Tame Your Distracted Mind with Adam Gazzaley
Hey, everybody, how's it going? I'm Chase Jarvis, welcome to another episode of the Chase Jarvis Live Show, here we are. You guys know the show. This is where I sit down with the world's top creators, thought leaders, and entrepreneurs and do everything I can to unpack their brains with the goal of helping you live your dreams in career, in hobby, and in life. I gotta cut right to the chase here, (drum rolling) everyone always makes a pun about my name, blah, blah, but this isn't about me, this is about this guy sitting right here. We were going through his intro before we went on camera and he's a speaker, a scientist, a researcher, an author. He defines the new paradigm of hyphen, but at his core he has used technology to retrain, program, and make better the human brain. My guest is the Adam Gazzaley. Yes. (upbeat jazzy music) (applauding)
They love you!
Excited to be here, Chase.
This has been so long in the making.
I know, we've wanted to do this for a while.
And for tho...
se of you who have been following the show for a super-long time, I think this was like, four years ago.
So it was like a sneak preview, it was like a 10 minute version of this and at CreativeLive, we were broadcasting live in partnership with Uber from the back of an Uber. We'd go around and pick up celebrity bad asses like yourself--
At South By.
At South By, and drive you to your next destination. So you had these like 10 to 15 minute little interviews. And I remember you and your wife Jo, we sat down.
Yeah, it was fun.
A lot of ground has been covered since then in your world. So knowing that you're using technology to improve the function of the human brain, with that as sort of the foundation, add a little bit of color. So I know you've got a research component here at UCSF, you've got a professional with Akili, your company that's focused on commercializing that technology. Give us a little bit of, what's the backstory, the big narrative?
Well, I'd say the backstory really cycles around my involvement with the brain, as a researcher and as a clinician, as a neurologist. I did my training in a very traditional way, a PhD in Neuroscience, medical training--
Very traditional, PhD in Neuroscience and then I was a doctor and I did this and then I landed on the moon.
But the path through neuroscience and understanding the brain was the standard. And then around 2008, I just got really frustrated with that. The meds that we use to treat our patients are really poorly targeted, lots of side effects. We've developed no other approaches besides this giant incumbent of using molecules to improve how our brains function, our cognition, our memory, attention, how we regulate our emotions. And I was just dissatisfied with that system. And so I really shook it up in 2008. I was already a tenured professor at UCSF at that point and that's sort of the license to go ahead and be a little crazy. And the big picture is that I wanted to come up with a way of helping us improve our brain function. And it started with people improving that function, people that have deficits, as neurological, psychiatric patients. Now it's expanded beyond that. But the idea was to not use molecules as we've relied upon.
And by that, you mean drugs?
Drugs, drugs. But rather to go back to a more ancient practice of improving the brain function which is through experience. If you look at Eastern philosophies and contemplative traditions of meditation or mindfulness, that was the dominant way that we improved brain function. And I would say that in modern era, both our education system of like, our didactic approach to just transferring information and then when minds are not developed in the way that we want them to be or are degenerating, we give them drugs. To go back to experience, and to say, can we build really powerful experiences to target brain networks more selectively than anything we've ever accomplished with a drug before? And to put a pressure on that system to change it, to have a healthy, stronger brain. That was the idea that started all of this, that has transformed my life and the lives of other people that are now involved in this mission.
It's so powerful. Watching your work at work is so cool. We met, I don't know, maybe four years ago. I think that was the first time we met was in the back of that car. And then I went and took a tour of your facility over at UCSF. And obviously, our social circles overlap a bunch now. So I'm gonna give a little bit of backstory. One of the reasons I'm so fascinated with you and your work and I think, why your work resonates, or for the folks who are just coming to know your work are going to be very impressed is, so my backstory was as an athlete, and seeing the power of the mind through visualization. I was on the Olympic Development Team and we had access to some sports psychologists. And they just gave me like, 10 seeds, like here kid, visualize yourself scoring a goal. And I got crazy powerful results. And this is just like me with a book and a couple of hours of training with a professional in, I don't even wanna say the year, 'cause it was a while ago. But I saw crazy, powerful results with how to let that programming my mind in a way. And I know you do it, we've talked about drugs already, but also technology. This was just like using your brain to try and retrain your brain. I become hooked. So it was very easy for me to latch on to your work. But one other piece of backstory before I just turn you loose here is, I think now, more than ever before, whether it's social pressures, or the anxieties of modern culture, the world is moving at a pace that our brains are struggling to catch up with. We have this two million year-old organ in our skull and it appears to me both experientially, like, as in, myself, and through observing, that we're not doing as good a job, or we'll falling short in some ways, whether it's in education, or whatever. And your work addresses that so broadly. So again, I'm trying to talk to the creator and the entrepreneur audience, you followed your passion to get into this and it was circuitous. But tell me how you got interested in this and why you are where you are today.
