#360 ‒ How to change your habits: why they form and how to build or break them | Charles Duhigg, M.B.A

View the Show Notes Page for This Episode https://peterattiamd.com/charlesduhigg/?utm_source=podcast-feed&utm_medium=referral&utm_campaign=250811-pod-ericverdin&utm_content=250811-pod-charlesduhigg-podfeed Become a Member to Receive Exclusive Content https://peterattiamd.com/subscribe/?utm_source=podcast-feed&utm_medium=referral&utm_campaign=250811-pod-ericverdin&utm_content=250811-pod-charlesduhigg-podfeed Sign Up to Receive Peter's Weekly Newsletter https://peterattiamd.com/newsletter/?utm_source=podcast-feed&utm_medium=referral&utm_campaign=250811-pod-charlesduhigg&utm_content=250811-pod-charlesduhigg-podfeed Charles Duhigg is a Pulitzer Prize-winning journalist and best-selling author known for distilling complex neuroscience and psychology into practical strategies for behavior change, performance, and decision-making. In this episode, Charles explores the neuroscience behind habit formation, including how cue-routine-reward loops drive nearly half of our daily actions and why positive reinforcement is far more effective than punishment. He explains how institutions like the military and Alcoholics Anonymous engineer environments to change behavior at scale, as well as discussing the limits of willpower and how to preserve it by shaping context. The conversation also covers the real timeline of habit formation, how to teach better habits to kids, the role of failure and self-compassion in lasting change, and the power of social accountability. Charles further discusses how cognitive routines enhance productivity and creativity, how to gamify long-term goals through immediate rewards, why identity and purpose are often the strongest forces behind sustainable behavior change, and the potential of AI to power habit change. We discuss: How Charles's background in journalism and personal experiences led to his interest in habit formation [3:15]; The science behind reinforcement: why positive rewards outperform punishment in habit formation [10:15]; How the military uses habit science to train soldiers using cues, routines, and rewards [17:15]; Methods for creating good habits and eliminating bad ones: environmental control, small wins, rewards-based motivation, and more [24:00]; How parents can teach kids to build habits and strengthen willpower [32:15]; How adults experience changes in motivation and cue effectiveness over time, and why willpower must be managed like a finite resource [34:30]; Keys to successful habit change: planning for relapse, learning from failure, and leveraging social support [38:00]; Advice for parents: praise effort, model habits, and normalize failure [47:45]; The time required for making or breaking a habit [50:45]; The different strategies for creating new habits vs. changing existing ones, and the crucial role of cues and reward timing [55:15]; How to create habits around long-term goals when the rewards are delayed (like saving money) [1:01:45]; How to stick with good habits that offer no immediate reward: designing reinforcements and identity-based motivation [1:11:15]; The potential for AI to provide social reinforcement [1:16:45]; Mental habits: how thought patterns and contemplative routines shape deep thinking, innovation, and high-stakes performance [1:23:30]; How cognitive routines boost productivity and habit formation but may stifle creativity [1:35:15]; Contemplative routines: using stillness to unlock deeper productivity and creativity [1:40:45]; How habits reduce decision fatigue and enable deep, high-quality productivity [1:44:15]; New research that reveals the power of environment and social feedback in habit formation [1:49:45]; How AI may transform work, identity, and our sense of purpose [1:53:45]; The potential of AI-powered habit change, and the essential—but often lacking—element of motivation [2:02:30]; and More. Connect With Peter on Twitter https://twitter.com/PeterAttiaMD, Instagram https://www.instagram.com/peterattiamd/, Facebook https://www.facebook.com/peterattiamd/ and YouTube https://www.youtube.com/channel/UC8kGsMa0LygSX9nkBcBH1Sg

Speaker names marked ? are inferred from speaking time and the show’s known hosts — they are not voice-verified.

• 0:11Dr. Peter Attia?

  Hey everyone, welcome to the Drive Podcast. I'm your host, Peter Attia. This podcast, my website, and my weekly newsletter all focus on the goal of translating the science of longevity into something accessible for everyone. Our goal is to provide the best content in health and wellness, and we've established a great team of analysts to make this happen. It is extremely important to me to provide all of this content without relying on paid ads. To do this, our work is made entirely possible by our members, and in return, we offer exclusive member-only content and benefits above and beyond what is available for free. If you want to take your knowledge of this space to the next level, it's our goal to ensure members get back much more than the price of a subscription.

• 0:54Dr. Peter Attia?

  If you want to learn more about the benefits of our premium membership, head over to peterattia MD dot com forward slash subscribe.

• 1:04Dr. Peter Attia?

  My guest this week is Charles Duhigg. Charles is a Pulitzer Prize-winning journalist and the author of several bestselling books, including The Power of Habit, and Smarter, Faster, Better, and, most recently, Super Communicators. He is one of the most trusted voices on the science of behavior change, performance, and decision-making, and he's known for translating complex psychological and neuroscience research into actionable insights that improve everyday life. I wanted to have Charles on the show because habits are the foundation for integrating nearly everything we talk about on this podcast when it comes to improving lifespan and health span, whether it's exercise, nutrition, sleep, or emotional regulation. If the behavior doesn't stick, the benefits won't accrue.

• 1:48Dr. Peter Attia?

  In this episode, we discuss the neuroscience of habit formation, how cue, routine, reward loops govern nearly half our daily behaviors, and why understanding this loop is integral to behavior change. Why positive reinforcement is 20 times more effective than punishment, and how to harness rewards to build lasting habits. How the military, Alcoholics Anonymous, and behavior change research structure environments to transform behaviors at scale. Willpower as a finite mental muscle, how it gets fatigued, and how environment shapes its effectiveness, and how to preserve it for when it matters most. The myth of 21 days to form a habit and the truth about timeline, relapse, and learning through failure.

• 2:32Dr. Peter Attia?

  Building better habits with your kids, teaching them how to identify cues and rewards, and modeling failures as data for learning. The power of social accountability and coaching in habit change, and why self-judgment is counterproductive to lasting success. Creating cognitive routines that foster deeper thinking, productivity, and innovation. Featuring lessons from elite pilots, parents, and writers. How to gamify long-term goals like saving money or taking blood pressure meds using short-term rewards and narrative cues. The relationship between identity, purpose, and behavior, and why meaning is often the most powerful habit reinforcer of all. So without further delay, please enjoy my conversation with Charles Duhigg.

• 3:21Dr. Peter Attia?

  Charles, thank you so much for making the trip out to Austin.

• 3:24Speaker 01

  Thank you for having me. This is such a treat.

• 3:26Dr. Peter Attia?

  You know, in many ways, you're kind of the OG guy when it comes to talking about habit formation. It's hard to believe, we were just talking a moment ago, that it's been 13 years since your amazing book on the subject matter. I probably read it eight years ago, but it's a topic that is relevant regardless of what you do. That said, for what I do, what my job is and how I try to sort of help people, it really comes down to knowing what to do and then putting it into practice. Give folks a bit of a sense of your background and maybe even how that factored into you taking an interest in this topic.

• 4:03Speaker 01

  Yeah, absolutely. So before I wrote The Power of Habit, I had been a reporter for quite a while, and a business reporter and a science reporter in particular. I decided to become a journalist after I went to Harvard Business School and I got my MBA. And about halfway through business school, I realized it's a lot more fun to write about business than to do it. So I decided to become a journalist. And one of the things that I noticed as I was writing, I was working at the New York Times at that point. One of the things I noticed, because I had spent time overseas in Iraq during the war, I had reported on a bunch of different things. I had two experiences that really got me interested in habits. The first is that when I was in Iraq, I got embedded with a unit that was right outside of Baghdad. And I was talking to a captain there, actually

• 4:45Speaker 01

  he was a major. I was asking him, how do you train soldiers to become soldiers? Because one of the things that you see in a war zone in particular, or anyone who's spent time around the military, is that the behaviors are so deeply ingrained. The goal is to engrain a set of behaviors that if a bomb goes off, which happened underneath my car, everyone around you, the 50 18-year-olds around you, who probably don't know how to do anything with their lives, they know exactly what to do in that moment. And they react automatically. And so I was talking to this major, and he's this like little short guy, and he's really muscular, he chaws all the time. And I said, how do you do this? And he said, well, the thing you have to understand, son, because he called me son, the thing you have to understand is, the military is a giant habit change

• 5:27Speaker 01

  machine. This is what we do. We teach young recruits, who maybe don't have any self-discipline, maybe prone to emotional ops, we teach them the right habits. And we've made a science of it. And when I came back to the US, I kind of had this experience where I was thinking about that. And I was thinking to myself, if I'm so smart and so talented, right? If I have this great job and I win these awards, why can't I get myself to lose weight? Why can't I get myself to go running in the morning every day? Why is this such a struggle for me when I'm so good at other things? And I realized it was because I had not learned and studied how habits function in my own habits. And that once I learned that, I had the tools to change how I behave automatically. Which is of course, the most important component

• 6:10Speaker 01

  of our behavior, because it's what we do every day.

• 6:13Dr. Peter Attia?

  So you get back to the US, what year?

• 6:17Speaker 01

  From Iraq?

• 6:17Dr. Peter Attia?

  Yeah.

• 6:18Speaker 01

  I was there 03 and 04, so I get back at the end of 04, beginning of 05. And I started at the New York Times, I was at the LA Times then, I started in the New York Times in 06.

• 6:27Dr. Peter Attia?

  And then what did you start writing about? When did you pick that thread up again?

• 6:32Speaker 01

  So I did this piece that was really fascinating to me. I was writing for the business section of the Times and I wrote a piece about the science of handwashing. There's been really, really interesting research, particularly out of the United Kingdom, about how do we incentivize people in developing nations to wash their hands? Something that would happen, and a lot of this was sponsored by Unilever, the soap company. They found that people in poor communities, particularly in India and Pakistan and in other parts of Asia, would buy soap and then they would save the soap for special occasions. It was like something you gave to a guest when they came over. It was something that you used before you went to mosque or for prayer. And so as a result, they weren't washing their hands every day. And of course, we know that using soap actually correlates with preventing a lot of diseases.

• 7:15Speaker 01

  So a number of researchers in the UK took this on to try and figure out, how do we create a handwashing habit using soap? And what they discovered was you need to be focused on the reward. Unilever and all the advertisements would talk about the benefits you got from using soap, that if you used soap, disease would go down. That was not influential.

• 7:36Dr. Peter Attia?

  Because it was too abstract?

• 7:37Speaker 01

  Couple of reasons. First of all, it was too abstract. Second of all, you're trying to educate people who don't think that they're at an education deficit. We see the same thing in the United States around vaccine resistance and other things. Telling people, oh, you don't know enough, I'm going to tell you the truth. That almost never works. What you have to do is you have to create incentives where you get an immediate reward for that behavior. And so what they did is they actually changed the scent of the soaps. They actually made the scent of the soaps less powerful because it seemed less like a perfume, less like a fancy thing. And then what they would do is they ran these ads where they equated washing your hands with taking care of your children. Not necessarily your own health, not your own cleanliness.

• 8:22Speaker 01

  But when I wash my hands with soap, I can feed my children. And so I'm creating that sense, that identity reward that says by doing this, you're a good parent. And that changed everything.

• 8:33Dr. Peter Attia?

  How long did it take them to figure out that that was the unlock? Was this iterative? What type of research did they have to do? I'm always intrigued by this type of problem.

• 8:44Speaker 01

  Yeah, absolutely. And there's really interesting papers, if anyone wants to read them. It took them years. It took a really sustained exposure. And what's interesting is part of this research and where it came out of was trying to understand the neural roots of disgust. Disgust is a really, really powerful instinct that all humans have. And they really wanted to understand, how do we capitalize on disgust as a negative reward? So they spent years on this. But like everything that ends up having widespread change, it really paid off enormous dividends.

• 9:19Dr. Peter Attia?

  By the way, when you say they, who are the types of people? Are these behavioral economists? Are they psychologists, sociologists? I'm very intrigued by who are the natural owners?

• 9:29Speaker 01

  So there's a woman named Val Curtis, who in particular led a lot of this research. I hope I'm getting Val's. It's been a little while since I read the research. So I hope I'm getting Val's name right. So Val led a lot of this research and I believe her background is in sociology. But they brought in, this was during the heyday of behavioral economics, when Danny Kahneman and others, Amos Tversky's work was really getting noticed for the first time and was making its way into other fields. And so they brought in a lot of the behavioral economists. They brought in a lot of psychologists, because obviously that's what they're looking at. I think it points to something kind of interesting, which is some of the most exciting research that's happening right now is this interdisciplinary research. And you know, because you've spent time in the academy, there tend to become these silos within universities. But when you look at what's really interesting that's happening,

• 10:14Speaker 01

  it tends to be the people who are stepping outside of those silos.

• 10:17Dr. Peter Attia?

  Now, the way you described it a moment ago, it was more avoidance of negative that got the job done. Can we talk a little bit about, and I think we're going to come back to this over and over again, but the more examples we have, the better. You can almost think of like a two by two, positive and negative, giving and taking. So give a carrot, give a stick. Take away a carrot, take away a stick. This is Like in my very simple framework, take away a stick. Disgust is bad. We're going to remove disgust. How do you think about or what does the science tell us about that four square?

• 10:53Speaker 01

  I'll tell you what the research says, and just to give a little bit of context, the reason why this is important is because every habit that we have in our life, and about forty to forty-five percent of what we do every day is habits. And this comes from research by Wendy Wood at USC. Every habit in our life has three components. There is a cue, which is like a trigger for that behavior to start. Then there's a routine, which is the behavior itself, what we think of as the habit. And then there's a reward. Every habit in your life delivers a reward, whether you're aware of it or not. And so you're right, there are negative rewards and there are positive rewards. But negative rewards and positive rewards act very differently. And to be most powerful, often we have to put them in combination with each other. So let's start by talking about negative rewards. You would think that the threat of

• 11:38Speaker 01

  something unpleasant happening would be the most powerful negative reward. Peter, if you don't run today, I'm going to hit you with a cane. That's actually not what the science tells us. What the science tells us is that the best way to use negative rewards is to establish the pain and punishment prior to the behavior and then remove the tension of it afterwards. So I'm going to give you an example. When I was in Iraq, one of the things I learned about was the extraordinary interrogation techniques that were used by the military. And stories came out, they would take people and terrorists, and if they weren't giving them information, they would put them in a little box and lock them up in this physically uncomfortable position. That's not actually what happened. What happened is you capture the person, you put them in the box.

• 12:21Speaker 01

  And then you tell them, I will let you out of the box if you give me the information I want. The presence of a negative reward or a punishment is much more powerful when we feel it than when we anticipate it. When we put it that way, it makes sense. The problem is negative reinforcement is about one twentieth as effective as positive reinforcement. So I have to hit you with a cane twenty times. To equal the motivation that you'll feel if I let you have a really nice smoothie after you go for that run.

• 12:52Dr. Peter Attia?

  Sorry, say that again, Charles. Did you say negative reinforcement is 1/20th?

• 12:56Speaker 01

  As effective as positive reinforcement.

• 12:58Dr. Peter Attia?

  And we define effective as likely to produce the desired outcome?

• 13:02Speaker 01

  Yes.

• 13:03Dr. Peter Attia?

  1/20th?

• 13:04Speaker 01

  1/20th.

• 13:05Dr. Peter Attia?

  I would have guessed one half. I'm not saying you're wrong. I'm just saying that's a staggering difference.

• 13:11Speaker 01

  It's a staggering difference. And it sometimes gets complicated by scale because you might really hate getting hit by a cane a lot more than you enjoy drinking a smoothie. But we know that if those two things are comparable in your head, I'm going to have to hit you 20 times to equal the motivation you'll find from drinking that smoothie. And that's a normal distribution. There's different behaviors and different tolerances among individuals. But the reason why this is important is because when there are negative rewards or punishments available to us in the environment, then we should take advantage of those. If I know that you feel a sense of disgust, and I can take advantage of that to help you build a habit of washing your hands, I should go ahead and do so. But that's

• 13:53Speaker 01

  not enough on its own. I have to pair it with a positive reward, where I'm creating a scent in that soap that makes you feel like you're clean, that makes you feel like you're doing something virtuous. I have to reemphasize to you, you're doing this for your kids. Every time you wash your hands with soap, you are a good parent.

• 14:10Dr. Peter Attia?

  So that's the ice cream, taking the scent away, taking the flowery scent away, is not hitting.

• 14:19Speaker 01

  We're replacing it with a different scent. The problem with the flowery scent is that it's too associated with luxury. So I need a scent that smells a little bit more medicinal to believe that it's doing its job.

• 14:30Dr. Peter Attia?

  Interesting.

• 14:30Speaker 01

  Yeah.

• 14:31Dr. Peter Attia?

