We have three neuroscientists...who are here.

We'll call the first one, Dr.

Judson Brewer of the Center of Mindfulness of UMass Medical. Judson...

[MUSIC]

Welcome to Le Web...

Thank you. It's great to be here.

Let's get started. Now,

let's just think of the magnitude of the problem.

My lab studies addictions. And if you take two addictions,

smoking and behavioral overeating, this accounts in the US for

nearly half of the drivers of healthcare cost, half of them.

Now, you can't cure cancer with blood pressure medications, right?

You can't cure cancer with blood pressure medications, and

you can't fix behavioral addictions by holding hands and

singing Kumbaya. So [LAUGH]

what we're looking at is,

what's the root of the problem, what's the mechanism behind behavioral addictions,

and how can we use things like mindfulness to help treat them?

So let's go through this together.

I thought we could start with: Why Facebook is like crack cocaine...

Move on to McDonald's... Go on to how Lolo Jones could have won the gold medal...

And finish up with how we can all become a Buddha in nine minutes, and perhaps quit

smoking as well. All right, so that's a lot to do. Let's see what we can do.

So let's start with Facebook. How are you feeling? Now it turns out,

when neuroscientists at Harvard gave people the choice to self-disclose,

or to earn money, while they scanned their brains, guess what they chose to do?

That's right... Talk about themselves... And it turns out that when

people talk about themselves, it activates the reward parts of your brain.

The one that that is arrow is pointed to is called the nucleus accumbens,

the same part of the brain that gets activated when you smoke crack cocaine.

And another study showed that you can actually predict the amount

of time that people spend on Facebook by the amount that the nucleus accumbens

gets activated when they self-disclose.

Okay, I took this picture at the Louvre a couple of days ago.

For those of you that aren't familiar with one of the top 25 inventions of 2014,

you can buy a selfie stick and take pictures of yourself. I love this picture

because the boyfriend is standing there, and he's been replaced by the selfie

stick. >> [AUDIENCE LAUGHTER] >> [LAUGH]

So, let's go through this together.

You're at the Louvre, you think, Oh, this is a great picture.

I'm going to take a picture of myself and post it to Facebook.

This is going to be great. And

you think about all the likes that you're going to get, and all the comments, and

how everybody's going to be jealous that you're in Paris. So you take a picture,

and you post it to Facebook, and you get all these likes. And it feels really good,

and your brain says, Yeah, do that again. [LAUGH]

Well, it turns out that this is one

of the most evolutionarily conserved brain processes. It turns out that if you go

back to the most primitive neuron system, the Aplysia, the sea slug,

with only 20,000 neurons, the sea slug learns the same way that people learn when

they're taking selfies at the Louvre. Basically, you do something,

it makes you feel good, you get an urge to make that good feeling continue, you lay

down a memory, and then this reinforces it. You probably all heard of positive and

negative reinforcement, because this same thing happens with negative reinforcement.

You do something unpleasant, you get yelled at by your boss, you have an urge

to make that go away... You go out for a smoke, or you eat a good snack or

some chocolate, you feel better and you learn, Oh, if I just eat chocolate,

I'll feel better. Now, typical treatments say, Well,

okay, you just avoid these things. So if you drink alcohol, avoid the bars.

And if you smoke cigarettes, maybe you should just eat carrot sticks instead.

So you can actually target these pathways. Well, it's interesting,

these don't work particularly well. 70% of smokers want to quit--it

takes up to six quit attempts, and only 5% stay abstinent at the end of a year.

So this is a very, very reinforced process that's very hard...

This behavior is very hard to change. Now, it turns out that 2,500

years ago the Buddhist psychologists described the exact same process, and

they described it this way. They said, Things get interpreted by the mind.

They're either pleasant or unpleasant. We have an urge for the pleasant to continue.

We want to hold on to that stuff. We want the unpleasant to go away.

We do a behavior to make those things happen. And then we lay down this self.

We get a self identity. And the problem is that this process reinforces itself. For

those of you that aren't familiar with it, it's described as samsara. The literal

translation of this is endless wandering, because it's just self-reinforcing, and

the problem is, with this skewed view, when we start seeing the world this way,

and we start getting attached to these things, it just goes on and on and

on. They described this, they said, Just as a tree, though cut down,

can grow again and again if its roots are undamaged and strong, in the same way,

if the roots of craving are not wholly uprooted, sorrows will come again and

again. I like this modern-day

interpretation a little bit more.

Now you get the idea. So, now on to our second one. Well, the food industry says,

Oh, evolutionary conserved process, we can make tons of money.

We're actually going to flaunt this. So McDonald's, they're after it...

They craft their food to your craving. Kellogg's cereal in the US now,

they now have Krave cereal. And if milk chocolate Krave isn't good enough,

don't worry, there's double chocolate Krave. And, of course,

we all know where this leads... Okay, so on

to how we can work with this problem. We start to understand what the mechanism is,

what can we do about it? Now, mindfulness has become much more popular over the last

couple of years. What actually is it? So you can think of this as paying attention.

Okay, we're paying attention, but we're bringing a quality of our

awareness to this experience. So we're bringing an openness, a curiosity...

