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Mindfulness for Addiction

Judson Brewer shares how the practice of mindfulness for addiction can also teach us how to untangle ourselves from what is said to be the biggest obstacle to mindful living—our attachment to craving.

Recently I had the pleasure of interviewing Dr. Judson Brewer. Jud is the director of research at the Center for Mindfulness at the University of Massachusetts. And, you know, he's really an internationally known expert in mindfulness training for addiction. He's considered to be a thought leader in the science of self-mastery.

And he combines 20 years of his own practice of mindfulness with his cutting edge research into the neural mechanisms of mindfulness. I think you're going to find these conversation both insightful and very, very practical. In this conversation, Jud reveals the science behind how addictive cycles begin and why mindfulness can really help us break free of those cycles. And we also speak about why human life is often characterized by a constant sense of wanting more and how we can become deeply fulfilled and content as a way of being in life. And finally, we also speak about the four step process that Judson uses to bring mindfulness to any moment when a craving or an urge arises.

I hope you enjoy my conversation with Dr. Judson Brewer. So Jud, thank you so much for taking the time to share with us here today. I really appreciate it. My pleasure.

Thanks for having me. And actually, I'm also going to take this opportunity to thank you very, very much for the presentation that you did for The Mindfulness Summit. I haven't had a chance to thank you in person. It was really insightful and incredibly helpful. We have amazing feedback about it.

So thanks for that too. Great to hear. So in, in that presentation that you did for the Summit, you spoke about how your research into how mindfulness can help us with addictive urges and, yeah, again, it was incredibly helpful and insightful. And I'd like to dig a little bit deeper into that today, but also just to talk about some general aspects of mindful living that you've picked up through your personal experience and research along the way. So first of all, I'd love to know though how, how your own journey into mindfulness started.

Was it something that began for you as a, as a child, or was this something that unfolded later in life? Tell us the story about your own journey there. It's hard to know exactly because in retrospect, you know, you look back and say, oh, maybe that was something, but definitively I do know that, right. I was about to start medical school in the mid nineties and had gone through a bad relationship breakup and was having trouble sleeping, probably for the first time in my life. And somehow this Jon Kabat-Zinn book landed in my lap. And I read a little bit of it in started, started meditating my first day of medical school.

I was listening to his cassette tapes, for those of you that remember what a cassette tape is. And started meditating right at the beginning of medical school and found that, you know, it was really helpful for me to work with my mind, work with stress and even, you know, during boring medical school lectures, I had lots of time to sit and pay attention to my breath as a, as a beginning practice. So that's when it started. Ah, and what was one of the first big aha moments, realizations, insights that came from your practice that you feel really had an impact on your life? A big impact. Great question.

That was a while ago so it's hard to say what some of the first ones were, but I did start noticing that, you know, during medical school and during graduate school that, you know, I really could start to not be sucked into this or this or this in terms of my mind spinning out of control. It was, it was really helpful in, in those respects. And then, you know, in terms of getting out of my own way, whether I was seeing patients or getting a review from a reviewer when I had submitted a paper or submitting a grant or working with a coworker that just all of these aspects of my life started showing up in a way that was very helpful. So it sounds like it helped you to break free of being caught up in cycles of stress and kind of struggle there. Yes, absolutely.

And as you reflect back now, how many years have you been formally practicing now? It's 2016, it's been 20 years. Twenty years. So as you reflect on that 20 years now, from where you're standing now, what would you say has been the biggest challenge or one of the biggest challenges in your practice and how have you overcome it? These are such great questions. One of the biggest challenges in my practice. You know, I'm kind of hard headed, so I, you know, practice has always been a real go-to for me in terms of coming back to the practice and so it's always been, there've been so many gifts that I've gotten through practice.

What's been challenging, cause it hasn't been, you know, I've been relatively regular in practicing, so that hasn't been a problem that some of, you know, maybe, just the way that, that my mind is. I had grown up playing the violin, so had learned that dedicated practice every day is very helpful in developing any new habits. So maybe that was something that was a little easier for me than, you know, than some people find. I'm trying to think what was it, what has been difficult in practice for me? Maybe just seeing how the mind, you know, when, when I'm really, when it's really clear to me how much suffering I've been part to, have caused. It, you know, that's, that's been a real challenge just to see how there's, boy I've caused a lot of suffering.

And in that sense, it's very humbling at the same time. Another difficulty has been trying to, you know, early on, I was trying to really intellectualize the practice as compared to just practice. In that sense, loving kindness was a particularly challenging practice for me. You know, my kumbaya letter went off, you know, off the charts. The woo woo meter.

Yeah. What is this touchy feely, goofy stuff? And I promised my teacher that I would just practice it as a concentration practice and that was it. And then I started learning that it was like just so much more than that. But it took me years, I think, of, of dedicated loving kindness practice to really see the doubt, you know, this wasn't some woo woo thing. So that was, that was another one of the, the big challenges for me was to get over my own concepts of what loving kindness was.

So those are a couple of examples. Great. So I'd love to just dig in a little bit deeper about your, your work with addictions and kind of dig a little bit deeper about some of the stuff that you spoke about in the summit presentation. And by the way, for everybody who's viewing this right now, I'm going to, at the moment you have to pay to see Jud's presentation, but I'm going to open it up for free for a week. So, and there'll be a link to it below this video.

So you can go and watch that as a compliment to these conversations so that you can kind of dig a little bit deeper into this. But in that, in that presentation, you spoke about exactly how our addictive patterns arise and you spoke about habit loops. So I was wondering if you could just now again talk about what habit loop is and also how mindfulness helps us break those habit loops. I'd be happy to. I think of that the habit loop has been something that's been described in modern psychology using terms like positive reinforcement, negative reinforcement, operant conditioning, associative learning, all of these point toward this process that, you know, basically if you break it into its simplest parts starts with the trigger.

So let's say we get stress as our trigger, that leads to a behavior, which is, you know, let's say that we eat chocolate or we eat a cupcake, and then there's a reward that comes from that. Oh, cupcakes tastes pretty good. So that habit loop, that's the simplest form of it. But we can think of it in terms of positive and negative reinforcement. That in the sense that we, you know, we see a cupcake, our brain says, oh, that looks pretty good.

We eat it. We tasted, it tastes very good. And, you know, we get this sugar rush or whatever, and then we lay down this memory, oh, cupcakes tastes pretty good. And we can also start to learn to associate positive mood states with cupcakes. Oh, you know, if I'm not feeling good, then my brain says, oh, I've got a great idea.

