- [Dr. Borenstein] Welcome to "Healthy Minds."

I'm Dr. Jeff Borenstein.

Everyone is touched by psychiatric conditions, either themselves or a loved one.

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(gentle music) Today on "Healthy Minds:" - And so that's a very broad definition of motivated behavior, but it really applies to almost everything that we do in life.

And I think it's really important for us to remember, as a society, that we have a lot of different approaches that we can think about holistically that can all impact the brain.

(gentle music) - This program is brought to you in part by: the American Psychiatric Association Foundation, the John and Polly Sparks Foundation, and the WoodNext Foundation.

Welcome to "Healthy Minds."

I'm Dr. Jeff Borenstein.

We all have bad habits that we may wanna change, and good habits that we may wanna develop.

Habits such as these are referred to as motivated behavior.

Today I speak with leading expert Dr. Nii Addy about motivated behavior.

(gentle music) Nii, thank you for joining us today.

- Thank you so much for inviting me back.

It's great to be here.

- I'm thrilled that you are back.

I wanna jump in and talk about an area of research that you've been engaged in, and it relates to motivated behavior.

First of all, tell us what that is.

- Wonderful question, and something I'm very passionate about.

So when we think about motivated behavior, we can think about that in two different ways: things that we are drawn to, and things that we are drawn away from.

So one term we often use is talking about positively motivated behavior, things that we find rewarding, enjoyable, things that we'll pursue, and negatively motivated behavior, other words, things that we would be avoiding, or find aversive, or something that we would reject.

And so that's a very broad definition of motivated behavior, but it really applies to almost everything that we do in life.

- Could you give some examples of how we're able to sort of encourage the good and discourage the negative in terms of our behaviors?

- Yeah, great question as well.

And we can think about it just in terms of everything we do on day-to-day basis.

So it's very easy when we talk about rewards, to think about things like food or things that we enjoy, and things that we would pursue, and that can be good, but we also know that the good can go to excess.

So let's say that you're someone, I'll make up example, who enjoys spending money, and you're attracted to things where you can spend that money.

If you do that too much and you get yourself into a lot of debt, that can be a problem, obviously.

When we think about negatively motivated behavior, again, the classical sense, we can think about things that are dangerous for us, things that are harmful, and things that we would try to avoid.

So that can be very healthy.

If I'm walking across the street and a car is about to hit me, I need to have some negatively motivated behavior to survive and avoid that thing.

But that can also go into realms where it can be unhealthy for us.

If I've developed a phobia of elevators, and every time I get on the elevator, I feel like I want to run off of that elevator, that can be detrimental.

And so those, of course, are two lighthearted examples, but there are lots of different ways that can show up in our lives on an everyday basis.

- Before we get into some more details about the behaviors and what could be done about them, I'd like you to speak a little bit about the biology of this, the basic science that we're learning about these types of behaviors.

- So in my laboratory, in particular, and a lot of other laboratories, people are looking within the brain to try and see what areas of the brain and what circuits and pathways are important for this motivated behavior.

So one of the things that we look at is reward-related behavior.

So within the brain, deep structures within what's known as the limbic system are really important for these behaviors.

And these are some of the neurotransmitters, or in other words, brain chemicals that people have often talked about in the public as well, so things like dopamine.

Dopamine is very important for reward.

And when we pursue things that are rewarding, we see increased levels of dopamine, that neurotransmitter in the brain, and that's what gives us that feeling that something is enjoyable.

But dopamine is also very important for helping us actually pursue those things that make us feel good.

So whether that's a piece of chocolate, whether that's some coffee, your favorite cake, your favorite dessert, but it's not just for foods, but other things that we find enjoyable as well.

So people have also looked at things like social reward and being in social settings, being in community.

That's also rewarding for our brain.

And we can look at some of those same brain pathways, and see that dopamine is involved, but we also know that it's not just dopamine, but there are lots of other brain chemicals that interact with dopamine, and can change how we respond to different situations.

