The Science of Personal Zen

In 2011, I created the stress- and anxiety-reduction app Personal Zen. I’ve written a good bit about the origins of Personal Zen, and my approach to digital therapeutics. But I write much less about how Personal Zen actually works. So here goes…

Personal Zen works by shifting our cognitive biases – invisible habits of thinking and paying attention. When we get anxious or stressed, we pay too much attention to the negatives and have less ability to see the positives in life.

The threat bias hijacks our fear brain and acts as an unconscious information filter, an imbalance in what we pay attention to that makes us actually prioritize threat and negativity at the expense of the positive. When the threat bias becomes a rigid habit of looking at the world, it puts our fight/flight response on a hair trigger, and sky-rockets our feelings of stress and anxiety.

For example, imagine you’re giving a public speech, and there is a smart audience in front of you, bright lights beaming down. If I have an amped-up threat bias, I would very quickly and intensely notice that there is this one person in the audience who is frowning, shaking his or her head, maybe falling asleep. I will fail to notice all the interested and smiling faces in the audience, and get stuck on this person. The natural result – I feel more anxious and stressed, I am on the look-out for further negative information, and I ignore positive evidence that I’m doing a good job. In this way, the threat bias drives the vicious cycle of stress and anxiety, takes up mental bandwidth, and puts us at a disadvantage when there is no real danger to face – when the monsters in the closet are only in our mind.

Yet, there is an empowering message hidden in the idea of cognitive biases. Biases are essentially habits. When we have a bad habit, we are not broken inside, we just need to learn a new habit.

Personal Zen helps us form new mental habits. It embeds techniques that derail the threat bias, which in turn creates the space to learn new habits that help heal the anxious brain. Here’s how it works.

We see both an angry and pleasant face (our cartoon sprites) quickly pop up on the screen. The sprites then disappear, but only the pleasant sprite leaves a trail. Our task is to trace that winding trail. Because the angry and pleasant sprite appear at exactly the same time, our brain is forced to decide which to attend to first. By ALWAYS following the trail of the pleasant sprite, our brains learn to automatically focus first on the positive and disengage from the negative. We start building a new habit of attention: Follow the joy. It’s deceptively simple, but clinical trials show that using Personal Zen changes how our brains respond to threat and reduces stress and anxiety after as little as one session.

When I created Personal Zen, my fundamental dream was to create a mental wellness tool, or even an intervention for serious mental health problems, that is delightful and fun while also being highly effective. It has to be truly “snackable” so it can fit into our lives like a pocket ritual, a chill pill without the pharmacy, where in just a handful of minutes, we are empowered to create a moment of peace in our hectic lives and to find our own personal Zen.

Finding My Personal Zen

I’m excited to announce our new venture, Wise Therapeutics, and the launch of the brand new version of our flagship product, Personal Zen. I am writing this in the midst of the COVID-19 health crisis. My team at Wise Therapeutics and I are offering Personal Zen free for six months in order to make this stress- and anxiety-reduction tool universally available. As we adjust to life under quarantine and beyond, I hope Personal Zen can provide support and be a tool in your toolkit for pursuing well-being in the days to come.

It’s been quite a journey to get to this day. I created Personal Zen in 2011, energized by hope and optimism …. as well as a deep sense of failure.

I became a psychologist and a researcher out of hope – hope that I could help improve the tools we all have to overcome problems like anxiety and depression. But a decade into my career I discovered that while we have excellent treatments and research, we weren’t giving people treatments that work and fit into their lives; Instead, we create treatments that are too expensive, too time consuming, too hard to access, and perhaps most importantly, deeply stigmatizing.

In 2010, while I was pregnant with my second child, I was wrestling with these issues. I decided, perhaps because I was contemplating the birth of my daughter, to give birth to something else – an app for that! Cliches aside, the next decade was a whirlwind of activity as I built and scientifically validated Personal Zen.

Flash forward to 2019, when I co-founded Wise Therapeutics with my partner and dear friend Raj Amin, an absolute guru in the health tech space. We now have the field of digital therapeutics, something that didn’t exist in 2010, when it was very much the Wild West. We are in an era of great digital health tools and forward-thinking companies, but digital health still isn’t working as well as we’d anticipated back in 2010. Why?

Using technology in the service of health is a very sharp, double-edged sword, with high potential costs as well as benefits. These costs are largely due to the elephant in the room – digital technologies have not been designed for our health and well-being. They have been designed for corporate profit. As a result, digital experiences designed for “engagement” are really just designed to keep us looking at our screens to click and buy more. We’re all starting to feel the exhausting burden of this.

