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

Welcome to Huberman Lab Essentials, where we revisit past episodes for the most potent and actionable science-based tools for mental health, physical health, and performance. I'm Andrew Huberman and I'm a professor of neurobiology and ophthalmology at Stanford School of Medicine. And now, my conversation with Dr. Alia Crum. Great to have you here. Great to be here. >> Yeah. Just to start off, you know, you 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? 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. 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? Do you view stress as 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. It's sort of distilling down those core assumptions that really shape and orient our thinking and action. >> Mhm. I've heard you say before that mindsets simplify life in some way by constraining the number of things that we have to consider. Um and it sounds to me like we can have mindsets about many things as as you said. Uh many people are familiar with our colleague Carol Dweck's um notion of growth mindset that if we're not proficient at something that uh we should think about not being proficient yet, that we are on some path to proficiency. But, what are some examples of mindsets um and how early do these get laid down, or do we learn them from our parents? Yeah, sure. So, I think it's important with 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 are fixed, static, set throughout the rest of your life, or do you believe that they can grow and change? The reality is, as it always is, complex, and it's a bit of both, and it's all of the things. But, as humans, we need these simplifying systems to help us understand a complex reality. But, they're not inconse- inconsequential, right? They 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 the mindset that it's fixed, why work harder at math if you don't think you're good at it? What our work has aimed to do is to expand the range of mindsets that we are, uh, studying, focused on, and also understand and expand the range of effects that they have. Uh, so, I mentioned, you know, 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? Generally, people, at least in our culture in 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. 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? Uh mindsets about illness. Do you view cancer as an unmitigated catastrophe, or do you view cancer as manageable? We've looked at mindsets about symptoms and side effects. Do you view side effects as you know, a sign that the treatment is 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, uh 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. I'd love to talk about this notion of how our 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're you've done with a milkshake study. 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 that. >> president of Yale. He's now the president of Yale, yes. >> So he's done well. He's he's done well for himself, and for the university and society. I had come in doing some previous work on mindsets about exercise and placebo effects in exercise, and I 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 bodies' physiological response to that food, holding constant the objective nutrients of that thing. So, that question might sound outrageous at first, but it was it's really not outrageous if you're coming from a place of having studied in depth placebo effects. So, placebo effects are this 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, 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 because of because of the clinical trial process in which all new drugs and medication are medications are required to outperform a placebo effect. So, we have a lot of data on the placebo effect. But anyways, going back to this question, it was like, all right, we've moved from, you know, medications solving our health crises to behavioral medicine solving our health crises, 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 um 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, um 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 a within subjects design, so it was the same people uh 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 of fats and sugars. And we were measuring their bodies gut peptide response to this shake. And in particular, we are looking at the hormone ghrelin. And medical experts call it the hunger hormone. Rises in ghrelin signal, you know, seek out food. And then theoretically, in proportion the amount of calories you consume, ghrelin levels drop signaling to the brain, "Okay, you don't you can 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 the study was that when people thought they were consuming the high fat, high calorie, indulgent milkshake, 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. 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. 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, it 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. 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 the 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. Um, and at least in that study we showed that has a a more adaptive effect on ghrelin responses. It's really remarkable. I it raises a question that um, I just have to ask. You've got people who are strictly plant-based, um, 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 kind of plugs into uh, 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. Each camp seems to tout all the health benefits and how great they feel. Could it be that mindset effects are involved there? It does matter what it is, and it matters what you think about that diet, and what others around you in 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, you know, 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, you know, 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, you know, in some cases you think you should be eating a certain way and then you don't live up to that. It might have a even an adverse effect because of the the stress and the anxiety associated with that. Yeah, there was a paper a year or two ago published in science um science magazine about brain regions involved in psychogenic fever that if people or uh you can actually do this in animal models too, think that they are sick you get a genuine 1 to 3° increase in body temperature 3 1 to 3° Fahrenheit increase in body temperature which is pretty pretty impressive. Yeah. Um and I guess plays into you know symptomology generally. So I I'm a believer in belief effects. Well, it's also I and I'll just say that you know, the term that we use in the in our field is nocebo effect for that which is sort of the placebo's ugly step sister. You know, it's when negative beliefs cause negative consequences. So you are told you will have you know, it's it's very well demonstrated that when people are told about certain side effects, they're far more likely to experience those side effects. Love uh for you to tell us about um the hotel worker study. >> 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. And we found a group of people who were getting a lot of exercise but weren't aware of it. A group of hotel housekeepers. So these are women working in hotels who were on their feet all day long pushing carts. It was clear that they were getting above and beyond at least the Surgeon General's requirements at that time were 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. 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 and, you know, 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. This 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 um 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, they had benefits to their health. So they lost weight, they decreased their systolic blood pressure by about 10 points on average. 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. Uh our current approach is just to basically tell people at large, you know, here's what you need to get. The intention with that is to motivate them cuz, you know, public health officials think, well, if I just tell people you need to get more exercise cuz it's good for you, they'll do it. We know now that that doesn't work, that these 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 k- you know, makes people worse off than they were without knowing about the guidelines. I'd love for us to talk about stress, because um your lab has worked extensively on this. Could you tell us at some point about the study that you've done about informing people about the different effects of stress? Um but also uh if there's an opportunity some takeaways about how we could each conceptualize stress in ways that would make it um serve us better. Great. Yeah, so I had you know, I'd come off the heels of doing some research in exercise uh and diet. The obvious next thing to think about was stress, right? The public health message was very clear, right? That stress was bad, right? Unmitigated and harm harmful on our health, our productivity, our relationships, our fertility, our cognition, you name it, right? Uh the messages that were out there by and large oversimplified 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, you know, 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 uh 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 uh physiological toughening, the process by which the release of catabolic hormones in the stress response recruit or activate anabolic hormones, which help, as you know, build our muscles, build our, you know, neurons to help us grow and learn. Uh and there was a whole body of emerging research on uh 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 um joy and passion for living. 