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Dr. Lisa Feldman Barrett: Why brains predict before sensing

How predictive processing reframes anxiety as determination and trauma as meaning; even depression maps onto a metabolic state you can shift.

Dr. Lisa Feldman BarrettguestSteven Bartletthost
Apr 17, 20252h 6mWatch on YouTube ↗

EVERY SPOKEN WORD

  1. 0:00 – 2:22

    Intro

    1. LB

      There are these experiments where they train people to experience anxiety, but as determination, because exactly the same physical state could be experienced completely different. And what they discovered is that at first it's really hard, but you practice, practice, practice and then eventually it becomes really automatic. So the first thing to understand is that...

    2. SB

      Dr. Lisa Feldman Barrett is a world-leading neuroscientist.

    3. LB

      Her groundbreaking research reveals that emotions like anxiety and trauma are built by the brain.

    4. SB

      And we have the power to control them.

    5. LB

      The story is that you're born with these innate emotion circuits, but you're not born with the ability to control them. That's false. Really what's happening is that your brain is not reacting, it's predicting. And every action you take, every emotion you have is a combination of the remembered past, including any trauma. And so you don't have a sense of agency about it because it happens really automatically, faster than you can blink your eyes.

    6. SB

      How does this change how we should treat trauma?

    7. LB

      Sometimes in life you are responsible for changing something, not because you're to blame, but because you're the only person who can. I mean, I had a daughter who was clinically depressed, was getting D's in school. She wasn't sleeping. She was miserable. At first, she was so resistant, but then she made the decision that she wanted to be helped.

    8. SB

      And did she recover?

    9. LB

      Yes, she did. So if you want to change who you are, what you feel, understanding these basic operating principles is the key to living a meaningful life.

    10. SB

      So what is step one to being able to make a change?

    11. LB

      So...

    12. SB

      This has always blown my mind a little bit. 53% of you that listen to this show regularly haven't yet subscribed to this show. So could I ask you for a favor before we start? If you like this show and you like what we do here and you want to support us, the free simple way that you can do just that is by hitting the subscribe button. And my commitment to you is, if you do that, then I'll do everything in my power, me and my team, to make sure that this show is better for you every single week. We'll listen to your feedback, we'll find the guests that you want me to speak to, and we'll continue to do what we do. Thank you so much. Dr. Lisa Feldman Barrett, you have a really remarkable twisting career journey. It, it's almost quite difficult to, uh, encapsulate in a particular mission or a particular, uh, summary of the journey you've been on and the, the twists and turns you've taken. But if,

  2. 2:22 – 4:14

    Lisa's Mission

    1. SB

      if I were to ask you now what mission you're on with the work that you're currently doing, are you able to summarize that?

    2. LB

      My goal is, as a science communicator, is to try to take really complicated science and present it in a way that people can use. You know, maybe they use it to entertain their friends at a dinner party. Maybe they use it to, um, help their kid who's, you know, struggling with depression. That was certainly, in my case, something that I had to deal with. Maybe they're using it to improve their workplace or improve the productivity of their, of their peeps or whatever. The point being that that's ultimately, that's what science is for. It's for, you know, living a better life. And average everyday people without PhDs can do that if they have the right information. Eh, I'm probably attempting to understand how it is that a brain like ours that is attached to a body like ours, that is pickled in a world like ours produces a mind. What is it? What is happening that allows you to have thoughts and feelings and memories, um, and, and actions, and somebody from another country, another culture also has a mental life which looks nothing like yours? How is it that the same kind of brain plan with the same general kind of body plan can produce such different types of minds when they are, when those brains are wired, in a sense, finish wiring themselves in cultural and physical contexts that are so widely different?

  3. 4:14 – 10:48

    Why Is It Important to Understand How the Brain Works?

    1. LB

    2. SB

      When you just talked about your pursuit of understanding how a brain like ours creates the mind and the reality that we have, if I'm able to understand all of that, as many people who read your book about the brain and emotions were able to understand, what is it that it offers me in my everyday life?

    3. LB

      Oh, my God. It offers you the opportunity to have more agency in your life.

    4. SB

      What does that mean?

    5. LB

      It means you have more choice. It means you have more control. It means that you can architect your life. I mean, you can't control everything that happens to you. You can't control every moment of feeling, um, but you have more control than you probably think you do. Everybody has more control over what they feel and what they do than they think they do. That control doesn't look the way we expect it to. It's much harder to harness than we would like it to be. Some people have more opportunities for that control than other people do, but everybody has the opportunity to have more control, and of course, the flip side is also more responsibility (laughs) , um, for the way they live their lives. And I think that's a really good thing, and I think it's a really good thing now when, you know, world events are swirling around you and you feel like, you know, you're just being buffeted around. Even within that craziness, there is, there are opportunities to, to be more of an architect of your own experience and your own life. I think a lot of people find that, um, optimistic and helpful.

    6. SB

      Yeah, because life can feel like we are a puppet, and we are just responding to what happens around us. And if it rains outside, then we're sad. If...... person sends us a message, then we're annoyed. And that we're just these sort of reactive creatures reacting to whatever happens around us. But you're telling me that if I have a greater understanding of the brain and how it works and emotions, then I can seize back some of that control and live a more intentional life?

    7. LB

      Yes, exactly. And I think for me, I mean, I started, um, I started my career studying the nature of emotion, but really it became a flashlight into understanding how a brain works. Why do we even have a brain? It's a very expensive organ. That piece of meat between your ears is the most expensive, metabolically the most expensive organ you have. Um, so what's it good for? What's its most basic function? How does it work in relation to the body? I think that certainly on your show, you've had a number of people who talk about the relationship between the brain and the body in some way, but I think scientists for a long time forgot or ignored the fact that the brain is attached to a body, right? Because we don't feel all the drama. Like right now, e- each, in you, in me, in all of our listeners, right, we all have this, like, drama going on. It's really quite intense and there's a lot of going on, and none of us are aware of it, I hope. If you are aware of it, I'm really sorry, it probably means that something is, you know, you're not feeling well today. But it's a good thing that we're not aware of what's going on inside our own bodies most of the time, because we'd never pay attention to anything outside our own skin again, right?

    8. SB

      Mm-hmm.

    9. LB

      But the problem is that in science, it often begins with starting with your own subjective experience and then trying to formalize that and, I mean, if you look at any science, physics is like that too, you just have to go back several hundred years or maybe a little longer to- to see it. And so it turns out that a lot of what you experience as properties of the world, of the way the world is, really is very rooted in your brain's regulation of your body. Um, and so I- I guess I'm, I started with emotion, but it really became a much larger project to try to understand, well, what is a brain? How is it structured? How did it evolve? How does it work? What's its most basic function, and where do thoughts and feelings and actions, perceptions, what role do they play in that function? So it's a bit flipping the question, right? Most people start with, what is an emotion? What is a thought? What is a memory? They define it, and then they go looking for its physical basis-

    10. SB

      Mm-hmm.

    11. LB

      ... in the brain or in the body. That's a pretty bankrupt perspective from, I mean, after 100 years, there weren't really good answers. So we flipped it around and we said, "Okay, well, given that we have the kind of brain we do, what can it do? What does it do? And in its normal functioning, how does it produce mental events, that in our culture, our thoughts and feelings and perceptions and actions, in other cultures, they're different conglomerations of features, right?" So for us, a thought and a feeling are super distinct. We experience them as very separate. In fact, really since the time of Plato, we've had this kind of narrative where, you know, the mind or the brain is a battleground between your thoughts and your feelings, right?

    12. SB

      Mm-hmm.

    13. LB

      In for control of your action. If your thoughts win, you are a rational creature, you are a healthy creature, you are a moral creature. If your instincts and your emotions win, you know, your inner beast, then you are irresponsible, you are childish, you are immoral, you are mentally ill. That's the narrative that we work in. In some cultures, thoughts and feelings are not separate. They're really... it's not that you have them at the same time, it's that they are one thing. They are features of the same mental event. In some cultures, your body and your mind are not separate. There are no separate experiences for a physical sensation versus a mental feeling. They're really one thing. So our minds are not the human nature, it's just one human nature, and there are other human natures too, and we have to figure out how general brain plan, a general body plan for a neurotypical human produces such wide variation, um, depending on the cultural context in which it grows.

  4. 10:48 – 13:55

    Measuring Emotions

    1. LB

    2. SB

      As it relates to neuroscience and understanding the brain and the way that we create r- reality, was there a eureka moment for you where you realized that most of us have it wrong, or that there's an underlying misconception about the way that our brain creates our reality?