Well, how you just described it is so in alignment with my latest views upon this. And I wouldn't say it was the nidus of this. I really approached this as a neurologist seeing deficits that we were not dealing with adequately. But now it is much bigger than that. And the idea that our brains and our minds have not been evolving to keep up with how the world is changing, and a lot of that is the influence of technology, is so salient to me that I would say that we're actually, as a species, experiencing what I've described as a cognition crisis right now, which would lend itself to a grand challenge of enhancing our cognitive abilities. And I think that it's a challenge on the level of things like climate change being a challenge. Because if we can't build our minds, and I mean, our attention, our perception, our decision-making, our emotional regulation, our aggression regulation, our empathy, our compassion, our wisdom, our love, if we can't build those things, we'll never deal with something like climate change. We just won't be able to think at the level, that time-delayed way of how it's affecting not you, but other people, to fix something like that. So we have to build stronger brains and better minds. Or else we're just going to suffer as a species in so many ways. And I think we see examples of that every time we look at the news, that we're just not keeping up. We've abandoned some of the, as I said, ancient ways that we used to be involved in in keeping our minds at a higher level. And so that's sort of what drives me right now.
I'm gonna try and continue to straddle this, why I gave you my personal backstory, which is, I basically had no tools, I mean, a couple tools, and it was the equivalent of a hammer and a rock, and I was able to make something work for me, way back then and I've since become obsessed with it as, I mean, CreativeLive literally exists as a vehicle to assist personal transformation. And what I've learned in living in this world for years and years now and through my own personal development and the hundred plus people who've sat in the chair that you're sitting in right now, the Tim Ferriss', the Kevin Roses, the friends that we share in common, the Brene Browns, it's within our grasp, it's within not just our lifetime, but now, there's so many things that we can do to tap into this what you called this sort of crisis. So with that as the backdrop, what are you doin' in that lab down the street? You're cookin' up video games--
Yeah, so the leap over is that technology has challenged our brains in lots of ways. I wrote a book on this last year called The Distracted Mind, Ancient Brains in a High-Tech World, about essentially that issue. But that is not something that I think about a ton anymore. I'm more interested in the positive side of it. How can we flip the story around? How can we build technology, or leverage existing technologies to maximally harness our brain's plasticity, to enhance our cognition, to refine our behavior, I mean ultimately, to elevate our minds. That is what I'm obsessed with now. And technology, as we all know, is so amazing and powerful in its global reach, its accessibility now, and if we can just jump on board and create technologies with the goal of not just entertaining or communicating, but to actually improve how our brains function, then we could really win as a species. That's the goal. So how do we do that? So one of the ways that I latched onto early on was to build experiences that were personalized and adaptive. So you described your history with approaches that allowed you to use your mind better, but as you said, they were sort of primitive in a way. We want to bring on all of the advances in processing and machine learning and artificial intelligence, in general, virtual reality video game technologies, motion capture, physiological recordings, all of that technology can be part of this closed-loop system that helps you optimize your brain. That's sort of the big picture.
This is gonna be a slam dunk, if this conversation we have today, we wanna do two things. I want to see where all this is going, specifically with the work that you're doing. And I understand that some research came out, what was that, like 48 hours ago, that you've been performing that research for how long, for two years?
And so this is a first (drum rolling), this is the answer game filter where they zoom in and go buh, buh. So I'd like to hear a little bit about that. That's also very theoretical, this is where it's all going and what it suggests, and then I also wanna straddle, what are things that you've seen be effective in culture now and today that people can do? What are some trends that you see? You've mentioned things like mindfulness and whatnot. So I wanna continue to bounce back and forth in those two worlds. Let's talk about the research first of all. Huge, huge victory here.
