Brain Waves: Cognitive Flexibility

I'm Brandon Stagland. Welcome to One Mind Brainwave. From schizophrenia to depression to post-traumatic stress and addiction, rigid and flexible thinking is a core impairment that's part of many, many different brain health conditions. Today's guest is leading the way in trying to correct this phenomenon. He's a pioneer in the use of deep brain stimulation to improve mental flexibility. And stick around. From a pacemaker for the brain to a vaccine for the mind. A little later in the show, we'll be talking with an author who will share his thoughts on the science of cognitive immunology, why we need and how we can achieve what he calls mental immunity. It's the subject of his latest book. We'll also check in with our team at One Mind Cyber Guide for their mental health app pick of the week and a helpful review on that app. But first, here now to discuss cognitive flexibility, i.e., how we can control our thoughts instead of our thoughts controlling us, is Dr. Alik Widge. He's an assistant professor of psychiatry at the University of Minnesota, where he directs the Translational Neuroengineering Lab. In 2017, he was recognized with a One Mind Janssen Rising Star Translational Research Award for his remarkable work. And he's also since been recognized by a huge NIMH grant to turn his discoveries from his Rising Star Award and his other research into technologies that people can actually use to benefit themselves with their mental health challenges. Alik, congratulations and welcome to Brain Waves.

Thank you so much. It's awesome to be back.

Great to have you back. Always good to talk to you. So viewers, we want to hear from you too. If you have any comments or questions, please post them in the chat of this webcast at any time. And if you're learning anything useful today you think somebody in your life could benefit from, please share this webcast with them too. So, Alik, you and I have talked a lot throughout the years, and this is fascinating stuff. Why is it so critical to our mental health for our brains to be flexible? Give us some examples of how learning to think more flexibly can enable us to make better decisions, live life more fully, perhaps even make us better as people.

So the way I often start by pointing— by talking about this is by pointing out that so many of the mental disorders that we try to treat, because I come at this first and foremost from a clinical perspective as a psychiatrist, that so many of these disorders involve getting stuck. The patients— I do a lot of work with patients with obsessive compulsive disorder, and they will say, well, you know, I know the thing I feel I know it's not going to happen, but I feel like I just can't stop responding to it. I can't stop doing the rituals even though I don't want to. The person with anxiety or trauma will say, I want my life back. I don't want this to control me, but I can't help it. Even the person with an addiction will say the same thing about their cravings, that it's just pulling at them and that—

Yeah.

It's become like a habit that they don't know how to kick. And so this is something that honestly, almost from the beginning of my research career, I've been fascinated by this question of how can we have so many people who say, well, this feeling, this action, it isn't me, it's not what I want, it's not who I am, and yet it controls my life. How do we get— how do so many people across so many different problems get stuck, and of course then, how can we unstick them? Because one of the things, and we're probably going to come back to this in a little bit, even just a little bit of unstickiness, even just kind of putting a little oil in the gears, giving people just a few degrees of shift could make a huge difference. And I often, I like to quote the old proverb that the journey of 1,000 miles can begin with a single step. So you think about, let's go back to that example of someone with severe anxiety or severe OCD. What do we, what the gold standard treatment for those isn't medications, it's exposure therapy. It's working with a compassionate, but very firm therapist who's gonna say, okay, you know the thing you're absolutely afraid of, like leaving your home when the front door actually is unlocked, touching a toilet seat that could be totally crawling with bacteria, going back to that place where you've got tons of triggers because that's where you were assaulted, you're going to go do that. And you're going to go do that over and over and over again until it no longer makes your heart pound, it no longer makes your palms sweat, you realize that it's not dangerous. You learn a new safety memory. And the problem with that is not that it doesn't work. It works great. The problem is getting people to take that first step. It's like the person that— yeah, I mean, I, I'm in Minnesota, we have lakes, and lots of people will get stuck at the edge of a lake, be like, well, I don't know, is it going to be too cold? And once they get in, they're like, oh my God, the water's fine, come on in, come on in, every— everybody. But they've got to take that first step. The patient with anxiety has to just try the smallest version of the exposure exercise. The person with addiction just needs to do that one time, go to an AA meeting. You don't have to share anything, just go. So now it's not so scary when you do it the next time. The person with severe depression who feels like, "Oh, I just wanna stay in bed all day," just needs to get up and take a shower, even if they do nothing else. We tell people, "Fine, go back and lay in bed. Just lay on top of the covers with your clothes on. That's progress for one day." Yeah. They just, that one step, that little bit of maybe today I'll do one thing differently. If they do that today, tomorrow they could do a little bit more. And tomorrow they could, the day after tomorrow, they can do a little bit more. And then suddenly they look back 3 months later and they're like, holy heck, my life's different. I'm better. And of course, then we get to, the clinicians get, we get to act all smug and be like, yeah, we told you. But They've got to start. And so what I think about, why I think this idea of flexibility is so important, is because it can let them take that first little step.

That's fantastic. God, what an amazing way to explain this. And it shows why your work is so important to help people take that first step. You know, as we mentioned, you've been researching the modification of brain circuits to improve mental flexibility. This is how you approach that, that flexibility problem. How has your research progressed since you received the One Mind Rising Star Award in 2017? And what have you discovered? Have you been able to figure out ways you can use brain stimulation to actually help people take that first step?