The Four Pillars of Personal Zen. So how can Personal Zen – or any digital therapeutic – live in this potentially toxic digital ecosystem? Personal Zen takes a fundamentally different approach, taking the best that technology has to offer while disrupting the digital disruptions of our lives and well-being. To do this, we pursue what you might call the Four Pillars of Personal Zen:

Science: From the beginning, and before many others appreciated the importance of clinical validation, we scientifically tested the effects of Personal Zen. Now, five randomized clinical trials later and counting, we give our community of users a scientifically honed tool, not snake oil.

Effortless: Personal Zen is designed to be non-invasive, used on-the-go, and no therapist required. Our goal is to bring barriers to an absolute minimum so that taking the first step towards mental wellness and stress reduction is easy and seamless. Use Personal Zen on the subway (like I do as a New Yorker). Use it before a big meeting. Use it on the toilet. Because as the next Pillar describes, it just takes a few minutes a day, a few days a week.

Micro-intervention: Personal Zen is all about the power of small. No need to get stuck on the screen for hours – we already struggle with that! As a micro-intervention, our research shows that the “active dosage” to reduce stress and anxiety is about 20-40 minutes a week. This can be divided over multiple days so the extra screen time is only 5 or 10 minutes anytime, anywhere. Slightly more concentrated use – around 20 minutes – can have immediate positive effects to boost resilience in the moment.

Delight: We believe that pursuing mental wellness should be delightful, not stigmatizing, not demoralizing, and not cold and clinical. We’ve designed Personal Zen to be a beautiful, elegant experience that you can reach for anytime.

Read more about how Personal Zen works here.

Blast From the Past….Digital Therapeutics in 2014

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Hmm….how much did I get right? In this guest blog for Brainscape, written eons ago in 2014, I talk about the gamification of mental health, my evidence-based anxiety- and stress-reduction app Personal Zen, and where the field of digital therapeutics – not yet called that! – needs to go.

Blast from The Past – Politics and the Culture of Fear: Is There a Place for Digital Disruption?

With the election less than two weeks away, we’re revisiting a previous post on “Politics and the Culture of Fear: Is There a Place for Digital Disruption?”:

It feels as if we can’t escape the culture of fear and extremism that is pervading politics. Political discourse is more vitriolic than ever after San Bernardino and Paris, and during the months of partisan name-calling and ugly mud-slinging among candidates for the U.S. Presidential Race. And clearly, there are no easy solutions to unraveling this vicious cycle.

During the Christmas holiday, I had an experience that perfectly illustrated this to me. My family and I were at a friend’s house for a holiday event, and I overheard her guests talking as I walked through the kitchen. I heard, “The more he says, the more I like him.” Then, “He says the things we all think but are afraid to say.” I started to get that sick feeling in the pit of my stomach, hoping they weren’t talking about Donald Trump. Then I heard, “The only problem with building a wall between Mexico and the U.S. is that it will have to be so big that it’s impractical and expensive.”  I tried to talk myself off the ledge, saying to myself, “Don’t open your mouth, just keep walking, don’t say anything, it won’t help or change anyone’s mind…..” But then as I was about to turn the corner, safely avoiding a conversation that would surely have turned ugly, I heard, “Of course we should ban Muslims from entering the country. Look what they did in Paris.” So, I turned sharply on my heel and unwisely marched over to the little group sitting around the kitchen table.

“Excuse me,” I said, “but I couldn’t help but overhear your conversation, and I wish that you would consider the fact that excluding or persecuting people solely on the basis of their religion or ethnicity is how (voice rising) the Holocaust started.” And then, when the response to that grenade lob was dropped jaws and the explanation, “It would only be temporary,” I looked at them incredulously, probably with disgust on my face, and said, “That’s what Hitler said and” just in case they didn’t get it the first time, “that’s how the Holocaust started.” Then I abruptly left, muttering, “This was a mistake, I can’t talk about this…..”

I found this conversation terrifying – not only because the thought of Trump as Presidentimages is terrifying, nor because I was disappointed in myself because I lost my cool, and created an extreme, unbridgeable divide between our viewpoints by invoking the Holocaust. No, this conversation was most terrifying because these people were not bad people. They were the type of people I appreciate: good, kind, hard-working people who love their kids and their family.

So where does that leave us?

I don’t have a solution, and indeed, my own extreme reaction during the kitchen table conversation shows that I lack objectivity and am certainly part of the problem. I do, however, as a scientist believe that we can harness what we know about our minds and brains to neutralize this vicious cycle of social and political extremism. Could digital disruption help move us along a path to such change? There might not be an app for that, but below I list three steps I believe could put us on the road towards digital disruption of the political culture of fear.