Why don't you eat a cupcake? I can relate to that. So we move from cupcakes, tasting good to suddenly a negative mood leading to us having an urge to eat a cupcake because we want that negative mood to go away. Right. We eat the cupcake, that negative mood goes away. And then we learn, oh, well just eat cupcakes when you're sad, when you're angry or you know, or whatever.

And so we start to form these habit loops around all sorts of behaviors, whether it's eating, smoking, using drugs, yelling at people, going, in, you know. You can imagine all the different types of coping mechanisms that we have in life as a way to deal with the unpleasantness, make, trying to make the unpleasantness go away. And trying to hold on to whatever's pleasant. You know, like, oh, it's been a great day. I'm going to take a picture and kind of, you know, try to hold on to this beautiful sunset that I'm watching as it goes away.

So the interesting, so that's the habit loop. And the interesting thing about this that the Buddhist psychologists described this 2,500 years ago in, in basically the same process. The only thing is they used a couple of other terms, one including ignorance, where they said that this process is perpetuated through ignorance. And in modern day, we describe that in terms of subjective bias. So if I eat cupcakes when I'm sad, I suddenly start wearing these glasses that sees the world, I see the world through, oh, if I feel bad I should eat cupcakes glasses.

Right? The Buddhist psychologists described this in terms of ignorance because we're not seeing clearly. Right. And what are we seeing clearly? Well, the cupcakes aren't going to fix whatever that root cause of my sadness is. They're just going to give me a sugar rush and make me feel a little bit better in the short term because I'm getting dopamine released in my brain, as an example. Yeah, and in the long term, we often, it's not going to give us, it's actually going to lead us towards more suffering and more pain, not towards what we're really looking for.

Right. Right, right. More suffering because eating more cupcakes isn't going to fix it. It's actually going to give us a stomach ache or give us diabetes, or, you know, make us obese, just using that example. So how does mindfulness, and again 2,500 years ago that not only do they know those causes, but also they spoke about how the work that you're doing now, how mindfulness can break that habit loop.

So can you tell us about that as well? Sure. So it's interesting that they really focused on craving as one of the core problems. So we get caught up in craving. We crave pleasant things. We crave for unpleasant things to go away.

And they said, well, if you focus on the craving, you can start to break down the craving and see what it actually is. So my patient, I've had patients come into my office and say, you know, if I don't smoke, my head will explode. And we say, okay, well, when your head explodes, put the pieces back together and call me and we'll document it. Right? Because it feels so bad, but these are just physical sensations. So if we can break it down, and that's what mindfulness is all about, if we can start to drop into our body and say, well, what does craving actually feel like? If we can get curious about that craving and instead of trying to push it away, turn toward it, we can notice the cravings are made up of body sensations.

And for some people there's a, there are tightness, there are restlessness. For some people, you know, there's some mouthwatering there. You know, it can be all sorts of physical sensations. But when we notice that, we can notice, oh, well tightness. Well, my head's not going to explode from tightness.

Okay. Restlessness. Okay. There's restlessness. And we can start to be with these sensations rather than trying to make them go away as quickly as possible.

And another element that's often described in mindfulness practices is curiosity. So, or interest. If we can get really interested, what does interest or curiosity itself feel like? Does that feel unpleasant like a craving?. No, curiosity actually feels good. So we can start to flip the valence from unpleasant craving to, oh, oh, oh, what does this feel like? And we can actually start to be with these sensations as they come and go and see that they're not, they don't last forever.

They're not permanent. And they're just these sensations that we've become identified with. Right. So I'm, I'm so glad that you brought up as well, that, you know, that these teachings have been around for so long. And this is something, I think something that I've often noticed when I speak to people about something like addictive urges, it feels very personal and there's a lot of shame and a lot of, but you're not alone in this.

This is something really fundamental about the human experience, so we're just learning how we can come into more wise relationship with it. Yeah. Absolutely. I would even say that, you know, we all fall somewhere on this addictive spectrum. So if you think of addiction, the far end of addiction being continued use despite adverse consequences.

So when we're so caught up in something that we're continuing to do it, we're eating that fifth cookie, even though we know it's going to give us a stomach ache. You know, this is how we learn. This spectrum is how we learn. And it was probably set up so we'd remember where food is. That's probably how our brains were set up.

But on every end of the spectrum is, you know, we learn to form a habit around tying our shoes, or we learn, if you think of the caught upness, you know, we get caught up in daydreaming all the time. Who doesn't get caught up in a daydream. So you can think of daydreaming being that temporary caught upness, stress being something that's a little more caught up and then addiction being so caught up that we're doing all these crazy things, knowing that we can't, that it's not good for us. And yet no, that we can't stop. Right.

Yeah. On your, the CravingToQuit website, for those of you out there that CravingToQuit is an app that Jud has created to help in a time when you're actually experiencing an urge. You can use this app to kind of help you be guided through that with mindfulness. But on the, on the website, you wrote that every substance abuse from tobacco to crack cocaine affects the same brain pathways, the mesolimbic pathway that mainly acts through the neurotransmitter dopamine. And every single time we do a line of cocaine or we feel a high from it, a cigarette when we're stressed out and then we use the cigarette to feel better afterwards, we reinforce that habit loop.

So this is something that I really want to just kind of make clear here. So every time we give into an urge, we make the addiction stronger. Is that true? Yeah. So every drug of abuse that's known to humans, whether it's alcohol, cigarettes, cocaine, heroin, all of those, in one way or another effect, the dopamine system, increasing the amount of dopamine in our brain. So is it true then also that with mindfulness and what you're teaching that each time we don't play out the addiction that we weaken, we don't play out the urge, we weaken the addiction? Certainly behaviourally we do.

We haven't looked at the neurochemical level to see how it affects the dopamine system particularly. We found that there are certain brain regions that are involved in kind of getting caught up in our experience that are associated with cravings and with addictions are affected by mindfulness training, in particular. We found this in experienced meditators and whatnot, but we've also found behaviourally that, that people can have cravings and that mindfulness helps them break that link between having a craving and automatically acting on it. And that it literally breaks, they can have a craving be with it and not act on it by smoking or whatever. Right.

So it's more that it's maybe, maybe the cravings might still come, but they're just not really that much of a problem. Over time, you get more and more skillful at just going well, it's just a craving. I can, and I can make a conscious choice about how I'd like to respond rather than just play it out unconsciously. Absolutely. And I just want to highlight one piece of that is it's not that we're cognitively saying, oh, that's just a craving.