We've discovered a couple things since I first got the award that I think are bringing us way closer to this idea that we could have therapies that really directly con— target this construct of flexibility and that could do so and could be not just like an antidepressant or an antipsychotic or a medicate or a treatment that's just for this one narrow disorder that— but that really we could be what we call transdiagnostic, that we could build a tool that could be helpful for people with a wide range of problems. And so when I got the award, we already had a lead. We knew that there was one spot in the brain, an area called the internal capsule, or sometimes people call it also the ventral striatum because that's a structure that's right next door. But— and we knew that electrical stimulation delivered there through a surgically implantable device, a deep brain stimulator, it looked like it could make people more flexible. And I got onto this because there had been clinical trials of brain stimulation in this spot for both depression and obsessive-compulsive disorder. Depression— The trial had looked positive, but not positive enough. OCD, it was positive enough and it got an FDA approval. But it's got me really thinking like, okay, well, what's the same about those two apparently totally different disorders? And that was when I realized, wait a minute, that's that stuck inflexibility thing I've been trying to figure out for so long. Oh, okay. Here's a lead. So that's what we knew back in 2017 when I first started talking about this. What we've since discovered is a science of how to measure it and how to more precisely target, tune, and control it. So when I say, oh, there's this spot in the brain, the fact is there's no single spot in your brain. Every brain— every— you know, first off, you're right, your brain, everybody thinks of it as this one organ inside your skull, but it's made of hundreds of different identifiable areas that are communicating together in networks, like different parts of a machine or a computer. But then, just like, okay, your computer's got all these chips in it, but then inside that chip, there's all these little different bits of silicon, different transistors, and each one does a different thing. Each of your brain areas has subparts that are— that you need to understand the subparts in order to figure out its function. So we had a really cool opportunity. We had patients who weren't psychiatric patients, they were in the hospital for epilepsy. But one of the things that happens when somebody has bad enough epilepsy is the surgeons say, what if we try to find where it's coming from in your brain and actually remove that, just that tiny piece of your brain, nothing else, just that? And the answer is, well, okay, but how do you find it? Epilepsy doesn't show up on an MRI. It's not a brain tumor. And what they've— what has been developed over a couple decades now is a science of basically putting— temporarily surgically placing through tiny, tiny holes in the skull, temporarily placing hundreds of little electrodes, little listening posts all around the brain. And then, just like— I mean, literally like the radar installations they're using to search— they're using to search for spy planes or missiles or anything else. It's just listening. And every time the patient has a seizure, you triangulate and say, "Oh, okay, there we go. It's coming from there. That's the spot." You draw a big bullseye around it. So that's what the— that's why the patients are in the hospital. But what that means is they're just sitting there watching daytime television and waiting to have seizures. It is the most boring thing in the world. And so when a young neuroscientist pops up and says, "Excuse me." Would you be interested if we used all those electrodes that you've got in your head anyway, and maybe we tried to study some things that could help people with severe mental illnesses? Would you be up for participating in some experiments? They pretty much— all the patients pretty much like, it's either that or— it's either that or the Hallbach channel. All right, what do you want to do and when can you start? And so what we had was a unique opportunity where some of our patients They were in there for epilepsy, but they had electrodes kind of near this internal capsule spot. And they're very fine-grained, the electrodes are spread really tight. And so what we could do was have them do some laboratory assays, just simple things where they're judging different numbers on a screen, trying to make decisions as fast as they can. And we're— We're— giving little pulses of electricity to different subparts of this internal capsule structure. And with that, we were able to build a map and show that there were subparts within it that were much better levers to pull on. They had bigger effects. Basically, people could make difficult decisions a little bit faster. And then what that let us do was build a mathematical model that would say, okay, you're sitting here, you're making these decisions. I'm using how fast you can make them as an index of how fast your brain can jump from one thought or one topic or one response to another. Now let me watch how fast you're doing in real time, and if I see you going a little bit too slow, that's when I'm going to turn on the stimulation. I'm going to try and speed you up. So that worked. So now we can map out in an individual patient where's their hotspot, where's the perfect place to stimulate for them to give them this flexibility boost— and we've got a mathematical way, either by watching their behavior or we can actually do it just by watching their brain electrical activity, we can build this, this kind of algorithm called a neural decoder— we can tell when they might need a boost. And what— the way I like to describe this is, I think I tell people about bicycles. So, right, let's say you've got to get— you've got someone who needs to get around. You try giving them a bicycle. Now, what if they say, yeah, but there's a really big hill between me and where I want to go, and I just can't get up and on this bike. I'm sorry, I'm not, you know, right, I'm not Tour de France, Tour de France cyclist, I can't do it. Well, you could get them a motorbike and say, okay, no problem, just, you know, motor on up that hill. The problem with that is in the long run, right? If they ride their motorcycle everywhere, the— if for any of your listeners who's watched WALL-E, remember the people, remember the people who are just like going around in their hover chairs, not even barely even able to move because they've gotten so used to machines doing all the work for them? That's no good. That's not what we want. I mean, pay— when pay— I, I will tell you, my patients feel terrible when they— about Oh my God, am I so broken that a machine has to do my thinking for me? And so, but with this flexibility technology, it's like you don't give them a motorcycle, you give them one of those e-bikes that only kicks in when you're pedaling fast enough. So that they start pedaling, but if it senses that they're getting into trouble and they need a little bit of extra help, it helps them. It gives them the work. It's like the spotter who gives you that little bit of extra help when you're weightlifting. It's that coach who's like, come on, you can do one more rep. You got it in you. Let's, let's, let's see it. And I think about, A, as I can get to in a second, this turns out to be potentially pretty clinically effective. But I think about what a cool story, as we, as we bring this technology to the clinic, what, what a better story I can tell people about how— about their own recovery.— that I can tell them, actually, no, it's not that your brain's broken and me, smart doctor, I'm going to fix it. It's that I'm going to give you a tool and then you're going to do the work, but you're going to be more able to do the work. But the person who's in the driver's seat, the person who's in control, the person who's really winning this battle is you. And I can tell you, we are doing a study right now because one of the things— I mentioned addictions as one of the places where there's just I mean, right? At least in depression, we have antidepressants. They don't always work, but at least we have them. In addictions, we have very, very little. And we've been talking to patients about, hey, okay, Neurosurgical Therapy, you gotta have brain surgery, but it might help your addiction. And that message of, but you'll be doing the work and it's a tool you use, really resonates with them. All of them have said— Cool. Wow. That makes a difference. I don't want something that takes away my control. I want something that helps me work my program, work my recovery. So I'm really excited about this.

