WEBVTT 00:00:10.417 --> 00:00:12.001 Let me tell you about my mom. 00:00:13.000 --> 00:00:17.018 My mom was 42 years old when I was born, 00:00:18.292 --> 00:00:22.292 and she started exercising for the first time in her life. 00:00:23.300 --> 00:00:25.300 She started by running around the block, 00:00:25.792 --> 00:00:31.557 and then she started doing 5K races, and then she started doing 10K races. 00:00:32.209 --> 00:00:35.390 And after that, she ran a marathon, 00:00:36.400 --> 00:00:39.762 and after that, my mom did a triathlon. 00:00:40.792 --> 00:00:43.821 By the time she was 57 years old, 00:00:44.292 --> 00:00:50.393 my mom was trekking uphill to the base camp of Mt. Everest. 00:00:51.050 --> 00:00:53.140 (Laughter) 00:00:53.918 --> 00:00:55.836 And let me tell you about my dad. 00:00:56.300 --> 00:00:58.140 (Laughter) 00:01:00.792 --> 00:01:05.376 When I was a kid, my dad used to take me to science classes. 00:01:06.501 --> 00:01:11.849 He was also my calculus teacher in high school. 00:01:12.400 --> 00:01:13.500 (Laughter) 00:01:13.600 --> 00:01:15.800 I wanted to crawl under the desk. 00:01:15.900 --> 00:01:17.300 (Laughter) 00:01:17.700 --> 00:01:19.710 I learned something important from my mom: 00:01:20.000 --> 00:01:22.083 The value of health. 00:01:23.000 --> 00:01:26.792 And I learned something important from my dad: 00:01:27.501 --> 00:01:29.584 the value of science. 00:01:30.209 --> 00:01:35.292 And these two values have guided me on my trek through life, 00:01:35.876 --> 00:01:39.502 and they've helped me appreciate an epidemic that we are all facing. 00:01:40.300 --> 00:01:41.700 And it's not Ebola. 00:01:43.501 --> 00:01:46.960 Instead, it is the epidemic of unhealthy living. 00:01:47.792 --> 00:01:52.138 A half billion people worldwide are obese. 00:01:52.584 --> 00:01:56.876 And you would think that 50 years after the first U.S. Surgeon General's report 00:01:56.918 --> 00:02:02.502 on the dangers of tobacco was published we'd be beyond the problem of smoking. 00:02:03.709 --> 00:02:08.501 Today, a billion people worldwide use tobacco. 00:02:09.292 --> 00:02:14.793 Tobacco and obesity are two of the most preventable causes 00:02:14.900 --> 00:02:16.600 of premature death. 00:02:18.000 --> 00:02:22.000 Solving these problems is like trying to solve a jigsaw puzzle. 00:02:22.417 --> 00:02:25.626 We engage in unhealthy behaviors because of our genetics, 00:02:25.792 --> 00:02:28.126 because of brain neurotransmitters, 00:02:28.127 --> 00:02:32.375 because of environmental influences such as peers and the media. 00:02:33.000 --> 00:02:35.292 Each of those pieces of the puzzle 00:02:35.292 --> 00:02:39.782 are not things that you and I can solve on our own. 00:02:40.918 --> 00:02:45.794 But there is one piece of this puzzle that may hold the key: 00:02:47.292 --> 00:02:52.162 Our choices about what we do with our cravings to engage 00:02:52.162 --> 00:02:55.949 in addictive behaviors like smoking or overeating. 00:02:58.709 --> 00:02:59.942 Our choices. 00:03:00.792 --> 00:03:03.999 There is a new science of self-control 00:03:04.000 --> 00:03:07.501 that may hold the key to reversing these epidemics. 00:03:08.501 --> 00:03:10.584 It's called willingness. 00:03:11.209 --> 00:03:16.001 Willingness means allowing your cravings to come and to go, 00:03:16.209 --> 00:03:20.001 while not acting on them by smoking or eating unhealthy. 00:03:22.083 --> 00:03:28.499 But actually, I'm not talking about willpower, and I'm not talking about 00:03:28.500 --> 00:03:30.100 "power through your cravings." 