I don't have to act on that. You know, if we could do that cognitively, then we would do it every time. But it's really, it's really about two pieces of this. One is seeing that these cravings are just body sensations that we can be with. And the second piece being that when we really pay attention to the results of our actions, to those rewards that we're getting, when we see that they're not that helpful, we naturally start to become disenchanted with them.

So for example, with smoking, people realize that smoking actually doesn't taste very good. And so they're naturally moved, their motivation is heightened to stop smoking cause they're like, well, why am I doing this? Yep. We see the same thing now where we have an eating program now, where we're using the same practices to help people learn the rewards that they're getting from stress eating as well as learning to ride them out in very much the same way as the smoking cessation program, because guess what? Sugar releases dopamine just like cocaine does. I love that you, I love that you brought up too, that there's, there's obvious crave, there's obvious behaviors that we think about when we think about addiction, right? There's Facebook and there's, you know, alcohol and hard drugs and shopping and sex and all of these that we think, you know, that's what we think about when we think about addiction. But it's striking to me that we, yes, there's the obvious stuff, but it seems like human life in general is characterized for many of us by a constant sense of wanting more.

Like if the voice of craving could have a voice, it would say I need something more than what I have in this moment. So it seems to me that there is a, that this is one of, this is not just the obvious stuff that we're working with - something much deeper about human lives. So when I was 19 years old, I worked in a nursing home as a diversional therapist, and I was working with people that were getting to the end of their days. And, and so pervasive is this part of human life that many of them felt really, really disillusioned and disappointed by the fact that they had lived their lives as a means to an end instead of really soaking it up. And they urged me not to make the same mistake.

So I feel like, you know, you just spoke about before, how the Buddha said something, you know, I think he's attributed to saying, you know, that the root of all suffering is the attachment to craving. So what do you, what do you, what are your thoughts on that? What are your comments on that? Well, I agree and our data tend to support that where, you know, that every time we get caught up in a craving, we perpetuate that habit loop cycle. And, you know, it's endless. So the early Buddhist psychologists described it in terms of, they used the term Samsara. Right.

Which literally when translated means endless wandering. Yeah. And so I wonder if the folks that you're describing from the nursing home, you know, at the end of their life, they'd realized that they had been endlessly wandering and were urging you to stop wandering. Now it's interesting somewhere, and this probably has happened, you know, throughout humanity, but somebody described to me that somewhere in Shakespearian times, the excitement was started becoming equated with happiness. And you can think about this in terms of how these, this endless wandering it's perpetuated in our daily lives now where we're constantly bombarded by advertisements that say, you know, you're not enough, or you could have more of this, or, you know, increase your desire or whatever.

That's based on this notion of this, this excited, you know this excitement being happiness, whether we're on a rollercoaster, eating chocolate, having sex, whatever, and not stepping back and saying, you know, is there actually a greater level of happiness that's not based on this treadmill. And when we step back and just rest in being rather than doing, we start to see, oh, this is actually pretty good. And even in a, if you want to bring it back to psychology, you know, in a Skinnerean sense, and so this guy, BF Skinner is famous for these Skinner boxes, where you put a rat in a, in a box that's this color versus this color. And then you shock them in this box. So suddenly it becomes more painful to be in this box than this one.

So they prefer this box over this one. Well in the same way, if we only know happiness as being excitement and suddenly we realize there's another box such as peace and joy, and just an awareness where we're not caught up in things, we can start to find the situations and the conditions that support this as compared to this. Right. It seems like it, it seems like a strange paradox in a human mind to say that finding a deeper level of fulfillment means actually stopping the seeking because we so strongly associate the seeking to the happiness. But yeah, I think that that was the Buddha's really great insight back then.

Wasn't it? It was actually, you could get off the treadmill if you want, and actually find out for yourself by going within and just resting. That there is a deeper level that actually happiness isn't kind of, I don't even the word happiness is a kind of, I think fulfillment resonates more with me, a deeper sense of fulfillment that you can have by just resting in your own beingness. Absolutely. And you can, even in that sense, you can, we can even start to differentiate the type of seeking that most of us are conditioned to do, which often is described as sensation seeking. Like looking, you know, looking for something novel, looking for something new, looking for more looking for this as compared to the seeking that many of us have that's like, oh, this, this isn't quite doing it for me.

So that's when we start turning inward and that seeking becomes a more of an exploration, and again, a curiosity, a question. And those answers come from not getting, but just noticing how our minds work and resting in what is as you're, as you're describing. And you're saying that the research, that the current research out there also supports that what we're saying here? There's a lot of research, and it's still pretty early stages, so there's nothing definitive. So I'll just speak a little bit to some of the research that we've done and some of the work that's been replicated, because I think it's important to be able to replicate results to know if they're they're real. There seems to be, for example, a brain region that's associated with kind of getting caught up.

So when we get caught up in excitement or get caught up in anger or rumination or craving, there's this brain region called the posterior cingulate cortex that gets activated. And the same brain region gets deactivated when we are concentrated on our in breath awareness, doing loving kindness meditation, choices awareness, you know, just an open awareness and even during curiosity or different Christian contemplative practices. So it seems that there's a common element here where this getting caught up in experience. Now the opposite happens when we are getting out of our own way, if you want to think of it that way. When we're not caught up in that excitement and just resting in a more of a boundarylessness where there's just awareness, just being.

Even it's hard, it's hard to describe because it's not about me. It's not about the self. It's not about any of that, you know, that taking things personally. It's just being deeply in touch with the unfolding present moment. So I'd love if, if you could actually walk us through, give us a kind of a simulation as if we had an urge right now in this moment, and maybe some people watching do have an urge in this moment.

So congratulations if you do. Because you have a four-part process, don't you a four-part way of guiding people using mindfulness through an urge, the RAIN process. Would you be able to give us a taste of what that's like? Sure, sure. And this was, I think, first attributed to Michelle McDonald, who's a Western Vipassana teacher or an insight meditation teacher. And we've modified it slightly based on some of the Burmese teachings.

But basically it's the four, the acronym is RAIN. So, and I can, so what's your favorite sugar sweetened thing that you might have an urge for when you are stressed out or something like that? Or maybe that doesn't happen... Oh, it happens. It happens. So what's your pick? We can use that object, so give me an example.