  Let's shift gears just briefly, and before we come back to this, and think about it through the lens of parenting, because it's the first thing that probably comes to many of our listeners' minds as we think about the words reinforcement, positive and negative reinforcement. So your child is misbehaving. Bedtime routine is a disaster. They don't want to brush their teeth or whatever it is. There's a punishment that you could allocate for that behavior. You could say, look, Johnny, if you don't go to bed now, you do not get to play Xbox tomorrow.

• 14:58Speaker 01

  Right.

• 14:59Dr. Peter Attia?

  That's a punishment. There's a reward, which is if you do this thing, I'm going to give you an extra 15 minutes of playing Xbox tomorrow. Based on what you just said, is it safe to say that offering 15 minutes of extra Xbox is significantly more likely to produce the desired outcome?

• 15:18Speaker 01

  Absolutely. And I think as parents, we know this. Any parent listening knows this, right? Your children, we're talking here about permanent behavior change. We don't want them just to brush their teeth tonight. We want them to brush their teeth every night. A positive reward, positive reinforcement is going to be much more powerful at ingraining that habit in their life. Negative reward, it might work tonight.

• 15:39Dr. Peter Attia?

  Do you have a sense of why this is from an evolutionary perspective? Because this seems awfully hardwired.

• 15:44Speaker 01

  Yeah, I don't know exactly the answer to that, and I'm not sure anyone does. I'll tell you what the hypotheses that I've heard are. One of the things we know, as you know, is that our brain tends to overnotice negative

• 15:57Dr. Peter Attia?

  Yes.

• 15:58Speaker 01

  outcomes. And that's good, because that means that if something can kill us, we're going to avoid it. But as a result, we actually are very good at discounting that reward very quickly. We have a very accurate mental representation of how painful a reward is going to be and whether we should avoid it or not. Our sense of a negative reward, negative reinforcement, is very finely tuned. Our sense of positive reinforcement is not. And as a result, there's an opportunity there to take advantage, to kind of arbitrage that difference within our brain, where when I give you a positive reward, you actually enjoy it more than you ought to. Here's a great example. We know this from slot machines.

• 16:42Speaker 01

  The way that a slot machine gets you hooked is they give you a consistent stream of rewards, every 10, 15 minutes, every 10, 15 pulls. And then they mix into that intermittent unexpected rewards, because that unexpected reward Gives me that dopaminic reaction, that reward sensation, much, much bigger than the actual prize that I'm getting. And so what we can do, slot machines take advantage of it in a negative way, but we can take advantage of it in a positive way and say, if I give you a reward, you're gonna love it even more than you'll hate that punishment. And that gives me an opportunity.

• 17:17Dr. Peter Attia?

  So now, going back to the military example, how did you come to understand the ways in which a myriad set of behaviors, because as you said, a soldier is able to do so many things that basically become autonomic, that might be very counterintuitive, in fact, might be counter to the value of your own life.

• 17:36Speaker 01

  Absolutely.

• 17:37Dr. Peter Attia?

  Moving this direction as opposed to that direction under threat.

• 17:40Speaker 01

  Absolutely, or training people to kill, which the many people have a natural reaction to not kill. So how does the military do it?

• 17:47Dr. Peter Attia?

  Yeah. How do they employ this reward punishment leverage?

• 17:51Speaker 01

  So one of the things that they do is they pay very, very close attention to teaching cadets to respond to cues. One would think if I was saying, okay, if a bomb goes off, what are you supposed to do? Let's talk about the behavior that you do when a bomb goes off. The thing about a bomb going off is that a bomb going off is a little bundle of cues, and we need to talk about which cues you should pay attention to and which ones you shouldn't, which ones should trigger an autonomic behavior. So in Iraq, the issue with bombs going off, IEDs, was dust. When there was an explosion of dust, that is when you should react, and we're going to practice that. So we're going to take you out into the field, and we're going to use ordinance that does not actually produce sounds, that

• 18:33Speaker 01

  does not produce fire. What we're going to do is we're going to put stuff in the ground that creates a huge cloud of dust, and we're going to train you to react to that. Because we have found that dust is a more predictable and reliable indicator of when you should behave than the noise of an explosion or being able to see the fire.

• 18:50Dr. Peter Attia?

  And to be clear, the noise could be coming from anywhere. You don't know where it's coming from. It could be a false alarm. It could be something that's a town away or something like that.

• 19:00Speaker 01

  That's exactly right. And it's oftentimes overwhelming. The thing about like a visual stimuli in this context is that it's very, very recognizable, whereas an audio stimuli, it's hard to tell.

• 19:11Dr. Peter Attia?

  It's hard to localize.

• 19:11Speaker 01

  It's hard to localize, but it's also so overwhelms you that it can kick in that fight or flight instinct that we're trying to avoid. So that's the first thing that they do is they pay a lot of attention to cues and they think really, really hard about that training. In one of my other books, Smarter, Faster, Better, there's a chapter about boot camp for Marines. And it's probably the most scientifically well-fined tuned training you will find on Earth because it takes in hundreds of thousands of people every year and we have to train them to be Marines. The other thing that they pay a lot of attention to is how do we reward that behavior in a way that will make it automatic? We mentioned that a habit is a cue, a routine, and a reward. That's known as the habit loop.

• 19:54Speaker 01

  But what happens in our brain to form that habit loop is that the basal ganglia, which every animal on Earth has a basal ganglia, the basal ganglia's job is essentially to make habits. Because without those habits, we essentially can't evolve. We just spend too much time in cognition. And what the basal ganglia helps encourage, and this is oversimplifying dramatically, is it takes that cue, that routine, and that reward, and it puts them in a kind of circuit where the neural synapses connecting the behavior centers of those three items becomes thicker and thicker and thicker, which means that as a result, an electrical impulse can travel down that synapse faster. So if I'm the general, my goal is to take these soldiers and to change their brain

• 20:37Speaker 01

  so that when they see smoke, they react immediately, which is they pull out their gun, they look for the threat, they go through the mental checklist of look for these five things. And then I want to have a reward for them that's predictable and consistent. Now, in that situation, there's not a natural reward. I have to create that reward. So one of the things that I do is I have them train as a unit. And as soon as they all take position, they all say to each other, "Good job, good job. I'm in position. Good job, good job, good job." They're all positively reinforcing each other. That becomes a reward that can build this behavior, which is why looking at the unit or the platoon is so important in how we train soldiers, is because oftentimes the rewards that are reinforcing our habits are social rewards that we're getting from other individuals.

• 21:23Dr. Peter Attia?

  And during training, let's say it's the first day they're going through this drill and two of the guys fall out of formation, they fail to get in position. The absence of being able to say, "Good job," is that sufficient? Or is there also a punishment of, "Hey, you two guys, you were in the wrong spot. Let's go do it again."

• 21:41Speaker 01

  Well, it's the Marines, right? Certainly the drill sergeants, they have a certain reputation to uphold about yelling at people. But no, it's actually-

• 21:50Dr. Peter Attia?

  But it's not doing that much, correct?

• 21:51Speaker 01

  It's not really doing that much. It's helping people correct. It's creating sort of that, instead of a wicked feedback system, a good feedback system where I'm learning very quickly. It's actually me seeking out that reward. One of the things that you'll find if you look at surveys of why people fight, inevitably they will say, "I joined because of patriotism and I stayed in the military because..."

• 22:12Dr. Peter Attia?

  Camaraderie.

• 22:12Speaker 01

  Because of camaraderie, because of the guys next to me. I couldn't go home. I'd have to take care of them. That's really encouraged by the military. And that becomes the dominant, overwhelming positive reinforcement, is that you act for your fellow soldiers. And when one of them turns to you and says, "Good job, good job," what he's really saying is, "You helped protect me and I'm going to help protect you." And that feels amazing.

• 22:31Dr. Peter Attia?

  So when you think about the number of people that make it through the various forms of training, and whether it be Marines, Special Forces, elsewhere, et cetera, are they screening for the capacity to be able to form these habits? Or is their point of view that we can basically instill this in anyone, provided some basic set of criteria of aptitude or psychological well-being is present?

• 22:58Speaker 01

  It's the latter. And I'm kind of curious, in your work, how that plays out.

• 23:02Dr. Peter Attia?

  That's exactly why I'm asking, right?

• 23:03Speaker 01

  Yeah, well, because what they believe, and the science tells us this is true, humans are habit machines. We literally have evolved a brain that is fantastic at making habits. And so we can take almost anyone, assuming a baseline physical readiness and mental capacity, we can take anyone and we can teach them to be a good soldier. Now, some people are going to be elite soldiers, right? Some are going to become Special Forces. They might have an aptitude where they're more comfortable with willpower, they're more comfortable with grit, they're more comfortable experiencing- Discomfort and so they might be able to create habits faster. They might understand intuitively or through learning how to affect their habits. But we can do this with anyone, which actually I'm curious. When someone comes to you, they are showing a habitual behavior that you think is negative.

• 23:48Speaker 01

  They want to race and you want to race. Are there some people whom you believe like it's just not going to happen like I can't help this person?

• 23:55Dr. Peter Attia?

  Well, the truth of the matter is, I just don't think this is an area where I personally have enough expertise. And therefore I'd be hesitant to judge the success or lack thereof for a patient. Because I don't think I'm a good enough coach. I'll tell you, I have a very, very basic framework on habit. Which is one of the reasons I'm excited about this discussion is I'm looking to bring many more insights into what we do. But the way I talk to patients about it is look, there's broadly speaking additive and subtractive habits. So if you're smoking, if you're drinking too much, I want to take away something, a habit of removal.

• 24:35Dr. Peter Attia?

  Conversely, let's say you don't exercise at all, or you barely exercise and we want to increase the amount of exercise you do. We want to add that thing in. I sort of have two different strategies for how to do that. For the former, it really comes down to default environment manipulation. So if a person wants to eat less junk food, my view is you have to actually take some pretty significant steps to reduce the amount of junk food that is around you.

• 24:59Speaker 01

  Absolutely.

• 24:59Dr. Peter Attia?

  It sounds obvious and sometimes it's very difficult to do because if you don't control your environment, it's hard. If you do control your environment, it's easier. And if you're in an intermediate state, you know, you have kids and the kids eat a lot of junk food, but you don't want to be eating like the mini wheats all the time, then it gets a little tougher. But you can exert willpower for briefer stints. For example, when you're at the grocery store and you have to make the decision of what to buy. But taking an easy example, if you live alone, if you're a single person, you control the food environment in your house. And that might mean one hour a week, you have to control your willpower when you're in the grocery store.

• 25:35Speaker 01

  Yeah.

• 25:35Dr. Peter Attia?

  But if you do that, it gives you the luxury of being surrounded by healthy choices for the other 167 hours.

• 25:42Speaker 01

  Absolutely. So that willpower muscle, you can either use it for other things or you can relax.

• 25:46Dr. Peter Attia?

  You just have to flex it briefly.

• 25:47Speaker 01

  Yeah.

• 25:48Dr. Peter Attia?

  On the other end of the spectrum, and again, this has always been my way of doing things. And I don't think it's unique because I've read other people talk about the exact same idea. So clearly others have thought of this as well. When adding new habits with people, we tend to start very small. And the win is basically defined by showing up, not by any performance.

• 26:08Speaker 01

  The science of small wins.

• 26:09Dr. Peter Attia?

  Yeah. So if a person says, Peter, I hate, I had this discussion two weeks ago or last week, actually. I hate doing cardio, Peter. I love strength training. I love being in the gym, but this whole zone two thing you want me to do, it's so painful.

• 26:23Speaker 01

  This speaks to my heart.

• 26:25Dr. Peter Attia?

  And a patient said, but Peter, you've convinced me like, I know I need to do this. I just don't want to. And I said, no problem. All I want you to do this week is three 15 minute sessions on a stationary bike. I don't actually care how many watts you're pushing. I don't want you to wear a heart rate monitor. I don't want to track anything other than time. Can you get on for 15 minutes? I want you to pick your favorite podcast and I've got some great recommendations for you. And I want you to just get on a stationary bike for 15 minutes, listen to this great podcast. And even if at the end of 15 minutes, you want to ride more, don't just get off. Why don't you do that three times? And then let's discuss that in a month. And this tends to be a quite productive way to do it.

• 27:10Dr. Peter Attia?

  Cause then you can start to increase the duration and then you can start to add other parameters around performance. Okay. Now we're going to actually start paying attention to the level of exertion. And are we getting you in the right spot? But if I just try to say, all right, we're going to go from nothing to four hours of zone two a week. And somebody who doesn't like it, yeah, the likelihood of success is pretty low.

• 27:28Speaker 01

  So there's a researcher, Katie Milkman at Wharton, University of Pennsylvania, who studied exactly what you're talking about quite extensively. How do we link a reward to the behavior so that you're experiencing the reward during the behavior? And she actually uses audiobooks, much like you use podcasts. And when she was doing this research, it was right when Harry Potter had come out. She loves Harry Potter. And so she made a rule. She can only listen to the Harry Potter audiobook when she's on the stationary bike. And she found that it just completely transformed her attitude towards doing this behavior that she previously really did not like.

• 28:01Dr. Peter Attia?

  Yeah, even for me, that is kind of the case. And again, I'm far enough along in my journey in my life. Those things have become so ingrained in me that I will do them. But there are days when I really don't feel like getting on a stationary bike because I do most of my zone two indoors because it's easier frankly than trying to hold a constant level of output outdoors. And frankly, some days it's just really boring, but there are two or three podcasts that I am addicted to and that's when I listen to them. I actually am looking forward to listening to the podcast.

• 28:33Speaker 01

  My guess is, and tell me if you think I'm wrong on this. My guess is that in addition to giving yourself a reward during that behavior, you're also rewarding yourself afterwards.

• 28:41Dr. Peter Attia?

  Well, for me, the reward after is the feeling. I'd love to talk about this as it pertains to exercise. Anna Lemka, who I'm sure you're familiar with her work. She talks about how for many people, the discomfort of exercise creates that imbalance in dopamine homeostasis such that post-exercise, many of us experience that subtle shift where we actually have, if not a euphoria, certainly a better feeling. And so for me, I always know that no matter how lousy I feel or how uninterested I am, and it's usually that I'm just too busy. Usually it's, I just want to do work for another hour. I don't really want to get on my bike, but I know that I'm getting this reward after of how I feel.

• 29:21Speaker 01

  Yeah. And what's interesting is what the research tells us, that's very real. The runner's high is a real thing. What's interesting is, and anyone who once didn't exercise and now does exercise who's listening knows this intuitively, the first couple of times that we tell someone to exercise, they do not anticipate the runner's high. And so as a result, it's a difficult motivating factor. My mom hates exercise and I always say, you're going to feel so good afterwards. And she says, you know what? I just don't feel good afterwards. Now she actually does feel good afterwards, but she tends to forget it. She engages in hyperbolic discounting very actively around this positive reward. But one of the things that happens when we start exercising is that we convince ourselves that we're going to feel better afterwards.

• 30:03Speaker 01

  An extrinsic reward, like giving myself a nice smoothie, congratulating me, calling Peter and he tells me you did such a good job for getting on the bike three times this week, that external reward moves to an internal reward where it's the feeling of accomplishment and it's the runner's high, the euphoria that I'm getting that motivates my behavior. But I have to learn the value of that intrinsic reward because you usually can't convince me of it without me having experienced it.

• 30:29Dr. Peter Attia?

  If you were to consider a group of 10 individuals who are similar in most observable ways externally, right? You want all of them to create a new habit in a domain that is entirely foreign to them. Are there attributes of these people that would allow you to predict who is more likely to be successful? For example, does willpower, which might form the basis of the initial, for lack of a better word, activation energy, getting over that hump the first few times, does that factor into it? I mean, truth to that, I don't even think I understand the science of willpower. So maybe we can spend some time on that if it's helpful.

• 31:03Speaker 01

  The answer is absolutely. I'm going to caveat the answer by saying there are certainly behavioral characteristics that make it easier for some people to understand how to change their habits and adopt new habits. There does not seem to be a great deal of evidence that there's genetic reasons to predict that. Some researchers will say there is slight genetic variations. We think that some people are more prone to willpower than others are. But it's so small and insignificant in comparison with the behavioral training that you have, the environment that you've grown up in. If you have parents who teach you willpower habits, if you're someone who is an athlete and so you have a team that's taught you how to push yourself a little bit harder

• 31:47Speaker 01

  when pushing yourself is hard, you already have an intuitive sense of how to adjust your own habits. And so as a result, if you're in a room with someone who has none of that background, they've never played on a team sport, their parents let them do whatever they wanted, it's going to take me longer to change that second person's habits because I'm going to have to train them more. And the training just takes time.

• 32:07Dr. Peter Attia?

  That makes sense. Okay, so low heritability.