00:03:30.792 --> 00:03:34.167 Instead, I'm talking about a different notion of cravings 00:03:34.918 --> 00:03:36.821 that looks like this: 00:03:39.258 --> 00:03:42.692 dropping the struggle with your cravings. 00:03:44.209 --> 00:03:47.918 Opening up to them, letting them be there, 00:03:50.100 --> 00:03:52.525 and making peace with them. 00:03:53.501 --> 00:03:55.668 Now at this point you may be very skeptical. 00:03:55.900 --> 00:03:57.610 (Laughter) 00:04:01.000 --> 00:04:04.209 I was when I first heard about it years ago. 00:04:05.083 --> 00:04:08.667 A friend of mine came to me with a book on willingness. 00:04:08.667 --> 00:04:11.001 He said, "Jonathan, 00:04:11.125 --> 00:04:15.085 this book will change your life forever!" 00:04:17.709 --> 00:04:23.501 And I said "Oh, OK... Yeah... yeah, I'll check it out." 00:04:24.000 --> 00:04:29.292 So I went through it and thought, "Nah, this is a bunch of psycho-babble," 00:04:29.400 --> 00:04:30.815 and tossed it aside. 00:04:31.709 --> 00:04:34.082 Until some years later when my wife 00:04:34.083 --> 00:04:37.875 brought me to a workshop on willingness at the University of Washington, 00:04:39.200 --> 00:04:41.800 and I was blown away. 00:04:42.792 --> 00:04:44.433 So then I read the book, 00:04:44.501 --> 00:04:46.710 and then I read a lot of books on willingness, 00:04:46.751 --> 00:04:48.629 and I got trained in it, 00:04:48.792 --> 00:04:53.082 and what I learned was that willingness is part of acceptance 00:04:53.083 --> 00:04:57.292 in the Acceptance and Commitment Therapy approach to behavior change. 00:04:57.400 --> 00:04:59.399 It's a broad approach to behavior change 00:04:59.417 --> 00:05:03.918 that's being used to help people with anxiety disorders, with addictions 00:05:04.209 --> 00:05:05.918 even some innovative companies 00:05:05.919 --> 00:05:09.085 are now using it to help improve their employees' performance 00:05:09.086 --> 00:05:10.584 and reduce their stress. 00:05:11.501 --> 00:05:14.416 Now, to understand why I was blown away, 00:05:14.417 --> 00:05:17.293 you have to understand the world I live in. 00:05:18.292 --> 00:05:20.001 In my research world, 00:05:20.209 --> 00:05:23.793 a common way you help people quit smoking and lose weight 00:05:23.918 --> 00:05:27.127 is you teach them to avoid their cravings. 00:05:27.292 --> 00:05:31.626 Avoid thinking about smoking, distract yourself from food cravings. 00:05:32.709 --> 00:05:36.709 There's a song from a Broadway show that captures this perfectly. 00:05:37.417 --> 00:05:38.818 It goes like this: 00:05:40.000 --> 00:05:44.792 (Singing) When you start to get confused because of thoughts in your head, 00:05:45.000 --> 00:05:47.690 don't feel those feelings, 00:05:47.881 --> 00:05:50.567 hold them in instead. 00:05:53.292 --> 00:05:57.811 Turn it off like a light switch just go click. 00:05:58.300 --> 00:05:59.592 We do it all the time 00:05:59.593 --> 00:06:02.876 when you're feeling certain feelings that just don't seem right. 00:06:02.876 --> 00:06:08.085 Treat those pesky feelings like a reading light and turn them off. 00:06:08.200 --> 00:06:10.100 (Laughter) 00:06:10.292 --> 00:06:12.709 (Applause) 00:06:15.709 --> 00:06:18.126 We all live in this world, 00:06:18.292 --> 00:06:22.584 where the song we keep hearing is "turn off the bad feelings." 00:06:24.000 --> 00:06:28.583 Now, let's take a look at these cookies. 00:06:28.584 --> 00:06:30.472 (Laughter) 00:06:32.792 --> 00:06:37.084 They just came out of the oven ooh, they are so good! 00:06:37.700 --> 00:06:39.400 Ah, they're so delicious. 00:06:39.709 --> 00:06:43.500 Mm-mm, just feel that craving to eat those cookies. 