AMA #5: Intrusive Thoughts, CGMs, Behavioral Change, Naps & NSDR
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Welcome to the huberman lab podcast, where we discuss science and science space tools for everyday life. I am Andrew huberman and am a professor neurobiology and open ology at stanford school of medicine today. Isn't ask me anything episode or A M A.

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Now without further a do, I will answer your questions. And as always, I will strive to be as thero as possible, as clear as possible and as concise as possible. Our first question is about abstaining from thoughts.

And in the answering this question, we're going to skirt right up against the topic that i've covered before in the podcast, which is obsessive compulsive disorder, which is a very serious disorder, I mean, can have a range of severity, but people with true ocd suffer a lot from obsessions. These are intrusive thoughts, compulsion, which are the behaviors typically associate with those thoughts. I think it's really important that we define ocd really clearly so that we can make sure that we're talking about intrusive thoughts and the desire to abstain from thoughts versus ocd.

And where there might be some overlap there, the functional definition of ocd that really pertains to the disorder, obsessive compulsive disorder, O C D, as opposed to, you know, we call people neurotic, or we said, you have O C D, or I am so O C D about this, or O C D about that. That's become a common use of the A R rony M O C. But true ocd is a situation in which the engaging in a particular compulsive behavior does not serve to reduce the intensity or the frequency of the obsessions.

In fact, IT makes IT worse. If so, the typical thing that we hear these days is, oh, you so ocd, or he's so ocd, or SHE so CD, or I am so ocd. Now if someone is ocd in that sense, okay, so not the clinical disorder, but O, C, D, in the sense that they're really clean, they're really festivity.

They need everything perfect. However, that person can achieve some level of calm and comfort that's fairly long lasting. If everything's clean and perfect, well then that's not obsessive compulsive disorder.

This is really important to understand as we've entry to answering the question about intrusive thoughts and the desire to abstain from certain thoughts. A person with true O C D will keep cleaning and cleaning or washing their hands or or arranging things at perfect right angles. But the more they do IT, the more they are anxious goes up.

A person who has more typical um kash, we don't relieve and have a language for this nowaday. Unfortunately, the sort of person that's extremely particular, they need things a certain way. They're very driven to resolve things and do things to make sure that things are done in a certain way or handled in a certain way.

Well, if that person can experience relief from engaging in, let's say, exercise or from cleaning, right? You say you're so O C D about exercise. Well, but if exercising for an hour, even two hours in the morning, make somebody really calm on to the rest of the day, and they don't need exercise even they're not necessarily true ocd.

They don't necessarily have a disorder related to exercise. However, if they're exercising for two hours in the morning and then they find them can concentrate on other things, and their desire to exercise just increases and increases and becomes intrusive for them, disrupting their quality of life throughout the day. Well, then that's falling into the umbrella of what we will call a true disorder OK.

So we want to highlight that because the question is about a desire to abstain from thoughts. And the question is, in your discussion with doctor ona empt y SHE just mentioned, doctor ona empt y is the director of our dual diagnosis addiction clinic at stanford university school medicine. She's the author of this incredible book, open the nation that I think everybody should read.

I do believe everyone should that book so important for the addict and non addi alike, because IT deals with basically the state of our life nowaday. We're living in this dolph mine rich world where we can quickly become dopamine depleted, which is terrible, leads the depression in addition to things like a addiction in some folks. At a honor was a guest on the podcast, you can find her episode at human and love out calm.

Just put, honor. I think this is the only guest we ve had thus far whose name is on us soil. Just pop up. Their other entire website is searched, but if you want to listen to that episode or watch that episode, you can access a huberman lab dot com.

Question is in your discussion, when doctor on a ym key, you were talking about abstaining from people's drug of choice for thirty days to reset the dopamine reward pathway in, indeed, that is the prescriptive that doctor on olympic gives for most all addictions and for people that are suffering from milder, even severe depression related to domine seeking behaviors, social media, video games, sex, food at that. However, of course, in the instance of food or in some other addictions, you can't abstain for thirty days. That would be terrible to obtained for food for thirty days.

I'm sure people have done IT um but this is not healthy to do certain things like alcohol and drugs people can sustain for thirty days in efforts to never go back to them again. There are cases of severe alcohol or opiate dependence where people can't go cold turkey or they risk dying. So there they had need to really work with a physician.

But the thirty day reset of the dopamine in system is something that's very real and that proteins to most people, that is, it's going to be very effective for most people struggling with either behavior or what are someone is called process addictions or other types of addictions, including substance abuse issues. The question continues. You said you were going to ask on a how to obtain in if your drug of choice is, I thought, or narrative, as opposed to a substance or a behavior.

The question continues as far as I can tell your discussion without a moved on. Before you answer the question, would you be able to discuss strategy for obtaining from addictive thoughts and narratives? okay. So let's talk about intrusive thoughts. And let's start off by asking ourselves, what is the thought of in the realm of neutral logy, we have sensations which the the processes by which are neurons and nerve cells convert light photons, sound waves, touch mechanical pressure at sara into electrical signals and chemical signals that heading into our nervous system, including our brain, and then our brain, least we think makes sense of them, and help us navigate the world that we're in case of.

