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Let me tell you about my mom.

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My mom was 42 years old when I was born,

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and she started exercising
for the first time in her life.

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She started by running around the block,

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and then she started doing 5K races,
and then she started doing 10K races.

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And after that, she ran a marathon,

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and after that, my mom did a triathlon.

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By the time she was 57 years old,

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my mom was trekking uphill
to the base camp of Mt. Everest.

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(Laughter)

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And let me tell you about my dad.

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(Laughter)

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When I was a kid,
my dad used to take me to science classes.

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He was also my calculus teacher
in high school.

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(Laughter)

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I wanted to crawl under the desk.

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(Laughter)

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I learned something important from my mom:

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The value of health.

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And I learned something
important from my dad:

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the value of science.

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And these two values have guided me
on my trek through life,

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and they've helped me appreciate
an epidemic that we are all facing.

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And it's not Ebola.

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Instead, it is the epidemic
of unhealthy living.

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A half billion people worldwide are obese.

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And you would think that 50 years after
the first U.S. Surgeon General's report

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on the dangers of tobacco was published
we'd be beyond the problem of smoking.

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Today, a billion people
worldwide use tobacco.

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Tobacco and obesity
are two of the most preventable causes

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of premature death.

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Solving these problems is like
trying to solve a jigsaw puzzle.

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We engage in unhealthy behaviors
because of our genetics,

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because of brain neurotransmitters,

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because of environmental influences
such as peers and the media.

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Each of those pieces of the puzzle

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are not things that you and I
can solve on our own.

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But there is one piece of this puzzle
that may hold the key:

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Our choices about what we do
with our cravings to engage

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in addictive behaviors
like smoking or overeating.

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Our choices.

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There is a new science of self-control

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that may hold the key to reversing
these epidemics.

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It's called willingness.

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Willingness means allowing
your cravings to come and to go,

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while not acting on them by smoking
or eating unhealthy.

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But actually, I'm not talking about
willpower, and I'm not talking about

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"power through your cravings."

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Instead, I'm talking about
a different notion of cravings

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that looks like this:

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dropping the struggle with your cravings.

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Opening up to them,
letting them be there,

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and making peace with them.

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Now at this point
you may be very skeptical.

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(Laughter)

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I was when I first heard about it
years ago.

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A friend of mine came to me
with a book on willingness.

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He said, "Jonathan,

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this book will change your life forever!"

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And I said "Oh, OK...
Yeah... yeah, I'll check it out."

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So I went through it and thought,
"Nah, this is a bunch of psycho-babble,"

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and tossed it aside.

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Until some years later when my wife

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brought me to a workshop on willingness
at the University of Washington,

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and I was blown away.

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So then I read the book,

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and then I read a lot of books
on willingness,

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and I got trained in it,

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and what I learned was
that willingness is part of acceptance

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in the Acceptance and Commitment Therapy
approach to behavior change.

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It's a broad approach to behavior change

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that's being used to help people
with anxiety disorders, with addictions

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even some innovative companies

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are now using it to help improve
their employees' performance

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and reduce their stress.

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Now, to understand why I was blown away,

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you have to understand
the world I live in.

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In my research world,

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a common way you help people
quit smoking and lose weight

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is you teach them to avoid their cravings.

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Avoid thinking about smoking,
distract yourself from food cravings.

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There's a song from a Broadway show
that captures this perfectly.

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It goes like this:

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(Singing) When you start to get confused
because of thoughts in your head,

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don't feel those feelings,

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hold them in instead.

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Turn it off like a light switch
just go click.

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We do it all the time

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when you're feeling certain feelings
that just don't seem right.

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Treat those pesky feelings
like a reading light and turn them off.

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(Laughter)

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(Applause)

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We all live in this world,

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where the song we keep hearing is
"turn off the bad feelings."

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Now, let's take a look at these cookies.

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(Laughter)

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They just came out of the oven
ooh, they are so good!

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Ah, they're so delicious.

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Mm-mm, just feel that craving
to eat those cookies.

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Ooh, they're lovely, they're so good.

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Now, turn it off!

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(Laughter)

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Turn it off!

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You want those cookies
even more now, right?

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You see the futility
of trying to turn it off.

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You can't turn it off!

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And maybe you don't have to.

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Maybe, you can leave the light on.

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Here is how:

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My research lab at the Fred Hutchinson
Cancer Research Center, here in Seattle,

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is conducting randomized clinical trials

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to see if showing people
how to be willing to have their cravings

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is effective for quitting smoking.

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We are conducting trials
and face-to-face interventions

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and a telephone quit smoking hotline
and a website called webquit.org

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and in an app called SmartQuit.

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These technologies have the potential
to reach millions of people

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with interventions
that could save their lives.

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That's pretty amazing.

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And let me tell you about the data.

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When you pool together the results
from six clinical trials,

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all six that have been published to date,

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including trials
conducted by our colleagues,

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what we see is that for the people
who were assigned

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to the avoidance approach -
avoiding your cravings -

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some of them quit smoking,

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and it varied depending on the study.

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However, for the people who were randomly
assigned to the willingness condition,

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twice as many quit smoking.

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Very, very encouraging.

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Now, of course, the data only tell us
one small part of the story.