For me, it's dark chocolate. So I don't have a huge sweet tooth, but dark chocolate. Okay, good. Well, dark chocolate is a good one because anything above 70% is considered a health food. But yeah, well if you tell yourself that, that's dangerous.

You see, that's what I found. You tell yourself it's a health food, and then you can eat more apparently. That's what my mind said. Great. So let's say, let's say that we, hypothetically speaking, we've had a rough day and we come home and we're tired and our, you know, it just does not feel very good.

And so, you know, we're not really hungry, but our brain says, you know, why don't I eat some dark chocolate? And so, you know, we see this chocolate, we look at the chocolate, it looks at us. We may have, it's like we have this connection. It says, you know, and I say, yes, you are, you are what I need. So at that moment, we start to get enchanted. It's like the chocolate is playing its little soothsayer, you know, the pipe or whatever to us.

And we start getting enchanted, oh chocolate. Yes, that's what I need. In that moment, the first thing that we need to do is recognize that we're caught up in that craving, because if we can't recognize it, we're going to just go along in that trance and eat the chocolate. We might eat one, two, nibs or eat the whole bar without even paying much attention it. So we have to recognize, that's what the R stands for.

And I even suggest that we relax into it because this isn't about like forcing ourselves not to do things. It's just about like, okay, this is what my brain is doing. This is what my mind is doing. So let's have fun with this. The next step is the A, which is to allow or accept or acknowledge that this craving is there.

So typically cravings are unpleasant. So we want them to go as quickly as possible and we'll say, okay, craving. What do I, what do I do? What do I need to do? Just tell me what I need to do. And it says, eat the chocolate. So we say, okay, you know.

So instead of just, you know, downing the chocolate to make that craving go away or trying to like stuff that craving into our closet, we just step back and allow it to be there. Like, okay, this is what's happening. And that's really helpful because we can't get intimate with our cravings if we tell them to stand on the other side of the room. Right? You stay over there. I'll stay over here.

We'll be cool, okay. We don't know what the craving's like, so how can we work with if it, if it's way over there, if we're kind of suppressing it. So really we have to allow it to be there. The next step is where it gets really fun. So the I is for investigate.

So instead of pushing that craving away, we say, okay, What's happening in my body right now? And we get really curious. It's like we put on our Sherlock Holmes cap and we pull out our magnifying glass and we just start looking just by noticing whatever the sensations are in our body. The key with the investigation is to get curious. Oh, what does this feel like? And then the N, which is often described, described as non identification, as a not taking things personally. We've simplified that in a sense that just simply noting whatever body sensations are present in any one moment.

So we might note that there's tightness and then the next moment there's the tension. And then there's, my mouth's watering because I'm thinking about that chocolate or my shoulders are slightly tight. So I just start noticing, oh, there's this now there's this now there's this, now there's this from moment to moment as I notice what my body sensations are that are making up that craving. And in that sense, if I can follow the algorithm, R-A-I-N, so recognize, allow it to be there, get curious by investigating and noting it, I can start to see, oh, these are just body sensations that are driving my life. They come and go, they come and go.

And I don't have to actually get sucked into them. So that disenchantment, kind of that spell of ebchantment is broken. So when, with the noting, would you, would you kind of maybe even stand there, you don't really have to close your eyes, but would you, you would stand there and actually mentally say to yourself, ah, tightness in the belly, ah, heart's racing, ah. You know that, so you would actually kind of step through and, and mentally note every, just the raw body sensations that you're feeling in that moment. Yes.

And by doing that, there's a deep personalization. You suddenly realize, oh, it's not this craving for chocolate. It's actually this sensation, that sensation, this sensation. Right, right. In that sense, you can think of like, whatever these sensations are, and this is us, they've taken us for a ride.

But if we note, oh, this sensation, tightness, tension, burning, suddenly there's just this and awareness of this. And by definition, by observing it, we're already changing our relationship to it. So we start to see that there's space to respond rather than just being sucked in. Right. So that just reminded me of that, that famous Viktor Frankl quote, what is it? There's a space in between stimulus and response.

And in that space lies our power and our freedom. So this is really what we're doing here, opening up a space for that power and freedom to make choices. Absolutely. Yeah. Well, that's where freedom comes is when we're not sucked into our habits.

Absolutely. And the, so the CravingToQuit app, if people want to actually be guided by you through those in real time in those moments, in the CravingToQuit app, they can, they can use it like that. You will actually walk them through the RAIN process whenever they have an urge?. Yes, we have in both of our apps, so the CravingToQuit app and the EatRightNow app, which is more focused on things like chocolate. Yep, I have to get that one.

We have a, we have a button in there called the 'want to' meter. So anytime I want, you know, like I'm craving a cigarette or in the eating app, I'm craving a chocolate, then I can click on there and I can see, it first walks me through how strong is that craving. So I drop in and start to notice, oh, this is how strong my craving is. And then from there it can walk me through the RAIN exercise so I can really pay attention and ride it out. Now, alternatively, because for example, we all have to eat to live.

You know, if I'm really trying to change my relationship to eating and not getting sucked into stress eating, we also have in the EatRightNow program, mindful eating exercises. So people can stop and start to really pay attention as they consume that food. Because, you know, they might actually be hungry, which is slightly different than cigarettes because we don't need cigarettes to survive. But both of the apps have that RAIN exercise in them so people can really, really have the tools and learn these skills so that then they don't even need the apps anymore. It's more of a skill generating process.

Oh, great. So I just have one more question for you before we close up. And, and that is, if you could go back now with everything that you know now, all the knowledge and wisdom that you've developed through your practice over the past 20 years, and you could go back and give your former self that was just sitting on the cushion for the first time just one piece of advice, what would that be? I would say, notice what you're actually getting from your habits. Pay attention and just see what you're actually getting from what you're doing. That's what I would tell myself.

And I still tell myself. Oh, cool. Thank you so much, Jud. Is there anything else that you would like to share with our viewers before you, before we close up? I don't think so. I think I'll just say, you know, folks are interested in playing with some of these practices, whether your addiction is smoking or eating or anything in between, you know, you can play, we make some of these, the versions of our apps, you know, available for people to try them out for free for a couple of days.

So I would just say, you know, the CravingToQuit or the EatRightNow programs give people a chance to start to play with some of these practices. Jud Doug, thank you so much for your time. I really appreciate it. I really enjoyed this conversation. Oh my pleasure.

Thank you.