The sensation part is a pure transformation of mechanical information, or in some cases, chemical information, like smell chemicals s literally volatile chemicals floating around in the world there, brought into your nose and your neurons in your own factory bub. Convert those into electrical, chemical signals that your brain can understand. Perceptions are your idea of what those signals out in the world are either because you paying attention to them or for some of the reason you decide that stop sign in front of you is red and that um the sun behind IT is White and that the sky is blue or cloudy, those are perceptions.

okay? So we have sensations and perceptions, then we have emotions, which are these things that include the mind and body that are related to newer modulates like dopa ian ceretani at sea, although those chemicals do other things as well. And of course we have behaviors, actions, everything from me moving my pen on a piece of paper to walking, running at sara.

Thoughts are a fifth category of neural functioning that we really need to define, but that doesn't have as strict a definition as sensations, perceptions or feeling or action. But thoughts are real, and we all know this thoughts are real. And one way that we can define thoughts is that thoughts are perceptions that include data from the past, present or future, okay, or combinations of past and present or present in future or future and past OK.

I'm not trying to give an overly complicated definition here, but if we are going to answer a question about how to abstain from thoughts in a really direct and actionable way, we really need to address what our thoughts. So thoughts are perceptions that are generated internally, right? We don't need any external sensation.

In order to have a thought. We can close our eyes. We could be in sensory isolation for that matter.

We will be floating with no gravity, and we can ever thought. Thoughts tend to run pretty much automatically in the background all the time. Some people refer to this as chatter in the back of our minds in a very unstructured way.

And then if we force our thoughts to be structured because we decide they need to be, or if something in our environment captures our perception, then our thoughts tend to be structured. Let me give an example but i'm just walking around if they were away in which we could broadcast my thoughts onto a screen hope we wouldn't do that, but those thoughts would be a mixture of semi complete sentences in gibberish. However, if somebody stops me and says, hi um good to see you.

What are you doing today and I started answering within my thoughts are suddenly being driven by an external stimulus, their question and some internal ideas, memory of who I am and what i'm doing that day so passed in present and so on. And so thoughts become structured. So when we have a question about how to abstain from thoughts, we need to be additionally specific and really in point that what we're trying to do is to abstain from thoughts we don't want, presumably either because they are too repetitive.

And distracting or because what's containing those thoughts is disturbing. Okay, this is important because IT gives us two answers to the questions that are highly divergent. One answer to the question of how to abstain from intrusive thoughts.

Your thoughts that we're addicted to is if those thoughts are merely on loop all the time and we can't stop them, but the thoughts themselves aren't particularly disturbing. So think about a song you can't get out of your head or you keep recounting some event, but the event itself isn't very disturbing. It's just intrusive because it's there.

Well, in that case, the data really point to trying to anchor your thoughts to some external stimulus. So getting into action, getting into activities that really draw your attention away from that thought. Now you may still hear IT scrolling ling in the background. You might be sitting in classical, hearing that looper thoughts in the background that something that, over time, ought to weigh IT ought to disappear.

If we trying to bring more and more attention to whatever is that in our environment, whatever IT is that we happen to be learning or doing physically at several things, like mindful meditation, doing a ten or even just five minute to day practice of sitting with ice clothes are lying down with ice clothes, and really focusing on one's breath, focusing one's attention on that sometimes is called the third eye center. But in science, we d say the just the region right behind the forehead, you're drain your attention. There has been shown to increase focus for singular topics and can improve memory and do a bunch of other things as well.

Those are data for doctor. When suzuki rabbit, new york university, he was a guests on the podcast as well. My laboratory is runs studies on mindful meditation as well. So what you really trying to do is learn how to focus Better on one thing. And by focusing on that one thing, you focus on these repetitive thoughts.

Now I have a feeling that this question was asked, and that many people up voted this question because the issue is interest thoughts that are intrusive, because they are there and on repeat, but because the thoughts themselves are actually troubling. This could be recounting a trauma. Someone harmed you.

You observe something that was disturbing um you felt wrong um you felt someone else was wronged um you can't seem to get your mind off of something and your emotions tend to follow and so it's uncomfortable ever feeling this is that the root of the question? In that case, the approach is very different. What we know from essentially all of the quality, scientific and clinical studies is that those sorts of intrusive thoughts are very much like a trauma.

Now we have to be clear in defining what trauma is. I'll use the definition. The doctor, paul county, another incredible guest that was on our podcast, a psychiatrist, stanford, harvard trained psychiatrist, I think one of the world's foremost leaders on the issue of trauma, psychiatry, psychology generally, he defines trauma as an event or something that fundamentally changes the way that your nervous system works such that you function less adaptively going forward from that event.

K, so not every bad occurrence in your life is a trauma. That's good news. The bad news is many people have traumas.

And Thomas, change the way that our nervous system works so that we don't function as well as we could. So in that sense, intrusive thoughts that are disturbing are, in many ways, traumas, and are reinforcing that trauma. Now we know that almost counter intuitively, in order to deal with trauma, you have to get very close to that trauma.