I can tell.

The other thing I'll say—

It's very exciting.

Is that we have evidence maybe that works. So one of the things when we did this study, and when we were able to track people and speed them up, A couple of them said, hey, I feel different and I feel better. There's a quote in the paper we just published from one of them where she says, well, normally I'm my own worst critic. I've got this like inner narrative, inner voice that's always like weighing me down or telling me that I can't do something or trying to distract me. And it was just less. It was like it couldn't get to me. I could just focus on what I want to focus on. I mean, and Who wouldn't want that? I could use some of that, honestly.

That's fantastic. It's a poem by Mary Oliver. Are you familiar with that poet, Mary Oliver? She's very well known. Talks about how you will hear many voices throughout your life. I'm paraphrasing. There are many voices throughout your life and event, and they'll be telling you, save me, help me, rescue me, do this, do that, do this. One day you're gonna hear your own voice and then you'll know what direction you wanna go in. So I thought, wow, what a great message that is and how much I would like that to happen. I live with schizophrenia, as you know, and many of our viewers know, When I was very sick in the 1990s, I was so scared, my delusions made me so scared that I couldn't, say, drive across a bridge, otherwise something awful would happen. And I was trapped in a small area geographically because I didn't— I was afraid to move beyond that. But a treatment helped me, a variety of treatments helped me together. And so, but The work you're developing is a targeted way to address that, that middle inflexibility. And it doesn't have that shotgun effect that so many medications have with the side effects they have, I imagine. I imagine it's less side effect ridden. Can you talk a little bit about that? How, how is this targeted brain circuit stimulation superior for repairing brain circuits and people's ability to think flexibly than say a medication or talk therapy might be?

Yeah, well, and so the reality is, first off, medications and talk therapy, even in the diseases where we have a lot of approved medications and multiply approved therapies, they work, but something like 30 to 40% of patients get no relief even from that. So what the first versions of this, are going to be, okay, we can help someone who nothing else has helped. That's because the first versions of this are brain surgery, and brain surgery is expensive, and it's a little bit risky, and it's kind of scary, right? I mean, you're giving over— you're giving over control of arguably your most important organ to this doctor who says, trust me, this is experimental, but I totally know what I'm doing. And so The first version of this is, I think, going to be more, all right, nobody— you're trying this because nothing else has worked. But then in the longer run, we should be able to make a non-invasive version. There are new technologies, such as focused ultrasound, that can get to these deep brain spots without surgery. There are ways that we might be able to affect them using clinical technologies I use today, like transcranial magnetic stimulation. Yeah. And when that happens, that's when I think this becomes really exciting and when we want to answer the question that you've just asked about, so is this better than medications or who should use it? Because the fact is— And what I love about a lot of our non-invasive technologies, they're almost totally side effect free, not 100%. Some of them will give you a mild headache, but you don't have to deal with affecting your heart, affecting your kidneys, affecting your liver. It's going to give you diabetes if you take it long enough. Okay, what if you— I mean, so many of my patients are female. Mood and anxiety disorders strike more among women than men. And a lot of them have real— I mean, every month I'm having a conversation with someone about, well, yeah, we'll have to talk about this if you want to try to get pregnant because it's clearly helping you, but it's also got some risk. Yeah. Many, not all of our drugs, but some of them definitely have developmental risks. Brain stimulation doesn't have any of that because it's directly going after the problem, nothing else, right? Mental disorders don't— they have effects below the neck. Your depression can affect your heart, absolutely. But the fact is, where do they exist? They're right here between your ears. And so— If we can target the treatment to just there, nothing else, I mean, and as such remove the side effect burden, that's gotta be huge. The other thing that I think is really exciting about this kind of paradigm about, hey, can we make people more flexible? Can we help them make different decisions? Can we help them get into or work on something rehabilitative or therapeutic that they never have been able to do before? What's exciting about that is, and then maybe we could stop. I mean, I think about, I've had orthopedic injuries in my life and many of your listeners have. And what happens? Sometimes you got to go to a surgeon and you got to have things fixed. But then the first thing the surgeon's going to do is say, great. And now you're doing 3 months of physical therapy to get you back. And then you're going to stop. And then maybe 6 years from now, and I say this from personal experience, every about 3 to 6 years, when one of my old injuries flares back up and I got to go see the physical therapist for 3 months and I have to do the exercises that he or she tells me to do, but then I'm good for another 3 years. And I don't have to take a daily pill and I don't have to use a daily anything or put something on my head or on my knee. I just live my life and I know, okay, I'm going to need to go in for a tune-up every so often, right? I'm like my bike or my car. I need a little bit of preventative maintenance. Imagine the day when that becomes how we treat mental disorders too, that we can tell people, okay, look, now you're in recovery and you can expect to be there for a while. I mean, and because I mean, again, talking with people with depression, one of the things they all, maybe not all, but like 80% of them will say to me is, Okay, so I feel better now, but I'm kind of scared to take on too much at work or make my life too big or do anything too strenuous because what if it comes back? I don't know when it's going to come back and I'm kind of scared that any minute it's going to come up and wreck something right while I'm in the middle of building it. So should I even try to build things? And that—