We're not saying, Oh, I know how this is going to go, or I don't like this, or

I want this to go away... We're just going to see what we can do to work with

the situation. And mindfulness is at least theorized to come

in, and instead of helping people avoid things or

substitute, actually drive this wedge of awareness in-between the craving,

that urge to act, and the actual behavior. So let's see if this is actually true.

Now, it's been shown empirically to be helpful for

a number of conditions. Just listing a few here--anxiety, depression, pain...

My lab has done some work with addiction, even boosting of the immune system, and

helping people score better on their graduate record exams,

if you want to graduate school. But how does actually paying attention work?

Does it actually help you change these very

deep-seated behaviors? Does paying attention, just by itself,

actually do anything? So what we actually do in our smoking treatment is to

have people smoke mindfully. That's the first exercise that they get. And the idea

here is, when you really pay attention to what you're doing, you see what you get.

And if it's helpful, you keep doing it, and if you don't, you stop doing it.

Here's an example from somebody with her first mindful smoking exercise. She said,

Smells like stinky cheese. She's obviously not French. Smells like stinky cheese and

tastes like chemicals. Yuck!

And the idea here is, she starts to see what she's actually getting in this moment

from smoking. She doesn't have to think about it. She knows smoking's not good for

her. But in this moment, she sees, Oh, this isn't actually as good as I thought

it was. So we took this, we did some randomized clinical trials, and

found mindfulness training was actually twice as good as gold standard treatment

in the US for smoking cessation. We had twice as good. This is on the level

with some of the best medications out there. And the effects lasted.

At our four-month follow-up, they were still largely, they had maintained their

abstinence. So this was pretty good. We're seeing a behavioral signal that you can't

argue with, they either have quit or they haven't quit. So we ask ourselves, Well,

what's actually going on mechanistically? And the hypothesis is, that if craving is

a fire and smoking is the fuel for that fire, if you stop adding the fuel,

that fire should be there for a bit but eventually die down. And

we studied this mathematically, I won't go through all the details... But, basically,

you get a strong correlation between craving and smoking at the beginning of

treatment. This is completely gone at the end of treatment.

And if you do all the fancy math, it has nothing to do with craving,

it has nothing to do with cigarette use... It's the amount of

informal mindfulness practice that people do that decouples craving and smoking, and

we can even see this in the raw data. If you look at the end of treatment,

same level of craving for the people that quit and the people that don't. And

for the people that quit, their craving dies off over time.

So that's really interesting.

It seems that mindfulness is actually driving this wedge in here.

We can see this mathematically. We can see this behaviorally, and importantly,

we can start to get it to psychological mechanisms of how it's working.

Okay, so then how do we disseminate this? So, training a lot of

people to facilitate mindfulness training is expensive, it's not scalable, so

we turn to the technology. And we said, Okay, let's develop an app that can

actually deliver this at the point of contact. And this is really important,

because context-dependent learning is where people learn to smoke.

They don't learn to smoke in their therapist's office.

They don't learn to smoke in the hospital. They learn to smoke in their car,

on their front porch, outside of work. And so, we put this manualized training

together in 21 days of modules, where they can get daily playlists.

They can have animations that help walk them through the core concepts.

They can pair this with in-the-moment exercises. And they can even...we

can collect data through experience sampling to make sure that it works.

We can also pair this with an online community where they have access to me

as the addiction psychiatrist, to peers, they can tell their stories,

they can learn from each other, we can crowdsource this... So

just to show you a quick video that kind of shows how this all fits together.

[MUSIC]

>> Welcome to Craving to Quit, a three-week program that will help you quit

smoking. This training delivered live at Yale University has been shown to be

twice as effective as other quit smoking therapies.

[MUSIC]

Now I'll walk you through the basic idea about how habits are formed.

[MUSIC]

First, recognize that the wanting or craving is coming on, and relax into it.

[MUSIC]

>> Now, it also turns out that sugar is more addictive than cocaine, and

so our next app is going to be an eating app that'll come out early next year.

More addictive than cocaine, which makes sense because that's how this process was

set up, so we'd remember where food is. Okay, so now let's get on to what's

actually going on in the brain, and I'll start with a story.

So Lolo Jones was an Olympic hurdler... She was favored to win the 2008 Olympics.

In fact, she was in the finals, in the lead at the ninth of ten hurdles. And

what she said in an interview with Time Magazine was, I was in the middle of

a race, and at one point I realized I was winning. And it wasn't like, Oh,

I'm about to win the Olympic gold medal--it just seemed like another race.

And then at a point after that, I started to notice that I was telling myself

to make sure my legs were snapping out. That's when I hit the hurdle. So

I overtried. Now, the idea here,

it wasn't that she had thoughts, it's that she got caught up in thinking, right?

She got caught up, she tripped herself up,

literally. And it turns out [LAUGH]

that this is a pretty common process.

About half the time of the day, we're actually spent either

daydreaming or getting caught up in our experience. And you can think of this as

a continuum--daydreaming, stress, and, of course, the far end is addiction. And

because we do this so much, we can actually study this in the brain, and it's

now aptly called the default mode network, because this is what we default to. And

I'm going to highlight a particular part of

the brain called the posterior cingulate,

which you can see here in the back of the brain... Which turns out,

when you look at all the data, there are a bunch of different things that will

activate the posterior cingulate--when we're thinking about ourselves,

when we're mind-wandering, when we're thinking about the past and future,

judging things... When we're thinking about ourselves in social situation,