On the other side, we also know that when negatively motivated behavior comes, that can be when we encounter a fearful situation, something that is a threat to us.

And so there are a lot of neurochemicals, again, in the brain that get activated.

One that we talk about often, again, is still within the mesolimbic dopamine system or this reward center, but it's neurotransmitters like epinephrine and norepinephrine that are released in areas like the amygdala and elsewhere when we approach something that's fearful or will cause us danger.

And so a lot of what we've been able to do is to see how those different brain chemicals respond in different situations, not only in situations that are appropriate, but even in those situations, like I mentioned before, where someone maybe has developed a fear that is unhealthy in a certain situation, and is using negatively motivated behavior in a way that actually is detrimental to them.

- So with this information, what types of treatment approaches are there, whether it be potentially medicine, or talk therapy, or other activities that can help a person build upon their good habits, and maybe avoid some of the negative habits?

- Yeah, an excellent question as well.

And I think it's really important for us to remember, as a society, that we have a lot of different approaches that we can think about holistically that can all impact the brain.

And so sometimes that can be talk therapy.

If someone has a phobia, say, for instance, of snakes, sometimes they can go through talk therapy, and actually talk through that to be able to decrease their emotional response, and actually decrease their brain response in that moment as well.

Sometimes people will use something called exposure therapy, where they may be exposed to that thing that it causes them fear a little bit at a time, again, so that their brain can have a lower response, and they can actually learn not to have that same response.

Another thing that I should also say is we've learned a lot about the circuitry in the brain, and how that helps us respond in different situations.

So we're in this situation that causes us a lot of an emotional response, we are, again, activating areas of the brain and the limbic system that are really important for those emotions.

And that's the area we often talk about when we think about things like our fight, flight, or freeze response.

But we also know that certain areas of the brain, like the prefrontal cortex, are also connected to those areas, those limbic areas of the brain, and the prefrontal cortex can actually help us regulate our emotions.

The prefrontal cortex is also very important for our higher order thinking, for our decision making.

And so some of the treatments that people will get will actually engage the prefrontal cortex, so things like cognitive behavioral therapy, where you might realize that this situation seems very fearful, but it's not as dangerous as I thought it was.

So people can use cognitive processes to basically bring that prefrontal cortex back online when they're having an emotional response, and dampen the heightened emotion they're having to actually move through fearful situations, or move through phobias or those types of things as well.

Because so often if we have stress or anxiety or something that is causing us some fear or uncertainty, we can actually start to believe things that aren't actually true, and we can engage the prefrontal cortex to reorient and reset how we think about certain situations.

- One of the areas that I know you've looked at has to do with the fact that we could change our brains, that the brain is, and the scientific word that we use is plastic, plasticity of the brain, and I'd like you to speak about that, and how it relates to motivated behavior.

- And as you've referenced, plasticity is a term that has also become part of the public dialogue, or the public discourse, in a sense, and something that people are very in tune to.

So one of the things that I always like to say is that all of our experiences can impact and can change our brain.

That can be good experiences, and that can be bad experiences that we have.

So if we're exposed to something that's harmful, if we're exposed to a trauma, there's been a lot of work that has looked at things like adverse childhood experiences, those things can actually change our brains and change how we respond in different situations.

But we also know that medications can change our brain.

So one of the medications that people have been looking at recently is ketamine, which is a rapid antidepressant.

People have also looked at esketamine, and we know that that can also change our brain, and again, as I mentioned, bring about some of these, this more activity in the prefrontal cortex is gonna help us regulate our emotions.

But then also people have looked at spiritual practice and how that can also impact our brain.

So when people are engaged in meditation or engaged in prayer, a lot of studies have shown how that can engage different parts of the prefrontal cortex, and again, impact and change our brain.

We know that substances can change our brain if we've taken substances for a while, but we can also have medications that can change that.