    3. LB

      I would say yeah, sure, there was a eureka moment, but it was a long, slow burn. When I was a graduate student, I wasn't studying emotion. I was studying the self. How do you think about yourself? What is your self-esteem like? How do you conceive of yourself, right? This is a- an important topic in psychology. And I was measuring emotion as an outcome variable, and the measurements weren't, weren't, the measures weren't working. And I thought, "Well, I need to be able to just literally objectively measure when someone is angry or when they're sad or when they're happy. I don't want to have to ask them, because they could be wrong." And in that phrasing of the question, there's a presumption, right, that there is an objective state called anger, that generally most instances of anger will look the same regardless of person and context. And I very quickly realized that...... There are no essences that anybody's been able to discover, right? So recently, in the last couple of years, um, researchers did a meta-analysis, which is a big statistical summary of, of hundreds and hundreds and hundreds of experiments. And what they discovered is that, and this is just in urban cultures, right? We're not even talking about remote cultures now. (laughs) So in urban cultures, when someone is angry, they, people scowl about 35% of the time when they're angry.

    4. SB

      A scowl is like a...

    5. LB

      Like a scowl, like a-

    6. SB

      Okay.

    7. LB

      Right? Like, you know, you knit your eyebrows, you, you frown, right? So it's...

    8. SB

      Okay.

    9. LB

      But that means 65% of the time when people are angry, they're doing something else that's meaningful with their face. And half the time when people scowl, they're not angry. They're feeling something else. They could be concentrating really hard. You could have just told them a bad joke. They could have a bad bout of gas. You know, a scowl is not the expression of anger. It is an expression of anger in some contexts, and it's also an expression of other states in other contexts. So what this means is that, you know, there's no really strongly reliable expression for anger that is specific to anger, and the same is true for every other emotion that's ever been studied. It's really clear that you're in anger or sadness or pick an emotion, you know, your heart rate can go up, it can go down, it can stay the same. Your blood pressure can go up, it can go down, it can stay the same. The physiology that is occurring in your body is related to the pr- your, your brain's preparation for particular behaviors.

  5. 13:55 – 16:08

    What Is the Predictive Brain?

    1. LB

    2. SB

      So let's start with that then. So the, the predictive brain is this idea that I only pretty much know from you, I'd never heard it before. When we say the predictive brain, what does that mean? And what does it not mean?

    3. LB

      So when you are living your everyday life-

    4. SB

      Yeah, like right now.

    5. LB

      Like right now. So right now, I'm guessing that I'm saying things to you and, um, you're perceiving what I'm saying and then you're reacting to it. That's how it feels to you, right?

    6. SB

      Yes.

    7. LB

      Okay. And that's how it feels to me too. So we sense and then we react.

    8. SB

      Mm-hmm.

    9. LB

      That's the way most people experience themselves in the world. That's not actually what's happening under the hood. Really what's happening is that the brain, your brain is not reacting, it's predicting. And what that means is if we were to stop time right now, just freeze time, your brain would be in a state and it would be remembering past experiences that are similar to this state as a way of predicting what to do next, like literally in the next moment. Should your eyes move? Should your heart rate go up? Should your breathing change? Should your blood vessels dilate or should they constrict? Should you prepare to stand? Right? Movements. And these movements, the preparation for movement, literal copies of those signals become predictions for what you will see and hear and smell and taste and think and feel. So under the hood, your brain is predicting what movements it should engage in next, and as a consequence, what you will experience because of those movements. So you act first and then you sense. You don't sense and then react. You predict action and then you sense.

  6. 16:08 – 24:13

    Examples of the Brain Making Predictions

    1. SB

      So give me a example which brings this to light of how my brain is predicting and then taking action.

    2. LB

      Okay. So right now, you and I are having a conversation and I'm speaking and you're listening. And you're, what, what's really happening in your brain is that based on many gazillion repetitions of listening to language, your brain is predicting, literally predicting every single word that will come out of my...

    3. SB

      Yeah. Okay. (laughs)

    4. LB

      And how surprising would it have been if I didn't say mouth, I said some other orifice of my body that words were coming out of? That would have been pretty surprising.

    5. SB

      (laughs)

    6. LB

      Because your brain is predicting that. Your brain is always predicting, and it's correcting those predictions when they're incorrect. And, you know, I, I have this, um, video that I often show when I'm giving a talk to scientists or to civilians, giving a talk and I sh- I, it creates a situation where they can predict something and they can s- they can feel that a prediction is not just this abstract kind of thought. It's your brain is, is literally changing the firing of its own sensory neurons to anticipate incoming sensation. (laughs) So you start to feel these sensations before the signals actually arrive for you to perce- perceive them. You start to have the experience before the world gives you those signals.

    7. SB

      Uh, I've read, I think it was in your book, but it might have been elsewhere about the example of being thirsty.

    8. LB

      Yes. So, um, when you, um, drink, so say you're super thirsty and you drink a big glass of water, when do you stop being thirsty? Almost immediately.But actually, it takes 20 minutes for that water to be absorbed into your bloodstream and make its way to the brain to tell the brain that you are no longer in need of fluid. Because across millions of opportunities, you have learned that certain movements now and certain, um, sensory signals now will result in that mental state. Or here's another example. So right now, keep your eyes on me. You're looking right at me. And in your mind's eye, I want you to imagine, um, a Macintosh apple. Like a, not a computer, but, like, an actual f- piece of fruit.

    9. SB

      Okay.

    10. LB

      Can you do it?

    11. SB

      Yeah.

    12. LB

      Can you see it?

    13. SB

      Yeah.

    14. LB

      Um, what color is it?

    15. SB

      Green.

    16. LB

      Okay. Does it have any red?

    17. SB

      No.

    18. LB

      Okay, so it's a Granny Smith apple.

    19. SB

      Yeah.

    20. LB

      Okay. What does it taste like? Like, imagine, imagine grabbing it-

    21. SB

      Yeah.

    22. LB

      ... biting into it, hearing the crunch of the apple.

    23. SB

      Mm-hmm.

    24. LB

      What does it taste like?

    25. SB

      It's, like, sweet and-

    26. LB

      Is it a little tart maybe?

    27. SB

      Yeah, yeah.

    28. LB

      Yeah. Is it juicy?

    29. SB

      It's very juicy.

    30. LB

      Yeah. Okay. So if I were imaging your brain right now, what I would see is I would see changes in the signal that is, um, related to neural activity in your visual cortex, even though there is no apple in front of you. And I would see a change in activity in your, um, auditory cortex, even though you didn't really hear the crunch. (laughs)

  7. 24:13 – 31:27

    Is the Predictive Brain at the Root of Trauma?

    1. LB

    2. SB

      What does this say about the nature of trauma and other mental health illnesses like depression, anxiety, et cetera? Because is this a misfiring of my...... predictions. I say this because prediction's reliant on something happening in the past and forming a pattern, like a pattern recognition system. So if I grew up and there were certain patterns that are now not the case, so if I grew up and every time a man walked into the room, he hit me, and now when a man walks into the room and I'm 35 years old, I'm getting that same sort of prediction in my brain, so I've got a fear of men, for example, is this- does this somewhat explain childhood trauma and why it's so hard to shake and why, as adults, we can sometimes have dysfunctional lives?

    3. LB

      I would say as a general principle, yes. Um, there are a lot of, you know, the devil is in the details, right? But yeah, sure. Um, so trauma is not something that happens in the world to you. Everything you experience is a combination of the remembered past and the sensory present. So there could be an adverse event that occurs. You're in an earthquake. Someone dies who's close to you. Something bad happens to you. Someone hurts you in some way. Um, there could be an adverse event-

    4. SB

      Mm-hmm.

    5. LB

      ... that is not traumatic to you because you're not- you're not using past experiences to make sense of it as a trauma. On the other hand, something that is- could be like an everyday experience to somebody else, to you, it links to a- a- a set of memories that are very traumatic, were very traumatic. Those events were very traumatic. Um, and so to you, it is a trauma. So trauma is not an objective thing in the world. It's also not all in your head. It's a rela- the trauma is a property of the relation between what has happened to you in the past and what is occurring in the present.

    6. SB

      Mm-hmm.