Talk

4.6

Mindfulness for Addiction

Judson Brewer shares how the practice of mindfulness for addiction can also teach us how to untangle ourselves from what is said to be the biggest obstacle to mindful living—our attachment to craving.

Duration

Your default time is based on your progress and is changed automatically as you practice.

Recently I had the pleasure of interviewing Dr. Judson Brewer. Jud is the director of research at the Center for Mindfulness at the University of Massachusetts. And, you know, he's really an internationally known expert in mindfulness training for addiction. He's considered to be a thought leader in the science of self-mastery.

And he combines 20 years of his own practice of mindfulness with his cutting edge research into the neural mechanisms of mindfulness. I think you're going to find these conversation both insightful and very, very practical. In this conversation, Jud reveals the science behind how addictive cycles begin and why mindfulness can really help us break free of those cycles. And we also speak about why human life is often characterized by a constant sense of wanting more and how we can become deeply fulfilled and content as a way of being in life. And finally, we also speak about the four step process that Judson uses to bring mindfulness to any moment when a craving or an urge arises.

I hope you enjoy my conversation with Dr. Judson Brewer. So Jud, thank you so much for taking the time to share with us here today. I really appreciate it. My pleasure.

Thanks for having me. And actually, I'm also going to take this opportunity to thank you very, very much for the presentation that you did for The Mindfulness Summit. I haven't had a chance to thank you in person. It was really insightful and incredibly helpful. We have amazing feedback about it.

So thanks for that too. Great to hear. So in, in that presentation that you did for the Summit, you spoke about how your research into how mindfulness can help us with addictive urges and, yeah, again, it was incredibly helpful and insightful. And I'd like to dig a little bit deeper into that today, but also just to talk about some general aspects of mindful living that you've picked up through your personal experience and research along the way. So first of all, I'd love to know though how, how your own journey into mindfulness started.

Was it something that began for you as a, as a child, or was this something that unfolded later in life? Tell us the story about your own journey there. It's hard to know exactly because in retrospect, you know, you look back and say, oh, maybe that was something, but definitively I do know that, right. I was about to start medical school in the mid nineties and had gone through a bad relationship breakup and was having trouble sleeping, probably for the first time in my life. And somehow this Jon Kabat-Zinn book landed in my lap. And I read a little bit of it in started, started meditating my first day of medical school.

I was listening to his cassette tapes, for those of you that remember what a cassette tape is. And started meditating right at the beginning of medical school and found that, you know, it was really helpful for me to work with my mind, work with stress and even, you know, during boring medical school lectures, I had lots of time to sit and pay attention to my breath as a, as a beginning practice. So that's when it started. Ah, and what was one of the first big aha moments, realizations, insights that came from your practice that you feel really had an impact on your life? A big impact. Great question.

That was a while ago so it's hard to say what some of the first ones were, but I did start noticing that, you know, during medical school and during graduate school that, you know, I really could start to not be sucked into this or this or this in terms of my mind spinning out of control. It was, it was really helpful in, in those respects. And then, you know, in terms of getting out of my own way, whether I was seeing patients or getting a review from a reviewer when I had submitted a paper or submitting a grant or working with a coworker that just all of these aspects of my life started showing up in a way that was very helpful. So it sounds like it helped you to break free of being caught up in cycles of stress and kind of struggle there. Yes, absolutely.

And as you reflect back now, how many years have you been formally practicing now? It's 2016, it's been 20 years. Twenty years. So as you reflect on that 20 years now, from where you're standing now, what would you say has been the biggest challenge or one of the biggest challenges in your practice and how have you overcome it? These are such great questions. One of the biggest challenges in my practice. You know, I'm kind of hard headed, so I, you know, practice has always been a real go-to for me in terms of coming back to the practice and so it's always been, there've been so many gifts that I've gotten through practice.

What's been challenging, cause it hasn't been, you know, I've been relatively regular in practicing, so that hasn't been a problem that some of, you know, maybe, just the way that, that my mind is. I had grown up playing the violin, so had learned that dedicated practice every day is very helpful in developing any new habits. So maybe that was something that was a little easier for me than, you know, than some people find. I'm trying to think what was it, what has been difficult in practice for me? Maybe just seeing how the mind, you know, when, when I'm really, when it's really clear to me how much suffering I've been part to, have caused. It, you know, that's, that's been a real challenge just to see how there's, boy I've caused a lot of suffering.

And in that sense, it's very humbling at the same time. Another difficulty has been trying to, you know, early on, I was trying to really intellectualize the practice as compared to just practice. In that sense, loving kindness was a particularly challenging practice for me. You know, my kumbaya letter went off, you know, off the charts. The woo woo meter.

Yeah. What is this touchy feely, goofy stuff? And I promised my teacher that I would just practice it as a concentration practice and that was it. And then I started learning that it was like just so much more than that. But it took me years, I think, of, of dedicated loving kindness practice to really see the doubt, you know, this wasn't some woo woo thing. So that was, that was another one of the, the big challenges for me was to get over my own concepts of what loving kindness was.

So those are a couple of examples. Great. So I'd love to just dig in a little bit deeper about your, your work with addictions and kind of dig a little bit deeper about some of the stuff that you spoke about in the summit presentation. And by the way, for everybody who's viewing this right now, I'm going to, at the moment you have to pay to see Jud's presentation, but I'm going to open it up for free for a week. So, and there'll be a link to it below this video.

So you can go and watch that as a compliment to these conversations so that you can kind of dig a little bit deeper into this. But in that, in that presentation, you spoke about exactly how our addictive patterns arise and you spoke about habit loops. So I was wondering if you could just now again talk about what habit loop is and also how mindfulness helps us break those habit loops. I'd be happy to. I think of that the habit loop has been something that's been described in modern psychology using terms like positive reinforcement, negative reinforcement, operant conditioning, associative learning, all of these point toward this process that, you know, basically if you break it into its simplest parts starts with the trigger.

So let's say we get stress as our trigger, that leads to a behavior, which is, you know, let's say that we eat chocolate or we eat a cupcake, and then there's a reward that comes from that. Oh, cupcakes tastes pretty good. So that habit loop, that's the simplest form of it. But we can think of it in terms of positive and negative reinforcement. That in the sense that we, you know, we see a cupcake, our brain says, oh, that looks pretty good.

We eat it. We tasted, it tastes very good. And, you know, we get this sugar rush or whatever, and then we lay down this memory, oh, cupcakes tastes pretty good. And we can also start to learn to associate positive mood states with cupcakes. Oh, you know, if I'm not feeling good, then my brain says, oh, I've got a great idea.