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So, to help you see willingness in action,

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I'm going to weave together
experiences I've had

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in counseling people for quitting smoking.

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And I'll together refer to them
as one person

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that we'll just call Jane.

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So, as is typical of people who come in
to want help for quitting smoking,

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Jane was a 45-year-old person

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who started smoking
when she was a teenager.

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She tried to quit smoking several times
and was not successful.

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So, she was very skeptical
that anything "new"

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was going to be helpful
to her for quitting,

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and yet she was really hopeful
that this time would be different.

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So, the first thing that I showed Jane
was to be willing,

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that is to be aware,
of her cravings in her body.

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So to notice where she felt cravings
in her body.

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And what I did was I asked her

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to journal that, and just to track
the intensity over time,

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and to see if she'd smoke afterwards.

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So in the middle of explaining this,
she stops me and says,

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"What are you talking about?
I don't have cravings, I just smoke!"

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So I said, "Well, why don't you try it,
and we'll see what happens,

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and if it doesn't work,
we'll try something else."

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So she came back a week later
and she said,

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"You know, I've been tracking my cravings,

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I've been tracking them all the time.

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And now I can't stop
thinking about smoking!

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(Laughter)

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What am I supposed to do?"

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Well, before I tell you my answer,
let's look behind the scenes.

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Now, what was probably going on here

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was that Jane
was having cravings all along,

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and like a lot of us,
she was living on autopilot.

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(Laughter)

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You wake up in the morning,
you smoke a cigarette,

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you have a cup of coffee,
you smoke a cigarette,

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you get in the car, you smoke a cigarette.

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We're often just not aware of
what we think, what we feel before we act.

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So, my answer to Jane was to be willing,

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and one of the ways
I showed her to do that

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was with an exercise called
"I am having the thought".

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So, one of Jane's thoughts
before she had a cigarette was,

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"I'm feeling a lot of stress right now,
I really need a cigarette."

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So I asked her to add the phrase

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"I'm having the thought" like this.

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"I'm having the thought

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that I'm feeling a lot of stress right now
I really need a cigarette."

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Then I asked her to add the phrase
"I'm noticing I'm having the thought,"

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so "I'm noticing
that I'm having the thought

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that I'm feeling
a lot of stress right now,

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I really need a cigarette."

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Now, we can all do an exercise like this
when we have any kind of negative thought.

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Like for my thought
that "I'm boring all of you with my talk"

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(Laughter)

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and I'm having the thought
that I'm boring all of you with my talk.

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So, what this exercise did
is it gave me a little bit of space

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between me and my thoughts.

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And it's in that space

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that I can choose not to run off
the stage in front of 1,500 people.

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(Laughter)

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And the fact is we don't act
on every thought we have,

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because if we did, we'd all be
in a whole lot of trouble.

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(Laughter)

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So, this was helpful to Jane,
but there was something else

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that was really difficult for Jane.

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I felt a lot of compassion
for her about it.

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That was the judgment that she felt

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from people when she would be
outside smoking a cigarette.

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The criticism from her husband
for being a smoker,

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and the self-loathing
that she developed about smoking.

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And she dealt with this shame
by having a cigarette,

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which gave her relief temporarily
until the shame came back.

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So, I said to Jane,

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"What would it be like
if we tried to honor this feeling of shame

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as part of the human experience?

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If you had a close friend
who is feeling shame about smoking,

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I said to Jane,

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what would you offer this friend
as words of caring and kindness,

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and could you then offer those words
to yourself, Jane?"

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And she looked up,

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and she had this look of this temporary
respite from the shame,

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which made it just
a little bit easier next time

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not to act on the craving.

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So, here is the secret to self-control:

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the secret to self-control
is to give up control.

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Because otherwise,

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we get into a tug-of-war with a monster,
a craving monster.

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And the craving monster says,

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"Come on, smoke a cigarette.
Come on, have that cookie. Come on!"

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And you're on the other side saying,

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"No craving monster,
I'm going to distract myself from you,

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I'm going to ignore you,
no, no, no, no."

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And the craving monster says,
"No, no, come on, you know you want it!"

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And you're just back here

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and you're going back and forth
and back and forth

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and pretty soon the craving monster
overpowers you

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 you have that cookie,
you have that cigarette,

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until the craving monster comes back.

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And then you're in the tug-of-war again
doing what we've learned how to do.

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Unless -

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unless you drop the rope.

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And what you discover

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is that if you just allow
the monster to be,

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to occupy a space in your body,

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00:14:19,792 --> 00:14:21,293
you discover in a few minutes

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00:14:21,294 --> 00:14:24,501
that the craving monster is not
as threatening as he appears.

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And sometimes, he even goes away.

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As we break for lunch, we're going to have
choices of what to eat.

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00:14:33,900 --> 00:14:38,774
(Laughter)

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00:14:40,083 --> 00:14:45,667
When you see them, try to be aware
of the cravings in your body,

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00:14:47,417 --> 00:14:49,626
try to be willing to have those cravings.

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See if they pass on their own.

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00:14:52,501 --> 00:14:56,293
Whatever choice you make,
try to bring a spirit of caring

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and kindness to yourself,

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for that is the mountain
that we are all climbing.

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Thank you very much.

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(Applause)