• 32:10Speaker 01

  Yes, exactly.

• 32:11Dr. Peter Attia?

  But high environmental and behavioral exposure as a child.

• 32:13Speaker 01

  Absolutely. And the research is pretty consistent on that.

• 32:16Dr. Peter Attia?

  So not to digress, but again, I think a lot of people in our audience are parents. I mean, this sounds like just good parenting 101, but let's double click on it a little bit. What do those of us with young kids need to do to enable our kids to become the type of adults who can make behavior changes and create better habits?

• 32:36Speaker 01

  The single most powerful thing we can do is we can teach them how willpower works and to build willpower habits. Because a willpower habit actually doesn't tax the metaphor of the muscle, willpower muscle that exists inside our head. And so Angela Duckworth, who probably many of your listeners are familiar with because of grit, she's done a lot of research on this. One of the things that's really powerful is to explain and demonstrate to kids how to diagnose the cue, routine, and reward, so that they can begin editing their own habits. So I have a 14-year-old and a 17-year-old. And one of the things that I do is I'm very ostentatious in how I reward myself for hard behavior. This is actually kind of counterintuitive because we're dads, we're supposed to be stoic.

• 33:20Speaker 01

  We go out and we run a half marathon and like, it's no big deal. So what I do is exactly the opposite. I go out and I run not even a half marathon. I just go and I run four or five miles and I come home and I say to my kids, "Oh, man, that was a hard run, but I pushed through it. Now you know what I'm gonna do? I'm gonna have this really yummy smoothie I've been looking forward to. For the next 15 or 20 minutes, I'm just gonna lay on the couch and enjoy myself because I feel so good right now." What I'm trying to do is I'm trying to model for them, giving yourself a reward, focusing on that reward, is a powerful way to reinforce or change your own behavior. And I'll do the same thing with cues. Oftentimes, some of the cues that I use for exercise or for other things, aren't visible to my children because I'm putting my running shoes next to my bed, so I see them when I wake up in the morning,

• 34:03Speaker 01

  and they don't understand the significance of that. Or I'm engaged in a ritual before I start writing that they don't see. So what I'll do is I'll be very explicit with them and say, "I need to start writing in 15 minutes. Here's what I'm gonna do for the next 15 minutes to get ready for that." I'm teaching them, think about the cues in your life. Think about the rewards in your life. If you focus on those two things, you can create almost any routine, any behavior that you want, or change any behavior that you want.

• 34:31Dr. Peter Attia?

  So the cues in that sense are just as important for the positive behaviors as the negatives. I think many of us probably associate cues with the negative, meaning be aware of the cue. If I'm trying to quit smoking, what's my cue to smoke? How do I need to spot it in advance? But you're paying just as much attention to... It's funny, I don't know that I really think of cues on my positive behaviors. I know they're there, I guess I'm just not even aware of them.

• 34:56Speaker 01

  If I was looking at your life... Okay, so let me ask you, before you work out, what do you do before you work out?

• 35:01Dr. Peter Attia?

  Make my electrolyte drink.

• 35:03Speaker 01

  Okay, so that's a preceding behavior.

• 35:05Dr. Peter Attia?

  Yeah, it's a preceding behavior.

• 35:06Speaker 01

  It's a ritualized behavior that's become a cue for you. It's not a negative cue. Forward to making that like, does it feel like a little sense of like anticipation as you're making it? Like, I'm gonna go work out?

• 35:14Dr. Peter Attia?

  No, because interestingly, and people will be so surprised to know this about me, but at least for the past year or two, I feel I'm so busy that I don't have the desire to work out until I'm in the gym.

• 35:28Speaker 01

  That's interesting.

• 35:29Dr. Peter Attia?

  Or on the bike. So in other words, it used to be that I couldn't wait to work out. But something has happened in the last two years where I really have to kick myself into the gym. Now, when I'm 15 minutes in, I feel great and I'm delighted to be there and there's nowhere I'd rather be. But the 15 minutes before I go into the gym, which includes making that drink, extracting myself away from my computer and doing my warm up, I'm like, that is actually, it feels like pure willpower, but also I guess I benefit from enough muscle memory of just, I've done this my whole life.

• 36:04Speaker 01

  Yeah.

• 36:05Dr. Peter Attia?

  I guess I'd have to think about how.

• 36:06Speaker 01

  Let me, let me posit a hypothesis and you can tell me if you think this is right. My guess is that that preceding behavior of making the electrolyte drink and doing the stretches, that was a very ineffective cue at one point in your life. And the effectiveness of that cue has diminished over time. But you found other cues, which is that one of it might just be a sense of anticipation that you're gonna feel good after 15 minutes.

• 36:27Dr. Peter Attia?

  I think that's a lot of it.

• 36:28Speaker 01

  Yeah, it might also be that you know that you're gonna put on your podcast. The cue of hitting start on the podcast is what gets your head in that place where you can start exercising and then experience.

• 36:37Dr. Peter Attia?

  Well, it's interesting, I only do the podcast for zone two.

• 36:40Speaker 01

  Okay.

• 36:40Dr. Peter Attia?

  It's the only thing. In the gym, for some reason, I can't lift weights and concentrate on something else.

• 36:46Speaker 01

  That's fascinating.

• 36:47Dr. Peter Attia?

  So I listen to music in the gym, which doesn't get me excited.

• 36:50Speaker 01

  That would actually suggest that you are using more willpower in the gym. Because that muscle, this is an inexact metaphor, but we can think of willpower as a muscle. And like all muscles, it gets stronger the more we practice using it. But it also gets fatigued in the short term.

• 37:06Dr. Peter Attia?

  Mm hmm.

• 37:07Speaker 01

  And so. This is why, if you look at data on when accidents happen in surgery, they most often happen when a surgeon has been either in his second or third surgery, or her second or third surgery, or when it's a very long surgery. They've been using their willpower for so long, they get fatigued. If you look at the number of affairs that happen among lawyers and doctors, they most often happen when someone has been at the office after nine or 9:30. And for years, people thought, oh, you get to the evening and it's like kind of romantic. No, it's that after nine or 10 hours of exerting your willpower in your office, your guard is down, your muscle is weaker. And so when someone comes up and they kiss you, instead of pushing them away, you kiss them back. Thinking about our willpower muscle, both strengthening it,

• 37:50Speaker 01

  but also protecting it when we need it, is critical to being able to be the people that we want to be.

• 37:57Dr. Peter Attia?

  And so part of that then is recognizing when you're vulnerable.

• 38:00Speaker 01

  Yes.

• 38:00Dr. Peter Attia?

  I mean, you used an extreme example of having an affair, but also vulnerable to fall. So let's use a less extreme example of, I really want to eat less dessert.

• 38:10Speaker 01

  Yeah.

• 38:10Dr. Peter Attia?

  Right? I really just want to eat less dessert.

• 38:12Speaker 01

  Or let's use smoking.

• 38:12Dr. Peter Attia?

  Okay.

• 38:13Speaker 01

  Smoking's a great one. James Prochaska at the University of Rhode Island has spent his whole career, and the data that we have on smoking cessation is enormous. It vastly outpaces almost everything else. Okay, so let's talk about what happens. Nicotine, as you know, is an addictive substance, but we're only addicted to nicotine for about 100 hours after our last cigarette. By that point, nicotine is out of our bloodstream. We don't have a physical dependency on nicotine. And yet, we all know people who smoked for years, quit, and they crave a cigarette a decade later after they have breakfast in the morning.

• 38:45Dr. Peter Attia?

  I didn't actually know that, Charles. So four days after you smoked your last cigarette or had your last exposure to nicotine, you no longer have a physiologic need for nicotine?

• 38:59Speaker 01

  Yeah, you have completed withdrawal.

• 39:00Dr. Peter Attia?

  I had no idea of that.

• 39:02Speaker 01

  But what you still have-

• 39:04Dr. Peter Attia?

  You still have the cue, and you remember the reward.

• 39:06Speaker 01

  Right, exactly. The habit loop still exists in your brain. If you have a cigarette with every morning cup of coffee, as soon as you pick up that cup of coffee, your brain is craving that nicotine. And that feels just like an addiction, a physical addiction. In fact, it's in some ways more powerful than a physical addiction. So what Prochaska did is he looked at how people quit smoking, and this gets to the point you were raising before about learning. He found that on average, a smoker needs to quit seven times in order to actually quit.

• 39:36Speaker 01

  So a committed smoker, somebody who's been smoking for years, they will give up cigarettes seven times before it actually works. Which raises this kind of interesting question. What is happening in those seven times? Like, why seven instead of four? What's happening? What the research tells us is that the first time I give up cigarettes, I focus on willpower. I say like, I'm going to resist these cigarettes. I'm throwing them out. I'm going to change my environment a little bit. But all those cues are still there. The craving for the reward is still there. And when my willpower gets taxed, my mother-in-law comes to town. I've had a really tough day at work. My willpower is really, that muscle has been exercised all day. That's the moment that I give in and I pick up a cigarette and I say, to hell with it, I'm going to start smoking again.

• 40:17Dr. Peter Attia?

  And just to be clear, what happens when you have that first cigarette? Why can you not, on that first cigarette, go, hey, it was just a lapse. I'm exhausted. Tomorrow's a new day.

• 40:28Speaker 01

  Well, it's because you don't have a plan. So you're caught off guard by this relapse. And as a result, tends to shake our faith in ourselves, even if it's almost subconscious. It tends to shake our faith in ourselves that we can't quit. Now, that's the first time.

• 40:42Dr. Peter Attia?

  I want to interject here. This is something that we try to talk a lot to our patients about. Because again, we're not dealing with something that's as binary as smoking. Let's just say it's exercise. Look, we've set a plan that you're going to do something for 30 minutes every day. And then you're going to have that day when you don't. What we tend to spend a lot of time coaching on is absolutely positively, under no circumstance do you judge yourself for that day. The next day, just get back on the horse. And don't let one bad day be two. And then it's fine. Because I think what we see is a lot of times a person will go six days of their routine. They miss a day, they beat themselves up, and then they're done. They're like, well, forget it. I screwed up. It can happen in the reverse.

• 41:24Speaker 01

  Yeah, well, and it makes sense, right? Because we're talking about rewards and positive rewards and negative rewards. I miss a day and I start beating up on myself. I'm flooding my brain with negative rewards, with recriminations, with feelings of shame. My brain pays attention to what gives me positive rewards and negative rewards. And it's saying, this exercise thing, it's a sucker's game. Because even if I feel good for a couple of days,

• 41:45Dr. Peter Attia?

  Right, you're going to miss it.

• 41:46Speaker 01

  I'm going to feel terrible when I miss it. So you're exactly right. We cannot engage in that self-blame.

• 41:51Dr. Peter Attia?

  So this poor smoker.

• 41:53Speaker 01

  This poor smoker.

• 41:54Dr. Peter Attia?

  His mother-in-law, who nags him, comes into town.

• 41:56Speaker 01

  His willpower is exhausted. He's been dealing with her all day long.

• 42:00Dr. Peter Attia?

  He lights up, sneaks outside in shame.

• 42:02Speaker 01

  Yes. So here's what happens. You do that once, you do that twice, you do it three times. Here's what's hard to happening around the third or fourth time. And this is what gets to your exerciser as well. Suddenly, people stop looking at it as a moral lapse and they start looking at it as a scientific experiment. Okay, here's the data that I've observed. I do a pretty good job of avoiding cigarettes until something really stressful happens. So I need to, ahead of time, figure out when that stressful thing occurs, what am I going to do instead of smoking? Because if I don't have a plan in place, what's known as an implementation intention. If I don't have a plan in place, I'm going to pick up the cigarettes. So here's my plan. Instead of beating up on myself, I'm going to write down that the next time my mother-in-law comes to town, I am going to have some sweet candy in the house.

• 42:47Speaker 01

  Because I know I'm going to have an urge to put something in my mouth. I'm going to want some type of quick boost reward and sugar can provide that to me, the novelty of taste. I'm going to have that candy in my house. And when she's driving me crazy, I'm going to walk over and pick up a piece of candy and go outside and eat it. So what happens is that over time, the reason why it takes seven times to quit smoking, or the reason why your clients and your patients have these moments of willpower failure, is because instead of looking at that as a failure, we have to look at ourselves as scientists who are conducting experiments and paying attention to the data. My wife is a scientist and you're a scientist. So you know, if every experiment that a scientist does succeeds, they're a terrible scientist. The goal is to figure out where it succeeds and where it fails and learn from the failures.

• 43:31Speaker 01

  We have to look at our own lives that same way and say, I meant to go run today and I didn't. Let me try and figure out why. And then I'll come up with a plan for the next time. Next time this obstacle emerges, I know what to do without having to worry about it.

• 43:47Dr. Peter Attia?

  Is it the case you think that people are able to kind of do that on their own? Or is this the enormous opportunity to coach a person through that? To create an accountability partner, for example, and say, look, I want to hear about it when you fail, just as much as I want to hear about it when you succeed. And when you fail, I'm going to direct all of the inquiry towards learning. What did you learn?

• 44:08Speaker 01

  Right. It's incredibly powerful because it's going to speed up that feedback loop. There are people who quit smoking on their own without ever talking to another person about quitting smoking.

• 44:16Dr. Peter Attia?

  So these guys are the outliers.

• 44:18Speaker 01

  They're absolutely the outliers and it's taking them longer to actually quit than someone who takes advantage of the social aspect of habit formation, where I know that I can get rewards and I can get learnings from other people in my life more effectively than I can find it in myself. The truth of the matter is, let's take alcohol as an example because AA is such a well-studied and interesting model. There are lots of people who engage in what's known as spontaneous recovery, where they will try and quit drinking and they'll relapse. Eventually they stop drinking. But people who engage in AA, because it's basically habit replacement, those people end up quitting drinking much faster. So we all have the capacity to do this on our own. But when we do it in an environment where we know that we're taking advantage of the cues and rewards

• 45:02Speaker 01

  that make behavior change easier, it goes faster and it feels better.

• 45:06Dr. Peter Attia?

  What is the overall success of AA for alcohol abstinence? Or, I mean, I guess AA does not support harm reduction. It's really about abstinence.

• 45:16Speaker 01

  That's absolutely right. So we don't know. AA is very extensively studied, but because it's anonymous, we don't have double-blind studies. We don't have a lot of longitudinal data. That being said, the estimates seem to be that for about 40% of people who come into AA, they can achieve lifelong abstinence if that's their goal. And 40% isn't great. That still means 60% of people, but it's pretty good for behavior change. What's interesting about AA is AA, much like the military, is built around asking people to identify the cues and rewards in their life and then changing the behavior that corresponds that old cue and finding a new behavior that delivers something similar to that old reward.

• 45:57Speaker 01

  The 10 principles of AA, the reason why there's 10 of them is because there's 10 commandments in the Bible. Bill W., the guy who came up with AA, he had no training in psychology or science whatsoever. The thing that makes AA successful is that when you walk in, you stand up and you say, "My name is Charles and I'm an alcoholic." And then at some point you tell your story. And when you're telling your story, you're reminding yourself of all the cues that prompt you to drink. One of the steps is I make amends. I go to all the people that I've wronged. That teaches me what those cues are. I'm learning. I'm looking at my life as a scientist. And then oftentimes, the reward for drinking is a relaxed, socialized experience. So when you go to an AA meeting, you have a relaxed, socialized experience.

• 46:41Speaker 01

  Absent alcohol, but you're talking to other people, you're communing with other people, the same thing you get at a bar. AA is a habit change machine that doesn't have to express itself that way.

• 46:52Dr. Peter Attia?

  I don't know much about AA, but the little bit I know suggests that people will go for life. They might not go as frequently, but I know people that are, have been sober for 20 years that are still going to a meeting twice a week.

• 47:04Speaker 01

  You're exactly right. You're exactly right. So oftentimes, people will develop a habitualized behavior around AA and they keep up with that habit for life. Just as frequent, and actually more frequent, is that people will commit to AA. They'd say like 90 meetings in 90 days. So they'll commit to AA at the beginning and then it will taper down over time. They'll start going to one meeting a week and then one meeting a month and then, you know, they move to a new place and they don't know where the new meeting is. But what they have learned is when I'm in that moment where I think I'm going to relapse, where my willpower muscle seems tired, where the cues around me are prompting me to drink, I'm going to go to a meeting instead of go to a bar.

• 47:43Speaker 01

  And so the AA, even if I'm not going consistently, if it's ingrained in my psychology as a way to avoid drinking, it's very, very powerful and I can activate that anytime in life.

• 47:53Dr. Peter Attia?

  Let's go back to childhood.

• 47:55Speaker 01

  Sure.

• 47:55Dr. Peter Attia?