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 uh more 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? Do you, you know, at 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 stress as uh 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. And we found in a number of correlational studies that that more enhancing stress mindset was linked to better health outcomes, better well-being, 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 is, 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. >> 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 heighten levels of performance that you've never experienced before. Exactly. 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 company, 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 a training on stress. But the three different conditions, some watched no videos, some watched the stress will crush you videos, and some watched the stress could enhance you videos. And what we found was that just, you know, it was a total of 9 minutes of videos over the course of the week led to changes in their mindsets about stress, which led to changes in their, um, physiological symptoms associated with stress. So, people who watched the enhancing films had fewer back aches, muscle tension, insomnia, racing heart, and so forth. And they also reported, uh, performing better at work compared to those who watched the debilitating videos. Now, interestingly, we didn't make anyone worse with the debilitating videos, which is which is good. We had We had told that, uh, 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. Uh, it was more this enhancing perspective that turned out to be inspiring. People get this wrong sometimes. They think that I'm saying that a stress is enhancing mindset means you should like stress. That's not what we're saying, right? Having a stress is enhancing mindset doesn't mean the stressor is a good thing, right? It doesn't mean that getting diagno- a cancer diagnosis is a good thing or being in object 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 enha- enhancing outcomes with respect to, uh, not just our cognition, but our health, our performance, and our well-being. 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, you know, just imagine we're stressed about something, 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? And 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, you know, negatively or to check out and say, "Oh, it's not a big deal. I'm not going to deal with it." I you know, you're basically in denial. So, people who have a stress is 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 or it needs to not exist, right? If you have a stress is 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, um, you know, have better science and treatments for the future, deepen my relationships with others, um, improve, you know, my priorities and so forth, right? So, the 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 stress is enhancing mindset have more positive affect, not necessarily less negative affect. Um, and it potentially changes physiology. We we have a few studies that show that, uh, people who are, um, you know, inspired to adopt more enhancing mindsets have more moderate cortisol response and they have higher levels of DHEA levels, um, in response to stress. We had a guest on this podcast. Um, he actually is a he's a PhD scientist who runs the UFC, um, performance training institute. His name is Duncan French and his graduate work at uh, UConn stores was very interesting. It was in exercise science and physiology. What he showed was that, um, 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? 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 epinephrine and epinephrine is derived biochemically derived from the molecule dopamine. If you look at the pathway and you even just Google it and go images, you'll see that epi- adrenaline is is made from dopamine. And dopamine and these anabolic hormones have a very close 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. But what's again remarkable to me is that all of these brain structures that control dopamine, epinephrine, testosterone and estrogen, they're all thought to be in the subconscious, meaning below um our our ability to flip a switch and turn them on or off. And yet, mindset seemed to impact them. So, I I All that's to say that there's a clear mechanistic basis by which this could all work. The way I think about mindset is that it's Mindsets are kind of a portal between conscious and subconscious processes. They operate as a default setting of the mind, right? So, if you know, if sort of programmed in there, you have stress equals bad, 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 the 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 like, you know, rev up the things that protect me versus rev up the things that help me grow. 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 do I 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, it can that can kind of operate in in the background influencing how your body responds and you don't have to say, okay, I'm stressed, I better tell my you know, anabolic hormones to go That that that doesn't work that way. >> No. Um, but these mindsets can help with the translational process. How should uh we, the listeners, think about stress? Is there a a short list of of ways that we can leverage stress to our advantage? Yeah, and that's an important important nuance in your language, which is 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? 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 most important thing is to clarify our definition of stress. The stress mind 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, so 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 and we don't stress about things we don't 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? We've developed a three-step approach to adopting a stress is enhancing mindset and briefly it's the first step is to just acknowledge that you're stressed. The second step is to welcome it because inherently in that stress is something you care about. And then the third step is to utilize the stress response to achieve the thing you care about not spend your time, money, effort, energy trying to get rid of the stress. Does that make sense? I think >> Makes sense and I and I love it as somebody who's laboratory studies the physiological effects of stress. The The effects that impress me the most are for instance the narrowing of visual attention that it then um drives a capacity to parse time more finely which then drives a capacity to process information faster. It's It's almost like a superpower. Right. And what I like so much about that framework is that the stress response is very generic. We unlike the relaxation response, we don't actually have to train up the stress response. So, we all kind of get this as a as a freebie. And then it sounds like it's a question of what we end up doing with that. >> Right. 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 and live by those. What are the mindsets that you try and adopt uh on a regular basis? 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. You know, I know many of your 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 I 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 how can we do better with this, right? How can we you know, 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 you know, the the potential for which is so great, and we've done almost nothing. You know, 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 my 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. Where can people find you, um, ask questions, find your papers, learn more? Yeah, well, all our papers and materials and interventions are housed on our website, mbl.stanford.edu. Uh, we also have a link there to 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. We will provide links to all of those for our listeners and viewers. 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 and really just, on behalf of all of everybody and 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 your you, your listeners, and all, you know, 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, in the comment section on YouTube is a great place to do that as well. Um, you will hear from them. Great. Thank you so much, Ali. >> Thank you.