I think we did a good job of setting up the big picture, this cognition crisis, the role of technology and hopefully helping us through this. The data that we just presented two days ago, yesterday, is sort of best place in the context of where that study came from. So I'll just quickly run through the time course of a 10-year journey to yesterday's data. So the first foray that we took into how we could create technologies to improve brain function was through the development of a video game that I designed, but was developed with friends of mine that worked at Lucas Arts and that game is called NeuroRacer. And it is a game that involves multi-tasking, resistance of distraction in a 3D environment. And it was designed in a closed-loop, which essentially means that the game is constantly reading out your performance and then adjusting the difficulty to challenge you right at the level of your ability.
So you're not swamped and you're not bored.
Exactly, right at that sweet spot, that flow state, which is what our game developers would call that. And we think that's the best way to harness brain's plasticity, to push you right to that level. And then use the game mechanics to target the neural network selectively. So we built that game and we did a study that was eventually, three years later, published in the journal Nature. It was the cover of the journal. I think this had happened just around the time that we were meeting, exactly, because this was 2013. And what we showed there was that older adults, playing our video game, if they played it for a month, they got better, not just at the game itself, which they did, in a remarkable way, but they also improved their attention abilities that were recorded on very different tasks and their working memory, holding information in mind. And that set up a whole series of events. The first thing was that I had to learn about aspects of translation of research into the real world that I didn't know anything about. So first, it's intellectual property, I filed a patent behind that methodology of that game. Now the patent is not the game, it's the engine of the game. UCSF owns that, that's how the faculty-university relationship works. We filed that seven years ago and it was just approved a month ago. So that's the first piece of news. Not yesterdays but--
Talk about 10-year, overnight success.
So six and a half years, it was approved in Japan first followed by the US. So now we have protectable property around that game engine, which is critical, as all the entrepreneurs listening know, to move something into real-world scale, that you have that protectable property. So we have that. I started a company, called Akili, with friends of mine that worked at Lucas Arts, and a venture group in Boston called PureTech Ventures, which basically helps incubate healthcare companies. And so we started off as a hybrid biotech tech company. So we're essentially gonna build a treatment for clinical conditions that's delivered through a video game. So we are a medical device company, but we build software in the form of video games. So again, not the easiest way to get investors, as we've discovered early on, 'cause you're really straddling two very different worlds. When I tell tech investors that it's gonna take us four or five years 'til we have a product, they're like, ah, not interested. When you tell healthcare investors that, they're like, that's amazingly fast. And software? So you have this disconnect between those two worlds. Now we've eventually wound a way through, we've just closed the series B last year of $42 million, so we're well-capitalized now. We've managed to find our investors that believed in us. And what Akili did was license that technology from UCSF and then built a way better video game, but made a decision to not put that video game in the consumer space, but rather to take that video game through numerous clinical trials as both a diagnostic and a therapeutic tool, to essentially think about not a pharmaceutical to deliver a molecule, but a digital medicine that delivers an experience. That's how I think about this. And so over the last three years, we've been conducting multiple studies as Akili, both phase one, phase two, and now phase three. So a phase three study is the study that you do right before you submit your data to the FDA to get approval, either as a medical device or as a drug. And so that's a multi-site trial, it's double-blind, and randomized-controlled, has very stringent requirements in order to reach that highest goal of being a prescribable FDA-approved therapeutic. And so we have multiple conditions that are being studied with this game, including autism, traumatic brain injury, depression, post-traumatic stress disorder, multiple sclerosis, early Alzheimer's disease. And the study that has reached the phase three level is studies of children with ADHD. So we just completed a month ago, a phase three trial, a 20-site study, treating children that have diagnoses of ADHD, with Eva, which is the name of the game, the internal name, which came from their research, or a control game, another game that was designed that actually winds up having even more engagement in a lot of ways, but we didn't think has any of the active ingredients to improve attention abilities. And so we completed the trial a month ago and it has been blinded and being analyzed by two separate groups that were sequestered, essentially. So I didn't even know the data until last week. I was actually in Japan and had to take a call at midnight to find out the data. So this is just days ago. We just announced it yesterday. But basically, what we found was that we hit primary outcomes, which was a measure of attention. It showed a significant change in the group that was treated with our game, but not the control group, and a significant difference between them. So we were able to improve the attention abilities of these children with ADHD. And now with that positioned where we hoped it would be, and it was presubmitted as a primary outcome through the FDA, now we submit to the FDA to try to advance this through. As what would be the first non-drug treatment for pediatric ADHD and, I guess, the first prescribal video game in the world.