  Cause I think this is such an interesting place. Maybe I'm incorrect. I'm assuming that again, a lot of these seeds are sown in how we're raised. And in the case of your kids, they're getting actually kind of like a master class because they've got a parent who's one of the world's experts in it.

• 48:09Speaker 01

  They would not say it was a master class. They would say I'm a little heavy handed, but thank you for that.

• 48:13Dr. Peter Attia?

  But you're being deliberate in how you're coaching. So for those of us who want to take a bit of that, I really think like, people always ask me like, what do you want for your kids? And that's an interesting question, right? I don't have any aspiration for what I want them to be professionally. Like it's not like, oh, I want this kid to be that and this kid to be that. I mean, you want your kids to be well adjusted and happy, but it's hard to imagine them doing that if they don't have some command and control over themselves. You could argue that this is one of the most important things that we want our kids to have.

• 48:46Speaker 01

  Yeah.

• 48:46Dr. Peter Attia?

  And yet I don't feel like we have any adequacy in the training for it.

• 48:50Speaker 01

  I think you're right. I think that this is something, if this was more of a curriculum in schools, if it was something we taught parents, and that's one of the reasons I wrote The Power of Habit, is I wanted to empower parents to teach their own kids this, to recognize things in their own life. I think that a number of us understand intuitively some aspect of this. A lot has been written about the growth mindset, Carol DeWex work out of Stanford. One of the things that she emphasizes is teaching children a sense of agency. That instead of saying, when you bring home an A on your report card, instead of saying, "Oh, you're so smart," which is something you don't have control over, to say, "Oh, you must have worked really, really hard because that's something you do have control over. I'm reinforcing your sense of agency." When we do that intuitively or deliberately,

• 49:33Speaker 01

  one of the things that we're doing is we're teaching our children that they have control over their habits. You went and you worked really hard to get that A. You developed a habit of studying. You used your willpower. I'm going to positively reinforce that by recognizing it. Whereas if I say, "You must be really smart. You got that A." I'm not positively reinforcing your belief that you can change your behavior. So in addition to explaining to kids and being ostentatious, showing off the cues and rewards in our own life and how we change our own habits, the way that we give rewards to our children also reinforces for them whether they believe that they are in control of their willpower or not.

• 50:12Dr. Peter Attia?

  And I suppose the other side of that is how do we handle our own failures in front of them?

• 50:16Speaker 01

  Absolutely. Do we even admit our own failures? There's a model of fatherhood from the 1950s that you don't burden your family with your ups and downs. Dad's a steady rock. But all the research tells us, one of the best things you can do is if you screwed up, and I try to do this all the time. I come home and I'm like, "Oh, man, I called this guy today and I just completely screwed up this interview." Because I want them to know. And then I say, "But the thing I realized from it is that next time I call, I need to have something to eat before I call because that's going to help me." I'm modeling for them. A failure is not a failure. A failure is a data point, and I'm a scientist about my own life.

• 50:52Dr. Peter Attia?

  What do we know about the length of time or the amount of friction it takes to create a habit? And the difficulty in breaking it? Maybe that doesn't make sense. I'll try to come up with an example. If it takes a long time to really create a habit around exercise or meditation, let's pick something new, not an easy thing to do. But let's say over years and years and years, you take a lot of time to build that muscle memory up. I assume that's creating some sort of physiologic headroom that makes it much harder for you to erode that down.

• 51:26Speaker 01

  Yes, absolutely. So what's happening when you're meditating is that, as we mentioned, there's these neural pathways that connect the synapses associated with the cue and the routine and the reward. They're becoming thicker and thicker and thicker over time. What's interesting is they almost never become significantly thinner. So if you develop a meditation habit and then you stop meditating, your life changes, the cues. When you come back to meditation, you will fall back into it much more quickly than the average person. So we know that creating habits, both good and bad, creates this neural pathway that we need to be conscious of. But to your question of how long does it take? The answer is, we actually don't know. There's this myth, this old wives' tale, that it takes 21 days to build a habit and

• 52:09Speaker 01

  it takes 30 days to break a habit. What the research tells us is that there is no number because different people have different thresholds and different kinds of habits have different timelines associated with them. If you want to create a habit of eating chocolate, you can probably do it in a couple of days, right? It's an immediate positive response. If you like chocolate, it's something you enjoy. The cues are plentiful around you, you just put chocolate bars in your house. But if you want to build an exercise habit, it's going to take a little bit longer. But here's the important thing is that regardless of how long it takes to build that habit or change a habit, every day you do it, it will get a little bit easier. And you might not feel that increase in ease the first couple of days, but what's going to happen is I'm going to push myself to exercise day one, day two, day three, I'm

• 52:53Speaker 01

  going to relapse on day four, I'm going to not do it, but instead of beating up on myself, I'm going to look for the science. What went wrong here? What's my plan for next time? And then I get to day 12, or I get to day 20, or I get to day 365, and it occurs to me exercising is really easy for me now. Like, I hardly even think about it. It just happens almost kind of automatically.

• 53:11Dr. Peter Attia?

  Now, what about the negatives? So if you take two individuals, one who has been smoking for a year, a pack a day for a year, and one who has been smoking a pack a day for 20 years, is it necessarily the case that the latter is going to have a much more difficult time quitting?

• 53:28Speaker 01

  Probably because it's a much more ingrained behavior. But this is where individual differences come into play significantly. Because if that first person, if they're an athlete, if they've worked on other habits in their life, if they've strengthened that muscle around habit change, they might be able to rely on that to give up smoking. Whereas the 20-year smoker doesn't. But yes, in general, the longer and more consistent a behavior becomes, the more reinforced it becomes in our brain.

• 53:57Dr. Peter Attia?

  And does that mean that, let's just assume both of these individuals were able to quit smoking. It's five years later, both of them are at a bar and they both light up a cigarette. Are they both equally susceptible to relapse? Or is the 20-year person more susceptible because his neural connections are more hardwired?

• 54:18Speaker 01

  Well, there's a lot of compounding factors there. So when the 20-year smoker lights up his cigarette, we're focusing on the habit loop associated with nicotine use. But there's probably other habit loops that he has developed over time, which is he might feel much more intense sense of shame over smoking than the one-year smoker. He might have emphysema or developing health problems. And those are creating mental habits for him that are countervailing the positive reinforcement of the nicotine. The answer to your question is it's really hard to say universally. What we do know is that the more consistent a reward, whether it's a reward that rewards a positive behavior or a negative behavior, the more consistent that reward and the more consistent that cue,

• 54:59Speaker 01

  the faster the habit will take hold and the stronger the grip it'll have on us. But when we're trying to change it or create a new habit, there's so many other variables that we can't predict how long it's going to take. But we do know that any habit can be changed.

• 55:15Dr. Peter Attia?

  Is there a rule of thumb that says on average, it is more or less difficult to break habits than to create habits?

• 55:23Speaker 01

  The science doesn't address that question. What we do know is that it takes a different technique to build a new habit than to change an old habit. If I want to build a new habit, if I want to start running, what I need to do is I need to sit down, come up with a cue, come up with a reward. By the way, all cues fall into one of five categories. It's a time of day, a particular place or environment. It's a certain emotion you feel. It's the presence of certain other people. Or it's a preceding behavior that's become ritualized. So tomorrow I want to start running. I've never run before. I'm going to take advantage of as many of those as I can. So my plan is set my alarm for seven o'clock. I want to be at the door by seven thirty running. And I'm going to put my running shoes and my running clothes on my floor next to my bed.

• 56:07Speaker 01

  So I see them when I wake up. It's super easy to put them on. I know what I'm going to wear. I'm going to ask my friend Jim to meet me on the corner. We're going to run together. I'm creating as many cues as I can.

• 56:17Dr. Peter Attia?

  If you can tap into all five, you're in the money.

• 56:19Speaker 01

  Some of them are going to stick.

• 56:21Dr. Peter Attia?

  Yep.

• 56:21Speaker 01

  And then when I get home, I have already decided what reward I'm going to give myself. I'm going to have a nice, long shower. I'm going to drink a smoothie. I'm going to take fifteen minutes to check social media or whatever else delights me. So that's how we build a new habit is we choose a cue and we choose a reward and we link it to a behavior we want to encourage. For a bad habit, a habit that we want to extinguish, our nomenclature is incorrect. We often talk about breaking a bad habit. But because that neural pathway exists in our brain, I've smoked for twenty years. I can't just extinguish those neural connections. What I need to do is instead of thinking about breaking that habit or extinguishing it, I have to think about changing that habit. And in that case, what I do is I identify the cue that prompts this behavior I want to change.

• 57:05Speaker 01

  Identify the reward that that behavior is giving me. And I'm going to simply insert a new behavior that corresponds to that old cue that delivers something similar to that old reward. And I'm going to let my brain eventually shift, keep the habit loop inside my head, but change the behavior, the routine.

• 57:24Dr. Peter Attia?

  I love this framework so much. So let's go back to the first one because it has so much applicability. So new habit, want to do something new. You've identified what the behavior is. That's the thing.

• 57:36Speaker 01

  Yep.

• 57:36Dr. Peter Attia?

  The playbook is pretty straightforward. I got to come up with as many cues as possible. So if I'm going to do single cue, not that likely I'll succeed out of the gate. But boy, you get five of them, four out of five of them, it's great. And obviously, some of them are more than others. So I know for our patients, the cues that tend to be very powerful are other people. People never want to let people down. So we always think that one of the most powerful cues is an accountability partner. Sometimes we have people that literally hire trainers for the sole purpose that they don't want to be embarrassed that they've not shown up. It's the only-

• 58:09Speaker 01

  You're kind of describing me right now.

• 58:10Dr. Peter Attia?

  Yeah.

• 58:12Speaker 01

  But you're right. The more cues that we can come up with, the better. And some will have more salience than others. We'll play with that and figure out which ones work for us.

• 58:20Dr. Peter Attia?

  And then, how do you help a person think about how to gauge the magnitude of the reward? Here's an area where you could get a little extreme.

• 58:29Speaker 01

  Yes.

• 58:30Dr. Peter Attia?

  I'm not going to embarrass myself with examples of things I've done in this department, but my wife could tell you some really embarrassing stories of how Peter can reward himself.

• 58:40Speaker 01

  Yes, exactly. So the first thing to do is to say, I have to give myself a reward, which is actually harder than it sounds. So if you think about how most people start exercising, instead of having this like, I'm going to take a nice shower, I'm going to drink smoothie. They go for a run and they get home and they're late. Now I'm rushing, I'm taking as quick a shower as I can because I gotta throw breakfast on the table for the kids and I'm running late to take them to school. I'm actually punishing myself for exercising and my brain pays attention to that punishment. It says, I don't want to exercise anymore. This is a sucker's game. So the first and most important step is to actually recognize, I have to reward myself and I have to create the time or the space or the resources to let myself have that reward and enjoy that reward.

• 59:24Speaker 01

  Now, the next question that you asked, how big should it be? One of the things that we know is that one of the most powerful impacts on this is how immediate that reward is. That in general, if I give myself a reward right away, if I eat sugar and it tastes good, it gives me that boost as soon as it hits my tongue, that's going to be a more powerful reinforcement than if it's something where I'm working out every day and three weeks from now, my muscles are going to be stronger. So the more immediate we can make the reward at first, the better. And we can oftentimes have a smaller reward if it happens quickly than having to have a bigger reward that comes later in time. Now, I mentioned though, that this is at first, and this is really important because,

• 1:00:06Speaker 01

  as I mentioned before, what happens with rewards is they almost always, if a behavior becomes a habit, they almost always move from extrinsic to intrinsic. So at first, the reward I'm giving myself is I'm letting myself have a smoothie. And that smoothie might not be that healthy.

• 1:00:22Dr. Peter Attia?

  You have got me very curious about your smoothie situation. You bring it up a lot. Is there something going on in Santa Barbara?

• 1:00:29Speaker 01

  So I'll tell you.

• 1:00:30Dr. Peter Attia?

  Santa Cruz?

• 1:00:30Speaker 01

  Santa Cruz.

• 1:00:31Dr. Peter Attia?

  Santa Cruz.

• 1:00:32Speaker 01

  So I'll tell you, I love smoothies. I put peanut butter in my smoothie. I'm taking all this healthiness and I'm erasing it by putting the peanut butter because I've already got protein powder in there. I don't need any more protein. But to your point, I'm increasing the magnitude of the reward that I get from this particular reward. But over time, as you mentioned, what's going to happen is your craving for that smoothie is going to go down as your brain begins to realize, oh, actually, when I run, I feel great afterwards. I feel endorphins, I feel dopamine, I feel these endocannabinoids. There's this soup of good feeling in my head. Your brain starts saying, I don't actually need the smoothie. I don't crave the smoothie quite as much. I don't need that smoothie because I just feel good afterwards. That's the reward. So the reward has moved from extrinsic to intrinsic.

• 1:01:15Speaker 01

  And that's a really important transition because that means the behavior becomes self-reinforcing without external rewards.

• 1:01:22Dr. Peter Attia?

  So let's think of a behavior where there is absolutely, positively no obvious link to a short-term reward. So we're going to have to fabricate one. Does it need to make sense? So the smoothie kind of makes sense after the run because you are glycogen depleted.

• 1:01:42Speaker 01

  Absolutely.

• 1:01:43Dr. Peter Attia?

  That's the perfect time to have a smoothie. You're most insulin sensitive. You actually can dispose of glucose the most easiest. If you're going to have a smoothie any time of day, that's the time to have it. Okay. Now, I come to you and I say, Charles, I'm three years out of college. I technically make enough money that I could start putting money into my 401K. I just don't want to, man. Because honestly, I know my employer matches and I know that it's leveraged dollars and I know all the intellectual reasons why. But the truth of the matter is if I start putting money into this 401K, I have less money to buy things now.

• 1:02:15Speaker 01

  Absolutely. And it's going to pay off in 40 years, right?

• 1:02:18Dr. Peter Attia?

  It's hard for me to get excited about 40 years from now.

• 1:02:22Speaker 01

  Yeah.

• 1:02:22Dr. Peter Attia?

  So how would you coach me into making that decision, especially around the cues?

• 1:02:30Dr. Peter Attia?

  And the rewards.

• 1:02:31Speaker 01

  Yeah, I love this question because there's actually been a bunch of research on this, particularly out of researchers at University of Pennsylvania Wharton. So what they did is they went into a series of communities in South America. They asked this exact question. How do we get people? And the reason why they were in South America is because they wanted people who are in a cash based economy where there wasn't a lot of credit cards. How do we get people to save more, increase their savings rate? When we know that the reward for savings is oftentimes far off in the distance, particularly if you're low income. They had two groups. The control group, they set up a box for them that they could put savings into. And they said, we'd like you once a week to come in and save some money. And by the way, we're going to tell you all the good reasons to save. You should save because eventually you want to send your kids to college

• 1:03:16Speaker 01

  or you want to buy that new truck and we're going to help you. We're going to help you. We're going to have a saving device for you. That's the control group. With the experimental group, they do the exact same thing, except there is a secretary who works in that bank, who every single time someone comes in and they put money into that box, they say, man, this is the fourth week in a row you've come in. I'm so impressed to see you. Your kids are going to go to college. They're going to be amazing kids. I just think about someday in the future, like they're going to buy you a new home. You are a great parent. Second group, the experimental group, savings rate went up over 40%. They were saving 40% more money than the first group. Not a bigger payoff, simply someone positively reinforcing. So what happened there? It's a long-term behavior, but we need short-term rewards.

• 1:04:01Speaker 01

  And so the researchers were manufacturing a short-term reward in the form of social reinforcement.

• 1:04:07Dr. Peter Attia?

  Has the following experiment been done as an extension of that where you have a third arm that gets the same reinforcement for a period of time? And then the secretary goes away after X number of months to see if the shift from extrinsic to intrinsic maintains the same savings rate?

• 1:04:27Speaker 01

  So I haven't seen that experiment in this particular setting, but in other settings, absolutely.

• 1:04:32Dr. Peter Attia?

  And what is the period of time that you need to remove the extrinsic reward?

• 1:04:37Speaker 01

  And make it intrinsic?

• 1:04:37Dr. Peter Attia?

  Yeah.

• 1:04:38Speaker 01

  I think it would probably depend. And on the type of habit we're talking about and the type of individual.

• 1:04:43Dr. Peter Attia?

  Yeah, there's not one answer.

• 1:04:45Speaker 01

  Yeah, I don't think there's one answer, but we do know that at some point it will move from extrinsic to intrinsic. One of the things we do know is that social rewards actually become intrinsic much faster. If I start working out and I know that Peter's going to tell me I'm doing a great job and I look forward to that. Eventually, that sense of pride that I feel, I'm just going to get it without you having to tell me I'm doing a great job. Social reinforcement, social rewards, sense of pride, particularly mental habits, become intrinsic much, much faster. That's something we can leverage. We can use those social rewards to move extrinsic to intrinsic.

