Dr. Alia Crum: Science of Mindsets for Health & Performance | Huberman Lab Podcast #56

– 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. And keeping with that theme, I'd like to thank the
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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, and perhaps even be a research subject in one of their upcoming
studies on mindsets, you can go to mbl.stanford.edu. There, you will also
see a tab for support, where if you like, you can
make a tax deductible donation to support the incredible research that Dr. Crum and her
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