So I'm gonna restate that as simply as I can. That is the prescription to play video games to cure an ailment, basically.
Yeah, to treat that condition.
To treat a condition, that's better. So first ever.
That's a huge--
We stand poised on that. If we had this conversation last week, I would say that we had a study ongoing but we don't know the data yet. We're still not at the point that I could say that we have this FDA-approved trial. That is the next step.
But I love having you on the show now, selfishly. I think it's incredible.
That's a good time.
And having known you and your journey for a long time. So that is the very specific, what you've been up to and obviously, there are massive implications of having a condition and using games to treat them. What's at play? Like, what's goin' on in the brain that you're able to do that? And what are the implications of what's going on into other areas of the brain?
Basically how our process works of developing, so that's largely I told you Akili's story. What happened back at the shop at UCSF, was that we realized that we were onto something here, a new pathway. And so we are really an incubator. So now we have six new games. And this is gonna answer your question because it'll tell you how we go about this process. And these games, some of 'em use virtual reality, some use motion capture. We now take physiological data and feed that into the game engine so that the game is adaptive, not just to your performance, but your heart rate. We have a game responsive to your heart rate, a game called Body Brain Trainer, a motion capture game that challenges you physically and cognitively. It keeps you cognitively right on the level that's personalized to you, but physically, by using your heart rate data. And we now have games that we developed and they take real-time neural data and feed that into the game engine. We have games that are coupled with brain stimulation to try to stimulate and drive plasticity and accelerate the learning curve. So that's all that's going on at Neuroscape, which is our neurocenter at UCSF, and what my lab has become. And so essentially, how we build these is, we start with a cognitive operation, let's say, we wanna improve internal attention, your ability to focus and not be distracted by mind-wandering. A knowledge of the neural systems that are involved in that, and then looking at even real-world practices, like meditation or mindfulness, then building a game engine which involves real-time adaptivity of challenge, that closed loop, but also feedback in lots of really powerful ways, feedback and reward. You come up with that engine to activate those networks selectively, and we know that from lots of neuroscience that it does that, and then we create the game around that. File a patent, so we now have six patents filed for all of these engines of these games. And the game can be delivered on a mobile device, it could be delivered in VR, depending on what we're trying to accomplish, and then we build it. And it takes us a couple years to build each one of them, to create the type of engagement and immersion that we think is critical to actually change the brain.
It's fascinating to me that there are jobs now, like, 40% of the people who are in school right now, their career hasn't even been invented yet. The concept of being a professional YouTube-er, that didn't exist even 10 years ago. And so right now in your lab, there are people who are video gamers, or they are writing code for video games that it's not just about entertainment interaction, it's literally helping to change the lives of--
Yep, we have a technology, a program, and a whole tech development team at Neuroscape. And same thing with the 15-person development team at Akili, they're a new generation of video game professionals. They develop, not just with entertainment in mind, 'cause they do, I mean, it has to be fun and engaging, especially for kids, right? They have such a high bar of what they're willing to tolerate. You have to hit that. But to bring in the very prescriptive algorithms that activate the network selectively, and the type of closed-loop system to put pressure on it, that's another skill set that they have now. So yeah, it's whole new careers.
So what I heard from you is that you guys have developed, you got a bunch of games and you have some selective games, the game that is in, just finished your third phase of trials, going to the FDA, which is the one for ADHD, is that right, ADD, ADHD?
And then you mentioned a handful of others. Where is this as a technology going? What do you believe that playing video games is capable of changing in the human brain? Right now, we think, I'm gonna take a drug for this. It's gonna make this happen, and I'm gonna take this other drug for my endocrine system and we're taking these pills, these pills are molecules that are delivered with the goal of affecting a thing. You are hypothesizing radical transformation of an entire industry, or a couple industries. What's possible?