You don't have to rex pose, and I would hope you would not be expose yourself to the very same trauma. But we know that one of the best ways to deal with traumas is to get very clear about the narrative around those traumas. Now this can be done with a therapies ideally, but not everyone has access to therapy or can afford therapy.

There's a range of quality of therapies for that matter. So we're always referring to the desire for people do great therapy with really great meaning, excEllently trained people. But IT turns out that if you want to extinguish an intrusive thought, one of the best ways to do that is to journal about that particular thought extensively.

So rather than the earlier strategy for intrusive thoughts where they're just on loop and intrusive because they're on loop in present, but their content isn't disturbing. When I thought is disturbing and intrusive, we know that it's very useful to script out as much detail about that particular thought in the things around IT as possible. Obviously, you want to do this in a way that is fairly structured, so you ideally would use complete sentences.

So the reason for doing that is that thoughts, as I mention earlier, can often be fragmentary. So they they pop up in our mind, almost. We seemingly spontaneously there. They inhibiting our ability to focus or be present to work or family or other things are sleep.

Writing things down in a lot of detail does seem to have this quality of both reducing the emotional load of whatever is that, that thought is about as well as diminishing the frequency of those, in truth, of thoughts over time. So this is far and away different than the strategy I mentioned for the other types of interest of thoughts. And really, it's far and away different from the thirty day abstinent approach that dr.

Ona yche was talking about for substances, behavioral addictions. Now, of course, this process of abstaining from thoughts or removing the addictive nature of certain thoughts can definitely take some time. So a good example there would be superstitions you i'll come clean here.

And i've talked about this before on a few podcast that when I was in college I developed a sort of knock on wood superstition. Um any time i'd say something that I didn't want to happen or did want to happen, I say not on wood and I not on what and then I started um suppressing the behavior most because I was all embarrassing. And then I started just telling myself in my head now and clearly a little bit of an O C D type thing, but again, O C D in air quotes here.

Um I think IT qualified as O C D in the sense that the more I did IT, the more I wanted to do IT. So I needed to go cold turkey on the thinking. But how can you go cold turkey on a thought? He couldn't.

What I was told to do, and what worked very well for me, was to just write down the worst possible outcome that I was concerned about. So I really get close to the nature or the underlying basis of that intrusive thought. And I raised this because a lot of times the intrusive thought is not okay.

I'm thinking about a car accident or i'm thinking about a break up or i'm thinking about an exam that I have that can be intrusive. But a lot of times it's some kind of nebula abstract set of words or ideas or images around something that happened that we saw or heard or experience. Ed, and by putting a lot of clear structure to what the thought is exactly, and to putting some thought and structure onto paper about what that pattern of not healthy thinking relates to, people often achieve tremendous relief in a fairly short amount of time.

Sometimes just in one session of writing IT down. Sometimes they need to write IT down multiple times. What you're essentially trying to do with a intrusive thought or a trauma of any kind is you're trying to turn a disturbing story that is a story that evokes a lot of emotion and captures become hijacker nervous system into what is essentially unknown but repetitive and kind of all the boring story where the emotional load has been depleted.

And there are, of course, I have to highlight the fact that getting sufficient rapid eyes movement sleep, we also know, is very important for removing the emotional load of traumatic experiences and intrusive thoughts, so you really want to strive to get the best possible sleep you can. That includes sufficient rapid eye movement sleep, and we have multiple zero cost resources for that. At huberman lab at com, we have the episode on mastery sleep, we have the episode on perfect your sleep, we have the tool kit for sleep, all of which are time stamped and all of which can be access to complete the e zero costs to trying get your sleep um as good as possible, including lots of rapid eye movement sleep.

So in order to remove intrusive and addictive thoughts, ask yourself, is this O C D of the classic sense? If IT is you should see a psychiatrist, they won't necessarily prescribed medication, but there are tools for true ocd that that are very effective in many cases. And we did the episode on ocd, which I invite you to to listen to as well.

You want to ask yourself, are the thoughts disturbing or merely intrusive and repetitive? If they're merely intrusive and repetitive, well, then learning to focus your attention on other things and getting Better at focusing on single things through and exercise like mindfulness meditation can really help. And indeed, the perhaps the best use of mindfulness meditation is to improve your level of focus.

IT does have other benefits as well, but that's going to be the major one that one will experience even with these very short five or ten minute day meditations. Great day on that for the scientific literature. And then if those intrusive thoughts are not only intrusive, but they're also disturbing, in that case, you really want to put as much structure and thought, believe or not, into what those thoughts are really about, write them out on paper in complete sentences, and maybe do that multiple times until the underlying emotions related to those thoughts really started to diminish.

And by doing that, you're essentially doing your own form of traumatic erp y for lack of a Better way to put IT. And again, the data really point to the fact that getting close to the specific details around those interest of thoughts is going to be the best way to extinguish. Thank you for joining for the beginning of this ask me anything episode, to hear the full episode and to hear future episodes of these.

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