• 1:05:18Dr. Peter Attia?

  What other ways are there besides social reinforcement to reward very long-term behaviors like savings?

• 1:05:26Speaker 01

  So I'll tell you what I do. I have a spreadsheet. I've had it for seven or eight years now. And I use Simplify. I used to use Mint. I use Vanguard. I have all the websites that consolidate all of my financial information. Once a week, it takes me about 15 minutes, I update my spreadsheet. I create a brand new set for this week. I input all the numbers. Here's my bank balance. Here's my Vanguard balance. Here's my private equity balance. And then I look at whether it's gone up or down. And you know what? I love it. I look forward to this.

• 1:05:55Dr. Peter Attia?

  Many times it's going down if you're based on the stock market.

• 1:05:57Speaker 01

  Absolutely. And when it's going down is when I tend to like not do it because part of my brain knows. Ah, the market's down. I just don't want to even be reminded of it. I'm going to wait another four or five days.

• 1:06:06Dr. Peter Attia?

  But what is the frequency at which you save money? Do you have an automatic, every one week or every month, I am automatically, mindlessly, without thinking about it, putting X dollars into?

• 1:06:16Speaker 01

  The answer is yes. It's because my income is more staccatic because I write and do things that deliver outsized rewards sometimes and sort of long periods without reward. But yes, absolutely.

• 1:06:26Dr. Peter Attia?

  But it's based on a percentage of what comes in?

• 1:06:28Speaker 01

  Anything that comes in, any new money that comes in goes immediately into my Vanguard account. And I've never taken money out of my Vanguard account.

• 1:06:35Dr. Peter Attia?

  So what is it specifically, Charles, that you are getting rewarded by if the number isn't monotonically going up? What is giving you the joy?

• 1:06:43Speaker 01

  What's giving me the joy is I feel a real sense of responsibility and I feel a relief from tension. We mentioned before that one of the most powerful Rewards is relieving tension. I put you in the box and I tell you, if you give me information, you can come out of the box. I'll remove the tension. And for me, when I went to HBS and I became a journalist, I was the lowest paid member of my class for the next seven years. I started a company before I became a journalist. I used to sell blood in order to make payroll. Money insecurity for me is a real thing. And to look at that spreadsheet and say like, oh, it went down by 2% this month, but it's okay. Cause that number, that number in the bottom is still big enough that I don't have to worry. That relief of tension is enough of a positive

• 1:07:24Speaker 01

  reinforcement to make saving a really positive experience for me. And here's the other thing that I do in that spreadsheet. I say, here's how much money I've made in the last year. Here's how much money I've made in the last two years. Here's how much money I've made in the last three years. And I have those right next to what my total net worth is. Because even if my net worth goes down this week because the market took a tumble, those numbers, one, two, three years, those are still positive. And I just look at those and I think, I made that much in three years?

• 1:07:51Dr. Peter Attia?

  Now, do you play other scenarios forward like, and this is how much money I'm saving for being able to help my kids go to college? Or what are these other activities? Or do you start to reverse engineer? And at this rate, I will be able to work for free. I'll be able to do whatever I want work wise and not be dependent on a paycheck by age X?

• 1:08:14Speaker 01

  That's exactly right. I'm creating anticipation for future rewards.

• 1:08:19Dr. Peter Attia?

  Which is very intrinsic at this point.

• 1:08:21Speaker 01

  It's very intrinsic and it's actually surprisingly powerful.

• 1:08:23Dr. Peter Attia?

  Do you remember the first extrinsic thing you had to do? Was the spreadsheet exercise sufficient initially as the sole extrinsic motivator?

• 1:08:33Speaker 01

  It's a really good question. I have to think back because it's been so long now.

• 1:08:37Dr. Peter Attia?

  It was for me. I'm a spreadsheet junkie and I remember in medical school, just as I'm getting ready to finish and start residency, it's my first real paycheck. I mean, again, I think we made $32,000 a year. So it's not like you were rolling in money, but I remember doing the math and being like, okay, Hopkins is going to match my, it was called a 403B, I think, because we were Universities, it's the same as a 401k. And I just remember thinking like, I'd read all these books and it's like, it's free money, like you gotta take it. But it became a game to me, so I gamified how little I could spend. So it was sort of embarrassing. I would be like, look, I technically don't need to spend money on food because I could just eat all the crap in the hospital for free.

• 1:09:20Dr. Peter Attia?

  There's always a free meal in the hospital. I don't actually have to buy clothes because I could be in scrubs 24/7. And so I had this huge budget that I would line item and it, I really had repayment of student loan, my truck loan, my rent. It was relatively finite and so discretionary money, most of it could go into savings.

• 1:09:39Speaker 01

  Yeah.

• 1:09:40Dr. Peter Attia?

  But yes, I made that spreadsheet and I obsessed over it. So it's interesting to say that you were the same way.

• 1:09:45Speaker 01

  Oh, absolutely.

• 1:09:46Dr. Peter Attia?

  I thought I was very unique in doing that.

• 1:09:48Speaker 01

  Well, what I love about what you just said is you said I gamified it. The way games work is that it delivers rewards to us. That's why we play a game. It has a reward schedule. And the way that you gamified it is you came up with a spreadsheet because you can't play a game without a game board. You need some way of keeping track of whether you're winning or losing. You created for yourself a game board where you could gamify savings.

• 1:10:11Dr. Peter Attia?

  This is interesting. I never really thought of it that way. I assume people have already figured out a way to do this for young people. I'm sure there must be someone out there who has cracked the code on gamifying savings.

• 1:10:20Speaker 01

  If so, I have not found them. There's a lot of companies trying.

• 1:10:22Dr. Peter Attia?

  The fact that you and I independently have done the same thing.

• 1:10:26Speaker 01

  But I think that there's a powerful aspect to that, which is, I think the reason why it was so powerful for us is because we felt a sense of agency and choice over it. We came up with this model. We thought about what works for us. And even though we were both using spreadsheets, I'll bet you our spreadsheets were pretty different.

• 1:10:41Dr. Peter Attia?

  Sure. Yeah.

• 1:10:42Speaker 01

  Like I think that we were measuring different things. We were investing in different things. We were getting rewards.

• 1:10:46Dr. Peter Attia?

  I know they were because your spreadsheet is more sophisticated because it's focusing on your returns. I was return agnostic. I was focusing on contribution. So my spreadsheet focused on the spend and how big could I make the contribution number?

• 1:11:01Speaker 01

  Right.

• 1:11:02Dr. Peter Attia?

  But went to Vanguard was like out of my hands. I was like, they're going to do their thing.

• 1:11:05Speaker 01

  They're going to do their thing. I'm not even going to pay attention.

• 1:11:07Dr. Peter Attia?

  Yeah.

• 1:11:07Speaker 01

  And there's probably something about your psychology and my psychology where that contribution, that sense of willpower and of sacrifice feels very, very rewarding to you. That it might feel less rewarding to me, but a sense of over time returns.

• 1:11:20Dr. Peter Attia?

  And it could have been age related to it.

• 1:11:22Speaker 01

  I'm sure it probably was because you're probably as return sensitive as I am now, right?

• 1:11:25Dr. Peter Attia?

  Yeah. Let's go back to the creation of other habits that are not immediately rewarding, because unfortunately, that again is, in many ways, the mainstay of health habits. Now, some things that we want people to do for health provide both short-term and long-term value, and it's easier for people to anchor to the long-term value. So, easy example of that would be, "Hey Sally, look, you're 30 pounds overweight, and I have to be honest with you, I don't particularly care that you're 30 pounds overweight from the standpoint of your weight, but you're also very insulin resistant as a result of it, and I know that if you can lose 30 pounds, it's actually going to improve your health. You're going to become more insulin sensitive, your risk of diabetes, cancer, heart disease is going to go down.

• 1:12:10Dr. Peter Attia?

  This is what I care about." And Sally might say, "Yeah, I mean, in the abstract, I agree with all of that, Peter, but look, I'm only 30 years old. What I really care about is being 30 pounds lighter, so I look great in a bathing suit." And so, here you have a situation where both I can and the patient can care about the same outcome, but for different reasons, and there's a great overlap, which is great. The way we're going to address this is we're going to make these changes in your diet, these changes in your exercise, and there's a win for both of us, because in six months, you're going to have the body that you want to have, and I'm going to have the numbers I want to have to feel confident that your risk of chronic disease is down. But for some things, it's very difficult to find the short-term win, and you have to

• 1:12:55Dr. Peter Attia?

  grind away at doing something for a long period of time. Now, I'll take a very simple example, which is taking medication. It's not a huge ask, but you'd be amazed, if you're not familiar with this, you might already be familiar with the literature on compliance of medication use, it's shockingly low. So, let's take something that you don't even feel, so the medicine truly has no bearing on how you feel, which is blood pressure medication. Even though the mainstay of therapy for blood pressure is weight loss and exercise, elimination of sleep apnea and things like that, there's still a sizable portion of the population that has what's called essential hypertension, and no matter how much they fix their weight and they exercise, they just have hypertension, and if you don't fix it, you're really setting them up for the risk of- Heart attack, stroke, and even Alzheimer's disease.

• 1:13:38Dr. Peter Attia?

  So I say, Charles, I really need you to take this medication and I need you to take it twice a day. By the way, I'd also like it if you could check your blood pressure three times a week at home so that I know it's working. And do I need to adjust it up or down? Now, for whatever reason, I might be able to get 50% of people to do that. How can I create a reward around that? What type of reward would you envision?

• 1:14:00Speaker 01

  Okay, so let's talk about what's been done because I think this is the key question and it's a really interesting one. Afterwards, I want to ask you what you have done that you found has worked. So one of the interesting things that's happened in the last five years is that vitamin use has gone up significantly. More people are taking vitamins now than before. And researchers have looked at why and what they discovered was the big thing that changed vitamin use is making them gummies. Because you can put a little bit of sugar on the exterior of a gummy. So what they're doing is they're creating an immediate reward for eating that vitamin. They're incentivizing the behavior. Let's take teeth brushing. There's a whole chapter in Power of Habit about the history of tooth brushing because if you went back 100 years, a little bit over 100 years, turn to the last century.

• 1:14:40Speaker 01

  What you saw is that there were tons of toothpaste companies and almost nobody had a tooth brushing habit. And then this one guy comes up with a formula for how to get people to brush their teeth. What he does is he adds a little bit of mint to the toothpaste. So it makes your gums tingle when you use it. Now, that's actually a pain response. But what he's saying is when you brush your teeth, you're actually doing something good. You can feel it working. You can feel it on your gums doing its job. You're protecting your teeth. He's creating a positive reward even out of a pain response. So the number one thing we can do is we can try and manufacture a short term positive reinforcement, some type of positive reward. That's going to incentivize that behavior. That's not possible with everything.

• 1:15:24Speaker 01

  So the next thing that we could do is we can work on people building a mental habit associated with that behavior that does deliver a reward. So savings is a great example, taking my heart medication. So if I'm taking heart medication and it's kind of a pain, the pill's dry, it's like taken with fish oil. So it's like this.

• 1:15:42Dr. Peter Attia?

  Yeah, that's a great example.

• 1:15:43Speaker 01

  And you get that like weird fish burp all day long. There's all these negative reinforcements. So what do I do in order to incentivize that behavior? Every time I take that pill, I think to myself, you know what? I'm going to be around for my grandkids. I'm creating a link inside my head by exploring the why that gives me a positive reinforcement. I feel a sense of responsibility. I'm a responsible person.

• 1:16:04Dr. Peter Attia?

  Now, that strikes me as an exceptional intrinsic reward.

• 1:16:09Speaker 01

  It is.

• 1:16:10Dr. Peter Attia?

  In the long run, would you lead with that?

• 1:16:12Speaker 01

  Absolutely.

• 1:16:13Dr. Peter Attia?

  Is that strong enough as an extrinsic out of the gate first 90 day version?

• 1:16:17Speaker 01

  It's going to take willpower. The thing about rewards is that we usually have to experiment with them because we're often very bad at anticipating how rewarding a reward is going to be. There are some people who say, I'm going to go for a run and then I'm going to have a kale smoothie. That's not a reward.

• 1:16:29Dr. Peter Attia?

  They don't realize how disgusting kale is.

• 1:16:31Speaker 01

  It's disgusting. It's disgusting. Nobody wants that. That's why I put the peanut butter in. So we have to experiment with rewards to try and figure out which reward is salient for me. And for me, thinking about my kids, thinking like, I'm a responsible dad. I'm taking this pill. I'm doing it for my sons. I'm going to be there for them. That is a very salient reward. For someone else, it might not be. And they have to find that thing. And the way that we find it is we experiment with different rewards. And we just see which one sticks.

• 1:16:56Dr. Peter Attia?

  We're in this era of AI and AI chatbots and AI agents. You've already talked a lot about how social reinforcement is huge. I go back to the experiment you described in South America. 40% increasing savings by simply having that woman there to just tell you what a good job you were doing when you were saving. Is there a belief? Has it been demonstrated that an AI agent can be as rewarding as a human being?

• 1:17:23Speaker 01

  So the research is so nascent on this. My latest book is actually about the science of communication. And so this question of AI has come up a lot. And I also cover AI for The New Yorker now. This question of whether an AI system can be as good a conversationalist as another human. We don't really know. We're only two years into the generative AI experiment. What we do know is that I can create a reward for myself that's built around this ritualized behavior with an AI. If I create that spreadsheet and I feel a sense of accomplishment from filling it out, I can get the same sense of accomplishment by getting into a ritualized behavior with AI. Hey, AI, you told me that I should run two miles today and I ran two miles. We know that it's going to respond by saying, good job. You're doing a great job.

• 1:18:07Speaker 01

  You're thinking about your health for the long term. Now, is the power there the AI system? Well, the AI system can automate it. But the real question is, do I invest in the pride I feel from being told that by an AI? And for some people, the answer is yes. For other people, the answer is going to be no. So the answer to your question is, yeah, AI is great because AI can help automate certain rewards. It can automate certain behaviors. But whether that reward is salient to me, whether that behavior is salient to me, really depends on me, and I have the power to choose.

• 1:18:39Dr. Peter Attia?

  Yeah, I'm just trying to think. That's really interesting because I know that, I mean, I've already figured out ways to use AI as a reward for me and for my kids.

• 1:18:50Speaker 01

  Like how so?

• 1:18:51Dr. Peter Attia?

  My boys and I love to just do Q and A sessions with ChatGPT. Just go down the rabbit hole of, okay, what is the most valuable baseball card ever sold? Okay, it's this one. Why? What was the PSA on it? Okay, but why was Mickey Mantle's worth less than Babe Ruth's?

• 1:19:16Speaker 01

  So can I ask you a question about that? So all of those questions you could have just asked Google before, or ChatGPT. You could have just done a Google search. What is it about doing it with ChatGPT that feels more pleasurable to you?

• 1:19:29Dr. Peter Attia?

  Great question. Now, of course, today, you're absolutely correct in that Google today is mostly powered off Gemini. If you're using the right version of Google, you're actually getting Gemini to do the work, and it's using a great version of Gemini. My favorite thing I like to do with ChatGPT or with Grok or whichever one, all the agents are really good, is I like to ask history questions because, you know, I was an engineer in college and I was one of those guys who, even though I think in engineering school, you had the option to take electives, I didn't take any. I just took more math.

• 1:20:01Speaker 01

  Interesting.

• 1:20:01Dr. Peter Attia?

  So I kind of feel like. I didn't learn anything. I mean, I learned my craft, but I didn't learn about history. And furthermore, because I grew up in Canada, I really know nothing about US history.

• 1:20:12Speaker 01

  Oh, that's interesting.

• 1:20:13Dr. Peter Attia?

  So I didn't, I don't even have the equivalent of high school history. So my US history knowledge is not what I wish it was. And so when I'm talking to an AI, it's like having a private tutor. Now that's assuming that the hallucinations aren't so bad. Still, it's really exciting to say, can we talk about this part of the Civil War? Like, what was it about Gettysburg that was the turning point? And then ask really complex questions, like, what would have happened if this had happened instead of that? And how pivotal was this battle? And so, yes, that for me is like a drug. Sitting down, spending an hour talking with a chatbot about that type of a topic. And also, I think part of it is the talking. It's I can talk and I can listen.

• 1:20:58Speaker 01

  Yeah, that's absolutely right. And so here's what I hear you saying, and tell me if you think this is right. There's sort of two rewards that this is providing to you. The first is you have a very personalized search engine. It's answering the question you're asking, instead of you having to like, put a vague term in and try and figure out where the answers are. But number two, it's mimicking, perhaps even authentically having, a form of communication that we have been habituated to, that we enjoy a lot. When you and I are in conversation right now, and I'm sure you know this, our bodies and our brains are changing to match each other. Our heart rates are matching each other, our breath patterns are matching each other, the neural activity in our brain. And there's a guy named Yuri Hassan at Princeton who's done amazing research on this. Our brains are looking more and more similar.