I think everything is possible. I think it should all be left on the table and should be eliminated by research alone. I don't think that there's any operation that the brain is capable of that can't be optimized through targeted experience. Whether or not we're capable of building those and then can validate them carefully enough to show that is the real-world rigorous challenging question. But there's nothing that I don't think we should not try to do. So it went through the list of what I think of as cognition that we're suffering right now, globally. Our attention, our ability to perceive, our memory--
Empathy, compassion, decision-making, how we regulate emotions at every level, including aggression. And wisdom. We can change these things. And our entire educational system is built on the premise that we can develop our brains as we go through developmental stages through experience alone. But we can do much, much better. I don't feel like we've tried. I feel like the big, powerful incumbents of our didactic education system and our pharmaceutical system in medicine, have just swamped out all the other creativity and innovation in developing new approaches. And this is a great one, and a timely one. Because I feel like we are in a crisis right now. I think the news could show us lots of evidence of that. And technology has now reached the point that it is completely scalable. It's so accessible. There's so many places in the world and I've been traveling around and around it, that we can't get doctors and teachers but we can get mobile devices. And people will have wifi-connected mobile devices everywhere in the world very soon. We have a game called MediTrain. It's a meditation-inspired game. It's played on a iPad. It uses principles of concentrated meditation, but integrated with our closed-loop system of feedback and adaptivity. And we already have data showing that 20-year-olds playing this, even for six weeks, can improve their sustained-attention ability, that's unpublished, we're actually writing that paper up now. We have a study in India on foster care children showing, well, not showing yet, but the study is to show, our hypothesis is that we can improve their ability to regulate their internal distraction. So this is a very at-risk group that doesn't have access to the normal care that we might. But we're able to get it in to those communities. So that's the potential is that we don't build a game and say, this game is for ADHD, or this game's for autism. We build a game for a cognitive operation that we're trying to optimize, and then say, who are the people that can benefit from this? Obviously, some of the people are those that have diagnosed clinical conditions, like ADHD, where they have attention deficits. But the bigger picture is that everyone could benefit from improving these abilities. So in parallel with our clinical program, we also have an educational program to see, can we take both better assessments of brain function and cognitive abilities, as well as these treatments through these interactive video games into classrooms and try to help every kid build better brains.
I advocate that the classroom of the future is wherever you are, that we're gonna see learning continue to massively decentralize. That's part of the principle behind CreativeLive and I think it's just accelerating. I think we're gonna see 50% of the universities in the next 15 years, go out of business or get rolled up into some other bigger universities. So there's a handful of crises goin' on. But there's also, in crisis, there's this opportunity to reinvent, and to create the technologies that are winning at scale. There's like 10 things I wanna talk about, I wanna talk about brain drugs, positives and negatives. I wanna talk about creativity because I've found that creativity is more of a habit than a skill. I wanna validate what the tactical things that you've seen work, that you're doing this with technology, trying to affect a major outcome. So there's three or four things I wanna touch on and I'm not quite sure where I wanna go. But let's just start at the start. So let's go with creativity. You're familiar with the show and other guests have been on before you. This show's largely for creators and entrepreneurs and people who care about affecting their outcome. Now having a brain that works really well is helpful for that. What do you see with the work that you're doing, what's current and future around creativity? I would say that the work that we do is the foundation of creativity. The ability to have control over your own mind is where it starts, so that you're not constantly on the treadmill of information.
Of self-doubt, of self-talk, of negative, all those things, right?
And also just receiving all of the info that we get through social media, news sites, and never having the control to set aside the time to be with your own thoughts where creativity takes place. And so to me it's about control. It's about controlling what you take in and how you interact with the world and your technology. And you do that through a stronger brain, better attention abilities, better cognitive control, in general. And so most of the tech that we create is designed to give you control of your own brain, essentially. So that, whether it's our meditation-training game called MediTrain, Body Brain Trainer, where we bring physical fitness elements to it, we have a rhythm-training game, which has principles of music and rhythm to try to improve the timing and anticipation abilities of the brain. But it's all about that. It's having a better foundation upon which to layer in other important features of the brain, including creativity and wisdom and empathy and compassion. So that's the place that I work in my team. But in the future, there's the opportunity to build interactive technologies that really specifically fine-tune the aspects of creativity that we wanna enhance. That's something that I haven't done yet. We're just still working on the foundation. But it's certainly possible and it's an amazing goal.