I've been there.

It takes them a lot of work to get past that. And again, you probably also have have some lived experience with this. And if we could help people get past that, if we could give them some reassurance that no, no, no, it's back in the box for a while, that could be— I mean, I think that that could be huge. Now, I think that this also highlights this isn't going to replace talk therapy. It's going to augment talk therapy. It's going to make it more possible. And of course, this is where you're going to be talking with the CyberGuide folks later about apps. Everybody's like, can you deliver talk therapy therapy through an app? Well, maybe. And maybe you can pair an app with brain stimulation. People are trying that right now. We're trying that in clinic. It's— I mean, there we are on the cusp of some real breakthroughs, I think, in making psychiatry more effective.

It's just fantastic. Fantastic.

It's a fun time to be a clinician.

Yeah, no, that is just really exciting. People talk about brain science as something that is just too complex to understand or even consider learning about. But, you know, like you say, it's not brain science, but you're making it extremely engaging and fun to learn about and attractive because you're offering hope to so many people, I think, who are watching that they may be able to approach therapy or approach treating their illness in a way that they can manage and that is not invasive and they can actually benefit from on an ongoing basis. It's the principle of neuroplasticity comes to mind where it's like, once you work, work out a certain muscle in your body, and by analogy, then it's stronger, and it gets stronger the more you continue to use it, just like the physical therapy analogy. And I've experienced that myself. So yeah, hats off to you. Fantastic. Um, on that note, are there specific exercises one can do to improve mental flexibility, uh, you can kind of do on your own? Is there a way that companies, for example, can promote mental flexibility amongst their employees with such approaches?

It's an interesting question as to what can somebody do on their own. And I think it, it depends a lot on what kind of flexibility you need. I mean, if you're trying to really break through like a genuine trauma level of anxiety or a severe obsessive compulsive disorder, I mean, that— don't go it alone, right? That, that's, that's a get professional help. But you are absolutely right. We can all use a little bit of flexibility and exploration in your life. And honestly, it's, I mean, it's the same thing I tell my daughters every night at dinner. Just try one bite. Just try it. Just even just come— people will often say, and in fact, my employee assistance program does this. They, we get these little daily emails on our wellness site that say like, Okay, today, or this week, we want you to try making a budget. Just try it for a week and see what you like to do, what you like, what you like about it. This week is culture week. We want you every day to learn one new thing about an— about another culture.

And—

Or it'll say, hey, here's a little tip. It may not apply to you today, but think about this way of celebrating diverse colleagues. And you know what? That's honestly— if somebody wants to be more flexible in your life, that's how you do it, is just say today I will do one thing. I will go, I will walk one block out of my way. I will take the turnoff to work one exit early and see what's there. I'll order the thing on the menu down one from what I normally order. Just do one thing different. I mean, that is honestly, that is a practice that I try to do in my own life. And, you know, a lot of times you're like, okay, well, What I've learned is the thing I liked is the thing I like, and there was a reason for that. But every so often it does surprise you.

Yeah, I find that the most meaningful experiences happen when you get outside your comfort zone. It doesn't have to be like, you know, out of the frying pan into the fire, but, you know, doing something a little bit uncomfortable can really pay off and make you feel better and have you learn something in the process. I experienced this just thinking about that yesterday. So, Alik, thank you so much. This is extraordinarily hopeful, everything that you've shared with us today. And really value your time that you spent with us on Brain Waves today. And I hope that our viewers have learned a lot as well. Alik, thank you very much, and look forward to talking with you some more in the near future.

Well, thank you, Brandon. It's all— it's been a pleasure as always.

Up now, he's the founder and executive director of CIRCI, the Cognitive Immunology Research Collaborative. He's also an author whose latest book is called Mental Immunity: Infectious Ideas, Mind Parasites, and the Search for a Better Way to Think. And like our last guest, he too is concerned with helping people understand their world in healthy ways and how to make healthy decisions. Dr. Andy Norman, welcome to Brain Waves.

Thanks very much, Brandon. It's nice to be here.

It's great to have you on the show. Thanks for joining us. And viewers, don't forget to post your comments or questions for our guests at any time. And thank you for watching as well. Also, if you find that the insights being shared by our guests today are of value to you and might be of value to somebody that you know and care about, please share this webcast with them too. So Andy, um, you know, over the last year and a half we've all been talking about infectious diseases and immunity and vaccinations, uh, but let's apply that concept to the brain.

Yeah.

What is mental immunity? Is it simply another way of saying critical thinking? What is it?