Why don't you eat a cupcake? I can relate to that. So we move from cupcakes, tasting good to suddenly a negative mood leading to us having an urge to eat a cupcake because we want that negative mood to go away. Right. We eat the cupcake, that negative mood goes away. And then we learn, oh, well just eat cupcakes when you're sad, when you're angry or you know, or whatever.

And so we start to form these habit loops around all sorts of behaviors, whether it's eating, smoking, using drugs, yelling at people, going, in, you know. You can imagine all the different types of coping mechanisms that we have in life as a way to deal with the unpleasantness, make, trying to make the unpleasantness go away. And trying to hold on to whatever's pleasant. You know, like, oh, it's been a great day. I'm going to take a picture and kind of, you know, try to hold on to this beautiful sunset that I'm watching as it goes away.

So the interesting, so that's the habit loop. And the interesting thing about this that the Buddhist psychologists described this 2,500 years ago in, in basically the same process. The only thing is they used a couple of other terms, one including ignorance, where they said that this process is perpetuated through ignorance. And in modern day, we describe that in terms of subjective bias. So if I eat cupcakes when I'm sad, I suddenly start wearing these glasses that sees the world, I see the world through, oh, if I feel bad I should eat cupcakes glasses.

Right? The Buddhist psychologists described this in terms of ignorance because we're not seeing clearly. Right. And what are we seeing clearly? Well, the cupcakes aren't going to fix whatever that root cause of my sadness is. They're just going to give me a sugar rush and make me feel a little bit better in the short term because I'm getting dopamine released in my brain, as an example. Yeah, and in the long term, we often, it's not going to give us, it's actually going to lead us towards more suffering and more pain, not towards what we're really looking for.

Right. Right, right. More suffering because eating more cupcakes isn't going to fix it. It's actually going to give us a stomach ache or give us diabetes, or, you know, make us obese, just using that example. So how does mindfulness, and again 2,500 years ago that not only do they know those causes, but also they spoke about how the work that you're doing now, how mindfulness can break that habit loop.

So can you tell us about that as well? Sure. So it's interesting that they really focused on craving as one of the core problems. So we get caught up in craving. We crave pleasant things. We crave for unpleasant things to go away.

And they said, well, if you focus on the craving, you can start to break down the craving and see what it actually is. So my patient, I've had patients come into my office and say, you know, if I don't smoke, my head will explode. And we say, okay, well, when your head explodes, put the pieces back together and call me and we'll document it. Right? Because it feels so bad, but these are just physical sensations. So if we can break it down, and that's what mindfulness is all about, if we can start to drop into our body and say, well, what does craving actually feel like? If we can get curious about that craving and instead of trying to push it away, turn toward it, we can notice the cravings are made up of body sensations.

And for some people there's a, there are tightness, there are restlessness. For some people, you know, there's some mouthwatering there. You know, it can be all sorts of physical sensations. But when we notice that, we can notice, oh, well tightness. Well, my head's not going to explode from tightness.

Okay. Restlessness. Okay. There's restlessness. And we can start to be with these sensations rather than trying to make them go away as quickly as possible.

And another element that's often described in mindfulness practices is curiosity. So, or interest. If we can get really interested, what does interest or curiosity itself feel like? Does that feel unpleasant like a craving?. No, curiosity actually feels good. So we can start to flip the valence from unpleasant craving to, oh, oh, oh, what does this feel like? And we can actually start to be with these sensations as they come and go and see that they're not, they don't last forever.

They're not permanent. And they're just these sensations that we've become identified with. Right. So I'm, I'm so glad that you brought up as well, that, you know, that these teachings have been around for so long. And this is something, I think something that I've often noticed when I speak to people about something like addictive urges, it feels very personal and there's a lot of shame and a lot of, but you're not alone in this.

This is something really fundamental about the human experience, so we're just learning how we can come into more wise relationship with it. Yeah. Absolutely. I would even say that, you know, we all fall somewhere on this addictive spectrum. So if you think of addiction, the far end of addiction being continued use despite adverse consequences.

So when we're so caught up in something that we're continuing to do it, we're eating that fifth cookie, even though we know it's going to give us a stomach ache. You know, this is how we learn. This spectrum is how we learn. And it was probably set up so we'd remember where food is. That's probably how our brains were set up.

But on every end of the spectrum is, you know, we learn to form a habit around tying our shoes, or we learn, if you think of the caught upness, you know, we get caught up in daydreaming all the time. Who doesn't get caught up in a daydream. So you can think of daydreaming being that temporary caught upness, stress being something that's a little more caught up and then addiction being so caught up that we're doing all these crazy things, knowing that we can't, that it's not good for us. And yet no, that we can't stop. Right.

Yeah. On your, the CravingToQuit website, for those of you out there that CravingToQuit is an app that Jud has created to help in a time when you're actually experiencing an urge. You can use this app to kind of help you be guided through that with mindfulness. But on the, on the website, you wrote that every substance abuse from tobacco to crack cocaine affects the same brain pathways, the mesolimbic pathway that mainly acts through the neurotransmitter dopamine. And every single time we do a line of cocaine or we feel a high from it, a cigarette when we're stressed out and then we use the cigarette to feel better afterwards, we reinforce that habit loop.

So this is something that I really want to just kind of make clear here. So every time we give into an urge, we make the addiction stronger. Is that true? Yeah. So every drug of abuse that's known to humans, whether it's alcohol, cigarettes, cocaine, heroin, all of those, in one way or another effect, the dopamine system, increasing the amount of dopamine in our brain. So is it true then also that with mindfulness and what you're teaching that each time we don't play out the addiction that we weaken, we don't play out the urge, we weaken the addiction? Certainly behaviourally we do.

We haven't looked at the neurochemical level to see how it affects the dopamine system particularly. We found that there are certain brain regions that are involved in kind of getting caught up in our experience that are associated with cravings and with addictions are affected by mindfulness training, in particular. We found this in experienced meditators and whatnot, but we've also found behaviourally that, that people can have cravings and that mindfulness helps them break that link between having a craving and automatically acting on it. And that it literally breaks, they can have a craving be with it and not act on it by smoking or whatever. Right.

