The Hidden 'Setting' That Controls Your Anxiety

0:00 Okay?

0:00 Theory of constructed emotion.

0:05 This is This is wild, guys.

0:07 Theory of constructed emotion suggests that 50%

0:09 of the emotion that we experience, up to 50%, is actually creatable, modifiable.

0:17 We create our emotional experience.

0:19 And the reason that we are so emotionally

0:24 [ __ ] up is because no one taught us that.

0:27 See, we go through life thinking that our feelings are not ours to control.

0:30 And this is what's so unfortunate.

0:33 We have this like weird therapy speak kind

0:36 of epidemic going on where people are like,

0:38 "You're entitled to your feelings." Right?

0:40 Your feelings are true.

0:43 We sort of take feelings as something that we are given.

0:47 And it's sort of like the feeling is not changeable.

0:50 It's not modifiable.

0:51 You shouldn't even try to change it.

0:52 You should just accept it.

0:54 Like if you feel angry, you're entitled to feel angry.

0:57 We What we sort of say is that if you have an emotion,

1:01 you should accept what it is, accept your emotion,

1:03 don't try to change it, don't try to control it,

1:06 don't try to suppress it, and then down the road, sure your feelings are valid.

1:11 Your conclusions based on those feelings may not be valid.

1:14 The behaviors that the feeling is driving you to do may not be appropriate,

1:18 but the feeling itself is not something that you have any control over.

1:21 So, just accept it.

1:21 Your feelings are true.

1:23 Not the consequences of the feeling.

1:25 We're not saying if you feel angry, you should attack people.

1:27 That is wrong, but the feeling itself is totally fine.

1:31 That's not what the Buddha said.

1:32 And this is what's so interesting is like, you know, a psychia- In psychiatry,

1:36 we get trained that there's no such thing as a good feeling or a bad feeling,

1:40 they're just all feelings.

1:41 And there's a good argument for that, right?

1:42 So, we've evolved to have anger and anxiety for reasons,

1:46 they all serve an evolutionary purpose.

1:48 But, hold on a second.

1:49 Don't we strive for more positive feelings?

1:52 We have words, positive feeling and negative feeling.

1:54 That just happens to not be true.

1:56 So, here's the Here's the insane thing.

1:59 You can actually control what you feel.

2:02 And by control, I don't mean suppress.

2:05 You can control what your emotional gen- what

2:10 emotion is generated in response to a particular situation.

2:15 And that sounds insane, except it's not, and we do this every single day.

2:19 Because when someone comes in with a generalized anxiety

2:23 disorder and experiences anxiety when they're ordering a hot dog,

2:27 and when they go to work, and when they're checking out at the grocery store,

2:30 we will literally alter their the creation

2:35 of emotion within them over the course of treatment.

2:37 That is literally what we will do.

2:40 What we will train them in.

2:43 Interesting, right?

2:43 Because we look at some people and we envy them because they're like,

2:47 "Oh my god, this person responds to this situation with so much resilience,

2:51 whereas I feel hopeless in the same

2:53 situation." There is something special about them, and but hold on a second.

2:58 The only way that that's true is if we start with the assumption

3:04 that the emotion that I create is not modifiable by me.

3:09 And as we have sort of moved towards this emotional acceptance,

3:12 we have actually given up like we've sort of thrown in the towel on a very,

3:17 very, very difficult battle, very important battle,

3:21 which is that you can actually generate a certain kind of emotion.

3:25 You can alter your emotional experience.

3:27 Another really good example of this is imposter syndrome.

3:29 When you look at people with imposter syndrome and they do a good job,

3:33 they generate a certain kind of emotion, which is fear.

3:38 So, literally what happens in their head is they When they do a good job,

3:41 they attribute their successes to circumstances,

3:44 and they attribute the successes of other people,

3:46 when somebody else does a good job,

3:48 it is through their hard work, talent, or effort.

3:51 When I do a good job, it is because of my circumstances or luck.

3:54 The situation is the same.

3:56 I got an A, you got an A.

3:57 When I look at you, my mind generates a certain kind of answer.

4:01 When my mind looks at me, it generates a different kind of answer.

4:04 Those two things also generate a different kind of emotion.

4:07 So, when I look at somebody else succeed, I feel admiration.

4:10 I feel happy for them.

4:12 When I look at myself succeed, I feel panic.

4:15 And this is torture.

4:17 It's adaptive because when I do a good job and I feel panic,

4:21 what do you think I do next time?

4:22 I don't relax.

4:24 That panic drives me to keep doing well, keep doing well, keep doing well,

4:27 which is why we see so much imposter syndrome at places like So,

4:31 I went to medical school at Tufts.

4:32 I did residency at Harvard.

4:34 Way more imposter syndrome at Harvard than there is at Tufts.

4:37 Tufts is like a bunch of people who are like basically going to chillin.

4:39 We like work pretty hard.

4:40 We do a pretty good job.

4:42 We're not the smartest group kids in the class.

4:44 We're sort of okay with that, right?

4:47 We got some gumption.

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5:27 But, you can literally create your emotional experience.

5:30 You can create which emotions come up in the first place.

5:33 And I think Buddhism is I think the best system for this.

5:37 Hinduism in that way is kind of like, "Eh." It's so concerned about that.

5:41 They're like, "Transcend the mind entirely.

5:43 Just like leave it all behind." Whereas the Buddhist they're like,

5:47 "Cultivate compassion.

5:49 Cultivate equanimity." you know, cultivate all these positive emotions.

5:52 So, you can change the way that you emotionally react to things.

5:56 You can generate a different set of emotions.