Yeah, I think the So the concept of mental immunity is one I coined. Actually, there were— I think some people used it to mean having to do with sort of resistance to emotional contagion, but I'm applying it to the mind's ability to fight off bad ideas. And so yes, it's closely allied to the concept of critical thinking, but I think it takes it much deeper and gives us more insight into what we really mean by critical thinking. So the concept of critical thinking has been around for over a century now, and it still is a vague feel-good term that means, oh, you know, the way we university-educated people like to think, or the way we people who ask lots of questions like to think. It really doesn't tell us much about how to think properly. And so if we— if you really study how the mind interacts with ideas and how it selects out the good ones for keeping and the bad ones for elimination, but often gets it wrong. If you really study that scientifically, you gain deep knowledge of how we can pursue wisdom more effectively. And so that's what my book is about.

That is fascinating. You know, I see wisdom as how you interpret your experiences, what you learn from them, but interpretation is the key. You know, how do we interpret our experiences in healthy ways and would love to learn more from you about how I can do that and how our viewers can help learn to do that as well. You say in your book— well, let's start with one of the core concepts of your book. You say in your book that a bad idea is not necessarily an idea that you happen to dislike, but it's actually more of a harmful idea. What exactly do you mean by bad ideas in terms of what we want our mind to develop a resilience to? And is there an objective set of criteria that we can use to define these bad ideas, or is it more subjective?

Yeah, the real trick is to get away from the idea that the goodness or badness of ideas is purely subjective or just a matter of arbitrary preference. So when you bring that attitude into conversational idea testing, it quickly pulls the rug out from under the whole activity by making it look pointless, because why bother debating the pros and cons of views if truth is all ultimately relative or completely subjective, right? The, the way to get your mind— mind's immune system functioning well is to discard the notion that goodness or badness of ideas is subjective, and instead recognize that ideas actually have properties. They have logical properties, and they have causal properties. They have causal properties because if you believe them or accept them, they have implications for human behavior. If you believe that your wife is cheating on you, you're going to behave in dramatically different ways. So it's important that we embrace true ideas. It's important that we embrace well-evidenced ideas. And it's important that we embrace ideas that serve us well, that serve the cause of human well-being.

Mm-hmm.

And if we hold our ideas to all of those standards instead of just some of them, we end up creating a higher bar, and we end up filtering out more of the bad ideas and filling up our minds with more of the good ones. And that's the key, I think, to making slow, steady progress towards wisdom, something my philosophical mentors and, and forebears have been struggling to find out. How do we become wiser together? If you look around the world today, you'd say philosophy has done a pretty lousy job of making us wiser, right? So I'm trying to get that project back on track by developing this new science that I call cognitive immunology, the science of mental immunity to bad ideas.

Wow. And yes, it's so important to interpret things in a way that is healthy, like you're saying, and your concepts are very novel and innovative, and would love to learn more about how you unpack those concepts of a true idea, a well-evidenced idea, and an idea that serves humanity. And how do we tell? How can we make those judgments within ourselves? Can you elaborate a little on that?

That's a lovely question. Yeah, I think— so philosophers discovered over 2,000 years ago that conversational idea testing, friendly conversational idea testing, is a wonderful way to weed out the bad ones. Here's why. You don't know— you can't always spot the defects in your own ideas, especially the ones you're fond of. So I can gently draw your attention to the defects with questions or challenges or objections. But if I have to do— but I have to do it in a friendly way so you don't feel defensive and push back.

Right.

Meanwhile, you can spot the weaknesses or defects in my ideas and call attention to them by using questions and challenges and objections. So we have to develop a relationship, first of all, where we feel comfortable testing each other's ideas and trusting that the other person really has our best interests at heart, even though they're whittling away at ideas we might have grown fond of. So Philosophers have been practicing this art of conversational idea testing for a long time, and it's basically about creating a space where you can ask clarifying questions first and foremost, and then raising, and then gently calling attention to the defects that you start to see when you look, examine ideas closely.

Okay.

So some people think you need fancy degrees or a lot of big brains to do philosophy. That's nonsense. All you need to do is kind of learn to love this process of collaborative idea testing, and it's something we can all learn in a few weeks and can become so much wiser and so much kinder both to ourselves and to others if we all learn this practice.

Wow, I love this, and we can actually help each other through the process of learning to understand which ideas are healthy to believe and can serve us well. You know, I think that's fantastic.

Yeah, go ahead. If I may add to that, right, we tend to think of learning as adding information to the mind's knowledge stockpile, the mind's information stockpile. But what philosophers realized long ago is that it's also important to subtract out the information that isn't serving us well. So our educational system is built on this idea of adding to the knowledge— mind's knowledge stockpile. Meanwhile, philosophers have been running around saying, "No, no, no, no, no, we have to subtract out the bad stuff too, otherwise we end up kooky ideologues driven by ideas that don't serve us well." Well, was it Lao Tzu, the Taoist philosopher, who said, I think it's in learning, "Every day something is picked up, but in the way of the Tao, every day something is dropped." —I quote a similar sentiment in my book from an economist named Med Jones. He says, um, let's see, "When you know, you acquire something new, and when you become wiser, you lose something old." Or it has to do with subtraction. The path to wisdom involves a lot of subtractive learning.

I like that.

And, um, but we have to be open to the idea that our ideas aren't Perfect. We have to be open to the idea that we have a lot to unlearn as well as a lot to learn.