• 1:21:39Speaker 01

  And because our brains have evolved to be good at communication, to be a pro-social species, we both feel a dopamine response to that. We feel better. We feel good after a good conversation. Now, if you're having a conversation with AI, do you have that same matching? Maybe, maybe not. But we do know that I'm in the habit of feeling good when I have a good conversation. Even if I'm having a good conversation with a chatbot, I'm gonna get some of those glimmers of the same great feeling I get from talking to Peter. And that's gonna make that conversation easier for me and more natural. And feel more fun.

• 1:22:15Dr. Peter Attia?

  Yeah, I think there has to be something there and I wonder if it is in how much it triggers the proximity to what is real. And I'll give you a silly example of why I think there's something to that. With ChatGPT, you get to pick the voice you're talking to.

• 1:22:29Speaker 01

  Oh, that's interesting. Right.

• 1:22:30Dr. Peter Attia?

  And I've tried them all out, but there's, I don't remember the name of the one I'm using, but it's a British guy. I don't know what it is about discussing history with a British guy, especially when you get into World War II history. Like, if you want to talk about World War II history with an older British man, it's awesome. It's fantastic. I don't think it would be nearly as enjoyable if I was talking about it with someone that didn't conjure up whatever image of wisdom that I'm gleaning out of this.

• 1:22:55Speaker 01

  Some 16-year-old San Diego surf chick.

• 1:22:58Dr. Peter Attia?

  Yeah, exactly. Totally different experience. Could be the exact same information, but there's an auditory component to it that is lighting me up in a way.

• 1:23:06Speaker 01

  And I think it's playing on old habits that you have. There's communication habits. I'm sure I just feel exactly the same way, that like, you listen to someone with a British accent and you just think they're smart. And by the way, I know lots of British journalists who like, are not that smart.

• 1:23:19Dr. Peter Attia?

  Right, right, I know. It's the old trope though, right? Like, as Americans, we think like, it's metaphysically impossible to have a British accent and not be brilliant.

• 1:23:27Speaker 01

  Yes, yes. And it works every time. And they use it to their advantage every time they come over to the United States. But I think what's happening there is it's taking advantage of these mental habits. And we've talked a lot about behavioral habits today, but most of the habits that exist in our lives are mental habits.

• 1:23:45Dr. Peter Attia?

  Hmm.

• 1:23:46Speaker 01

  They're habits that we don't even recognize as habits, because they're happening inside our brain. And they are incredibly powerful. They make you believe that a chatbot is more intelligent if it has a British accent than if it has a San Diego accent. These mental habits make me believe that when someone cuts me off in traffic, a perfectly appropriate response is to get angry, which does not benefit me, does not change the situation. I know that I should be zen about it. It compels me to behave a certain way.

• 1:24:15Dr. Peter Attia?

  So let's say more about that. Let's say more about the mental habits. I read something the other day, which didn't surprise me one bit, because anybody who has meditated will know this. We have an average of, I believe, 47 thoughts per minute.

• 1:24:32Speaker 01

  Wow.

• 1:24:33Dr. Peter Attia?

  Almost one per second. If you don't meditate, or you haven't spent some time doing mindfulness meditation, you would think that's impossible.

• 1:24:42Dr. Peter Attia?

  But if you've ever done the exercise of sitting there focusing on your breath, watching every single time you are distracted by a thought, you'll be like, yep, I can believe it's 47 times a minute.

• 1:24:52Speaker 01

  That actually sounds small to me, based on my meditation.

• 1:24:54Dr. Peter Attia?

  So we've got this crazy thing that is just a thought generating machine that we can't control, but thoughts are not thinking. So what translates us from thoughts to thinking? How do we form better habits or reformat maladaptive habits around that? You give a great example, by the way, of the reaction to getting cut off, an anger reaction.

• 1:25:17Speaker 01

  That's absolutely right. So the way that we can influence our mental habits is that we have to deliberately choose to figure out what the cue is, and then we have to give ourselves a reward afterwards. They operate by the same principle as behavioral habits or physical habits. But it's a little bit more tricky. So oftentimes, let's take innovation. Innovation is one of the, a mental habit that's studied. Why do some people manage to innovate on demand much better than others? We can all be innovative, but some people, they need the muse to strike. It takes them years. And so other people, you walk in and you say, hey, look, I need 30 great ideas by tonight, and they can sit down and they knock them out. So what's happening there? When researchers have looked at the lives of serial innovators, what they found is

• 1:25:59Speaker 01

  that the most important part of that is that oftentimes, the people who are really good at it have built up what's known as a contemplative routine to spur that innovation. Now, these contemplative routines can be something like, every week I sit down and I reflect on all the good ideas I had last week, just for 30 minutes, and I try and think of good ideas for next week. Or the contemplative routine can be, whenever anyone asks me to come up with 30 ideas, the first thing I do is I go take a walk. And I just think about it in my head. I'm not writing anything down. I'm not committing myself to anything. I'm just letting it percolate a little bit. I have a routine that I know works for me to spark contemplation. Because when you think about it, when it comes to mental routines, and when it comes

• 1:26:43Speaker 01

  to mental habits, and when it comes to success, the most successful people throughout history are the people who can get themselves to think more. Most deeply, making the right choice is so much more powerful than executing really well on the wrong choice. So the question is, particularly in a fast paced world like today, how do we get ourselves to think more deeply? This is the killer app for our brain. And the way that we get ourselves to think more deeply is to build these contemplative routines that we automatically fall into, because those contemplative routines push us to think more deeply. And I can give you an example of this, if you'd like. I described this in Smarter, Faster, Better. There was a plane, Qantas Flight 32, was a plane, an

• 1:27:26Speaker 01

  Airbus A380 that took off from Singapore to Sydney in the early 2000s. Perfect takeoff, the captain was a great captain. About 10 minutes into the flight, one of the fan blades in one of the jet engines detaches, and it punches this enormous hole in the wing. It also hits another fan blade, and that fan blade explodes. And it was like the shrapnel from a bomb going off inside the plane wing. So within about 12 seconds, there's 14 major systems that are needed to keep a plane aloft. Within about 12 seconds, 12 of those systems had gone offline. No hydraulics, no fuel, no measurements on anything. So the captain, a guy named Richard DeCrespigny, he has to figure out how to land this plane safely. This is the worst midair mechanical disaster in modern aviation. So what does he do at

• 1:28:11Speaker 01

  that moment? What he does at that moment is, there's all these alarms going off inside the cockpit, there's all these red flashing things on his board, the computer is telling him, you have to do these 10 things, and as soon as you do those 10 things, you have to do five more things, you have to do 13 more things. What he does is he takes his hands off the controls for a second, he closes his eyes, and he says to himself, I'm telling myself a story about the plane that I'm flying. And the story in my head is the Airbus A380, and it's really complicated, because I have to think about fuel lines, I have to think about hydraulics, I have to think about brakes. You know what I'm gonna do? I'm gonna change the story inside my head, I'm gonna change the mental model that I'm using on where to focus. And I'm gonna pretend I'm flying a Cessna. Now, a Cessna is the plane that

• 1:28:54Speaker 01

  he learned to fly on, it's the plane he feels most comfortable in. And he actually sort of announces this to air traffic control and to his other pilots, and they freak out, because they're like, why is this guy talking about flying a Cessna, he's in an Airbus A380? But that moment of contemplation. Allowed him to access that muscle memory, those habits of flying, and he lands the plane safely. They touch down, all 469 passengers get off. About half an hour later, there's not one injury on board. Now, they've tried to recreate this landing again and again in simulators. Almost every single time it crashes. So what did Richard DeCrespigny do differently? Why was he able to land that plane? And I've asked him, and what he'll tell you is, he'll tell you, he actually doesn't know or remember exactly what he did in the moment.

• 1:29:37Speaker 01

  But by changing that mental model in his head, by engaging in this contemplative routine, which felt supernatural to him to say, I need to be in charge here. I need to stop reacting. I'm going to choose to pretend I'm flying a Cessna. That unlocked all of these learned habits of safe flying that allowed him to land that plane.

• 1:29:57Dr. Peter Attia?

  Tell me more about him outside of the airplane. What kind of a man was he? What were his pastimes? This story is so impossible to imagine that I can't believe he's a normal guy.

• 1:30:11Speaker 01

  So he's not a normal guy. He was trained to fly by the Australian military, Australian Air Force. And anyone who's learned to fly in the military, they know that a huge part of it is learning technical skills, but a huge part of it is also learning these mental habits, these mental skills. And in particular, learning how to train your focus based on building mental models. And the way that a mental model works is as we go through life, everything we do, there's a little story inside our head that we're telling ourselves. And our brain is comparing that story to what's actually happening to help us figure out what to pay attention to. There's so much that I could pay attention to right here, right? There's bright lights, there's your expressions, there's a camera, there's wood paneling. I need to figure out where to actually focus.

• 1:30:56Speaker 01

  And so what my brain does is it creates a mental model where it says, the story of right now is that I'm having a conversation with Peter. So I'm going to focus on Peter. I'm going to be very, very attuned if something changes unexpectedly in your demeanor and very unattuned if something changes outside the light, because it doesn't matter to me right now. So when you're learning to fly in the military, they tell you. Be really deliberate about how not only you build mental models, but how you challenge your mental models. And so the morning before that flight, before Qantas Flight 32 took off, Richard DeCrespigny did this thing that he did before every single flight. He's in the shuttle from the hotel to the airport, and he turns to his co-pilots and he says, because he's the captain, says, "What's the first words out of your mouth if we lose Engine 2?

• 1:31:42Speaker 01

  Where are your eyes going to go first? Where are they going to go second? What are you going to do with your hands? If we lose Engine 3, how are your words going to change?" In other words, what he's doing is he's saying, "Tell me a story about how we will react if there is an emergency." And if you listen to the cockpit recordings from when that hole appeared in the wing, what you hear is you hear all these pilots talking to each other in calm, collected voices. There's not an ounce of panic in their voice. It's as if they had practiced this 1,000 times, because of course they had. They had practiced it in those rides from airports or in the simulator. But that's not the only thing that DeCrespigny did. The thing that made DeCrespigny special is that when he would ask his co-pilots to tell him those stories, he would argue with them.

• 1:32:26Speaker 01

  "That's what you're going to say first after Engine 2? Why are you going to say that? Why shouldn't we say this? You're going to move your hands left and then right? Let's talk about like, why not right and why not left?" He was in the habit of challenging his own mental models and other people's mental models. And that challenge is what allowed him, in the panic of that moment, imagine you're flying a plane and all of a sudden, all your alarms light up? It's so easy to become reactive. It's so easy to fall into just, "I'm going to do what the computer's telling me. I'm not going to think about this. I'm not going to challenge the story inside my head." But he's in the habit, because he practices it with other people, of challenging not only their stories, but his story.

• 1:33:06Dr. Peter Attia?

  What fraction of pilots are behaving that way?

• 1:33:10Speaker 01

  Particularly military-trained? A huge fraction. Now, there's a really interesting study, particularly out of South Korea, that in some cultures, there's too much deference given to the captain. And so as a result, they're engaging in less challenging of each other's mental models, and there's been a lot of interventions to try and change that.

• 1:33:27Dr. Peter Attia?

  The tragedy on Canary Island, if I recall, there was a KLM flight.

• 1:33:32Speaker 01

  Yeah.

• 1:33:33Dr. Peter Attia?

  And it was the KLM flight that was at fault. Everybody, I think, died on that flight.

• 1:33:38Speaker 01

  Yeah.

• 1:33:38Dr. Peter Attia?

  It was a similar issue, wasn't there?

• 1:33:39Speaker 01

  Yeah.

• 1:33:40Dr. Peter Attia?

  Where the captain, who was there, if I'm not mistaken, he was the most impressive captain in their entire fleet.

• 1:33:47Speaker 01

  Right.

• 1:33:48Dr. Peter Attia?

  But a similar situation was not heeding the input from less senior.

• 1:33:52Speaker 01

  That's exactly right. That's exactly right. And sometimes there's an Air France flight. I don't know if you remember, it was from.

• 1:33:58Dr. Peter Attia?

  Brazil.

• 1:33:58Speaker 01

  Brazil, yeah. And so we have the cockpit recording of what happened there. And if you listen to it, there was nothing wrong with the plane the entire time. It was that the pilots became what's known as tunnel focus. All I do is I pay attention to the most obvious inputs and I stop challenging that story in my head of what's going on. So they actually caused the plane to stall and it fell into the ocean. It happens all the time.

• 1:34:21Dr. Peter Attia?

  So have you interviewed Sully, Sullenberger?

• 1:34:24Speaker 01

  No. So it's interesting. I spent a lot of time talking to Richard DeCrespigny, and me and Sully share a speaking agent. They're both very similar. These guys are engineers, engineers. Like, you talk to DeCrespigny, he's not a guy you'd go have a beer with. He is really difficult to talk to. First of all, he believes there's a process for everything, and there's a right answer, and there's a wrong answer. And when I bring something up, he'll be like, nope, you got that exactly wrong. Let me tell you where you got it wrong. This instinct to challenge mental models is so ingrained in him that it comes out all the time. And they actually have this expression in the Australian air community, and they might be in the US too, that when someone's a really good pilot, they're known as an asshole pilot. Because they're so uptight, they're such an asshole. They challenge everything you say. They're always picking a fight with you about whether

• 1:35:09Speaker 01

  you're doing the right thing. That guy's an asshole, but he's a great pilot as a result. It means you don't want to have a beer with him, but you definitely want him flying your plane.

• 1:35:17Dr. Peter Attia?

  Super interesting. What are some less dramatic examples of how this manifests in the lives of those of us who don't carry in our hands the lives of 400 passengers?

• 1:35:30Speaker 01

  So let me ask you a question. So. What do you do to get ready for each week? A process you go through or what is it that you do?

• 1:35:37Dr. Peter Attia?

  Every Friday afternoon, I make a list of everything I'm going to accomplish on Saturday and Sunday. And every Sunday, I make a list of everything I'm going to accomplish Monday through Friday. So I have two lists, a five day week list and a two day weekend list. And they include the most important things that have to be done. Now, not things that are automatic, so I don't write my workouts and stuff because those are kind of on cruise control. But it can be anything as mundane as gotta go to Dick's Sporting Goods and get a set of baseballs. The old baseballs are getting beat up. Need to finish working on this newsletter, need to prepare for this podcast, need to take my daughter here.

• 1:36:20Dr. Peter Attia?

  It's just basically, it's how I kind of organize the blocks of the week.

• 1:36:23Speaker 01

  And why does that feel good to you? You would end up taking your daughter anyways. You would probably see the baseballs and be like, oh, that's right. I gotta go to Dick's. There's something about that list, that's a contemplative routine for you. What reward is it providing?

• 1:36:33Dr. Peter Attia?

  Well, I am someone who, it's weird, and this has always been the case, even in school, high school. I really enjoy checklists and I enjoy checking things off a list. There is a dopamine hit that I am getting.

• 1:36:48Speaker 01

  Absolutely.

• 1:36:49Dr. Peter Attia?

  I have a box and I write what I'm gonna do. And then if it's in progress, it gets a single line through the box. And then when it's fully done, it gets the X through the box.

• 1:36:58Speaker 01

  I love that.

• 1:36:58Dr. Peter Attia?

  So for example, if one of the things was connect with Charles this weekend. Okay, let's say I call you tomorrow and we talk for five minutes, but then you have to run. I would put a half slash through it, which is all right, we partially connected, but we haven't fully connected. So I know that I still have to come back to it.

• 1:37:17Speaker 01

  Yeah.

• 1:37:17Dr. Peter Attia?

  And connect with you. And if I don't, then it goes on the next list of the week or something like that.

• 1:37:21Speaker 01

  So here's what I love about that. There's a need for cognitive closure that all of us feel. The research on people who'd make to do lists find that 60% of people, when they're writing a to do list, will write down something they have already completed because it feels so good to check it off.

• 1:37:35Dr. Peter Attia?

  So I used to do that.

• 1:37:37Speaker 01

  Okay.

• 1:37:37Dr. Peter Attia?

  I stopped doing it about 20 years ago. But I did, I used to take great. Pride in sneaking in a couple wins.

• 1:37:44Speaker 01

  Yeah.

• 1:37:44Dr. Peter Attia?

  Out of the gate.