Is it ironic or, obviously you've thought a lot about this, but that I think the point could be made that technology was in part, largely responsible for this era that we're in, an era of anxiety of an overabundance of information, most of which is not helpful or needed, that we believe it is because of our two million-year-old brain that's programmed to help us survive, sees a bad news story and thinks it's a saber-toothed tiger. Is it ironic, or what's your view that the thing that you are using, potentially to save us as a species, technology, to train our brain, is the thing that got us here in the first place? So put me on this ethical roller coaster.
This is why I avoid having these interviews if they're too short, 'cause my messaging is complicated. As I said, I wrote a book last year that was published, called The Distracted Mind, Ancient Brains in a High-Tech World, getting to your point that we do have these ancient brains. And the message there was really that some of the aspects of our brains that evolve the most, which is, in my mind, the pinnacle of the human brain, is our ability to set goals, amazing goals, long time-delayed goals that are interwoven with multiple goals and multiple people's goals. And that's an amazing future of the human brain. But then we have these fundamental limitations in cognitive control, how well we can focus our attention, and we can't distribute it very well at all, how well we can hold information in mind, called working memory, and when we try to engage in more than one task, we suffer performance decrement with every switch between those networks that are involved. And these limitations are not very different from other animals. And that's why I said we have ancient brains. And those two things collide with each other. So there's high-level goal-setting abilities and our limitations in cognitive control. And so we have this conflict between what we wanna do and what we're actually capable of doing.
I'm thinking about myself right now, like, I wanna change the world but, cookie.
Exactly. And technology has aggravated this. This has always existed. As humans, we've always had this conflict. But technology, because of the unprecedented exposure to information that we have, and the fact that it's in our pockets, the fact that it pings us and not just us reaching out to it, has just led us into these cycles where we're constantly challenging these fundamental abilities. And we don't have time to develop things like empathy, compassion, creativity, wisdom. Our attention's fragmented. And so technology has, in my mind, clearly aggravated this issue that we face around the entire world. And if that was the end of the story, it'd be a completely unsatisfying one, to me at least. It's why I actually didn't wanna write that book because I find it unsatisfying to talk about this negative part of the message too much. I think it's a good jumping off point. But the most exciting thing to me is that the very technologies that we've created that have challenged us, if developed thoughtfully with informed decisions based on how the brain actually works, can help improve the brain. And that's what takes a little time to explain that it's flipping it around. And video games is the most complicated place to have this discussion. So here we are talking to parents, many of whom who have blamed video games on their kid's ADHD in the first place, and we tell them that their doctor, instead of prescribing a medicine in its traditional format, through a drug, is going to prescribe a medicine that's a video game. And so this is a little bit of the complicated paradigm shift that I think has to occur to bring these new medicines into people's lives.
But that's what's beautiful and that's why I wanted you on the show. It's the paradox, the contrast of what's possible. And I think we all experience it. I wanted to take a second and talk to the people who are watching and listening. Don't you feel more anxious now? Don't you feel more, probably unnecessarily aware of all of the things that are happening? And what's the simple statistic, violent crime, safest time in human history, unequivocally, no questions asked, bar none, infinitely safer than it was even a hundred years ago, or certainly a thousand years ago, and yet we believe as a culture because of the reporting and our access to information, that it's the scariest, deadliest, of all time. And what does that create? It creates a ton of anxiety. So if you're out there--
Anxiety and depression. And you see it in young people, really, children, at like an epidemic level now. It's a really serious problem that we face as a global society. And I agree. And I think that the anxiety that occurs both by FOMO, I actually saw that written on someone's desk as aside as we walked past. But also productivity anxiety, that you're not doing everything you need or could be doing at this very moment has really put us in these loops, this iterative sink hole that some of us just can't find a way out of. You don't really wanna check the news all the time. It's sort of a downer. And you can't do anything about a lot of it, but you do check it, at the sacrifice of many other things that are important for us to develop. I would imagine that your audience does resonate with what you said, that people feel this burden.