If we have different circumstances before we learn that, you know, when I approached this situation, I thought this outcome was going to happen.

Maybe that outcome didn't happen.

We learned over time that we can get a new outcome.

That can also change our brain.

So hopefully, I know I'm giving a very wide ranging answer, but really, there are so many things that change our brain.

We're learning more and more about that the more research that we do.

- I think the wide ranging answer is right on target, because there are so many ways, and you've touched on a number of them, which I wanna get to.

And let me start with an area that I know is important to you, which is spirituality and faith.

Often as scientists, we may not think about that, but it's very important for so many people.

Could you tell us about the role of faith in changing our brain, in changing bad habits?

- One of my colleagues, Dr. Charles Dike, who is a psychiatrist, had actually looked into some of this as well, and it was really intriguing to see some of the data that continues to emerge.

And so people have actually looked at things like spiritually augmented psychological interventions.

And so some of the studies that have been done have said, well, what happens if we take a group of individuals and look at how they process through different situations, and how that's also impacting their brain?

So one study that I found a few years back was a very interesting study where they were actually looking at people's threshold to a mild amount of pain.

And so what they did is they had three different groups: one group that said they didn't use any spiritual practices, another group of individuals that said they were involved, and you know, participated in meditation, and a third group of individuals who said they prayed to a higher power.

The interesting thing is there was a difference in how much pain these individuals could sustain in this experiment.

I should mention that they didn't do something that was outlandish, so it wasn't something that was going to cause harm to the individuals, but what they found is that those individuals that meditated and those that prayed to a higher power actually had a higher amount of pain they could sustain.

And that's not to say it's diminutive if someone doesn't have those practice, but to show how those practices can actually impact people's responses to difficult situations.

The other intriguing thing is they also looked in their brains as well, and saw different amounts of activity, again, those prefrontal cortex connections with the limbic system.

So it wasn't only that they could withstand more pain, but their brains were actually responding differently to that pain, again, suggesting that that could happen for a long period of time.

And we know from our research with plasticity that when you have a certain pattern that happens over and over again, the brain learns that pattern, makes stronger connections, and that is actually what we describe as plasticity.

And of course, as scientists, there are a lot of different experiments we do to try and understand what happens in the brain in terms of the connections, what happens in terms of the structure of the brain, what happens in terms of the electrical activity that actually facilitates that plasticity, and allows those connections to be even strengthened more.

- On the other side of the coin might be experiences that are negative, such as experiencing trauma, childhood trauma, and how that affects the brain.

And I'd like you to speak towards that as well.

- Yeah, that's been a very important and very fascinating area of research as well.

So people have done experiments and shown not only as you referenced for the trauma that happens in an individual themselves, but sometimes traumas that have happened to previous generations that get passed on to the offspring.

And so it's been really important for us to pay attention to that, and to say that when, for instance, if someone has a very traumatic experience, that can actually heighten this fight, flight, or freeze response in that person's brain, in those areas of their brain, they're important for that response.

So let's say someone was in a situation that was very dangerous for them.

Later in life, they may be in a similar situation that others would think is not dangerous, or is innocuous, is not going to cause harm.

But because of those previous experiences, that person's brain has learned to have what we call a hypervigilant or a more increased response to those certain situations.

And so that's something that's important for us to pay attention to.

But the other thing that's really important is to say and to state that that does not mean that that person is going to be at a loss forever.

If we can pay attention to those changes early on, we can also do things to intervene.

And that goes back to the question you asked earlier about how can we actually have this plasticity in our brain?

So even if someone, for instance, has been exposed to some type of trauma, we can intervene with things like psychotherapy, we can intervene with things like medication, we can intervene with things like integrating spiritual practices, and that can further change that person's brain to help them actually navigate through those specific situations even more effectively.

So we have to think about it from all sides.

- What should we think about when we're talking about children, and parents, what can they do to help their children move towards healthy habits, good habits, away from the negative?