• 1:37:45Speaker 01

  So what you've done, that need for cognitive closure, it can push us to like, do the laundry when we don't need to do laundry. Cause we just want to feel some sense of accomplishment. You have actually redirected it through a cognitive routine to be a very positive influence in your life. I'm going to create the goals that I actually want to accomplish. I'm going to create a system where I can satisfy that need for cognitive closure. And I'm going to have a tracking device in order to do it. The reason why that's useful is because you have a routine around it. You have this cognitive routine that on Friday afternoons, you're doing the weekend list. On Sunday, you're doing the week ahead list. For me, my cognitive routine is every day when I come home from work, I tell my wife about my day in excruciating detail. And she is bored to death by it. She does not care how this interview went or what came out of this meeting.

• 1:38:31Speaker 01

  But I'm not doing it for her. I'm doing it for me because as I'm describing my day, I'm paying attention to this went well. Why did it go well? This didn't go as well. Like, what do I need to do differently next time? I have a cognitive routine of describing my day to my wife that provides me with a dividend.

• 1:38:48Dr. Peter Attia?

  Does she understand that?

• 1:38:49Speaker 01

  Oh, absolutely. She tunes me out. She doesn't pay any attention. She knows that I'm describing the day for my benefit. And she does the same thing to me and I kind of tune out sometimes what she's saying about her day.

• 1:38:59Dr. Peter Attia?

  Interesting. You know, it's funny, I sometimes worry that I'm too rigid in having these lists and that, especially the weekend list.

• 1:39:07Speaker 01

  Yeah.

• 1:39:08Dr. Peter Attia?

  Maybe would my life be better off without it? And even though I would have to give up some productivity, would I be less wed? Cause sometimes I get a little dogmatic.

• 1:39:17Speaker 01

  Yeah.

• 1:39:17Dr. Peter Attia?

  Right?

• 1:39:18Speaker 01

  And so we feel bad.

• 1:39:19Dr. Peter Attia?

  I get up on Sunday and I'm like, dude, you didn't get much done yesterday. You've loaded the deck for today.

• 1:39:24Speaker 01

  Yeah, I think that's a really good instinct and I think it's worth experimenting with. One of the things that we know, so the way that I write articles for the New Yorker. Is historically, and I do this with books too, I will write an outline that's almost as long as the article itself, just to make sure I understand.

• 1:39:39Dr. Peter Attia?

  In bullet point?

• 1:39:40Speaker 01

  No, actually, in a narrative to my editor. Yeah, I write a letter to my editor. I do all the reporting and then I put it aside and I just write my editor a letter saying this is what I think I'm gonna say. And it's easier because the stakes are very low and I don't have to return to the reporting. If I get something wrong, it's okay. And that's worked really well for me, particularly in writing books and writing long form pieces. But I do think it's impacted negatively my creativity. There's something about having more options and having that sense of risk that sometimes pushes you to figure out how to say something in a new way, or pushes you to figure out how to say something in a kind of fun way that didn't occur to you before.

• 1:40:18Speaker 01

  And so I play a lot with rigidity and freedom in trying to find that right balance. And my guess is that you do too, in many of the things you do. I know that intellectually you do, like I listen to the show and there's some questions that you ask that you ask everyone. And there's some lines of inquiry you go down that are clearly like the right line of inquiry. But then sometimes you ask a question that comes out of nowhere, or you ask something that's kind of unexpected that causes the guests to say something they didn't anticipate they were gonna say. I think intellectually, you're engaging in that same exploration versus exploitation process that's at the core of all information gathering.

• 1:40:55Dr. Peter Attia?

  I want to go back to this contemplative routine idea because the first thing that came to my mind when you described it is going back to something that Ryan Holiday wrote about the stillness is the key. Have you read that book?

• 1:41:08Speaker 01

  Yeah, and I'm a huge fan of Ryan. I think he's great.

• 1:41:11Dr. Peter Attia?

  Obviously, Ryan has written more books than I can count, but that is my favorite. Stillness is the key is my favorite. It's the one I've gifted the most. It's a book I go back to. I'm actually due to reread it. It's probably been two years since I last read it, so I'm due to reread it. And it's something that my brother does so well. My brother, his superpower is making stillness time. He's very disciplined about this. He is very disciplined about time to think.

• 1:41:41Speaker 01

  Tell me how he does that. Like, tell me a little bit more. If I was watching him, what would it look like?

• 1:41:45Dr. Peter Attia?

  Well, you would actually think at the surface, it's quite selfish. He'll say, for the next two hours, he'll tell his wife and his kids, I need to be left completely alone. And I need to go for a walk with no phone, with no anything. I'm gonna walk in the fields. He lives on a farm and he's like, and I'm going to just be with my thoughts and with nothing else. And then I can come back and do my best work. But he forces that in. And I think I am convinced that all of us could do better work if we did that. And yet I struggle to do it. There's a bit of a trap that I fall into, which is,

• 1:42:28Dr. Peter Attia?

  yeah, but think about how much more I could get done in those two hours.

• 1:42:31Speaker 01

  Yeah.

• 1:42:31Dr. Peter Attia?

  Like, I don't have the two hours to be still.

• 1:42:33Speaker 01

  Right. So Cal Newport has done a lot of work on this. One of the mistakes that we make, and this is just a cognitive heuristic that we fall into, is that we look at some types of activities as being unproductive because they don't yield immediate dividends.

• 1:42:48Dr. Peter Attia?

  This actually is part of the whole habit system.

• 1:42:50Speaker 01

  It absolutely is. It's about building those habits to recognize deep productivity, deep work. And so one of the things that I'm sure it happens to me, I'm sure it happens to you, is that I say, if I go take a walk in the woods for two hours, what do I have to show for it? Whereas if I sit down and I pound through these emails for two hours, my inbox is half the size it used to be. It feels really like an accomplishment. Now, of course, all that does is create more emails for me. And it turns out, half of those I could have ignored. So what I need to do is I need to train my brain. And my brain oftentimes doesn't believe me. I know intellectually, taking that walk in the woods is gonna yield dividends, that I'm gonna be able to do better work. But my brain, there's a part of my brain that looks at my stated preferences, what I believe and want to be true.

• 1:43:35Speaker 01

  And another part of my brain that looks at revealed preferences. How do I actually behave? And that revealed part of my brain is saying, you never take walks. You always sit down and do your email. You must think that doing email is more valuable than taking a walk. So I have to convince myself, convince that revealed preference is part of my brain. No, the walk is really good. If I take this walk, I'm gonna get more work done. I'm gonna be able to get through those emails faster because I'm gonna hit delete on more of them. This actually is a productivity enhancer. We have to hack our own brains sometimes. We have to remind ourselves of a reward. Oftentimes, the salience of a reward increases simply because we tell ourselves it is a reward. And we have to take advantage of that to try and sometimes play with our own brain,

• 1:44:19Speaker 01

  because we'll act sometimes in not our best interests.

• 1:44:22Dr. Peter Attia?

  What do you think is the relationship then between productivity and habit? How implicit and how explicit is it?

• 1:44:30Speaker 01

  So I think it's huge. I think it's huge, but let me be very clear how I mean that because oftentimes the things that we do out of habit are not the productive things. But our habits can set us up to be productive. As I mentioned before, the most important element of productivity is deep thought. Because making the right choice, making the right decision, spending my time on the right task right now yields many more dividends than simply getting something done. It's the difference between productivity and busyness. So the question is, how do I set myself up to make better choices? Well, the way that I do that is I build habits that give me not only the time and space to make a choice, but the prompt to make a choice.

• 1:45:15Speaker 01

  Because there's a lot of times that I'm going to avoid making a choice if I can. My brain doesn't like making choices. It costs energy. It feels like it's depleting me. So my brain is going to say, oh, you walked in the cafeteria. Don't get the salad. Just get the sandwich you get every single time. You know, it's going to, you're going to like it. So how do I build a habit that allows me the space to make that choice and the prompt to make that choice? That's why habits are so important, is not because they make us productive. It's because they allow us to be productive.

• 1:45:41Dr. Peter Attia?

  Say more about the decision fatigue, because I think that's something that many people listening to us right now can relate to. I have become much more aware of it in myself recently. And I don't think it's age related, per se. I think it's just complexity related. So the more things you're juggling, the more I find myself unable to make simple decisions. And it's like, I can't tell you how internally frustrated I get sometimes when I'm asked to make decisions.

• 1:46:13Speaker 01

  So there's two things happening there, and you're exactly right. Decision fatigue is real. We've seen it in, actually at this point, hundreds of studies, that the more decisions you have to make in a day, the more fatigue you get. There's some elements that play into this. The first is structuring decision design. So President Obama, in one interview, he said that the most important habit that he developed when he was president is he bought 12 of the same suits and shirts. So every morning when he woke up, he knew exactly what he was going to put on. There's no other options in his closet. He just has to grab one of them. And he said the reason why is because the day was so exhausting with decisions and each of the decisions he made was so important that he had to preserve his ability to make decisions and avoid that fatigue.

• 1:46:57Speaker 01

  So the first thing is, how do we design our decisions so that we're only having to make the important ones and we're making the less important ones automatic, things where we don't have to make a choice? The second thing that happens there is that decisions are harder to make in a hot state than they are in a cold state. So if you're hungry and you go into the cafeteria, it's going to be a lot harder for you to choose that really healthy salad over that really tasty sandwich because you're in a hot state. Now, in a cold state, that morning when you just had breakfast, if you say my implementation intention is I'm going to eat a salad today, when I walk in, I know which salad I'm going to get, it's a lot easier to make that decision. So here's what I think is happening. Number

• 1:47:39Speaker 01

  one, you don't have a mental heuristic in place to say, I'm going to curate the decisions I have to make. And you probably do now, but like, the first time it comes up, you don't have the heuristic. And the heuristic is, when my wife asks me where to go to dinner, I'm just going to choose one of them. I'm not even going to like, think about like, which one is the best one. I'm just going to choose one. So I'm going to create a decision structure for myself that allows me to focus on the most important decisions and ignore the smaller ones. Secondly, I'm going to ask her not to ask me to make that decision at the end of the day when I'm exhausted and I've been making choices all day long.

• 1:48:09Dr. Peter Attia?

  Yeah.

• 1:48:09Speaker 01

  I'm going to say, look, I'm in a hot state right now. I can't think about where to go to dinner. I'm thinking about other stuff. But if you ask me two hours from now, after I've had a beer and I've started watching TV, I think I'll be ready to answer that question.

• 1:48:21Dr. Peter Attia?

  You're so right that that's the obvious answer. And yet you feel, or at least I feel like, how can I not be more gracious?

• 1:48:29Speaker 01

  Oh, right.

• 1:48:30Dr. Peter Attia?

  Like, I feel embarrassed that I would have to say that and obnoxious.

• 1:48:34Speaker 01

  Absolutely.

• 1:48:35Dr. Peter Attia?

  But it's true of everybody in my life. Sometimes my assistant will email me and say, we're having an offsite and can you pick your lunch? And I'm like, I can't. And it sounds silly, but like, if it comes through on text, it's even more debilitating.

• 1:48:48Speaker 01

  Yeah.

• 1:48:49Dr. Peter Attia?

  Cause then I have to click the menu and see the menu and it's like a restaurant. And I'm like, I wish you could read my mind and you knew what I wanted. But I don't want to have to do this.

• 1:48:59Speaker 01

  It's very Canadian of you that you feel a sense of guilt around telling someone you can't make the choice right now. Part of our brains, particularly for successful people, everyone listening to this podcast, you and I, when we are successful, our self-definition becomes rooted in success instead of failure. We are the type of people who have been successful because we make good decisions. And so we beat up on ourselves when we can't make a decision. We beat up on ourselves when we have a human frailty or a human weakness. But you know this from training athletes. The key is not to not have frailnesses. The key is to recognize your frailnesses, plan for them and strengthen your behavior around the frailness. Every single one of us makes bad decisions.

• 1:49:42Speaker 01

  And if our self-definition is, I'm someone who like, every time everyone asks me a question, I can give them the right answer. Then we're setting ourselves up for failure.

• 1:49:50Dr. Peter Attia?

  It's been 12 years since you wrote what is, I think arguably the most authoritative text on habit creation. How much have you stayed up to date on the science of habit? And if so, how much has changed in the last 12 years? If you were to rewrite that book today, what are two or three things that you think might be different? Or that we're just outright missing?

• 1:50:13Speaker 01

  I've tried to keep very current on the literature around it. And the fundamentals haven't changed. The fundamentals have been true for thousands of years about a cue, a routine and a reward, how our brain works and forms habits. What has changed is our understanding of how much influence we can have over those cues and rewards by influencing our environment. So I'll mention another author, David Epstein. Wonderful. He's a wonderful writer. I had him on the podcast about six, seven years ago. Yeah, he's great. He's great. And he talks a lot about current research, looking at environments where we have a lack of resources and environments where we have a lot of resources. And environments where we have a lack of resources oftentimes produce better outcomes. But not all resources are created equal.

• 1:50:57Speaker 01

  If I tell you, you have a time limit on coming up with a new idea and your time limit is five minutes, that's not going to be helpful. But if I tell you, Peter, you can't spend more than two days on this, that is helpful. So what we're learning a lot about is how to use constraints, how to create what are known as wicked environments, where the feedback is ambiguous, it takes a long time to arrive, and it's not being delivered in a social context versus helpful contexts or good contexts, where the feedback is immediate, it's very, very clear, and it's being delivered to me oftentimes in a social context, which reinforces it. We're learning a lot about how these different environments influence our ability to act

• 1:51:41Speaker 01

  in different ways. And this is at the core of behavioral economics. We've known for a long time that the decision architecture matters, that environment matters. But what we're learning is we can get much more precise. So if I was writing The Power of Habit today, one of the things that I would include is a chapter on thinking much more deliberately about your environment. Not just, I'm going to put apples on my desk so that when I have a craving to eat something, I eat one of those apples instead of a donut in the break room. But also, I'm going to structure my day so that I make my most important decisions in the morning, because I know that that's when my decision making is strongest. I'm going to structure my day so that I go and I take a walk in the afternoon, because I know that if I do that, I'm going to do better work that evening. I think that one of the things that we are learning is our environments matter much more

• 1:52:26Speaker 01

  than we thought they did. And it's worth paying attention to that.

• 1:52:30Dr. Peter Attia?

  Do we have a greater sense of appreciation for the social component today than we did then? Obviously, it was strong and well understood then, but it almost seems to me that, and I don't know if it's just coincident with social media, but we just understand the power of social influence.

• 1:52:47Speaker 01

  And that's actually one of the reasons I wrote Super Communicators, is because what I came to realize is that when we focus on habits, we tend to focus on ourselves. But most of our most important work, both for ourselves and professionally, is work that we do in conjunction with others. The value of my life and your life is largely based on the conversations we have with our spouses and our kids. That's whether we feel good or bad. And so what I realized is by focusing on habits exclusively, I'm missing this incredibly important part of what makes people successful and happy, which is how do we interact with other people? We are living in a golden age of understanding communication like never before. Because of advances in neural imaging and data collection, we can see inside people's brains as they're having a conversation. We know what's happening there.

• 1:53:32Speaker 01

  And we're learning a tremendous amount about what kinds of social reinforcement are positive and which kinds aren't, and which kinds are powerful, more powerful than other kinds.

• 1:53:42Dr. Peter Attia?

  So I'm not going to ask you if you're working on another book, because I know you might not want to talk about it, but you're always in a state of learning. Is there something that is brewing as the next evolution in your thinking?

• 1:53:53Speaker 01

  And in fact, I'll tell you what the next book I want to write, and invite listeners to reach out to me if you think there's something I should know about. So I think AI is really, really interesting and really, really important. Now, I'm not one of those guys, and I interview a lot of these guys, who says AI is going to change every single part of life. It's going to revolutionize everything. I think there's a lot of humanness that's really important to us. But I do think that AI has the same potential that the first industrial revolution and the second industrial revolution had, that the wide adoption of the internet had. And what's interesting to me is if you look at the history of nonfiction literature, what you see is that there were these moments of real discovery and someone wrote a book that explained to us how to think about it.

• 1:54:37Speaker 01

  One of my favorite examples is The Right Stuff. Many people have seen the movie. The book is fantastic. It's written by Tom Wolfe. It's an amazing book. And what he's really writing about is he's not writing about the science of the Apollo missions. He's writing about the psychology of the people who are designing those rockets and are getting on those rockets. His basic question is, What kind of a person is willing to strap themselves to a rocket? Before we knew that this was safe and easy? And send themselves into space? Before we knew we could survive there? Why? Why is someone willing to do that? Why are people competing for the opportunity to do that? And he found a lot of interesting answers. That's what I'm wondering right now about AI. And we might be a little bit too early in the process to really have any conventional

• 1:55:21Speaker 01

  wisdom or takeaways. Why do some people see the world differently in a way that allows them to develop these generative AI systems and other AI systems that are so potentially transformative? And most importantly, how will it change how the rest of us think? How will it change our definition of self? How will it change how we work? Those are really interesting questions. So that's what I'm hoping to write about in the next book. And I think there's probably going to be a lot of lessons in it about how we ought to behave.