I'd like to shift gears, 'cause we've been talking about what's possible, where it's gone, the technology, your work in particular, because you've also been on this journey for a long time as a human, a friend, as a partner, as a human move through the world, you see a lot of this. And presumably, you've seen people be more successful, some people be more successful than others at navigating this. And so the question is, what are some of the patterns that you've seen observed personally and professionally, for strategies to help mitigate some of this that maybe these folks that are listening don't have access to your games yet. But what are some things that you've seen?
It's true, the things that we're creating are not here yet. It's still a future story. And we're building these approaches that we're very excited about, but we really wanna understand them and know that they work before we put them out there. And so what do we do in the meanwhile? What do I do in the meanwhile? I'd say step one is understanding and being informed and really having a better appreciation of what your brain is good at and what it's not so good at. And not thinking that you're just good at everything because you want to be. That's the starting point. It's not enough in itself. A lot of people know that cigarette smoke is really bad for you, but they smoke anyway. So it's not enough to lead to change on its own. But it is a starting point. It's the motivation. And then after that, it's just figuring out the steps to take control, to build new habits that are healthier, that get you to the better place. And it takes time. And there will be failures. One of the ways that I deal with technology myself, because I'm not speaking from the top of some mountain. I am equally challenged by all of it as everyone else. And I'm trying to work my own way through it. But I now spend a bit of time every day where I do one thing. It's easier to do it when that one thing is going to the gym and focusing on running on the elliptical or working out with weights. But even in other parts of my life, whether it's interacting with my significant other or whether it's working on a project and really just locking down and getting better and more comfortable with single-tasking. And those tasks could be many. And it really is actually sort of awkward the first time you start doing it. I mean, you're like, I'm gonna set aside an hour to work on this project and I'm not checking social media, I'm not checking email. I'm just going to do that. And you feel the burden very quickly. You feel the anxiety and you feel the boredom that I just feel that we have a very low tolerance to. I mean, even waiting in line at Whole Foods for like, three minutes, you just wanna like, pull out your phone instantly. You can't just sit there, be quiet in that moment.
Observe. And as we say, that's where creativity takes place in those moments where you're not taking in information. You're just letting it sift around and find the connections naturally. And so when I find that I wanna do that, if I wanna set an hour aside to not multi-task, the concept of going through an entire hour like that is almost unbearable, which is weird to say. It's embarrassing to say, but it's true. But what I found is that if you take little baby steps, you know, 10 minutes, and then a small break, and that break is not social media. And I use social media all the time but that will just take you away and away. And you won't get back. It's a short break. That break might be some quick push-ups, some exercise. It might be some mindfulness, some breathing and focus, maybe just looking at nature if you have it accessible, taking a little walk, and then right back in again. Get through that hour and each time you do it, just take a little bit bigger of a step until you start building up the skills to actually sustain in that way.
It's amazing that we're retraining the most simple skill which is where to direct our attention. And yet we're so bad at it, that mindfulness. My wife Kate's here in the room and, Adam, you know Kate. I get to sit down with a lot of people and she doesn't crash very many. She's crashing this one because of her personal fascination, our fascination as a family around what's possible to train this muscle that we largely have ignored or let atrophy. So you talked about single-tasking. And you use the example I thought of the gym as interesting. I'm also a big fan of positive association. So is there some things that cognitively you're, how do you associate something that's very hard, painful, as you're trying to break this habit of single-focus. Is there some tricks, is there a dopamine hit? How do you biochemically reward yourself?
I think those breaks are really very valuable. They're not a trivial part of it. In the physical fitness world of which we borrow a lot of design principles from, like high-interval training, high-intensity interval training, where you're blasting and then taking a restorative period, is something that we don't talk about that much in the cognitive training and enhancement world. But you will fatigue cognitively just like you do physically. And so you do need periods of restoration to recover from that fatigue. And so having those short breaks, I talk to Tim Ferriss about this a lot because we both use these p-bars, which are like Paralletts, in my office, and just 10 quick pushes of just activating your body and stepping away from what you're doing and then back in, really helps a lot. And I think that is a burst, in that way. But to give a positive association, if you think about someone training for a marathon, it's really the same process. You don't just run a marathon in one day. You baby-step into it. And what started out being incredibly painful turns into an enjoyment. And that actually has started happening to me now. Now an hour of just focused effort, which I could do without a break and take a break then, is sort of like that runner's high a little bit. You just find a different type of pleasure in just something that's sustained and maybe not so exciting.