    7. LB

      So here's an example. There's a- an anthropologist who works at Emory University, and she studies, um, people, um, in- in a lot of different cultures, and she studies trauma in a lot of different cultures. And there was this one girl that she wro- she wrote about, a case study of a girl named Maria, um, who was a young adolescent girl, and she lived in a culture where it was more normative for men to physically, uh, be very physical with w- women and- and girls. So i- in our culture, we- we- we would say it's physical abuse. But in her culture, this is just what men did. She didn't expe- so her stepfather would- would slap her around, and she didn't like it, but she didn't show any sign of trauma. (laughs) The way she made sense of it was that men are just assholes. It was very much a, "This is not about me. This is about them." It's not pleasant, but she slept okay. Her grades were okay in school. She had friends. She didn't have any signs of trauma at all. Then she watched Oprah, and she heard all of these women talk about having been the subject of physical abuse from their boyfriends or their fathers or, you know, their husbands, and she recognized the similarity in the physical circumstances of these women's descriptions and- and her physical circumstances. And she also observed them experiencing traum- tr- like, you know, symptoms of trauma. And all of a sudden, she started to, um, have difficulty sleeping, and she- her grades dropped, and she had trouble concentrating, and she became socially withdrawn. Her way of making meaning, her way of, if you think about physical movements as actions, she made different meaning of those actions, and she experienced trauma where she didn't before. Now, if you're somebody who believes that there's an objective world out there, where, you know-

    8. SB

      Cause and effect.

    9. LB

      Yeah, that- that really there was some kind of latent trauma in her, and she didn't experience it before, but then it was, like, triggered, and then she'd be... You could tell a whole story like that, and people do tell whole stories like that. But that's not what the best scientific evidence suggests is happening. What's happening is that the physical movements were the same. The psychological experience of those movements was different because experience is a combination of the sensory present, the physical present, and the remembered past. And th- you need both in order to have a particular kind of experience. So the way to describe what happened to Maria's trajectory was that she experienced something as an unfortunate aspect of, like, physical life, and then it became about her. It became something, not so- not this person was doing something bad, but this person was doing something bad to her because of who she is.

    10. SB

      And she was also shown how she should be responding to that by watching Oprah show and watching these other-

    11. LB

      Yeah.

    12. SB

      ... individuals responding in the same way.

    13. LB

      Right. So it became about her as a person, not just about, you know, her stepfather was an asshole. And if you think about it, what we do in this culture when- when people go into therapy for trauma, right, is we're attempting to- to actually-... reverse the narrative. So we try to teach people that it's not, when something traumatic happens to them, it's... And I wanna be really clear what I'm saying, right? I'm not saying that when people experience trauma, it's their fault.

    14. SB

      Hmm.

    15. LB

      I'm not in any way saying they're culpable for what's happened to them. But sometimes in life, you are responsible for changing something, not because you're to blame, but because you're the only person who can. The responsibility falls to you. And so in this culture, we try to teach people who've experienced trauma that they can experience those physical events that happened to them in the past in some other way. And when they do, they no longer feel traumatized anymore.

  8. 31:27 – 36:29

    Cultural Inheritance, Trauma, Anxiety, and Depression

    1. LB

    2. SB

      My mind's a little bit blown for a number of different reasons, because it's a real paradigm shift to think that we are giving meaning to the thing that happened in our past, and sometimes that meaning is coming from watching other people give it meaning, and we're inheriting that meaning now.

    3. LB

      Oh, yes, that's called cultural inheritance.

    4. SB

      It's like a cultural... It's like a contagion.

    5. LB

      So it turns out that, you know, there's, there's one kind of old evolutionary theory, right? This is called the modern synthesis, where inheritance is really your genes. You inherit in- you... Whatever you inherit, you inherit by your genes, and then natural selection, you know, chooses some gene patterns and, uh, and not others. And, and that's really how inheritance works across generations. Most evolutionary biologists don't, don't hold to that view anymore, because for the most part, there are many, many ways to inherit things, and a lot of what we think of as inheritance is really more what's called epigenetic, meaning it doesn't really involve DNA very much. (laughs) And I would say, uh, the way I like to say it is that we have the kinds of nature that requires a nurture. We have the kind of genes that require experience before anything is wired into our brains. And most of our characteristics work that way. Very few characteristics work just by genes alone. What always happens in a neurotypical, uh, brain is that you're born with your brain incomplete, right? An adult brain has, has a s-... We, we say that it's wired to its world. That world includes its own, your own body. Um, but a baby, um, is not a... Baby's brain is not a miniature adult brain. It's a brain that's waiting for wiring instructions from the world and from its own body. So your brain is wired for you to see out of eyes that are the exact distance of your eyes from each other. If somehow, you know, magically, we could transplant your brain into somebody else's skull, you would not be able to see out of that skull. (laughs) You would not be able to see out of those eyes because they're not in the right place. You hear with ears. Your, your ability to hear comes from signals that are shaped by the s- shape of your ear, so your brain is wired to hear out of these ears. Not any ears, these ears. Similarly, you, as a baby, you are taught the meanings of physical signals. You're taught how to make sense of these things. That's called cultural inheritance. Many things that we think of as hardwired into the brain are actually culturally inherited across generations. That's how people survive in a particular environment. You know, so like in the 1800s and 1900s when explorers would go off and they would go off to Antarctica or here or there and they would very quickly die, the Inuit lived there, they lived perfectly fine. How? Well, because they had culturally inherited knowledge. We're always transmitting, um, knowledge to each other, and that knowledge becomes fodder for our own predictions. So your predictions don't just come from your personal experience. They also come from you watching television, you talking to guests, you reading books, watching movies. Um, also, your brain, like most, um, human brains, can do something really fantastic, which is you can take bits and pieces of past experience and put them together in a brand new way so that you can use the past to experience something new that you've never experienced before.

    6. SB

      You talked a second ago about therapists try and make you think about the past differently, but I do think there's an underlying belief in our culture and society and on social media that if something happened to you, almost like this Freudian approach of if this happens to you, this is who you become. And I was reading that book, The Courage to Be Disliked over Christmas, and it kind of, it c- changed my view on this quite profoundly in an important way because it helped me to understand. I think it basically says that what happens to us doesn't create who we are. We use what happened to us, and we apply meaning to it, which then determines the behavior we have. And really interestingly in that, it means that many of the beliefs I have about myself, who I say I am, my identity, and therefore, like, the ways that I behave every day, whether they're productive or unproductive, are actually just choices I've made to apply meaning to the past. Does that make sense?

    7. LB

      It's a... Completely makes sense.

    8. SB

      And, uh, this is really... This is such, like, a profound... I don't know if the, whoever's

  9. 36:29 – 42:41

    How Reframing the Meaning of Past Events Can Change Identity

    1. SB

      listening now understands what I'm saying here, but-We said at the start of this conversation, you go through life thinking you're a puppet and you're being controlled by what happened to you, who you are, your identity. But actually, your identity is just this, this construction of meaning that you've given to the past-

    2. LB

      So-

    3. SB

      ... to serve your purpose now, as it says in the book.

    4. LB

      Yes. I would say it slightly differently, but the message is the same. I think, um, there are r- in the sensory present, right, there are sights, there are sounds, there are smells, some stuff's going on inside your own body, right? And these signals are, are going to your brain. They have no inherent psychological meaning. They have no inherent emotional meaning. They have no inherent mental meaning. What gives them meaning is the m- are your memories from the past. You are creating... You are a meaning maker. Meaning isn't a set of features like a dictionary definition. So meaning, the meaning of this cup isn't that it ha- it's made of metal and that... I mean, we certainly can talk about those features, but the meaning of this cup in this moment is what I do with it. So it could be a vessel for drinking. It could be a weapon. It could be, you know, a flower holder. It could be, uh, a measuring cup. It, the meaning of the vessel is what I do with it in the moment. That's its meaning. And so the meaning of the vessel isn't in the vessel, and it's also not only in my head. The meaning is the transaction. It's the relationship between this, the features of this vessel, this object, and the signals in my brain which are creating my actions. In fact, even the fact that this is a solid object, the property of solidity is not in the object. It's because I have a body of a certain type with certain features that makes me experience this as solid. The solidity isn't in me and it's not in the object. It's in the relationship between the two. That means everything, everything you experience is partly of your own making. You don't have a sense of agency about it because it happens really automatically. It's happening automatically now as we're talking.

    5. SB

      Mm-hmm.