1. Frame political extremism as an emotion regulation problem. Before any digital disruption can happen, we have to make sense of the problem and have a concept of what’s going wrong. We have all had one of those kitchen table conversations I described above. In these conversations, our emotions get the better of us – fear, disgust, anger. This is a problem in how we control our emotions and how our emotions control our thoughts, decisions, and actions – something psychologists call emotion regulation. The problem is that our strong emotions rarely convince our debating partners. Instead, they solidify the views everyone already holds, causing us to cling to them even more strongly and rigidly. Common ground is lost, and the divide between perspectives seems increasingly unbridgeable.

Imagine how a version of that kitchen table conversation happens on the political world stage, sabotaging attempts at diplomacy and mutual understanding. The result is not just upset and angry people. Now the result is that our emotions directly shape political discourse, legal decisions, and policies that can affect generations to come.

Thus, a first crucial step towards disruption of the political culture of fear is to frame political discourse in terms of emotion regulation – applying what we know about what goes wrong and how to fix it on the individual and group level.

2. Use technology to promote empathy. Recent research in political psychology suggests that empathy can help heal rancorous political divides. A recently-published study showed that when political advocates fail to understand the values of those they wish to persuade, this “moral empathy gap” causes their arguments to fail. However, when political arguments are reframed in the moral terms of the other side, they are more effective. For example, when asked about their views on universal healthcare, conservatives who heard “purity arguments” (e.g., sick people are disgusting and therefore we need to reduce sickness) were friendlier towards universal healthcare, compared to when they heard “fairness arguments,” which are more consistent with liberal values.

If we can use technology to bridge the moral empathy gap, we might be able to reduce political polarization and promote better emotion regulation, more compromise, and deepened understanding. Virtual Reality (VR) might be one such technology. I previously wrote about Chris Milk’s thought-provoking TED talk on VR as the “ultimate empathy machine.” By creating a sense of presence and of real interactions with people and worlds, VR forges empathic bridges leading to greater understanding and compassion. In his work with the UN, Chris Milk uses VR to vividly portray the plight of refugees to politicians and policy makers. How does seeing and experiencing the suffering of 5-year-old children in the refugee camps influence policy making?: Almost certainly for the better.

3. Use technology to calm the fearful brain. As political ideologies become increasingly polarized, neuroscience research suggests that the differences between liberal and conservative viewpoints may extend beyond policy preferences to fundamental differences in the “fearful brain.”

In a paper I wrote in 2014 with Dave Amodio, a professor at NYU, we found that children of liberal compared to conservative parents showed a stronger “N2” brain response to mildly threatening and conflicting information. A greater N2, derived from EEG, suggests more openness to uncertainty, ambiguity, and threat. A culture of fear, in politics or otherwise, is marked by the opposite of this: inflexibility and discomfort in the face of uncertainty and ambiguity, along with resistance to change. These aspects of fear are part of the foundation upon which intolerance is built.

What if we could create computerized interventions that promote our ability to cope with uncertainty and change – perhaps by strengthening the N2 response? My research on the stress reduction app Personal Zen, as well as other research, shows that this may be possible. More research is needed, but if science-driven digital mental health continues to evolve, reducing the political culture of fear could soon be in the palm of our hand.

Mental Health on the Go

My forthcoming research paper reporting on a mobile app that gamifies an emerging treatment for anxiety and stress  – a paper that hopefully will be officially out in the next month or so – is starting to be discussed in the media, including the Huffington Post. Thank you Wray Herbert for such great coverage of the study.

 

 

My Personal Zen

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To follow up on my posts about gamifying mental health, I’m excited to announce that Personal Zen, my science-based (but still fun) stress-reduction game, is ready to share with the world! It’s free in the App Store, so please download it and check it out.

Research from my lab supports its efficacy to prevent and reduce stress and anxiety. Yet, as a game, it’s a beta version and our goal is to get any and all feedback to make it more fun, user-friendly, and effective. So please try it and let me know what you think (either via this blog or the app, which has a “send feedback” button in the menu).

My larger goal is to develop a suite of mobile games for health based on sound scientific principles. As we increasingly curate our own emotional and mental wellness, I think it’s crucial that we have scientifically-supported options to chose among. Because stress reduction is key to wellness, that’s where I’m starting with Personal Zen.

Here’s how it works (as I wrote in the App Store): When we get anxious or stressed, we pay too much attention to the negatives and have less ability to see the positives in life. These habits of attention reduce our ability to cope effectively with stress and can create a vicious cycle of anxiety. Personal Zen helps to short-circuit these habits and frees you up to develop a more flexible and positive focus. You can reduce your stress and anxiety in as little as one sitting, and the more you play, the more you strengthen well-being and vaccinate yourself against the negative effects of stress.

Essentially, the app works by helping people build new habits of paying attention to the world. But building new habits takes some practice, so we recommend spending time with it every week. I love using it on the NYC subways, and it’s truly “snackable” in that using it a few minutes at a time reaps benefits.

If you’re interested in any of the scientific background on the app, I’m happy to share both specific take-home messages and data.