practice in a war of a connection practice and then a choice, us awareness practice where they were you'd. They were not focused on it.
Particular object, but just whatever came into their awareness with the objective of their awareness that moment and we look to see what was common amongst those three meditation practices. What we found was very striking one was we didn't find a single brain region, there is increased, inactivity, inexperienced verses
I was meditating, which was a little shocking to me, and I think when against my primary hypothesis was the tempest
he's some brain region activating cause. I'm sure work in my ass off this back before you
Only ten years into practice and still didn't have quite a clue about what force was sick, but they are,
The thing that we found was that there were a particular brain regions that were deactivated, inexperienced versus novice meditated and these
to do with this network called the default, my network that has to do with self referential processing. So when we take something personally, basically, this network of brain regions gets activated. So, for example, when will in its use, for example, of the cake you know it's like. Oh I I want that light last peek a piece of cake
kind of holding onto our work, whereas clinging to it so to speak, also happens when we ruminate eye when we're depressed it happens, will persevere. Eight
were anxious were worried about the future, so they're a bunch of different things that when we take them personally, when we are worried about the future, when we regret things in the past, when we want that piece of cake, they all activated
my network and lo and behold, this same network was deactivated. Inexperience meditated is now is this year. I have spoken about the default mode network before in this context. It is the finding the same for the media, prefrontal cortex as the posterity single it or are we mostly talking about?
foster singular for these. The activation of the ESA great question we ve moved. We ve done most of our experiments in the post, your your singular cortex, and that's because that was the stronger, the brain region that have the most deactivation, inexperienced, verses, knowest method.
It offers and also progress,
ethically, when we started doing real time, Neuro feedback experiments, we didn't have the techniques to be able to give feedback from multiple brain regions at once that you're pretty highly correlated
but would most of the work that we ve done, has been with the posters England there's also a theoretical reason for that, which is the media prefrontal cortex part of the pre frontal cortex with such a younger part of the brain.
Has been more linked to the conceptual sense of self where's, the post area, single cortex.
Was actually through. Some work that we done and others had done, seems to be more links to an experience. All sense of self in is also directly anatomically connected to.
Brain regions involved in memory like the hippocampus, so the poster single it's what we ve been focused on primarily, but a fair number of studies have shown that the both are pretty intimately correlated the. So we wanted to actually understand
This? The activation meant because there's a big issue in narrow imaging under a science around reverse in France, where, if you see a brain region activated, you assume that something is happening based on what
Their people have done in other experiments, but you can't make that assumption accurately because it could be doing something else, and we just don't know it. So the best way to reduce that likelihood is to do real.
I'm experiments where you can measure brain activity and show people there
in activity in real time, while they're doing in particular task. In our case, we are having people meditate and that way you can link up the subjective experience their first person. Trajectory
France, with their brain activity in real time and really know what's going on. So we did a bunch of these experiments with novice and experienced Mediterranean and we
found something that was really striking, which was that this act, this activation in the post year, singular cortex was correlated not just with things like mind wandering are craving, but it's the degree to which people get caught up
in that experience, and we found this because not only word things like craving or mind wandering activating these brain regions which other people had found before, but we found.
Other experiences were also activating it, such as when people were trying to meditate harder, as one person put it. Yes, I tried to look at the there are linking the graph is an object, timidity.
And I said I tried to be more aware of four or force it basically and that actually induce did an active, increased activity or increase activation of the post. Your simulate cortex, whereas,
there are people were reporting that the more they let go and stop trying to do
anything that less their post your seal. It was activated
So you mentioned that you, you gave people three different practices to do, and two of them,
were essentially mindfulness, but one was to focus exclusively on the breath and the other was choice. Less awareness the which is today, you just leave Europe,
attention wide open a notice whenever you notice were those different in terms of the activity of the posterior single it. They both showed deactivation, inexperienced versus novice meditated.
As in when people were focusing on that object, weathers the breath urges anything come into their awareness and the less they tried, the less they got caught up in in doing and we're just resting in awareness, the more deactivated stare post, your single it got wrote wrote the American feel this subjectively, and this is the difference between feeling, like the meditate, her right, where Europe strongly identified, with the aims of your attention: you're the locusts of attention in the head,
and you're, now pointing attention strategically at the breath and trying to get closer to it and noticing the competition between doing that? If you'd like to continue listening to this podcast you'll need to subscribe, it Samharris, DOT, org you'll, get access to
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Transcript generated on 2019-12-18.