    6. LB

      It's happening faster than you can blink your eyes. But it's still happening, and that means, if you are partly, even if you, even though you don't have a sense of agency, you are partly in control and also therefore responsible for the meaning that is being made. And when I said at the outset of our conversation that my goal was to try to, you know, as a science communicator, was to try to explain to people that they have more control over their lives, they have c- or more control over who they are in any given moment than they think they do, to give them more agency in their lives, this is, this is exactly what I mean. You, you don't have an enduring identity. You are who you are in the moment of your action, and actions are a combination of the remembered past, so stuff your brain is using to predict, that's h- it's, that your brain's assembling super automatically, and the sensory present, right? So if you want to change who you are, you want to change what you feel, you want to change what your impact is on someone else, you have a couple of choices. You can try to go back into the past and change the meaning of what's happened before so that you'll remember differently, you'll predict differently in the future. That's what psychotherapy is. That's what, you know, heartfelt conversations at 2 o'clock in the morning are with your friends or whatever. That's really hard shit.

    7. SB

      Mm-hmm.

    8. LB

      Doesn't, doesn't always work so well. The other thing that you can do, though, is if you realize that whatever you experience now becomes the seeds for predictions later, then you can invest in creating new experiences quite deliberately for yourself now. You can expose yourself to new ideas. You can expose yourself to people who are different than you. You can practice cultivating particular experiences like you would practice any skill, and that will... Any new concepts you learn, new experiences you have in the moment, if you practice them, they become automatic predictions in the future.

    9. SB

      So let me take that and try and apply it to this example of this silver cup in my hand. So psychotherapy would try and go back into the past and explain to me why this actually isn't something I should drink out of and that it could be other things. Whereas what you're saying is another approach is if I go and get some flowers right now and I put them in there, I'm creating a new prediction for the future because I've created a new pattern in the present of this actually being a vase for flowers. And I can start to create a new pattern that w- silver cups like this one aren't just for drinking out of. They are also vases for flowers.

    10. LB

      Exactly.

    11. SB

      Okay, so I can either go back in the past and try and convince myself that a cup isn't a cup, or I can, in the present moment, create a new pattern which will mean that in the future my brain will predict. Next time it sees a silver cup, it won't just think, "Drink out of it, Steve." It will think, "Pop some flowers in it."

    12. LB

      Right.

  10. 42:41 – 44:11

    Meaning as a Consequence of Action

    1. LB

      And remember, it's, it's actually, the thinking comes after the action, right? So what will happen is, the next time that you are approaching a table where a silver cup might be, your brain will already be starting to prepare the actions to go get the flowers. (laughs)

    2. SB

      Right.

    3. LB

      And then you will think, "Oh, right, I can use this as a... Oh, look, there's a great vase." Right? So in your brain, it's action, you're, at first, your brain is controlling, it's preparing the actions of the viscera, what we call visceral motor. So does your heart rate need to change? Do your blood vessels need to dilate? Do you need to breathe differently? It's basically anticipating the needs of the body and attempting to meet those needs before they arise. That supports your physical movements.

    4. SB

      Mm-hmm.

    5. LB

      Right? So if you're gonna, if you're walking over somewhere to pick up some flowers and cut the stems and whatever, that, those are all physical movements that require glucose and oxygen and shit like... So all of that has to get prepared in advance, milliseconds before the actions start to be prepared. So it's not what you think determines what you feel. It's what you prepare to do determines your thoughts and your feelings and the sights and sounds and smells and sensations. That's how it really works under the hood. So meaning is in terms of what you do, and then as a consequence of that, if meaning is a, a consequent- it becomes what you feel and what you think and so on.

  11. 44:11 – 45:43

    How to Overcome Fear by Taking Action

    1. SB

      So let me give you some specific examples then. So if I'm scared of spiders, how would I go about overcoming that fear of spiders using route number two that you described there?

    2. LB

      So one of the ways that you change, to change predictions, you can't just will yourself to change a prediction. I am really afraid of bees. I, I had a traumatic experience when I was five. I'm afraid of bees. I know a lot about bees. I'm actually a gardener, and I, I, and I know a lot about the evolutionary biology of bees. But when I am outside, if a bee comes around, my first reaction is to either run or to freeze, right? I'm afraid of bees. I could talk to myself until the cows come home. It won't matter. I ca- Right? So what I have to do is dose myself with prediction error, meaning I have to interact with bees in a way that changes my actions, which will change my lived experience. And I can't just do it all at once. It's not like, a good idea would not be for me to say, would not have been for me to go to, like, somebody who has beehives and, you know, put on a suit and go work. I mean, that would be, like, overwhelming, right? So instead, maybe I don't run. Maybe I stand and watch.

  12. 45:43 – 47:37

    Prediction Error

    1. LB

      Maybe I get closer to a bee. Maybe I plant bushes and flowers that bees like a lot to bring bees to me so that I can sit and just be around them while they're buzzing and doing their thing. Maybe I deliberately let myself get stung at some point, which I did. But, you know, you're dosing yourself with, your brain is making a set of predictions. Those predictions, there are a set of predictions. That means your brain isn't preparing one action, it's preparing multiple actions.

    2. SB

      So you need to prove to your brain that those predictions are wrong.

    3. LB

      Yes. So exactly. You need, you are setting up a circumstances so you can prove to yourself that your predictions are wrong. If you're predicting well, you have a few action plans. If you're predicting poorly, let's say overgeneralizing, maybe you have 100 plans. Like, if there's tremendous uncertainty, your brain doesn't know which action plan to... So there might be many of them, right? Sensory signals are coming into your brain from the sensory surfaces of your body, from your retinas, from your cochlea. You've got sensory surfaces on your skin, inside your body, in your muscle cells. All these signals coming to your brain, they help select which prediction signal will be completed as action and lived experience. Okay, so let's say you put yourself deliberately in a situation where the incoming signals will not select any prediction because there's too much unpredicted signal there. It's error. There's another name in psychology for taking in prediction error.

  13. 47:37 – 49:47

    Learning Through Exposure

    1. LB

    2. SB

      Exposure therapy?

    3. LB

      Learning.

    4. SB

      Oh, okay.

    5. LB

      Yeah, exposure therapy, which is a kind of learning.

    6. SB

      Yeah.

    7. LB

      All learning, all learning is you taking in prediction sign- prediction error signals you didn't predict, or there's no signal that you did predict. You predicted a signal, it's not there. So what you do is you set up situations for yourself that you will take in signals that are novel, right? And this seems like an easy thing to do. We, people actually sometimes seek novelty, right? But too much novelty, it, it is not necessarily a good thing all the time, particularly if, you know, you're metabolically... It's expensive metabolically to take in prediction error and learn something new. Like, the biggest costs that your brain expends energy on are moving your body, learning something new, and dealing with persistent uncertainty.... those are really expensive things for us. So if you're metabolically encumbered in some way, say you're depressed or you have anxiety disorder or maybe you have heart disease or diabetes or you're living under chronic stress, you don't have the spoons necessarily to take in prediction error. You're just gonna go with your predictions. You aren't gonna learn. You aren't gonna be able to update those predictions.

    8. SB

      You're gonna be stuck.

    9. LB

      You're gonna be stuck in your head, right? Every experience, every action, a combination of the remembered present- the remembered past, the predictions, and the sensory present. But the sensory present is there just to select which remembered past you're going to act on. And sometimes under, in moments of great metabolic load, the brain just goes with its own predictions and ignores what's out there in the world.

  14. 49:47 – 54:06

    Dangers of Social Contagion

    1. LB

    2. SB

      I was thinking earlier on as you were speaking about this sort of social contagion where we can apply meaning to our lives and what happened to us and then consequently make ourselves sad because we see how other people on TikTok or Instagram are feeling. And it made me think that you must, you must think the world is crazy to some degree. You must see social contagion in the world where suddenly everybody becomes traumatized because trauma's become almost popular, you know, to think about what happened to you and create meaning to it and then suffer that meaning. But there's other types of social contagion where, which are spreading through society. I mean, young people are getting more and more anxious. They're getting more and more depressed. We're self-diagnosing ourselves with different illnesses and different things. But, uh, now you've explained to me how the brain works, I'm thinking, "Gosh, as a society, we are bonkers."

    3. LB

      Well, I-

    4. SB

      We're living out lies.

    5. LB

      Yeah. I think, I guess the way I, I, I do f- I do find it frustrating at times, but, but, but only because I think we are meaning makers as an a- Animals are meaning maker. We create meaning. We create meaning by virtue of living, (laughs) like by virtue of interacting with, with things in the world, by interacting with each other. Very few meanings are given a- that, that is that they exist independently of us. And so what I find frustrating is that there's a lot of suffering. And, uh, understanding these basic operating principles of the brain will not remove all suffering, but it, it could ameliorate, it could remove some. And people don't understand that they are sometimes making their suffering worse than it has to be.