00:06:43.501 --> 00:06:46.501 Ooh, they're lovely, they're so good. 00:06:46.709 --> 00:06:48.210 Now, turn it off! 00:06:48.292 --> 00:06:50.501 (Laughter) 00:06:52.200 --> 00:06:53.700 Turn it off! 00:06:54.209 --> 00:06:56.292 You want those cookies even more now, right? 00:06:57.792 --> 00:07:00.042 You see the futility of trying to turn it off. 00:07:00.334 --> 00:07:02.126 You can't turn it off! 00:07:02.292 --> 00:07:04.210 And maybe you don't have to. 00:07:04.792 --> 00:07:08.477 Maybe, you can leave the light on. 00:07:10.501 --> 00:07:11.793 Here is how: 00:07:12.709 --> 00:07:18.293 My research lab at the Fred Hutchinson Cancer Research Center, here in Seattle, 00:07:18.500 --> 00:07:21.200 is conducting randomized clinical trials 00:07:21.792 --> 00:07:26.791 to see if showing people how to be willing to have their cravings 00:07:26.792 --> 00:07:28.710 is effective for quitting smoking. 00:07:29.292 --> 00:07:32.584 We are conducting trials and face-to-face interventions 00:07:32.709 --> 00:07:39.001 and a telephone quit smoking hotline and a website called webquit.org 00:07:39.209 --> 00:07:42.292 and in an app called SmartQuit. 00:07:43.000 --> 00:07:47.209 These technologies have the potential to reach millions of people 00:07:47.417 --> 00:07:50.293 with interventions that could save their lives. 00:07:51.292 --> 00:07:53.509 That's pretty amazing. 00:07:54.918 --> 00:07:57.001 And let me tell you about the data. 00:07:57.792 --> 00:08:01.875 When you pool together the results from six clinical trials, 00:08:01.918 --> 00:08:04.001 all six that have been published to date, 00:08:04.209 --> 00:08:06.501 including trials conducted by our colleagues, 00:08:07.083 --> 00:08:10.584 what we see is that for the people who were assigned 00:08:10.584 --> 00:08:13.626 to the avoidance approach - avoiding your cravings - 00:08:13.627 --> 00:08:15.678 some of them quit smoking, 00:08:16.000 --> 00:08:18.200 and it varied depending on the study. 00:08:18.792 --> 00:08:24.084 However, for the people who were randomly assigned to the willingness condition, 00:08:24.459 --> 00:08:27.287 twice as many quit smoking. 00:08:28.200 --> 00:08:30.100 Very, very encouraging. 00:08:30.792 --> 00:08:35.208 Now, of course, the data only tell us one small part of the story. 00:08:36.082 --> 00:08:38.875 So, to help you see willingness in action, 00:08:39.792 --> 00:08:42.833 I'm going to weave together experiences I've had 00:08:42.958 --> 00:08:45.251 in counseling people for quitting smoking. 00:08:45.584 --> 00:08:49.085 And I'll together refer to them as one person 00:08:49.100 --> 00:08:50.721 that we'll just call Jane. 00:08:50.918 --> 00:08:56.001 So, as is typical of people who come in to want help for quitting smoking, 00:08:56.100 --> 00:08:58.800 Jane was a 45-year-old person 00:08:59.292 --> 00:09:02.001 who started smoking when she was a teenager. 00:09:02.584 --> 00:09:05.751 She tried to quit smoking several times and was not successful. 00:09:06.000 --> 00:09:08.417 So, she was very skeptical that anything "new" 00:09:08.418 --> 00:09:10.834 was going to be helpful to her for quitting, 00:09:10.918 --> 00:09:14.210 and yet she was really hopeful that this time would be different. 00:09:14.417 --> 00:09:18.792 So, the first thing that I showed Jane was to be willing, 00:09:18.876 --> 00:09:22.377 that is to be aware, of her cravings in her body. 00:09:22.417 --> 00:09:25.001 So to notice where she felt cravings in her body. 00:09:25.300 --> 00:09:26.999 And what I did was I asked her 00:09:27.000 --> 00:09:31.501 to journal that, and just to track the intensity over time, 00:09:31.584 --> 00:09:33.502 and to see if she'd smoke afterwards. 