• 1:55:49Dr. Peter Attia?

  What do you think about the importance of purpose to our species?

• 1:55:53Speaker 01

  I think it's incredibly important. And here we get like a little mystical, right? Because we don't know why purpose seems to light up so many parts of our brain, but we know that it does. We need a why. That story that's inside our head, that mental model that tells us what to pay attention to and what to do next. We are a storytelling species. We look for correlative links in life. I told this one funny joke, and so the girl fell in love with me. I started running every single day. And then, you know, I got in better shape and I was able to give up smoking. That might be correlation and not causation, but we look for those causal links. We want them to exist. We make sense of the world by telling ourselves a story about the world.

• 1:56:38Speaker 01

  At the core of most stories is the why. Why is the knight getting on his horse and going to fight the dragon? There's got to be some reason for it. There's got to be some motivation. He wants to win the hand of the princess. Why do you remain faithful to your spouse? There's temptations all around. Our biology tells us that we should probably not be faithful, but there's a why there that's at the core of our story. And the reason why that story is so important is because it's our self-identity. It is how we make sense of ourself as an individual. In this world. And if we had to reinvent our self identity every morning, it would be exhausting. That's actually what schizophrenia is. One of the contemporary ways of looking at schizophrenia

• 1:57:18Speaker 01

  is that it's someone who has biochemically a more difficult time telling themselves a consistent story from day to day. And it's awful. And so the purpose, that why is so important because it grounds us in our story. And that tells us who we are.

• 1:57:35Dr. Peter Attia?

  So many of the stories then about AI's power and potential is that many of us will not be necessary from a, at least a work perspective. And so let's just assert that there's some truth to this. And again, I would put myself and my career near the top of the list of things that could be outdone. So what do we make of a world in which many people no longer have a professional why? Is it something that could be substituted with a personal why? In other words, is there a world in which I'm no longer necessary in any way, shape or form for any of the things I do? AI will do a better job at podcasting. AI will do a better job at doctoring. AI will do a better job at everything I do.

• 1:58:19Dr. Peter Attia?

  My kids will be too old to need me as a parent. I'll become so obsessed with chess that that will become my why. Does that work?

• 1:58:27Speaker 01

  What I would suggest is two things. We've always had this concern. There's always been this concern that each technological leap forward will mean that work disappears. And it's never come true. It just means that work changes.

• 1:58:38Dr. Peter Attia?

  Right.

• 1:58:38Speaker 01

  The second thing I would argue is you're already there. I mean, look, at this point, you don't need to work for the paycheck.

• 1:58:44Dr. Peter Attia?

  No, that's my point.

• 1:58:45Speaker 01

  Yeah, you've got enough money.

• 1:58:46Dr. Peter Attia?

  But I still choose to.

• 1:58:47Speaker 01

  You choose to work. You call it work, but it's also stuff that you would probably do in your spare time, even if it was uncompensated.

• 1:58:54Dr. Peter Attia?

  Absolutely. I enjoy this.

• 1:58:56Speaker 01

  You don't take ads for this podcast. You have made a decision. This is a hobby for you. Very impactful, very successful hobby, but it's not work, but you define it as work. You feel a sense of obligation to it because it fulfills a purpose for you. I am not worried about AI spreading and us losing our ability to create purpose.

• 1:59:17Dr. Peter Attia?

  Is that a contrarian view or do you think most people would share that view? And I ask that not knowing the answer.

• 1:59:22Speaker 01

  I think if you were in Silicon Valley, it would be a contrarian view, but I will say a lot of the people who work on AI. They are not very close to normal life. They're not living the lives that you and I live. And so I think they're possibly rightfully worried about issues that you and I don't worry about quite as much. I would say among the broader population, particularly among scholars, my view is more in the mainstream, that there's a recognition that this hand wringing over losing the need for work has always existed with us. Elevator operators, basically elevators have been taken over by AI, really dumb AI, but like it's an AI. It used to be that every elevator you got on, there had to be someone there who stopped it at the right floor. There are not people walking around right now who say like, ah, man, if I could only

• 2:00:05Speaker 01

  be an elevator operator, my life would be so much better because they found something else to do. They found something that was equally meaningful to them. Our human ability to find purpose and manufacture purpose and create purpose is infinite. And as we move into a new world with different technological challenges and different technological opportunities, we will find that purpose because the truth of the matter is, maybe someday AI can raise your kids. Maybe your kids get old enough and they don't call you anymore and say, hey dad, I need your advice on this, but they still need you as a dad. They're still going to mourn you when you pass away. There is something elemental in human about being human and that can't be taken from us.

• 2:00:47Dr. Peter Attia?

  Do you think AI needs to internalize the value of human life for us to be able to coexist with it? Or is there an actual risk, an existential risk to our species if AI doesn't understand our uniqueness?

• 2:01:04Speaker 01

  I have no idea. There are certainly some people who are smarter than me who feel like they can answer that question more authoritatively and say, yes or no, it's a huge risk to us. It's going to kill all of humanity. There's other people who say, actually, AI is such an alien, when it eventually does reach this point of AGI or superintelligence or the moment where Skynet becomes real, that it's such an alien form of thinking and form of cognition and form of sentience that it won't really care about us, the same way we don't really care about ants. So there's people on both sides of this. The answer is, I have no idea. I actually don't even know what AI actually is. Defining AGI, artificial general intelligence, is really, really hard. Second of all, I don't know how AI is going to be exploited.

• 2:01:48Speaker 01

  I mean, right now, we use it to have fun conversations about history with our kids. But if you think back to the internet, when the internet first started, nobody thought that the really important, financially productive and impactful way to use it would be to sell everything through one store and to allow people to basically shout at each other on social media. It wasn't the technology that gave rise to those either advances or weaknesses. It was people like Jeff Bezos seeing the world in a new way that the technology empowered. We're not at the stage yet where people are seeing the world in a new way because of the AI, but they're going to. And they're going to use it in ways that surprise us that we can't anticipate.

• 2:02:30Speaker 01

  And until they start doing that, I don't know that I can answer your question.

• 2:02:34Dr. Peter Attia?

  Yeah, which I think brings me back to one of the most exciting things that I would love to see AI have a huge impact on is one of the things that we as humans have the biggest challenge with, which is behavior change and encouraging and helping people to change behaviors, which kind of brings it all full circle, right?

• 2:02:53Speaker 01

  Yeah.

• 2:02:53Dr. Peter Attia?

  Which is, if there is an AI agent that can be the most powerful tool for behavior change, as powerful as having you stand next to a person 24/7 as their behavior coach, then you really change lives.

• 2:03:11Speaker 01

  And do you think we're going to see that? Is that an achievable outcome?

• 2:03:16Dr. Peter Attia?

  Honestly, I think, Charles, you're in a better position to answer that because I think you have a far better and a deeper knowledge of the science. Because the real question is, do we have the data for how to do this under perfect circumstances that can serve as training data through this vehicle? Because if you take a step back and ask, is the LLM platform the right platform? I think the answer is yes, for this application. We can debate whether the LLM is the right platform for all applications. Of AI, it may or may not be, but given the transformer in 2017, that took us down this path. But I have to believe it's the right platform for this problem. So now the question becomes, do we have enough training data? Do we know what the solution space looks like? Do we have the data to train it?

• 2:03:59Dr. Peter Attia?

  And if so, then it comes down to how important is an actual human in this element versus the words?

• 2:04:08Speaker 01

  So I'm going to add one more element to the formula that you just described. The solution space assumes that delivering the knowledge is the bottleneck. I need something to deliver me the right knowledge at the right moment, very, very easily.

• 2:04:21Dr. Peter Attia?

  Not necessarily. It could be that, well, it depends how you define knowledge. I was thinking about this more broadly, which is, let's say I'm, I need help changing my habits. You standing next to me, you will provide me with knowledge. You'll provide me with accountability. You'll provide me with reassurance.

• 2:04:38Speaker 01

  So here's the thing that I'm going to suggest is that there's a step before that, which is, are you actually motivated to change? I mean, because the truth of the matter is, if you say like, sure, I'd love to lose 10 pounds, but it doesn't really matter that much to me. It doesn't matter how much I stand next to you, how much positive reinforcement I give you. If you don't have fundamental motivation to make that change, it's probably not going to happen, or at least not in a profound and lasting way. And so now the question becomes, AI can certainly deliver the information to me. It can certainly deliver the positive reinforcement. It can certainly deliver all the subsequent parts of the formula. Can AI generate motivation in me to change?

• 2:05:15Dr. Peter Attia?

  What fraction of people who fail to make change fail because that is missing? Or because all of the coaching, queuing, behavior modification that follows is missing?

• 2:05:27Speaker 01

  So let me ask you, how many copies of your book have you sold at this point, Outlive?

• 2:05:31Dr. Peter Attia?

  Uh, almost 3 million.

• 2:05:33Speaker 01

  3 million, that's a lot. Okay, so 3 million people who have gotten fantastic information.

• 2:05:37Dr. Peter Attia?

  Maybe some didn't read it.

• 2:05:38Speaker 01

  Maybe some didn't read it. As long as they bought the book, how many of those 3 million do you think made the change that they wanted to make after reading the book?

• 2:05:48Dr. Peter Attia?

  I'd like to believe that many people have made a change.

• 2:05:51Speaker 01

  Yeah.

• 2:05:52Dr. Peter Attia?

  But probably very few have made every change.

• 2:05:55Speaker 01

  And what I would suggest is that the people who are picking up that book, they're motivated to begin with.

• 2:05:59Dr. Peter Attia?

  That's a selection bias out of the gate.

• 2:06:00Speaker 01

  Yeah. So here's what I would say. I would say, I think this motivation question is the most important one.

• 2:06:07Dr. Peter Attia?

  It's the inception question.

• 2:06:08Speaker 01

  It's the inception question. It's a necessary prerequisite. It's not sufficient on its own, but it's a necessary prerequisite. And there's a lot of people who pick up your book, and I'm going to include myself in this, who say, I really want to do everything Peter tells me. Like, I want to be super healthy. I want to work out every day. I want to live forever. And I read the book and I say, I'm going to do this. But I have motivation for 15% of it, or 20% of it, or 50% of it. But then on the other 50%, I don't have the motivation yet. And the question is, how do I generate that motivation? It's not your job to generate the motivation for me. You can give me the argument. You can tell me why this is important. And you're persuasive, and maybe that will motivate me. But ultimately, you're delivering me the information I need once I'm motivated.

• 2:06:51Speaker 01

  So that motivation part is a real question. Now, let's look at someone like Tony Robbins. What does Tony Robbins deliver? He delivers the motivation. If you listen to what Tony Robbins says about financial stuff, and I think the world of Tony Robbins. I think he's had a huge impact on people's lives. I don't think his advice is the most sophisticated advice on the face of the planet. I think his ability to motivate people is incredibly sophisticated. And as a result, he's changed a lot of lives. What do you think? Does that make sense?

• 2:07:17Dr. Peter Attia?

  Yeah. So what do you think is the element of that? And does it work uniformly? Or is there a susceptibility? Is there a subset of people for whom that style of motivation works?

• 2:07:31Speaker 01

  So we know that there are people for whom that style of motivation works and other people for whom it doesn't. And it might just be taste. It might just be habituation.

• 2:07:39Dr. Peter Attia?

  Like, there's a really funny meme of him at a, I don't know, one of his, whatever they do things.

• 2:07:45Speaker 01

  Yeah.

• 2:07:46Dr. Peter Attia?

  And he's getting this guy to roar like a lion. Like, it's the funniest thing I've ever seen. It's just like, again, there's a subset of people for whom that roaring like a lion is going to change his life. And then there's a subset of people that look at that and think, yeah, that's.

• 2:07:57Speaker 01

  Not for a million dollars.

• 2:07:59Dr. Peter Attia?

  That doesn't change anything. That doesn't, that's not going to change anything.

• 2:08:01Speaker 01

  Right. It's actually going to make it, I'm going to be demotivated because this seems so silly. That being said, anyone who's listening, you should go to a Tony Robbins thing, even if you don't believe it or enjoy it. It's just the spectacle of it is amazing. What he does on a stage is really astounding. So I think what you're asking is like, what do we know about the science of like creating this motivation?

• 2:08:19Dr. Peter Attia?

  Yeah. Do we know that there are some people for whom the way he delivers a message is the turnkey to make this happen? And if I sit there and listen to him give a talk, it makes a ton of sense. It's very inspiring. It seems like, yeah, that all makes sense. I always think of that as the easier problem to solve. I think the harder problem is the one that you're trying to solve, which is, okay, Tony might get you to realize you need to quit smoking. Quitting smoking is hard.

• 2:08:46Speaker 01

  How do I come up with a plan for that?

• 2:08:47Dr. Peter Attia?

  They're both necessary and neither is sufficient.

• 2:08:50Speaker 01

  I think that's right. I think that's right. One of the things that we do know about motivation is much like rewards. It tends to be very different from person to person. And so the only way to really figure out what motivates you is to experiment. My guess is if I was to ask you, what motivates you to work out every day?

• 2:09:08Dr. Peter Attia?

  It's many things. There's the cognitive piece of it, which is I really, really believe what I preach daily, which is, exercise as a tool is the single most important tool in both magnitude and direction at lengthening life and improving quality of life. So in as much as I want to live longer and live better, exercise is as important, if not more important than anything I could do.

• 2:09:37Speaker 01

  Now, let me ask you, those motivations that are getting you to work out every day, are those the same motivations that would have worked on you when you were 20 years old?

• 2:09:43Dr. Peter Attia?

  No, not at all. It wasn't even on my mind when I was 20.

• 2:09:45Speaker 01

  Right. As a result, what we need as a motivation changes over time. It changes from situation to situation. The environment, the choices we make. So it's not like we can say like this one form of motivation is the right form of motivation. What we can say is motivation is really important. We know that motivation has certain characteristics, but we also know that it is something that is incredibly adaptive in people's lives and that they find motivation from different sources throughout the course of their life.

• 2:10:12Dr. Peter Attia?

  Yeah, that's a really good point is that what got you here yesterday isn't going to get you there tomorrow necessarily.

• 2:10:17Speaker 01

  Yeah, and it might be when you're 70 years old. I just turned 50. You're 52, is that right?

• 2:10:23Dr. Peter Attia?

  Fifty-two, yeah.

• 2:10:23Speaker 01

  Fifty-two. We're in the same place. For the first time, that road is really realistic. And because you've written so eloquently about it, I'm sure you've thought about it a lot.

• 2:10:32Dr. Peter Attia?

  No, no, I'm long past that. I mean, I might have 30 years left on earth.

• 2:10:34Speaker 01

  Yeah, it's real. It's real. That also has an impact. And what motivates you 20 years from now might be different from what motivates you today. But what's important is if you're paying attention and nurturing that motivation, if you're conducting experiments to see what does motivate you and what doesn't motivate you, it's when we stop thinking about it that we get in trouble.

• 2:10:53Dr. Peter Attia?

  Charles, this has been super interesting. And I know it's kind of funny that I've read Super Communicators last summer, last spring, actually, when it came out. But really, what I wanted to talk about today was a book you wrote 12 years ago. So I would recommend everybody read everything you've written. But this is, in some ways, I think, this is the book that I think can have a greater impact on people's lives. It's an exceptional book. And I hope that we've spurred people to kind of go back and try to apply it. Because in many ways, what you've written about is the bookend of what I'm trying to write about. And I'm trying to write about the what you need to do. But at the end of the day, if you can't create habits around these things, it is difficult.

• 2:11:30Speaker 01

  Well, thank you for having me on, and thank you for those kind words. I'm such a huge fan of you and of the show, and it's just an incredible honor to be here. So thanks.

• 2:11:38Dr. Peter Attia?

  Well, thank you for coming out. And I'll have to think of a good smoothie place in Austin to send you. I want to reward you for sitting through this.

• 2:11:46Speaker 01

  As long as they've got peanut butter, then I'm good.

• 2:11:49Dr. Peter Attia?

  Thank you, Charles.

• 2:11:50Speaker 01

  Thank you.

• 2:11:51Dr. Peter Attia?

  Thank you for listening to this week's episode of The Drive. Head over to peterattiamd.com/shownotes if you want to dig deeper into this episode. You can also find me on YouTube, Instagram, and Twitter, all with the handle PeterAtiaMD. You can also leave us a review on Apple Podcasts or whatever podcast player you use. This podcast is for general informational purposes only and does not constitute the practice of medicine, nursing, or other professional healthcare services, including the giving of medical advice. No doctor-patient relationship is formed.

• 2:12:27Dr. Peter Attia?

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