    6. SB

      You paused on the word responsible.

    7. LB

      Well, I want to be really clear that, again, I'm not saying people are, are to blame. Culpability and responsibility are not the same thing. Culpability is blame. Are you blame-worthy, right? You can, nobody... I'm not bl- saying people are to blame for their own suffering. I'm saying that people can be more responsible in by taking more responsibility, they could reduce their suffering some. That's not the same thing as saying, you know, that they, that they're, it's their cause, their cause to begin with. So I'll give you an example. Social contagion. Contagion is an interesting word. It means that you are infected by something, even a virus. There are these experiments that were done 15, 20 years ago where, um, these were done by Sheldon Cohen, who was a psychoimmunologist, which means he's a psychologist and he studies how immunology, um, that is your immune system, is related to your psychological state. And so what he did across a number of experiments is he took people and he sequestered them in hotel rooms. And then he took the same dosage, the same concentration of virus, and he put it in every person's nose. (laughs) And then he controlled how much they slept, how much they ate. He measured their symptoms. He, like, weighed their tissues after they blew their nose. I mean, like, he did, right, just really, really, really, really careful metrics. And across these experiments, somewhere between 20 to 40% of people became symptomatic with respiratory disease. That means the virus is necessary, but it is not sufficient to cause illness. Another necessary but not sufficient cause is the state of each person's immune system.

    8. SB

      (laughs)

    9. LB

      That is, your brain and your immune system have to be in a particular state in order for you to be infected by a virus in these experiments. So the point that I'm making here is exactly the same about suffering.

  15. 54:06 – 58:33

    Anxiety in the Context of Social Contagion

    1. LB

      Also, let's take a- a- anxiety, for example. You know, we in a cu- as a c- in a culture, we automatically make meaning of certain types of signal patterns as anxiety. When there's a lot of uncertainty, um, there's an increase in a- in norepinephrine and some chemicals in the brain, um, that often goes with an increase in, um, heart rate and so on. And we automatically make meaning of this physical state as anxiety. But exactly the same physical state could be determination.It could be just pure uncertainty. Again, meaning making is about action, right? So when you are un- when you are experiencing high arousal, even if it's super unpleasant, as, a- as determination, you do something different than if you experience it as anxiety or uncertainty. So here's an example. There are people who experience test anxiety. Really serious test anxiety prevents people from finishing courses or graduating from college. People who graduate from college have a lifetime trajectory of earning that is hundreds of thousands of dollars more often than somebody who drops out of college. So test anxiety over the long run, it's more than just a, a bit of discomfort, you know? It has serious implications for o- oh, your earning potential across your life.

    2. SB

      Mm-hmm.

    3. LB

      There are these experiments that were done where they trained people to make sense of high arousal, uh, physical states not as anxiety but as determination. And these people learned to do this. First they practiced like a skill. It's like driving. At first it's really hard, you have to give a lot of effort to it, but you practice, practice, practice and then eventually it becomes really automatic. And then what happens? They're able to take tests. They're able to pass tests. They're able to continue taking courses and so on. I watched this actually happen right in front of my eyes. My daughter, when she was 12 years old, she was testing for her black belt in karate. Her, her sensei was a tenth degree black belt. This guy... A tenth degree black belt is the highest you could be.

    4. SB

      (laughs)

    5. LB

      This guy could break a board, like, by looking at it.

    6. SB

      (laughs)

    7. LB

      He was a scary, scary dude. And my daughter was, like, not even five feet tall when she was 12, and she's h- she's this tiny little thing and she's got to spar with, like, these hulking, like, 15, 16, 18-year-old boys. She's got to actually spar with them. And so, you know, she's... And this is across several days. She's got to do this really... And so I'm sitting there, her, you know, I'm... Her dad and me, we're sitting there, we're watching her, and so her sensei, you know, saunters up to her and he says, "Sweetheart, get your butterflies flying in formation." And I was like, "That's fucking amazing." Get your butterflies flying in formation. He's not saying, "Calm down, little girl." That would actually be bad. You don't want to be calm. You need that arousal. It's there for a reason. It's uncomfortable, but you need it. He's saying, "Use it." That, to me, was like a perfect example of find a different meaning for that arousal, and that meaning is the action that you will engage in. No matter how hard it is, no matter how much it doesn't really look like what it's supposed to, the control is there. It's there. It's not there all the time, it's harder to get, a- you know, yada yada, but it's there and it means that you have more agency. You have more control. You're never gonna have as much control as you want. It's always gonna be harder to get. Your options aren't always gonna be the same. But you can always find a little more control over what you do and what you experience, and that's the key to living a meaningful life.

  16. 58:33 – 1:02:08

    Is Social Media Programming Us to Be Sad?

    1. LB

    2. SB

      Are you somewhat concerned about the world that young people are growing up in, where they're scrolling on social media and social media is telling them what certain feelings are? So they are just being programmed-

    3. LB

      Right.

    4. SB

      ... constantly.

    5. LB

      Yeah. They are.

    6. SB

      To be anxious, to be depressed-

    7. LB

      Yes, they are.

    8. SB

      ... to be sad.

    9. LB

      Yes, they are. And think about it, too. Social media is pernicious uncertainty there. You know, you... First of all, even when we're sitting face-to-face, we have all of these cues, we have all these signals. I can see your face, I can hear your voice. Even when all this information is there, there's still some uncertainty, right? We're not reading each other. Bodily movements are not a language to be read. It's a bad metaphor, right? We're guessing. We're always guessing, and we're using a lot of signals to guess. But when you're on social media you ha- have very few signals. There is a lot of ambiguity. There is a lot of uncertainty. And the only thing that you can do is fill in that uncertainty with your own guesses, which could be bad, right? So people who go on TikTok and whatever are giving up... (laughs) They're, like, volitionally giving up their agency and they don't know it.

    10. SB

      What do you mean by that?

    11. LB

      They're choosing to be led. They're choosing to be influenced. I, I'll give you an example. I've listened to podcasts about metabolism, I've listened to podcasts about, you know, skincare, I've listened to pod... You know, I'm curious. I'm curious about, like, what kind of information people put out there. I probably turn off 90% of the... I get, like, ten minutes into something and I will turn it off. That's what it means to be a consumer. You have choice. I think people are... They don't realize that by virtue of what they do and what they don't do-... they are making choices about what will be retained in their heads that will then be used automatically later.

    12. SB

      Brainwashing.

    13. LB

      A little bit, except that you're, you're the one who's, you're, you're choosing it. You know, I'm empathic and I'm not blaming people, but they could, things could be better for them, you know? I mean, I had a, an, a daughter who was clinically depressed. That was one of the most frustrating experiences I've ever had in my life, in addition to being really tragic. I mean, I can talk about it now without breaking into tears. That took a long time. But at first she was so resistant. Eventually, you know, she made the decision that she wanted to be helped, and then we completely changed her life. But she had to make that decision. I couldn't force her to do it. And I feel like a little bit it's the same kind of situation now where there's so much bullshit out there in the wellness industry. There's so much, you know, um, swirling around on TikTok and on other areas of social media, and not all of it is useful, and some of it's really harmful.

  17. 1:02:08 – 1:03:03

    Ads

    1. LB

    2. SB

      Do you mind if I pause this conversation for a moment? I want to talk about our show sponsor today, which is Shopify. I've always believed that the biggest cost in business isn't failure, it's the time you waste trying to make decisions, time spent hesitating, overthinking, or waiting for the right moment. When I started my first company at 20 years old, I had no experience and no money. What I did have was an idea and the willingness to move fast, and that made all the difference. If you've been thinking about starting your own business, Shopify makes this entire process so much easier. With thousands of customizable templates, you don't need coding or design skills, you just need a willingness to start. Shopify connects all your sales channels from your website to social media, and it handles the backend payments, shipping, and taxes too, so that you can stay focused on moving forward and growing your business. If you're ready to start, visit shopify.com/bartlett and sign up for a one pound per month trial period. That's shopify.com/bartlett.