So it's more that it's maybe, maybe the cravings might still come, but they're just not really that much of a problem. Over time, you get more and more skillful at just going well, it's just a craving. I can, and I can make a conscious choice about how I'd like to respond rather than just play it out unconsciously. Absolutely. And I just want to highlight one piece of that is it's not that we're cognitively saying, oh, that's just a craving.

I don't have to act on that. You know, if we could do that cognitively, then we would do it every time. But it's really, it's really about two pieces of this. One is seeing that these cravings are just body sensations that we can be with. And the second piece being that when we really pay attention to the results of our actions, to those rewards that we're getting, when we see that they're not that helpful, we naturally start to become disenchanted with them.

So for example, with smoking, people realize that smoking actually doesn't taste very good. And so they're naturally moved, their motivation is heightened to stop smoking cause they're like, well, why am I doing this? Yep. We see the same thing now where we have an eating program now, where we're using the same practices to help people learn the rewards that they're getting from stress eating as well as learning to ride them out in very much the same way as the smoking cessation program, because guess what? Sugar releases dopamine just like cocaine does. I love that you, I love that you brought up too, that there's, there's obvious crave, there's obvious behaviors that we think about when we think about addiction, right? There's Facebook and there's, you know, alcohol and hard drugs and shopping and sex and all of these that we think, you know, that's what we think about when we think about addiction. But it's striking to me that we, yes, there's the obvious stuff, but it seems like human life in general is characterized for many of us by a constant sense of wanting more.

Like if the voice of craving could have a voice, it would say I need something more than what I have in this moment. So it seems to me that there is a, that this is one of, this is not just the obvious stuff that we're working with - something much deeper about human lives. So when I was 19 years old, I worked in a nursing home as a diversional therapist, and I was working with people that were getting to the end of their days. And, and so pervasive is this part of human life that many of them felt really, really disillusioned and disappointed by the fact that they had lived their lives as a means to an end instead of really soaking it up. And they urged me not to make the same mistake.

So I feel like, you know, you just spoke about before, how the Buddha said something, you know, I think he's attributed to saying, you know, that the root of all suffering is the attachment to craving. So what do you, what do you, what are your thoughts on that? What are your comments on that? Well, I agree and our data tend to support that where, you know, that every time we get caught up in a craving, we perpetuate that habit loop cycle. And, you know, it's endless. So the early Buddhist psychologists described it in terms of, they used the term Samsara. Right.

Which literally when translated means endless wandering. Yeah. And so I wonder if the folks that you're describing from the nursing home, you know, at the end of their life, they'd realized that they had been endlessly wandering and were urging you to stop wandering. Now it's interesting somewhere, and this probably has happened, you know, throughout humanity, but somebody described to me that somewhere in Shakespearian times, the excitement was started becoming equated with happiness. And you can think about this in terms of how these, this endless wandering it's perpetuated in our daily lives now where we're constantly bombarded by advertisements that say, you know, you're not enough, or you could have more of this, or, you know, increase your desire or whatever.

That's based on this notion of this, this excited, you know this excitement being happiness, whether we're on a rollercoaster, eating chocolate, having sex, whatever, and not stepping back and saying, you know, is there actually a greater level of happiness that's not based on this treadmill. And when we step back and just rest in being rather than doing, we start to see, oh, this is actually pretty good. And even in a, if you want to bring it back to psychology, you know, in a Skinnerean sense, and so this guy, BF Skinner is famous for these Skinner boxes, where you put a rat in a, in a box that's this color versus this color. And then you shock them in this box. So suddenly it becomes more painful to be in this box than this one.

So they prefer this box over this one. Well in the same way, if we only know happiness as being excitement and suddenly we realize there's another box such as peace and joy, and just an awareness where we're not caught up in things, we can start to find the situations and the conditions that support this as compared to this. Right. It seems like it, it seems like a strange paradox in a human mind to say that finding a deeper level of fulfillment means actually stopping the seeking because we so strongly associate the seeking to the happiness. But yeah, I think that that was the Buddha's really great insight back then.

Wasn't it? It was actually, you could get off the treadmill if you want, and actually find out for yourself by going within and just resting. That there is a deeper level that actually happiness isn't kind of, I don't even the word happiness is a kind of, I think fulfillment resonates more with me, a deeper sense of fulfillment that you can have by just resting in your own beingness. Absolutely. And you can, even in that sense, you can, we can even start to differentiate the type of seeking that most of us are conditioned to do, which often is described as sensation seeking. Like looking, you know, looking for something novel, looking for something new, looking for more looking for this as compared to the seeking that many of us have that's like, oh, this, this isn't quite doing it for me.

So that's when we start turning inward and that seeking becomes a more of an exploration, and again, a curiosity, a question. And those answers come from not getting, but just noticing how our minds work and resting in what is as you're, as you're describing. And you're saying that the research, that the current research out there also supports that what we're saying here? There's a lot of research, and it's still pretty early stages, so there's nothing definitive. So I'll just speak a little bit to some of the research that we've done and some of the work that's been replicated, because I think it's important to be able to replicate results to know if they're they're real. There seems to be, for example, a brain region that's associated with kind of getting caught up.

So when we get caught up in excitement or get caught up in anger or rumination or craving, there's this brain region called the posterior cingulate cortex that gets activated. And the same brain region gets deactivated when we are concentrated on our in breath awareness, doing loving kindness meditation, choices awareness, you know, just an open awareness and even during curiosity or different Christian contemplative practices. So it seems that there's a common element here where this getting caught up in experience. Now the opposite happens when we are getting out of our own way, if you want to think of it that way. When we're not caught up in that excitement and just resting in a more of a boundarylessness where there's just awareness, just being.

Even it's hard, it's hard to describe because it's not about me. It's not about the self. It's not about any of that, you know, that taking things personally. It's just being deeply in touch with the unfolding present moment. So I'd love if, if you could actually walk us through, give us a kind of a simulation as if we had an urge right now in this moment, and maybe some people watching do have an urge in this moment.

So congratulations if you do. Because you have a four-part process, don't you a four-part way of guiding people using mindfulness through an urge, the RAIN process. Would you be able to give us a taste of what that's like? Sure, sure. And this was, I think, first attributed to Michelle McDonald, who's a Western Vipassana teacher or an insight meditation teacher. And we've modified it slightly based on some of the Burmese teachings.

But basically it's the four, the acronym is RAIN. So, and I can, so what's your favorite sugar sweetened thing that you might have an urge for when you are stressed out or something like that? Or maybe that doesn't happen... Oh, it happens. It happens. So what's your pick? We can use that object, so give me an example.

