Anxiety specialist Dr. Jud Brewer gives a 2016 TED talk on how to break a bad habit.

Conversations on COVID: Breaking the anxiety cycle

Dr. Jud Brewer, director of research and innovation at Brown’s Mindfulness Center, explains how practicing mindfulness can curb the spread of coronavirus anxiety in individuals’ personal lives and social circles.

PROVIDENCE, R.I. [Brown University] — As coronavirus continues to reach new corners of the globe, it has inspired countless conversations among medical practitioners, public health officials and political authorities about how to stop its biological spread.

But the disease has also created what Dr. Jud Brewer, director of research and innovation at the Mindfulness Center at Brown, calls a “second contagion” — a far-reaching sense of anxiety that is infecting personal habits and social interactions.

“Anxiety is that feeling of worry or unease that comes when we face an uncertain outcome,” Brewer said. “You can imagine how this feeling would increase when we are smack dab in the middle of an uncertain situation like we are now.”

As a researcher and clinical psychiatrist, Brewer uses mindfulness — which he describes as the practice of cultivating a “curious awareness” about how one’s own mind works — to help patients prevent worrying from becoming a habit.

“When worry goes up, anxiety goes up, and when anxiety goes up, worry goes up,” he said. “Mindfulness can help our brains let go of this habit that isn’t helping us.”

To help people break this anxiety cycle in the midst of COVID-induced uncertainty, Brewer has used his YouTube channel to teach people how mindfulness can reduce worry arising from the coronavirus pandemic. Each day, Brewer posts a brief video focused on a specific issue arising from coronavirus anxiety, such as news addiction or how anxiety becomes panic. He also hosts an interactive livestream, called “Office Hours with Dr. Jud,” during which he answers questions from listeners from around the world.

“As a practicing psychiatrist who studies habit change and anxiety, I happen to have a skill set that’s really needed right now,” Brewer said. “There are so many aspects of mental hygiene that are relevant to what’s currently happening.”

In this Q&A, Brewer draws upon his clinical research to explain what mindfulness is and how it can help to curb the spread of anxiety in individuals’ personal lives and social circles — even during this uniquely anxious time.

Q: How do you describe what mindfulness is?

Some describe mindfulness as seeing clearly and particularly focusing on seeing how we’re pushed and pulled by circumstances. But I really understand mindfulness as being aware of how our mind works. If we can see what’s driving us, then we can get back in the driver’s seat and drive ourselves.

If we don’t know how our minds work, there’s no way we’re going to be able to work with them. If our car is misaligned, and we just keep yanking at the steering wheel to keep it going straight — not only do we get fatigued, but we wear out our tires. Similarly, a lot of the coping mechanisms that we develop don’t really reduce anxiety — we distract ourselves, we eat food, we do all sorts of things that might feel like they’re doing something, but they’re actually making things worse in the long term.

Q: How does practicing mindfulness help patients manage typical anxiety?

You’re really putting people back in the driver’s seat with mindfulness. Being aware of how our mind works in a moment of anxiousness helps us see how unrewarding a behavior like worrying is. Worrying just perpetuates anxiety, because worrying doesn’t actually fix whatever the problem is, and it feels bad, which just feeds more anxiety, which in turn feeds more worry.

Practicing mindfulness also helps us see how awareness itself can be rewarding. Curious awareness is the ability to focus on what you are experiencing instead of trying to understand why it’s happening. Because curious awareness feels better than getting caught in worry, it then becomes a new habit that replaces the old, harmful one. I actually give my patients the mantra, “hmm,” because it’s a great way to engender curiosity in the moment you feel worry.

Q: Is there anything unique about how anxiety is manifesting in this moment?

There are three ways that it’s unique. First of all, nobody alive has experience with a pandemic of this magnitude, which makes it difficult for other people to reassure us. Secondly, we don’t know the contagion level for this particular coronavirus because we don’t have enough testing in place yet. So that’s a crazy big unknown in the current situation.

Add to these factors another contagion — social media, which is magnifying our sense of threat, thus increasing the anxiety we’re already feeling. With people sneezing on your brain from anywhere in the world, with us not knowing how widespread this is yet, with nobody having had experience to say, “I know what to do,” the current situation is not necessarily reassuring.

Q: How can people practice mindfulness to manage anxiety in this COVID moment?

I would start by having them pay attention to and map out habit loops surrounding worry. Every time they start to get anxious or get worried, they can map out: What’s the trigger for this worry? What’s the result of it? What do I get from this?

My wife was talking about this this morning. She’s been using this when she wakes up in the middle of the night worried about something. She asks herself, “What do I get from this?” And that helps her brain see that her worry isn’t actually helping her solve anything. It’s just making hard for her to sleep. And so her brain naturally becomes less excited to do it in the future.

Q: What inspired you to begin publishing daily COVID updates on your YouTube channel?

I’ve been seeing a lot of people focused on the physical manifestations of coronavirus — how not to get infected — but no one really has been talking about coronavirus anxiety, the mental hygiene aspect of things. So I thought, well, why don’t I put together short videos every morning based on what’s actually happening?

These videos are pragmatic — they provide short practices that viewers can use right away. As a clinician, I always ask, “What can I do to help my patient today?” I was moved to help. I still am every day. I wake up early and am just motivated because this work needs to be done.

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