If you're speaking to a parent of a young child, what do you recommend?

- That's an excellent question.

That's one that comes up very frequently, even as I'm talking to elementary school parents or teachers.

And so one of the things that's really important, which I think we are doing a better job of, is just the challenges that people go through, and the challenges that children go through.

For so long, it's been so difficult to have those conversations because of all the stigma that comes about.

So if a child has had a really difficult experience, or doesn't seem to be acting themselves, sometimes we'll just have them just try and move through that without acknowledging the struggles that they're having.

So one of the first things is just acknowledging that those challenges do exist, and then also giving children the space to talk about how they're feeling, and making sure that we continue to do that as children go into their later years in secondary school or high school, and as they grew up so often in so many circumstances, it's been too easy for people to try and put that to the side or not know how to address that and deal with that.

Another thing that has been really helpful, again, is just giving children time to pause and reflect.

So Dr. Michele Borba, who does a lot of work with children, has actually referenced some of the work that's been done in different schools, where the teachers would actually integrate a minute or two of quiet time at the beginning of every class of the day.

These children were allowed to do whatever they wanted.

They could meditate, they could rest, they could relax, or they could just think about what was coming up during the day.

And what they found is that had a dramatic improvement in so many aspects of the children's lives.

Disciplinary problems went down, as she referenced.

Some of their scholastic performance went up just from having that time to pause.

And so that's one of the things that has been really important to have that time to be able to pause, to have that time to be able to reflect, acknowledge when the challenges come up, and then to tap into different resources, where children are actually able to talk through those feelings and to get those processes at a very early age, so that when challenges arise, if they've experienced something that's challenging or negative, they can actually move through.

One story I will share with you, which is from older children, there were a group of girls, I believe this was in the school on the West Coast, a study that was shown that they were having a lot of microaggressions and being mistreated.

Now obviously that was detrimental to the girls.

They weren't able to sleep as well, and they were having some mental health problems as well.

What the staff that school did very wisely was actually to bring those girls together and to give them time to connect as peers, and share their experiences with one another in a structured way, and what they found is that that actually helped the girls process through that.

They started sleeping better, their mental health improved, and so part of that was just taking that time to acknowledge the challenges, and give them time to talk to together as a group in a peer-to-peer counseling type of setting.

And that likely was also impacting their brains.

We may talk about this as well, but the power of community also causes plasticity in our brains and can help us move through some of these challenges, and ultimately improve our motivated behavior.

- In the example you just gave, it just shows how being able to see that other people might be living through what you've lived through can be so helpful for an individual.

You're not alone in having this experience.

- Exactly.

- I wanna shift a little bit about another quote-unquote "bad habit" that parents are concerned about with children, which is social media and screen time.

And I'd like you to speak about how that may be changing children's brains, and what we all should be doing about that.

- This would be an example tying back to even what we said at the beginning of the conversation of something that we could see as a positively motivated behavior.

Children and adults find social media very rewarding.

It's nice to get those likes on our page or our posts or our videos, but that is also something that can be problematic.

There are a lot of different studies that have started to look at the impact of social media and just screen time in general on the brain and plasticity.

One example in particular looked at the engagement in the brain.

So I've referenced this whole idea of social reward, and how that is actually important for us to be able to enjoy that time together as community.

It also leads to increases of molecules like oxytocin that people know is important for creating bonds amongst groups.

But one of the things that people have found is that there's a difference between having that engagement in person versus having that engagement on a screen or social media.

And so in that instance, if you're using social media to excess, you are not building your brain in the same way as you would be if you were having those in-person connections.

The other thing that's really important when we're talking about kids and with youth is the fact that there is an important aspect of expectation.

Expectation plays a key role in how we actually navigate through the world, and how we feel about ourselves and our motivated behavior.