00:09:33.503 --> 00:09:36.584 So in the middle of explaining this, she stops me and says, 00:09:36.918 --> 00:09:41.566 "What are you talking about? I don't have cravings, I just smoke!" 00:09:42.501 --> 00:09:47.208 So I said, "Well, why don't you try it, and we'll see what happens, 00:09:47.209 --> 00:09:49.626 and if it doesn't work, we'll try something else." 00:09:49.627 --> 00:09:52.499 So she came back a week later and she said, 00:09:53.051 --> 00:09:56.259 "You know, I've been tracking my cravings, 00:09:57.390 --> 00:10:00.352 I've been tracking them all the time. 00:10:00.792 --> 00:10:04.293 And now I can't stop thinking about smoking! 00:10:04.400 --> 00:10:07.000 (Laughter) 00:10:07.083 --> 00:10:08.667 What am I supposed to do?" 00:10:09.292 --> 00:10:13.708 Well, before I tell you my answer, let's look behind the scenes. 00:10:13.709 --> 00:10:15.679 Now, what was probably going on here 00:10:15.679 --> 00:10:18.042 was that Jane was having cravings all along, 00:10:18.250 --> 00:10:22.298 and like a lot of us, she was living on autopilot. 00:10:24.209 --> 00:10:25.872 (Laughter) 00:10:27.292 --> 00:10:29.667 You wake up in the morning, you smoke a cigarette, 00:10:29.709 --> 00:10:31.989 you have a cup of coffee, you smoke a cigarette, 00:10:32.009 --> 00:10:34.381 you get in the car, you smoke a cigarette. 00:10:34.381 --> 00:10:37.917 We're often just not aware of what we think, what we feel before we act. 00:10:38.501 --> 00:10:41.501 So, my answer to Jane was to be willing, 00:10:41.918 --> 00:10:44.106 and one of the ways I showed her to do that 00:10:44.107 --> 00:10:47.292 was with an exercise called "I am having the thought". 00:10:48.000 --> 00:10:53.020 So, one of Jane's thoughts before she had a cigarette was, 00:10:53.584 --> 00:10:56.793 "I'm feeling a lot of stress right now, I really need a cigarette." 00:10:56.876 --> 00:10:58.418 So I asked her to add the phrase 00:10:58.419 --> 00:11:00.876 "I'm having the thought" like this. 00:11:00.918 --> 00:11:02.160 "I'm having the thought 00:11:02.160 --> 00:11:05.514 that I'm feeling a lot of stress right now I really need a cigarette." 00:11:05.514 --> 00:11:09.334 Then I asked her to add the phrase "I'm noticing I'm having the thought," 00:11:10.417 --> 00:11:12.917 so "I'm noticing that I'm having the thought 00:11:12.918 --> 00:11:14.918 that I'm feeling a lot of stress right now, 00:11:14.918 --> 00:11:16.334 I really need a cigarette." 00:11:16.334 --> 00:11:21.835 Now, we can all do an exercise like this when we have any kind of negative thought. 00:11:21.918 --> 00:11:26.085 Like for my thought that "I'm boring all of you with my talk" 00:11:26.200 --> 00:11:27.600 (Laughter) 00:11:27.709 --> 00:11:31.126 and I'm having the thought that I'm boring all of you with my talk. 00:11:32.209 --> 00:11:35.501 So, what this exercise did is it gave me a little bit of space 00:11:35.502 --> 00:11:37.800 between me and my thoughts. 00:11:37.918 --> 00:11:39.627 And it's in that space 00:11:40.083 --> 00:11:45.834 that I can choose not to run off the stage in front of 1,500 people. 00:11:45.870 --> 00:11:47.399 (Laughter) 00:11:47.417 --> 00:11:50.709 And the fact is we don't act on every thought we have, 00:11:50.709 --> 00:11:54.293 because if we did, we'd all be in a whole lot of trouble. 00:11:54.350 --> 00:11:56.200 (Laughter) 00:11:56.417 --> 00:12:00.209 So, this was helpful to Jane, but there was something else 00:12:00.210 --> 00:12:03.199 that was really difficult for Jane. 00:12:03.209 --> 00:12:05.459 I felt a lot of compassion for her about it. 00:12:06.209 --> 00:12:08.583 That was the judgment that she felt 00:12:08.584 --> 00:12:11.792 from people when she would be outside smoking a cigarette. 