That is fascinating. And speaking of unlearning, um, we talk about propaganda or disinformation or gossip. Um, you know, these ideas tend to proliferate and spread faster. Uh, they may catch fire in people's psyches more efficiently than what we call healthier ideas that may in fact serve us better. Um, why is it that such ideas are so seductive and infectious?

Yeah, I mean, I think built into that question is a really important insight. It's that ideas often have properties that help them infect minds and spread from mind to mind, even though they're not serving us well. So when conspiracy thinking leaves you paranoid and delusional, and everybody can recognize that there are other conspiracy theories, at least, that are having that effect on other people. Well, the fact is we can get seduced by bad ideas too. In fact, every single one of us is seduced by bad ideas all the time. Or we pick up an idea that serves us pretty well in the— in certain contexts, and then we apply it in new contexts, assuming they'll continue to function well, and it turns out they don't, right? So it's perfectly human and perfectly understandable and not a knock on your intelligence if you pick up bad ideas. We all do it, and we all need to be humble enough to acknowledge that so that we can begin the process of unlearning. I think I may have addressed part of your question, but not all of it. Bring me back.

Yeah, so what— why are these, say, propaganda or disinformation ideas so seductive? Is it because they're simpler and easier to grasp, or what are the properties that make them so so graspable.

Yeah, so take the idea that there's a cabal of elite pedophiles that runs our nation, right? Now, if you feel as though our nation isn't functioning well, and you won't get any argument from me that our nation is not functioning well, it's much easier to believe that that all comes from a deep conspiracy of deep state actors than it is to accept the truth, which is that big democracies are hugely messy processes that take wrong turns all the time. So it's simpler. It makes you feel as though you're in on a big secret. That's part of the seduction of conspiracy theories, right? You can see through, see past the veil of that that blinds everybody else, so you're special. Um, that's a seductive thought. Conspiracy theories also have this sort of built-in way of avoiding falsification. So if evidence comes out that your conspiracy theory is wrong, you can always just say, "Oh, see, the conspiracy runs even deeper than I thought. The global cabal has manufactured this apparent counter-evidence." Right, so there— it's a kind of belief system that's self-insulating, and so it can't be honestly assessed in many cases, or it has a tendency to twist minds and get people deeply invested in an unlikely hypothesis. And so yes, conspiracy theories are like that. Propaganda— the most effective propaganda infects minds and gets people angry and passionate about it. And so if people are using information to hijack your emotions, to whip up your emotions and make you angry, you're almost surely being played by them. And we need to learn that, especially in our time when culture warriors and disinformation spreaders are busy hijacking people's minds all over the place. And too many Americans, I think, are vulnerable to that kind of manipulation by bad actors. And if we can see this and understand how they hack— essentially hack our minds by spreading suspicions of conspiracy and other nonsense, um, then we can regain our freedom and our autonomy. Mm-hmm. From these people who are pulling our strings.

Wow, that's— it's so important to consider how we can address these problems in our society that cause such strife and division. But once, you know, it seems very hard to change these difficult, these dangerous ideas like you were saying earlier. Is it simply Is there a way to neutralize bad ideas once they've taken root? And like, how might that be approached, both for individuals and for our society?

Well, here's what the science indicates, is that it's much easier to prevent a mind infection than to cure one. Now, if I just pick up a wrong idea about the correct exit on the road, you know, the— and miss my exit, you're not going to have a whole lot of trouble correcting that opinion because I'm not terribly invested in it. But if I live with the idea that my political ideology is the correct one for long enough, I've become deeply— I hitch my identity to that idea.

Hmm.

And then I become resistant to challenges to it. And that's really dangerous. There's a reason why we're so polarized and angry at one another, right? Now, it's because we've allowed ourselves to grow too attached to the ideologies that define us. We let ideologies define us rather than say, wait a second here, it's not a good idea to hitch my identity to a controversial ideology. That just closes my mind to all kinds of things that I might otherwise be learning. Far better to hitch your identity to the idea of honest inquiry. Mm-hmm. Or the idea of collaborative idea testing. I mean, tell yourself, I'm not a conservative, I'm a collaborative idea tester. I'm not a liberal, I'm an open-minded seeker of truth. If you can make that mental adjustment, you can rescue yourself and make— and open your mind to learning fabulous new things. And then you become part of the solution instead of part of the problem.

It's all about having an open mind. It's— I remember there have been times when I put my head in the sand like an ostrich, and in part because I didn't want to— like, I was caught up in my own thoughts and didn't want to learn, didn't have a motivation to learn more. But what, what you're saying makes so much sense. There is truth, and there's evidence for the truth. And if we're open to learning new evidence about reality, then we may become more, um, better adjusted to the reality that really is around us and better able to handle the challenges that come our way in our lives and thus make better decisions for ourselves as well.

That's right, and there's no way you can unlearn or rethink something if you take the idea of truth and the idea of true for me and just mush them together as though they're one and the same thing. Everybody starts off with the idea that, yeah, my beliefs seem true to me. Okay, yes, they seem true, but that doesn't mean they are true. There's a kind of objective truth that is always, at least in principle, different from what seems true to you now. And if— unless you are open to the idea that there could be a gap there that can— that we need to explore, you're going to miss out on 90% of the learning opportunities in life.

Yeah, it's like the story of the blind men and the elephant. Everyone perceives a different part of the elephant, but there really is an elephant there that has a greater reality than any of us can perceive individually. So that's why we need each other to learn from each other, right?