  18. 1:03:03 – 1:05:18

    First Step to Making Life Changes to Overcome Mental Issues

    1. SB

      The advantage you have as a objective onlooker is you have a huge amount of information and knowledge which is guiding you to make better decisions. But a lot of people don't have that information and knowledge. In fact, they have counter-information and knowledge. So when I think about what it takes for someone to make a change in their life, um, whether it was your daughter or whether it's someone else who feels like they're stuck and they feel like they're trapped in an algorithm or trapped in a life that they want to break out of, based on everything you know and based on the experience you had with your daughter, what is step one to being able to make that change? Because I'm really curious as to what it was about your daughter that made her decide that she wanted the help.

    2. LB

      Well, I think that the, the general answer is baby steps. It rarely works to completely change everything all at once. I'm not saying it never works, but it rarely works that way. Um, it... So for example, you know, you could deliberately get off social media for one day a week or do something else instead with a friend or go for a walk or just, and build it into, build it into your day as a scheduled thing. So that's the other thing is that you can't do things because you want to do them. You have to force yourself to do them. So for example, I had major back surgery, major back surgery, very serious, and, um, I knew that, um, after I had back surgery that I was gonna experience sensations I had never had before. Just like, you know, if you go for a-

    3. SB

      Mm-hmm.

    4. LB

      ... filling in your tooth, right, and then, you know, something's there that wasn't there before, and then your tongue is, like, constantly poking at the tooth and you're not supposed to, but you do anyways because your brain is foraging for information. It's foraging for prediction error.

    5. SB

      Mm-hmm.

    6. LB

      And then eventually it adjusts its predictions and then it ignores the sensations because they're not relevant, right? So that was gonna happen on a massive scale for me, and I knew that. I had made a plan before surgery

  19. 1:05:18 – 1:08:23

    Chronic Pain

    1. LB

      to dose myself appropriately with prediction error so that I would not develop chronic pain, because chronic pain is like a set of bad predictions that, that don't update, right? So your brain still believes that there's, um, tissue damage in your body when there's no more tissue damage.

    2. SB

      So does that mean that pain often is just a figment of your imagination?

    3. LB

      No, that's the wrong way, that is the wrong way to think about it. The way to think about it is every experience, remembered past and sensory present. So pain is in your head, vision is in your head-

    4. SB

      Mm-hmm.

    5. LB

      ... hearing is in your head. You don't hear in your ears, you hear in your head, in your brain. You don't see in your eyes. You need your eyes, you need your ears, but you don't see in your eyes, you see in your brain. So pain is a combination of the, just like vision is a combination of the remembered past and the sensory present.

    6. SB

      Okay. Okay, so it's both.

    7. LB

      So chronic pain happens when your brain was receiving signals from the body that there was tissue damage, nociceptive signals they're called, and it was making sense of them as pain, and when you're recovering from an illness, that's metabolically taxing, so there's not as much metabolic re- there's not as much of your metabolic budget devoted to learning. So you can be in a situation where your brain doesn't update itself.And you still experience pain even though the, the, um, the tissue damage is no longer there.

    8. SB

      Mm-hmm.

    9. LB

      It's just like seeing a green apple in your mind's eye when there is no apple in front of you. It's not all in, it's not all in your head in the, in the, you know, insulting sense. It's just, it's a normal consequence of how brains work that-

    10. SB

      The injury's gone though, but the signal of the injury is still replaying itself.

    11. LB

      Yeah. Exactly. Just like, um, it's like a phantom limb. It's like tinnitus is also like that.

    12. SB

      Oh gosh, yeah, I had that for a little while.

    13. LB

      Yeah. So um, so I, I tried to really hard to set a schedule for myself, um, you know, um, that would allow me to sort of like optimally dose myself but with prediction error, but that meant, you know, that I, I had to follow that schedule. And I think if you're committed to changing your habits, this is how you change any habit really. You change the context and you, um, and then you practice. You practice new, um, new behaviors. So with my daughter,

  20. 1:08:23 – 1:09:17

    What Is Depression?

    1. LB

      depression, we think about depression in our lab, um, as, um... Let me back up and say your brain's most important job really is not thinking, it's not feeling, it's not even seeing. It's regulating your body, it's regulating your metabolism basically. That's your brain's most important job. Your brain's most important job is anticipating the needs of your body and preparing to meet those needs before they arise. The metaphor that we use for this predictive regulation of the body which is the formal term is called allostasis, um, that's the scientific concept, but the, but the metaphor is body budgeting. It's running a budget for your body. Your brain is running a budget for your body. It's not budgeting money, it's budgeting salt and glucose and oxygen and, um, potassium and like all of the

  21. 1:09:17 – 1:12:26

    Body Budgeting and Body Bankruptcy

    1. LB

      nutrients and chemicals that are necessary, um, to, um, en- run an energetically costly body. You know, you've got all these really low level kind of processes, you can just think of them as vital parts of, to keep yourself alive.

    2. SB

      Mm-hmm.

    3. LB

      So some of your energy budget goes to that. Some of your energy budget goes to repair and growth, so you get, if you get taller, you need more cells. When you learn something, you have to thicken up your myelin and your, your neurons, you've got to grow more receptors and stuff. That's, you know, the kind of growth and, and repair. And then the rest of it is all for anything effortful. What is effortful?

    4. SB

      Like work or going to the gym.

    5. LB

      Dragging your ass out of bed in the morning is effortful.

    6. SB

      Yeah.

    7. LB

      Learning something new is effortful. Dealing with uncertainty is effortful. Everything we call stress. Stress is just really your brain is predicting a big metabolic outlay because there's some effort involved, right? Some motivated effort involved. So those are the three things that make up your energy budget. And the really important point, you as an organism have a fixed amount of energy that you can produce in a day, meaning ATP, like these little chemicals that, these little protein things that, you know, your cells use as literal energy that come from glucose and, and other things like fats and-

    8. SB

      So there's nothing I can do to increase it?

    9. LB

      Well, you're in a range.

    10. SB

      Okay.

    11. LB

      But there is-

    12. SB

      Interesting.

    13. LB

      ... a finite limit, upper limit for that range because you are a h- because you're a human organism and you've got to do these three things, these, right, vital functions, growth and repair, and then everything else. If you've got a lot of psychosocial stress going on or you have some kind of disease that's taking up, you know, much of the budget, then you don't have a lot of budget left for other stuff that you need to do, right? So what your brain will attempt to do is to cut costs. If you look at the symptoms of depression, they are, um, symptoms of, um, that are related to cutting costs. Distress, fatigue, problems concentrating, um, lack of sensitivity to the context that you're in, all of these things are indicative of, um, reduced, um, metabolic outlay. And then depression also has symptoms that are related to increased costs, like 70% of people who are depressed have, uh, inflammatory problems, so they have enhanced inflammatory, um, systemic inflammation and, and your, your immune system is a very expensive system to run.

  22. 1:12:26 – 1:15:00

    What Stress Does for Weight Gain

    1. LB

      So if you have persistent and, um, systemic inflammation, you're, that's like a persistent tax on your budget, your, you know, meaning things are costing more than they necessarily need to. And even, you know, like there are these really interesting studies, I think they're interesting as a scientist, as a person I find them like slightly horrifying, but you know, like if you, within two hours of eating a meal, if you encounter stress, social stress, it's as if you ate 104 more calories than you actually ate.So you're so inefficient in metabolizing that it's like, it's like having eaten 104 more calories than you did. And the f- your even good fats will be metabolized as if they're bad fats.

    2. SB

      And potentially stored as-

    3. LB

      Yeah.

    4. SB

      ... subcutaneous fat.

    5. LB

      So if you, if you add up 104 calories at every meal for a year, that's almost 11 pounds. That means that if you are in a stressful environment and, um, for a year, and you eat exactly the same thing as you ate the year before, you would gain 11 pounds. In depression, we know, for example, that, um, there's cortisol dysregulation in depression. That means there's dysregulation in, um, metabolism, because cortisol is a metabolic, you know, it's a, it's a metabolic chemical. Um, people who take, uh, SSRIs, they take for depression, antidepressants are SSRIs usually, or SNRIs. That means they are acting on serotonin to keep more serotonin in the, in the juncture, uh, between neurons. Serotonin is a metabolic regulator. Norepinephrine is a metabolic regulator. These are, um, chemicals that are directly involved in your metabolism. So it's not an, a belief that depression is a metabolic, has a metabolic basis to it. I think the question is, what is the elixir of all these metabolic influences that would lead somebody to, um, develop a depressive state? Um, but, uh, the point, the simple point that I was making is, I actually came to this idea about metabolism and depression because I was doing a shit ton of treating, trying to figure out how to help my kid.