For me, it's dark chocolate. So I don't have a huge sweet tooth, but dark chocolate. Okay, good. Well, dark chocolate is a good one because anything above 70% is considered a health food. But yeah, well if you tell yourself that, that's dangerous.

You see, that's what I found. You tell yourself it's a health food, and then you can eat more apparently. That's what my mind said. Great. So let's say, let's say that we, hypothetically speaking, we've had a rough day and we come home and we're tired and our, you know, it just does not feel very good.

And so, you know, we're not really hungry, but our brain says, you know, why don't I eat some dark chocolate? And so, you know, we see this chocolate, we look at the chocolate, it looks at us. We may have, it's like we have this connection. It says, you know, and I say, yes, you are, you are what I need. So at that moment, we start to get enchanted. It's like the chocolate is playing its little soothsayer, you know, the pipe or whatever to us.

And we start getting enchanted, oh chocolate. Yes, that's what I need. In that moment, the first thing that we need to do is recognize that we're caught up in that craving, because if we can't recognize it, we're going to just go along in that trance and eat the chocolate. We might eat one, two, nibs or eat the whole bar without even paying much attention it. So we have to recognize, that's what the R stands for.

And I even suggest that we relax into it because this isn't about like forcing ourselves not to do things. It's just about like, okay, this is what my brain is doing. This is what my mind is doing. So let's have fun with this. The next step is the A, which is to allow or accept or acknowledge that this craving is there.

So typically cravings are unpleasant. So we want them to go as quickly as possible and we'll say, okay, craving. What do I, what do I do? What do I need to do? Just tell me what I need to do. And it says, eat the chocolate. So we say, okay, you know.

So instead of just, you know, downing the chocolate to make that craving go away or trying to like stuff that craving into our closet, we just step back and allow it to be there. Like, okay, this is what's happening. And that's really helpful because we can't get intimate with our cravings if we tell them to stand on the other side of the room. Right? You stay over there. I'll stay over here.

We'll be cool, okay. We don't know what the craving's like, so how can we work with if it, if it's way over there, if we're kind of suppressing it. So really we have to allow it to be there. The next step is where it gets really fun. So the I is for investigate.

So instead of pushing that craving away, we say, okay, What's happening in my body right now? And we get really curious. It's like we put on our Sherlock Holmes cap and we pull out our magnifying glass and we just start looking just by noticing whatever the sensations are in our body. The key with the investigation is to get curious. Oh, what does this feel like? And then the N, which is often described, described as non identification, as a not taking things personally. We've simplified that in a sense that just simply noting whatever body sensations are present in any one moment.

So we might note that there's tightness and then the next moment there's the tension. And then there's, my mouth's watering because I'm thinking about that chocolate or my shoulders are slightly tight. So I just start noticing, oh, there's this now there's this now there's this, now there's this from moment to moment as I notice what my body sensations are that are making up that craving. And in that sense, if I can follow the algorithm, R-A-I-N, so recognize, allow it to be there, get curious by investigating and noting it, I can start to see, oh, these are just body sensations that are driving my life. They come and go, they come and go.

And I don't have to actually get sucked into them. So that disenchantment, kind of that spell of ebchantment is broken. So when, with the noting, would you, would you kind of maybe even stand there, you don't really have to close your eyes, but would you, you would stand there and actually mentally say to yourself, ah, tightness in the belly, ah, heart's racing, ah. You know that, so you would actually kind of step through and, and mentally note every, just the raw body sensations that you're feeling in that moment. Yes.

And by doing that, there's a deep personalization. You suddenly realize, oh, it's not this craving for chocolate. It's actually this sensation, that sensation, this sensation. Right, right. In that sense, you can think of like, whatever these sensations are, and this is us, they've taken us for a ride.

But if we note, oh, this sensation, tightness, tension, burning, suddenly there's just this and awareness of this. And by definition, by observing it, we're already changing our relationship to it. So we start to see that there's space to respond rather than just being sucked in. Right. So that just reminded me of that, that famous Viktor Frankl quote, what is it? There's a space in between stimulus and response.

And in that space lies our power and our freedom. So this is really what we're doing here, opening up a space for that power and freedom to make choices. Absolutely. Yeah. Well, that's where freedom comes is when we're not sucked into our habits.

Absolutely. And the, so the CravingToQuit app, if people want to actually be guided by you through those in real time in those moments, in the CravingToQuit app, they can, they can use it like that. You will actually walk them through the RAIN process whenever they have an urge?. Yes, we have in both of our apps, so the CravingToQuit app and the EatRightNow app, which is more focused on things like chocolate. Yep, I have to get that one.

We have a, we have a button in there called the 'want to' meter. So anytime I want, you know, like I'm craving a cigarette or in the eating app, I'm craving a chocolate, then I can click on there and I can see, it first walks me through how strong is that craving. So I drop in and start to notice, oh, this is how strong my craving is. And then from there it can walk me through the RAIN exercise so I can really pay attention and ride it out. Now, alternatively, because for example, we all have to eat to live.

You know, if I'm really trying to change my relationship to eating and not getting sucked into stress eating, we also have in the EatRightNow program, mindful eating exercises. So people can stop and start to really pay attention as they consume that food. Because, you know, they might actually be hungry, which is slightly different than cigarettes because we don't need cigarettes to survive. But both of the apps have that RAIN exercise in them so people can really, really have the tools and learn these skills so that then they don't even need the apps anymore. It's more of a skill generating process.

Oh, great. So I just have one more question for you before we close up. And, and that is, if you could go back now with everything that you know now, all the knowledge and wisdom that you've developed through your practice over the past 20 years, and you could go back and give your former self that was just sitting on the cushion for the first time just one piece of advice, what would that be? I would say, notice what you're actually getting from your habits. Pay attention and just see what you're actually getting from what you're doing. That's what I would tell myself.

And I still tell myself. Oh, cool. Thank you so much, Jud. Is there anything else that you would like to share with our viewers before you, before we close up? I don't think so. I think I'll just say, you know, folks are interested in playing with some of these practices, whether your addiction is smoking or eating or anything in between, you know, you can play, we make some of these, the versions of our apps, you know, available for people to try them out for free for a couple of days.

So I would just say, you know, the CravingToQuit or the EatRightNow programs give people a chance to start to play with some of these practices. Jud Doug, thank you so much for your time. I really appreciate it. I really enjoyed this conversation. Oh my pleasure.

Thank you.

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