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

old personal-zen-screenshot-169x300

 

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.

Keep Your Friends Close…: Technology and the Politics of Fear

Speaking at the Personal Democracy Forum (PDF) 2016 was one of those paradigm-shifting conference experiences for me. Before PDF, I tended to hear technophilic, almost Pollyannaish narratives about how technology can make our lives- and our civic lives – better. I was clearly behind the times because I now see the narrative shifting and morphing into a much more challenging, questioning viewpoint that might be best described by the saying “keep your friends close, but keep your enemies closer.”

In almost every talk I heard, technology and the digital economy was described as a double-edged sword, as a way to ignite change, but with high potential costs, and full of booby traps. Those who create technology? A mixed bag at best. Anil Dash didn’t mince words when he called the technocrats and Silicon Valley billionaires liars and the new robber barons. Kentaro Toyama compared the digital economy to The Matrix, in which our personal data is the lifeblood of same Silicon Valley billionaire evil robot overlords.

I have to admit that I take grim pleasure in the aptness of these metaphors, and have uttered identical words myself. However, it is also clear that these ideas are polarizing and, like extremism in politics, privilege emotions above logic to drive more fractious and divisive discourse. Luna Malbroux’s hilarious talk about “EquiTable,” a faux app she developed to create dialogue about social justice and equity, is a nice example of how to break away from bitter recriminations and instead to use humor as a powerful weapon for change.

But if technology is a very sharp double-edged sword, how do we wield it without cutting ourselves?  How do we, as Yvette Alberdingk Thijm described in her talk about using technology as civic witnesses, harness technology for good without allowing others to use it against us.

Keep your friends close…

PDF yielded many ideas and solutions. I mention only a few below (including mine). I was particularly interested in those ideas and solutions demanding that technology serve humanistic goals and that the well-being of people be part and parcel of how we design and build technology. To do this, we have to open our eyes and take a cold, hard look at how our romance with technology has caused us to take our hands off the wheel (no pun with driverless cars intended).

My talk (text can be found here) centered on technology and mental health. I argued that the psychological and emotional nature of the tech we build is not peripheral or ancillary – it is fundamental to shaping how we use tech for healing. Right not, technology and digital culture is precisely and relentlessly designed to high jack our attention and our emotional brains for the economic benefit of its creators – this is the basis of the attention economy. To gather, mine, and sell our personal data, technology needs to be addictive, keeping us looking, clicking, buying, eyeballs on the screen, swiping, checking, clutching our devices, hoping to hear the next best thing, to feel connected, soothed, and understood. This is counter to health promotion, and creates imbalance instead of balance, weakness instead of strength. The notion that technology is designed to high jack our brains was beautifully and compelling described in a blog post just a few days after PDF by Tristan Harris.

I ended my talk with a call to action, that we must reclaim the technology culture to serve and amplify humanity and well-being, rather than serve the attention economy. We must further anchor this new culture in key values, including the value that our attention is sacred and valuable,  not just the coin of the realm. We must own and be responsible for how we spend our precious attention.

Sherry Turkle observed how our excitement over the rapid pace of technological advances makes us forget some fundamental, common-sense things we know about life. For example, after research suggesting that self-reported declines in empathy among millennials could be caused by growing use of social media and digital communication, one researcher’s solution was to build an “empathy app.” Why would we ever think that technology could make us more empathic, that the thing that might have caused declines in empathy could also be the solution? Dr. Turkle described how many aspects of digital technology actually allow us to effectively hide from the challenges of feeling and expressing emotions in our relationships, to “sidestep physical presence” and seek “frictionless relationships.” Solution – we need to reclaim common sense and realize that we are the empathy app, as Dr. Turkle quipped.

danah boyd called our attention to the immense ethical disconnect in how the digital infrastructure of our civic lives – code – is constructed.  This is an industry in “perpetual beta” and thus there are few if any standards, audits, or inspections of code. There also is little consideration of the resources taken up to maintain the immense glut of data generated every day, and little awareness of how bias and inaccuracy are built into data analytics.  These questions are of the utmost importance because an increasing number of decisions in our personal and civic lives are being made based on algorithms and digital profiling.  She exhorts us to be careful of how and what we code.

…but keep your enemies closer

As in everything, knowledge is power. I felt that we at PDF, speakers, participants, and audience alike, implicitly but universally agreed to keep our eyes open, to look our crush, technology, in the face and see that she may not be on our side anymore but to hope that it’s not too late. Technology is empowering, BUT…. We all agreed to spend more time on the “buts,” as well as on the when, how, and under what conditions we can reclaim technology for humanity. In his PDF talk, Kentaro Toyama evoked the great Isaac Asimov and the First Law of Robotics from Asimov’s “I, Robot” (A robot may not injure a human being or, through inaction, allow a human being to come to harm). In Asimov’s universe, the powers of technology are at their fundamental core designed and harnessed for the benefit of people. I believe that we must and can insist that our technology conform to this higher standard, and that with this as a guiding light, we can wield the double-edged sword of technology for more good than ill.

The Future of Medicine is in Your Smartphone

Picture by Helen Weinstein

A great essay from the Wall Street Journal on the promise and challenges of the smartphone revolution in healthcare – from mobile physical exams, to merging day-to-day health data from wearables with medical records. A key – and underdeveloped – innovation here will be to integrate health tracking with mobile therapies. This transformation of healthcare – both physical and mental – is going to happen, and it is up to us, as patients and professionals, to make sure that it is done right, with the privacy and well-being of the individual as top priorities.

I’ve been interested in some emerging companies, like Mana Health, that are on the cutting edge of this revolution because they are solving the problem of how to effectively merge clinical data with health data collected in the daily lives of patients, and directly empowering patients to have a clear voice in their healthcare and greater collaboration with doctors.

The Body-Data Craze

I’ve been working on a post about the Quantified Self movement. To set the stage for that, I thought I’d post this thought-provoking article from Newsweek.

Today, I’ve been on the phone four times, for an average of 24 minutes a call. my last phone call was 22 minutes 23 seconds long, according to the digital time device on my landline. It took me exactly 45 minutes and 10 seconds on the train to reach Brooklyn the other night: I counted the seconds off on my smart phone. My average mile when I ran 5K yesterday was 8 minutes and 45 seconds that showed up on the pedometer. (Nothing to boast about, I know.) As I was on deadline for this piece, I walked only 4,000 steps, not the advised 10,000. I know I am exactly 45 percent through my friend’s excellent nonfiction book thanks to Kindle (in the past you could have estimated that you’d read more than half). I am able to hold my plank at the gym for 54 seconds rather than the minute I always thought I could, which I know thanks to my phone’s stopwatch. My optimal sleep time is seven hours and 20 minutes and I wake up twice a night: I discovered that from a wristband that measures sleep duration and intensity. I now know for certain what before I only assumed: I always sleep lightly unless I take an Ambien. Continue Reading