    6. SB

      What were her symptoms at

  23. 1:15:00 – 1:17:02

    Depression in Adolescents

    1. SB

      that time? Just, if there are any parents, like, listening right now that can relate, or anybody that's listening that can relate.

    2. LB

      Yeah. Oh, well, I will tell you that I've given this talk before, um, about depression in adolescents. Adolescence is a, um, it's like a m- It's like a perfect storm of metabolic, uh, vulnerability for many, many reasons. You know, your brain is trapped in a dark, silent box called your skull. It's receiving signals from the body and from the world. It doesn't know what the causes of those signals are. It's receiving the effects. It has to guess at the causes. What are the guesses? Predictions from the past, right? So it doesn't know about hormone surges immediately as they happen. It, you know, it takes 20 minutes or so, or sometimes a little less depending on where the hormonal changes are and what their origin is, for the brain to receive the signals of those changes, and then it has to guess at what the causes are. The narrative that's used in psychiatry and medicine is a narrative that goes something like this. It goes back to this, like, your brain is a battleground, right? So the idea is that, you know, you're born... The, the story is that you're born with these innate emotion circuits. You're not. You don't have any emotion circuits. You don't have any emotion circuits, actually. But the narrative is, you're born with these innate emotion circuits, they work, but you're not born with the ability to control them. That has to develop over time. So in adolescence, the idea is that, um, mood disorders arise because you're, you don't have enough cognitive control and you have too much emotion. So you've got this unbridled emotion, and that's the problem. That's a really compelling narrative. It's just neuro bullshit, basically. There's not good evidence for that narrative.

    3. SB

      I, I

  24. 1:17:02 – 1:18:30

    Is Depression a Chemical Imbalance?

    1. SB

      heard it was a chemical imbalance.

    2. LB

      Yes, well, the... Sometimes people talk about that chemical imbalance in terms of serotonin being a happy chemical and dopamine being the reward chemical, and that's also, uh, that's such a simplification that it's not even wrong, okay? Dopamine is not a reward chemical and serotonin is not a happiness chemical. They're both metabolic regulators. You see increases in dopamine in some, uh, neurons during episodes of punishment. And serotonin's, uh, does many things in your body in many places, but one of the things that it does in controlled experiments is it allows animals to spend, to forage, to engage in activity, physical activity, and learning when there is no immediate metabolic, uh, reward at the end. There's no im- There's no deposit at the end.

    3. SB

      Mm-hmm.

    4. LB

      Um, so dopamine is seen more, I think now, uh, by many neuroscientists as a, a chemical that is necessary for effort, whether that is a physical effort or learning something, a mental effort of learning something. It's not really specific to reward per

  25. 1:18:30 – 1:21:09

    The Story of Lisa's Daughter

    1. LB

      se. So at first with, with my daughter, you know, she went from being, uh, a really exuberant, engaged socially, very socially connected kid, um, who, you know, and she did great in school. And it's not like she had, you know, it's not like she was a perfect kid, but she was pretty en- enthusiastic and pretty exuberant and, and had a lot of friends, and, and then, you know, by the time she was in 10th grade, she was withdrawn. She was getting Ds in school. She couldn't concentrate. She wasn't sleeping. She...... um, she was miserable. She was really suffering, but she was miserable to be around. And, uh, and to be honest, at the beginning, we thought she was being lazy. We thought, you know, she didn't want to do anything. She wanted to spend all this time in her room. She didn't, you know, she wanted to get rid of all of her activities. And we thought, "Come on, man, step up. Like, where are you..." You know, we thought she was being lazy. I mean, really, it just never occurred to me in a million years, because she had no mood symptoms as a kid, like none. And then all of a sudden, she just, she appeared to have no energy to do anything. But it, to us, it looked like she was being lazy, and she didn't want to do her homework, and she seemed really disengaged. And, and, and, uh, it, it took me a while to realize, "Oh, no, this is something else." She was having trouble remembering conversations that we had. And I, at first, I thought, "Oh, you're not paying attention to me." But then it seemed really clear that even in day-to-day conver-... She couldn't tell me what was happening in her day. She just had no details. That's also a sign of depression, where you lose the episodic memory of details of the day. You can only talk in gist. You can't give specifics about times and places and events. You just lose, you don't retain that information long enough to be able to remember it later. There's no consolidation of that information. And, um, when she was in 10th grade, sh- you know, she came home with Ds in school, Ds in mathematics. And this is a kid who was doing fun-... You know, she was doing rudimentary algebra when she was eight. And, um, we told her that we, she had to be, we had to have her assessed because we just didn't know what was going on. And that's when we realized that she was clinically depressed. The other thing

  26. 1:21:09 – 1:24:07

    Oral Birth Control as a Risk Factor for Depression

    1. LB

      I sh- I should say is that, you know, she had very bad menstrual cramps. And so a lot of... One, um, one treatment for bad menstrual cramps is to put girls on birth control pills because it, it evens out the, um, hormonal fluctuations of the month, and it does actually improve menstrual cramps. But it's pretty well-known now, it wasn't so much known then, that, um, there is somewhere between a 40 and 70% increase in the likelihood of major depressive episode in young women who use birth control pills. If it's a combination estrogen-progesterone pill, it's more like 40%. If it's a progesterone-only pill, which a lot of young women take because it has fewer side effects, you have a 70% increase in, in a ma- in major depressive episode. And this is in... The first study that I read about this was in a million women. And when I read that study, I remember exactly where I was. It was like a flashbulb moment. I read the study, I called her pediatrician, my daughter's pediatrician, and I said, "She's coming off pill today. Today. So tell me if there's anything... Are there any side effects, or can we just stop it?" And he's like, "Well, in my opinion..." And I'm like, "I don't give a shit about your opinion. I have just read a study that is like, you know, it's a large-scale epidemiological study of a million women. Today. She's coming off today."

    2. SB

      And this was after or before she was experiencing depression?

    3. LB

      This was after. It was-

    4. SB

      After.

    5. LB

      ... it was, um, maybe a year after she was diagnosed. Much later, I read, um, I was reading a book by, uh, Naomi Oreskes, the historian of science, and she wrote a book called Why Trust Science? And it's a wonderful book. But in the book, she talks about, she gives examples of places, uh, phenomena where the public didn't trust science, and they should've, and this is one of them. (laughs) Um, apparently, it's been known for a really long time. And I just want to point out that estrogen, progesterone, testosterone evolved as metabolic regulators. I'm highlighting it because in a lot of, because in a culture that separates mental from physical, we don't think about the role of metabolism in vision or in, even in mood. That's a really recent thing. In our lab, we, one of the things we study now is the role of metabolism in, in really basic, really, really basic psychological phenomena, um, like just as a fundamental building block of your mind basically.

  27. 1:24:07 – 1:29:11

    How Lisa Helped Her Daughter Out of Depression

    1. SB

      So your daughter exhibits those symptoms. I'm really curious to hear what conventional medicine at that point told you you should do with a daughter in that situation at that time versus what you did. You have this wealth of information. You, you have a medical background

    2. LB

      (overlapping dialogue) Yeah, so I should say, this was, you know, this was, um, some years ago, right? So currently, there is a, kind of a revolution going on where, um, there's actually something called metabolic psychiatry now. Back when this was h- when, you know, when I was reading about this, it sounded crazy. When I saw wha- what my daughter was, what, that she was suffering, like really suffering, it's really hard for me to talk about this because as I'm talking to you about this, I'm thinking, I, I just, I wish that I, you know, I wish that I had figured this out earlier. But, um, but anyways, what we did was I, we found, I found every possible route that I could think of to target her, um, her body budget, so basically target her metabolism. And then we, we-... and we basically came up with a, a daily routine, which she participated in making, um, to see if we could put her on a different trajectory, you know? And that involved everything from getting off social media and-

    3. SB

      Because?