So many times on social media, what people are seeing and what people often talk about is they're seeing the highlight reels of other people's lives, and then often starting to have expectations that their lives should also look the same way.

And so that's going to impact how people actually feel about themselves, how they behave in certain situations, their motivated behavior, and that can negatively impact that motivated behavior.

So for parents who are listening, it's often good to set limits and to set structure.

Sometimes that can cause tension and that can feel awkward, but that is also very important for our brains.

So structure, in particular, helps engage that area of the brain knows as the prefrontal cortex that can help actually regulate our emotions.

So having that structure, even though a child or a teen might rebel against that restructure, can actually be helpful for their brains, can help them process rewards and negative things more effectively, and can help them to also increase the activity in their prefrontal cortex as children are developing, to have more regulation of their emotions and to actually be more mature in their interactions as well.

So a long answer, but a very good question.

- All important information for all of us, especially parents of young kids.

When we were growing up, we didn't have this.

- Exactly.

- But now everybody does.

It's all over.

And for somebody who's watching now, who, they wanna change, but it's hard, it's difficult, what do you say to them?

- I say to them, they've already taken the first step.

And that's a phrase I often use when someone says they want to change, that's great, because they've acknowledged that a change is needed.

And the second step is to be able to try and tap into resources that are available.

So oftentimes it's good to be able to talk to someone else as well, and to actually say what change you want to make, because having someone who you can have that conversation with, whether that's a friend, or a family member, or a therapist, or a psychiatrist, actually helps us create that structure.

And again, as I mentioned before, that's helpful for our brains.

It helps engage our prefrontal cortex, and gives us that structure and that accountability to actually to be able to move forward, and then to be willing to take steps that might be outside of your comfort zone, or outside of one's comfort zone, to actually move forward.

Sometimes it might be things that we think about as small, breaking a habit of maybe procrastination, or wishing that we had more patience with our children, or with our friends, or with our parents, or maybe breaking a habit of excessive use of social media like we talked about, or substances, and so to really avail oneself to all the different tools that are there to be able to move through those things.

And then also, the last thing I'll say is to give oneself grace.

So to know that these things take time, that it's not going to happen overnight, but there are steps that we can make, and to be able to celebrate those steps along the way, and to continue to move forward.

- And don't try to do it alone.

Make use of the people around you, friends, relatives, spiritual leaders.

Don't try to do it alone.

- Exactly, and it's so important, and the science and the neuroscience backs that up as well.

- Where do you see your research in this area going?

What are you looking at moving forward?

If we speak with each other in a couple of years from now about this, what will you be telling us?

- In terms of the research itself, one of the things that we are trying to do is to make sure that these are tools that people can use in their everyday lives in addition to what we are doing within the laboratory, which is also thinking about medications.

And so as we are moving forward in the research, one of our aims is also to be able to take some of that neuroscience information, and disseminate that in a way that's accessible to the general public, so that people can take certain practical tools that they can apply in their everyday lives, so for instance, try and break bad habits, and to also try and build good habits so that as people are moving through and thinking about their motivated behavior, and why they do certain things, to have these tools, have this understanding from neuroscience, that can actually help them to improve their choices, improve their behaviors, improve their relationships, and ultimately improve their lives.

- Nii, thank you so much for joining us today.

Thank you for the work that you're doing, the science, the getting the word out there, all that you do.

I so much appreciate it.

- Oh, thank you, Jeff.

It was a pleasure to be here.

And thank you for this opportunity and for the work that you all do with this program, which I know is so important to your viewers.

(gentle music) - We have the ability to change our brains, whether it be through medication, meditation, therapy, faith.

We can change our brains, and it's best to seek help from family, friends, and others in the process.

Remember, with help, there is hope.

(gentle music) Do not suffer in silence.

With help, there is hope.

This program is brought to you in part by: the American Psychiatric Association Foundation, the John and Polly Sparks Foundation, and the WoodNext Foundation.

(gentle music)