Yes, and I like to say that mental immune health is a team sport, and wisdom seeking is a team sport.

Love it.

You can't do it alone, and nor can you do it by just surrounding yourself with a bunch of people who share your views.

You have to seek out people with different views.

And take their objections seriously.

Thank you. Yeah. So that's one great way to build up our mental immunity against dangerous ideas. Are there other objective ways you can talk about that can help us all build up our mental immunity and think, believe healthier, in healthier ways?

Here's a couple of things that I like to emphasize in my teaching on this topic. One is to embrace the idea that I will yield to better reasons. When you come up with a better reason why I should change my mind, I'm going to back down. I'm going to acquiesce. I'm going to submit to the force of the better reason. When you do that, you're essentially embracing what's called the growth mindset, an ability to learn continually. So I call this norm that each and every one of us has a deep, profound moral obligation to yield to better reasons. Mm-hmm. I call this idea reasons fulcrum, because unless you embrace that idea, reasons can't do their job to change your mind. So embrace reasons fulcrum, celebrate it, and try to practice it in each and every day. And also, um, learn to love asking questions, and especially clarifying questions. We all need to ask more clarifying questions and fewer critical or condemnatory question. If you can actually spend a little time at the beginning of a conversation just getting clear about what people mean by things, a lot of times you can navigate past these obstacles that would otherwise frustrate the dialogue. Clarifying questions are a wonderful way to build trust. When I ask you a to clarify what you're saying and give you time to elaborate, I'm saying I'm really interested in what you're saying and I really want to understand what you're saying, because if there's some wisdom in that, I want to learn from it. But if you, if in the process of spelling it out, you start to bring certain problematic features of the idea to light, I'm going to be a friend and gently try to call your attention to those things so that you can learn from them and perhaps grow. Thank you.

I love that.

I think that's the attitude we all need to bring to this wonderful art of idea testing that is the key to becoming wiser.

Yeah, yeah, the growth mindset. That's fantastic. I'm going to say, yeah, no, that's a beautiful, beautiful set of ideas. And maybe what I was thinking about will come back to me as we continue to talk. But you're sparking so many questions in my mind and thoughts that that may help me understand things better if I have them clarified. So let's proceed. So you talked about some solutions for helping people develop a better mental immunity. How can companies foster a work environment of healthier critical thinking amongst their employees? Are there programs or techniques they can promote?

Yeah. So I'm not familiar with the literature on— so there are organizational psychologists who study this kind of thing, and what my understanding is that the best functioning teams are ones that where everyone feels free to raise questions or doubts about other people's assumptions and ideas about the way forward. When you create an environment that celebrates that and rewards it rather than punishes it, or— then group decision-making gets much, much better. You're much more likely to settle on a real solution rather than a fake solution to a problem, and your organization is much more likely to be successful.

Mm-hmm.

So, I mean, the team of scientists that had to work out the details of how to send a man to the moon, Neil Armstrong to the moon, had to work in collaborative teams that were wide open to challenges. Like, no, that's not gonna work because then Neil will die, right? I mean, those are the kind of questions you really want to air. If you want to send Neil Armstrong to the moon and back safely. If anybody, you know, pushes back by, "Oh, quit being a naysayer," or, you know, "Get with the program and stop raising objections. We're trying to get this done," that would very likely have resulted in Neil Armstrong's death and the failure of the whole Apollo mission, right? The way you solve problems, the way you understand problems, is to have groups of minds all explore the territory carefully enough, um, by drawing one another's attention to the pitfalls so that you can navigate around them.

That's a wonderful insight to, to share and to promote. Yeah, thank you. So tell us about your new initiative, the Cognitive Immunology Research Collaborative. What drives your passion for this mission?

Yeah, so I've been really concerned in recent years about the spread of divisive ideologies, conspiracy thinking, science denial, anti-vaxx views, climate denial. These attitudes are threatened— become a deep threat to our democracy, deep threat to our world. And I think cognitive immunology and the strategies it teaches are the key to rescuing our world from this increasingly existential problem. So I'm— I feel very fortunate. I pop out of bed every morning just with a sense of purpose and confident in my belief that I'm on the right track, that I have some solutions here that the world can put to use. So it's a privilege to be able to promote those— this new science. I've named it cognitive immunology, but that research on it goes back decades. And I think this— if we really learn from this science and use it to strengthen our mental immune systems, we can all become less vulnerable to bad ideas, in essence wiser versions of ourselves, and all become part of the solution. Mm-hmm. And we need to do— and we need to apply it fast because our mutual trust is eroding as our divisive politics is— divisive politics and culture wars don't just divide nations, they also damage mental immune systems, making it so people can't think clearly in fair-minded ways. —and right now America is deeply divided, in part because we've been neglecting and abusing mental immune systems for decades. We need to fix that now if we hope to persist as a nation.

Thank you. This is extremely important, the work that you're doing. It's not just, uh, dividing, uh, a nation between factions, but divides families down the middle as well. I mean, families live in— have different points of view, and I was listening to a friend who talked about how they're having a cousin come for Thanksgiving dinner, but they didn't want to get vaccinated due to whatever reason they had. And it just causes challenges within families and discomfort. And there's so many other points about that that we can talk about. But I think that people ever recognize this, because everyone's going through this. So I think everyone will recognize the value of the work that you do to bring people together and, and work collaboratively, um, to, to really understand reality and, and as a basis for something we can agree on. Uh, yeah.