    4. LB

      ... because first of all, she was using, like a lot of kids do, she was using, um, her screens late at night. And at that point, and again, this was something I just happened upon, right, but it, a- actually at an, at a NCI meet, a National Insti- Cancer Institute meeting. (laughs) Um, you know, we have retinal ganglion cells. We have cells in our retina that, um, regulate circadian rhythm and they're sensitive to light at the wavelengths that comes from your screen, from a screen. So if you look at those screens at night, your brain thinks it's daytime, like your circadian rhythm, you give yourself a circadian rhythm disorder basically, and it will be harder to get, um, into a regular sleep cycle. And you need that regular sleep cycle in order for toxins to clear and in order to consolidate, um, what you've learned s- during the day so that you can remember it later. And there are a whole bunch of restorative things happen during deep sleep that you really need, and if you can't get enough deep sleep, that will make your budgeting problems worse basically. So we targeted her. We got her off social media. Well, first of all, off screens after, you know, like 7:00, 8:00 at night, no screens. Um, off social media to reduce social uncertainty, social stress. I got up with her at 5:30 every morning, made her breakfast, sat with her while she ate breakfast, so made sure that she was eating nutritious food, not pseudo food, like, you know, Pop-Tarts and shit like that. We had to start her, like, exercising again, so s- she started to walk long distances. We s- she started doing Pilates, like not, not Pilates on a mat, but, like, Pilates with a reformer that would make anybody cry, you know?

    5. SB

      Why exercise as it relates to this budget and the metabolic functions?

    6. LB

      Because exercise, um, basically, um, exercise throws your, throws your... It's like your brain, it's like you're, you're throwing yourself out of, uh, metabolic balance so that the brain can learn to get e- itself back in. You're basically improving the resilience of your, of your physical systems is, is basically the way to... So she's not, uh, you know, w- she needed something more like interval training, which is what these Pilates classes were as opposed to, you know, practicing to play tennis or whatever, something that would, would, where she'd, you know, after a certain period of time, she'd be dysregulated metabolically and then she'd drink water and, you know, eat something healthful and, um, and then her system basically was learning to become more flexible-

    7. SB

      Mm-hmm.

    8. LB

      ... again, not so stuck.

    9. SB

      Mm-hmm.

    10. LB

      So again, it, it was like dosing with prediction error or, like, showing the, providing the brain with opportunity to learn that it was wrong. And then, um, omega-3s. So we sh- we took, I can't remember the exact dose, but I, I dosed it out high omega-3s, low omega-6s. With her doctor's permission, we also used a baby aspirin once a day w- on a full stomach to reduce systemic inflammation. Um, before

  28. 1:29:11 – 1:35:26

    Social Support

    1. LB

      bed, I mean, before bed we had always done, um, like a cuddle, you know? Like when she was little we would read a story or whatever and in her early adolescent years, you know, she rejected that, and then we brought it back. So an hour before bed, we would, either me or her dad, sometimes all three of us, we would read a book together or, you know, he would read a book to us, or we would, I, I, she, we would sit and talk and she would tell me, you know, all the things that were happening at school that she could remember and sometimes they were really horrible and I just had to empathize. That was really hard for me because I just wanted to fix it. I just wanted to fix it. And it was really, I had to really draw on my own, um, experience as a therapist (laughs) to just sit with the distress and empathize rather than say, "Do this, do this, do this, do this." It took me a long time to learn that and I'm still sometimes struggling with that.

    2. SB

      Why was that important?

    3. LB

      Because then she feels heard-

    4. SB

      Right.

    5. LB

      ... and, and she feels understood. And when you, it took me a long time to learn this, when she, when she would tell me that, you know, someone had done something terribly mean, if I did anything other than empathize, she would feel like I hadn't heard her. And social support is a major... Uh, I mean, we are the caretakers of each other's nervous systems. Humans are social animals. It's hard to believe, uh, I think in a culture like ours where we're so individualistic, right, and it seems like a political statement or something. It doesn't really matter what your political views are. We evolve the way we evolve, man. We are social animals. We affect each other metabolically. We can add savings and we can add taxes and s- you know, the best thing for n- a human nervous system is another human. The worst thing for a human nervous system is another human.

    6. SB

      The wrong one.

    7. LB

      ... there are so many experiments showing such... I mean, I just saw a set of experiments from one of my former post-docs that was just amazing, um, where she looked at glucose metabolism in mothers and babies, and I think she also did it in dating partners, if I'm not mistaken. And she looked at them alone and, like, a- and then together, like, alone during a task, and then together during a task. And mothers and babies that are attached well, they're actually, their glucose metabolism is more efficient, (laughs) like literally more efficient. And I believe she, I, I believe she also showed this with dating partners too. You know, there are these studies, these old studies showing that, um, that, you know, it's, like, less calorically demanding to walk up a hill with a backpack if you're with a friend than if, with y- with a stranger. And a million, just all these really batshit crazy findings that if, but if you realize that humans are literally affecting each other on a physical basis, whether they're aware of it or not, whether they intend it or not is completely (laughs) irrelevant, or s- or it's unnecessary, I would say, to have that effect, um, to have the effects be there. Um, then it starts to, y- it starts to make sense, you know? Like, the idea that... And th- again, meta-analyses show that you will live years longer, years, on average, years longer if you are in, if you have a, a social, um, life filled with people who you trust and who trust you.

    8. SB

      So is that why you got the family round just before bed? Because it was regulating her nervous system, her, her body?

    9. LB

      Yeah. Sometimes she, she... Sometimes she still says this to me, actually. She'll say, "Can you just be my friend for a minute and not my mother?" And I'll be like, "Yes, I can." And then I actually have to do it, which is sometimes hard. Or I will say to her... This is for parents. Anybody who has an adolescent or an adult, um, child, this is, this is, like, one of my... I, I don't know how I came up with this, but it's, like, golden, right? I say to her, "Can I... J- I'm having a mother moment where I feel the need to nag you about something, and if I can just nag you for a minute about it, I, I won't need to tell you again." So I'm basically asking her permission, "Can I tell you this thing which I really want to tell you? And I know you don't want to hear it, but you would be being, doing me a real kindness if you would just listen to me for a minute? And I know it's me. It's all me. It's not you. It's all on me. This is me, but I just... I would be better if you could just let me." And most of the time she says, you know, with great forbearance, right, like, "Sure, Mama, go ahead." Sometimes she says, "Not today." (laughs)

    10. SB

      (laughs)

    11. LB

      And then I actually have to listen, you know? So-

    12. SB

      That's so funny. (laughs)

    13. LB

      Yeah. But there are probably other things I'm not thinking of right now. I've written them all down because a lot of people have asked me (laughs) this question. And what I like to say is, "This is... I'm not a physician. This... I'm not a psychiatrist. This is not a recommendation or recipe for your children. I'm just telling you what I did as a scientist."

    14. SB

      And you wrote down what you did. You still have a copy of that. So I can link it below for anyone that does want to read what you did.

    15. LB

      Yes, but it's, again, it's... I-

    16. SB

      It's what you did for your daughter at that time.

    17. LB

      Yeah, just as a person who had read the literature. I... It's not a, it's not, um... This is not medical advice. It's, I'm really strongly... And also, I should say, I, you can't force your adolescent to do anything. You can't even force your kids, really, to do anything unless you threaten them with physical harm. They have to make that choice themselves, right?

    18. SB

      And did she

  29. 1:35:26 – 1:39:12

    Lisa's Daughter's Recovery from Depression

    1. SB

      recover?

    2. LB

      Yes, she did, and I think one of the reasons why she is good now, it's not that she never has challenges with her mood, but she understands them in physical terms. She doesn't understand her mood as being a psychological problem. She understands it as a symptom or a barometer of her body budget.

    3. SB

      This is something I learnt from your work while I was researching, which w- was really, really helpful to me, and it's pretty much exactly what you just said, which is, sometimes I'm in a not-so-good mood, and if I'm not conscious about that, then the bad mood can wreak havoc, right? It can, I can be short with people, whatever, and when I was reading your work and thinking about bad or good moods through the context of this body budget, it makes you pause for a second and go, "What am I missing?" And it makes you very conscious of what you then do. It almost makes you suddenly take hold of the wheel and go, "Okay, so there's a problem here. It's a physical problem. I didn't get sleep last night. I haven't eaten." Whatever it might be. Be really aware of what this makes you do or feel or think, and h- and the actions you need to take are maybe cancel everything you were planning today (laughs) and go back to bed. (laughs)

    4. LB

      Well, but I think that you just put your finger on the really important thing. It's that it changes what you do next.

    5. SB

      Yeah.

    6. LB

      And that changes the trajectory of what happens, and I think this is, this is really... It's not like a magic cure, but it... And again, you know, but when someone is... When, when you feel really distressed, you either look to the world like, "What is wrong with the world?" Or you look to yourself, "What is wrong with me?" And really, it could be... Maybe there is something wrong with the world. Maybe there is something wrong with you, but most likely, it's something... There's a body budgeting problem. Even if it's the case that there's something wrong with the world, you're better equipped to deal with that thing if you are...... managing your body budget.

Episode duration: 2:06:30

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