00:12:14.501 --> 00:12:17.710 The criticism from her husband for being a smoker, 00:12:18.501 --> 00:12:22.793 and the self-loathing that she developed about smoking. 00:12:24.292 --> 00:12:28.210 And she dealt with this shame by having a cigarette, 00:12:28.709 --> 00:12:32.293 which gave her relief temporarily until the shame came back. 00:12:33.918 --> 00:12:35.710 So, I said to Jane, 00:12:36.584 --> 00:12:41.085 "What would it be like if we tried to honor this feeling of shame 00:12:41.792 --> 00:12:44.084 as part of the human experience? 00:12:45.709 --> 00:12:50.376 If you had a close friend who is feeling shame about smoking, 00:12:50.600 --> 00:12:51.835 I said to Jane, 00:12:51.918 --> 00:12:57.085 what would you offer this friend as words of caring and kindness, 00:12:58.292 --> 00:13:02.210 and could you then offer those words to yourself, Jane?" 00:13:03.792 --> 00:13:05.090 And she looked up, 00:13:06.292 --> 00:13:12.584 and she had this look of this temporary respite from the shame, 00:13:12.584 --> 00:13:15.001 which made it just a little bit easier next time 00:13:15.918 --> 00:13:17.644 not to act on the craving. 00:13:19.083 --> 00:13:21.375 So, here is the secret to self-control: 00:13:21.709 --> 00:13:24.627 the secret to self-control is to give up control. 00:13:25.918 --> 00:13:27.001 Because otherwise, 00:13:27.002 --> 00:13:32.209 we get into a tug-of-war with a monster, a craving monster. 00:13:33.417 --> 00:13:35.001 And the craving monster says, 00:13:35.083 --> 00:13:40.166 "Come on, smoke a cigarette. Come on, have that cookie. Come on!" 00:13:40.500 --> 00:13:42.296 And you're on the other side saying, 00:13:42.297 --> 00:13:45.166 "No craving monster, I'm going to distract myself from you, 00:13:45.167 --> 00:13:47.167 I'm going to ignore you, no, no, no, no." 00:13:47.167 --> 00:13:50.553 And the craving monster says, "No, no, come on, you know you want it!" 00:13:50.553 --> 00:13:51.829 And you're just back here 00:13:51.829 --> 00:13:54.244 and you're going back and forth and back and forth 00:13:54.244 --> 00:13:56.743 and pretty soon the craving monster overpowers you 00:13:56.743 --> 00:13:59.324 you have that cookie, you have that cigarette, 00:13:59.324 --> 00:14:01.418 until the craving monster comes back. 00:14:01.419 --> 00:14:05.084 And then you're in the tug-of-war again doing what we've learned how to do. 00:14:06.292 --> 00:14:08.214 Unless - 00:14:09.203 --> 00:14:11.490 unless you drop the rope. 00:14:12.203 --> 00:14:13.538 And what you discover 00:14:13.538 --> 00:14:15.918 is that if you just allow the monster to be, 00:14:16.709 --> 00:14:19.210 to occupy a space in your body, 00:14:19.792 --> 00:14:21.293 you discover in a few minutes 00:14:21.294 --> 00:14:24.501 that the craving monster is not as threatening as he appears. 00:14:25.918 --> 00:14:28.210 And sometimes, he even goes away. 00:14:29.918 --> 00:14:33.794 As we break for lunch, we're going to have choices of what to eat. 00:14:33.900 --> 00:14:38.774 (Laughter) 00:14:40.083 --> 00:14:45.667 When you see them, try to be aware of the cravings in your body, 00:14:47.417 --> 00:14:49.626 try to be willing to have those cravings. 00:14:49.626 --> 00:14:51.502 See if they pass on their own. 00:14:52.501 --> 00:14:56.293 Whatever choice you make, try to bring a spirit of caring 00:14:56.294 --> 00:14:58.292 and kindness to yourself, 00:14:59.209 --> 00:15:03.318 for that is the mountain that we are all climbing. 00:15:04.200 --> 00:15:05.500 Thank you very much. 00:15:05.584 --> 00:15:07.586 (Applause)