I have a wonderful resource I'd like to share with your listeners. Uh, my very good friend Lee McIntyre is a fellow cognitive immunologist. He just recorded a video for How To Academy, and it's basically how to talk to your relatives about COVID Over the Thanksgiving holidays.

Okay.

He offers some wonderful practical guidelines for how you can keep those conversations constructive and affirming and relationship building while also opening, helping people understand that they have more to learn about this issue. I mean, the reality about COVID is so hugely complex. Nobody has mastered all of it. Every single one of us needs to be open to the idea that we can learn from others. But the idea that we have it all figured out and that the special cabal of vaccine deniers that we've discovered online is the final word on the subject is misleading many people and causing them to adopt profoundly unsafe— help make profoundly unsafe health decisions.

Okay. Yeah, your work is extraordinarily important to heal our society. Thank you. I want to ask you one last question, something we ask at the end of every Brain Waves interview: looking to the future, what gives you hope?

I love the question, um, and I— it's terrific that you make a habit of that. So if you look back a few hundred years, uh, European scientists discovered the germs were the basis of much disease. It was— it's called the germ theory of disease. And that discovery created a revolution, transformed the human condition by giving us better, more reality-based understandings of how to combat disease. It eventually led to a science called immunology that allows us to actually enhance the body's immune system so that it can fight off smallpox and diphtheria and, um, and COVID. I think a new science— I'm sorry, I think the germ theory of cognitive contagion, the idea that our minds can become infected with, um, germ-like ideas, combined with this new science of cognitive immunology, I think could transform the human condition again. And make us dramatically less vulnerable to mind contagion. And when that happens, I think we can build a world so much more peaceful and more prosperous than the one we have now. There's another scientific revolution coming, and it can save us from our own worst instincts, but we have to develop it and we have to start applying its findings now.

Absolutely. It happened before with the germ theory and the revolution in immunology for physical diseases. It can happen again with mental immunology. And thank you for developing this science. And it brings to mind the idea that I am not my thoughts. I am not my ideas. Such a healthy thing for me personally to recognize, having lived with my own actually psychotic delusions, having had schizophrenia over 31 years. And that has freed me and liberated me, that idea has. Thank you. From— well, to enable me to go move in new directions that are actually healthier. So hats off to you and the work you do.

That's a beautiful insight. And of course, that's the core of mindfulness practice, is learning not to identify with the stream of ideas that happen to pop into your mind. And in the same way, we can learn not to identify with the beliefs that happen to take root in our minds. And in both cases, the result is freeing and health-enhancing.

Thank you. Thank you for enhancing all of our health today with your great good ideas and healthy ideas that you're sharing today. Very much appreciated. Thank you, Andy. Viewers, thank you too. Before we leave you, here is our team at One Mind Cyber Guide for a helpful review of their mental health app pick of the week. Take it away, Cyber Guide team.

Hi, my name is Steven Schuler, and I'm the Executive Director of One Mind Cyber Guide. You probably already use your phone for many things throughout the day, but did you know that there are also apps to help you manage your mental health and well-being? There are literally thousands of mental health apps available for download today. With so many choices to choose from, it can be hard to separate the good from the bad. That's where One Mind Cyber Guide comes in. Can help. At One Mind Cyber Guide, we review apps on 3 different metrics: credibility, user experience, and transparency. We've reviewed over 200 products, and all of these reviews are available for free on our app guide at onemindcyberguide.org. If you're interested in using a mental health app and you already see a therapist, try working with them to find an app to integrate into your treatment. They may have their own recommendations for apps or may suggest ways to use an app to add on to the work work you're doing in therapy. In the age of technology, it's still as important as ever to build connections and a community of support for mental health. Why not use apps as a starting point for conversations around mental health, just as you might suggest a helpful app to a friend who needs help with their time management, fitness tracking, or navigation? The more we normalize these conversations, the better chance we have of decreasing mental health stigma. CogniFit is a cognitive training program intended to help users improve brain functioning. By playing specially created games, users can address many core cognitive functions, including working memory, visual processing speed, and attention. The user is prompted to complete an initial 10-minute cognitive assessment, customizable for each user and their goals. Training programs range from targeting dyslexia, insomnia, or driving skills. Cognifit allows users to track progress over time and compare scores with those of others. Is intended to provide diverse programs suited for many users, not just those looking for remediation of cognitive difficulties. Cognifit scores highly on our credibility metric, receiving a score of 4.67 out of 5, highly on our user experience metric, receiving a score of 4.24 out of 5, and receives an acceptable score on our transparency metric, around data security and privacy. We look forward to seeing you next week for another app review.

Thanks, CyberGuide team. And also thank you to Dr. Andy Norman and Dr. Alik Widge for sharing their wisdom and insights with us today. Please don't forget, you can check out all of our past Brain Waves episodes at onemind.org/brainwaves, where you can also sign up for our newsletter to be alerted of any new Brain Waves episodes coming out. Everyone, thank you for watching and participating today. Look forward to seeing you again next time. Take care. You're feeling anxious, afraid, alone.

I haven't been able to see my family or my friends.

Families that struggled to find mental healthcare before find it even harder now. I feel a lot of guilt in not being with my family. Are there solutions? Visit onemind.org. Seeking the answers, bringing help to those who need it. To the front lines, accelerating brain health for all. Help us fund new treatments at onemind.org.