5:58 And at the beginning,

5:59 this requires a little bit of work because you have to Usually,

6:02 it starts with cognition.

6:04 Literally think about the situation in a different way,

6:07 cultivate compassion for this person.

6:09 What is it like to be this person?

6:11 Let me really try to understand.

6:13 And then another really good example of this is like

6:15 take a look at Think about someone who's like your bully.

6:17 You know, oftentimes, bullies The weird thing,

6:19 right, is that bullies are oftentimes popular.

6:22 And so, you think to yourself like why

6:25 is someone this way when they have everything?

6:28 When they have friends, they're captain of the football team.

6:32 Like what must it be like to have so many of the things that I don't have,

6:36 the things that would make me content,

6:38 the things that would make me feel so much happier?

6:40 And if I had all of those things,

6:42 what would have to be going on inside me to be an ass to other people?

6:49 Changes your perspective.

6:49 And then what happens?

6:50 This is what The cool part.

6:52 This is why it requires training, conditioning, neuroplasticity.

6:55 The first time that we think a different way, it's really hard.

6:58 And then as we think a different way again and again and again and again,

7:02 then it starts to become automatic.

7:04 This is what we do in psychotherapy for generalized anxiety disorder.

7:08 We alter the baseline emotional response that people

7:11 have as they navigate through the world.

7:14 And you can do it, too.

7:16 When you're talking about me changing

7:17 at the fundamental level and not the environment,

7:20 are you talking about changing the ego sense of self?

7:22 I'm actually talking about even a deeper layer than that.

7:25 So, your ego or your sense of self is your identity.

7:27 What we're talking about is changing the automatic response

7:31 that is generated by you in a particular situation.

7:34 Ego responds to that.

7:37 How does ego death affect that?

7:39 It's going to [ __ ] It's is to be a riot.

7:42 Okay.

7:42 Near death experiences and personal values.

7:45 Near death experiences reportedly foster

7:47 value transformations and decrease suicidal ideation.

7:52 89 survivors of near death experiences judged values related to material

7:55 and social success as less important than did 175 control subjects.

8:00 So here's what's really interesting.

8:02 I observed something very strange as a psychiatrist.

8:06 If you look at the data on risk factors for suicide,

8:11 one of the risk factors, no surprise, is a history of prior suicide attempts.

8:16 Another risk factor is completed suicide in the family.

8:21 Now there's a problem with these risk factors,

8:24 which is that what we do with risk factors is we look at a large population.

8:28 Let's say we look at 10,000 people and we look

8:30 at let's say the thousand people the 10,000 people who attempted suicide.

8:34 And then we discover that okay, out of the 10,000 people that attempted suicide,

8:38 3,000 of them attempted it before.

8:41 So we say that's a risk factor, makes sense, right?

8:44 But 7,000 people didn't attempt it before.

8:46 So often times, even though something is a risk factor,

8:49 it's not a risk factor for everybody.

8:52 And something really strange happened.

8:53 I I once had a patient and they had a history of multiple suicide

8:57 attempts and I was doing a safe a safety assessment one day and I said,

9:00 you know, do I need to be worried about you attempting suicide?

9:04 And my patient said, no.

9:05 And I said, why is that?

9:07 And he said, well, you know, the last time I attempted suicide,

9:10 I realized that I'm trying to kill myself and there is something

9:13 within me that wants to live more than I want to die.

9:17 So even though I want to end my life, my heart wants to keep living.

9:22 My liver is detoxifying things.

9:24 My respiratory my lungs are like breathing no matter how much I want to stop.

9:29 So something in me wants to live more than I want to die.

9:33 And that's why I won't try to kill myself.

9:35 I I like, that's a really [ __ ] profound answer, man.

9:40 So, here's the other thing.

9:43 One of the most protective factors,

9:44 and I'm not suggesting that you go do this, and if you're, you know,

9:47 having thoughts about hurting yourself,

9:48 you should absolutely see a mental health professional

9:50 and call 911 and go to the emergency room.

9:53 I really believe that stuff, okay?

9:54 I believe that as someone who's worked in the emergency

9:56 room and helped people when they're thinking about suicide,

10:01 immediately tried suicide, I really don't think it's a good option.

10:05 But, the weird thing is that a passion

10:08 for life can sometimes come from almost dying.

10:13 And this is something that I know sounds crazy,

10:15 but it's actually not when you think about it, right?

10:18 When someone almost dies and they survive, they have a zest for life.

10:24 And it's really interesting because if you look at this paper,

10:26 what they sort of show is that when someone almost dies,

10:31 they divest and detach from social and material success.

10:37 And it kind of makes sense.

10:39 Like, sometimes when people when someone almost dies,

10:41 that their subjective experience will be as like,

10:43 it made me realize what's important in life.

10:47 And that a lot of their lust for life

10:50 improves because they no longer care about money as much.

10:55 They no longer care about being well-liked as much.

10:58 The really interesting thing is that if you look at this paper,

11:01 there's actually, um, let me show you guys.

11:04 It's fascinating.

11:04 Yes.

11:05 So, it did not find that the study group valued self-actualization,

11:09 altruism, or spiritual spirituality more highly than did the control group.

11:12 I think this is a really cool finding.

11:16 Because it's not like spirit, almost dying brings you closer to God

11:20 or makes you meditate more or anything like that.

11:22 It actually doesn't do that.

11:23 Doesn't make you like a better human being.

11:26 All it does is causes you to divest from material and social success.

11:33 As things that are important to you.

11:38 And it decreases your desire to die.

11:40 Fascinating.