How different is that than, so I've got a video out on the internet about how I use my time, and I break it up into 90 minute chunks 'cause I feel like maybe it's different lengths for different folks, but 90 minutes, I can't do anything that is materially constructive, where I'm creating, in less than 90 minutes. Maybe it happens in the 10th minute, but even the anxiety of only having 10 minutes will mitigate my ability to get into a flow state and to find the answer that I'm looking for. So I set aside a 90-minute chunk.
And just to be clear, I meant that also, like an hour or 90-minute chunk to do one thing. I was talking about very brief little breaks to step away and return.
So let's talk about mindfulness. because to me, this is all very connected. And you brought up Tim. This is probably five years ago, I started harping, Tim's like, dude, you're killing it, you're so chill, what's going on? Because both he and I are hard-charging type-A people. And I think we have had a long-standing belief that part of the way we were able to occasionally achieve success was because of this edge. And I found through part luck and part my wife Kate, that meditation, this thing that was like this ooey-gooey thing, boy this is really gonna undermine my edge. But what I found out was that not having it, it was like I'd been swimming with an anchor for the previous 40 years of my life. Tim, the same way. So when Tim on both Tribe of Mentors and Tools for Titans, the last two books--
I'm in that one.
Which one'd you get, Tools of Titans or--
Tools of Titans.
Yeah, me too, nice one, yes. Meditation and mindfulness, some meditation or mindfulness practice was the number one thread of all of those people. So to what do you attribute the correlation? Is it one begets the other or just describe that for me.
I mean, it is exactly what we've been talking about. So it's pretty easy. It's that, I mean, a lot of meditation practices are essentially attention-training exercises. You're slowing down the stream, grabbing your focus, directing it internally, monitoring your awareness for when it drifts and then refocusing. It's about controlling your attention. It's everything we've been talking about. It's in many ways no different from any of our closed-loop video game trainings, whether we think that they're based on meditation principles or not, they're all about fine-tuning different aspects of attention. This is one amazing ancient way of doing it without any technology. But the message is exactly the same. It's like, if you could learn how to take control through a practiced procedure that you engage in in baby steps and get better at, you will be able to control everything better, your emotions, how you respond in a complex situation, how you interact with people you care about, whether it's in a work or a professional capacity. And so it makes sense that that's at the core to this. It's at the core to everything that we're doing through experience as a means of improving brain function. I also engage in my own form of meditative practice. I recently, Tim actually did this as well, at my recommendation, went on a 10-day silent retreat. I'm really good friends with an amazing mindfulness leader named Jack Kornfield, who started Spirit Rock. And he actually was one of our development partners on our meditation game, MediTrain, he actually narrates the whole beginning of it. And we're now, this is another discussion now, going into the world of thinking about using these as empathy and compassion-builders, but I digress, back to the 10-day silent retreat. Have you done anything like this yet?
I haven't, but Kate does 'em regularly--
Phew, it is, it's not subtle, let's just say that.
I've done a one-day--
I did it.
And it thrashed me.
Yeah, Tim recently just did it, as well. We've talked a lot about it.
Yeah, he said this was his most profound one.
Yeah, it's a lot to be alone with your thoughts because it's not just silence. It's no technology, it's none of the human interaction. It's a big change in how you interact with the world. But I learned there, my own way of doing mindfulness was not necessarily through the traditional seated practices, but more in movement. So when I go to the gym, I actually use my physical fitness workout time as a meditation period, where I focus on the movements and just in the same way that you might focus on your breath, I focus on the movements and the repetitiveness of it and go into that state. So I sort of accomplish two things at the same time.
Again, Tim's a mutual friend, and he's done a really good job of finding shortcuts and then you just alluded to two things at once, two birds, so are there hacks, again, in the absence of your technology being readily available to all the listeners, I tend to be wary of hacks, but if you think of learning from people who have already done this, what's the most direct path to get some of the benefits? You mentioned mindfulness, you mentioned for some folks, it's moving their body. Are there other things that we're ignoring that are just sitting right there on the surface for us?
I think about meditation as a very specific practice, either it's concentrated meditation, open meditation, it's a defined procedure. But mindfulness, I think about as something that takes the skills of meditation but brings it into any aspect of your life. So in some ways, in the gym, what I think I'm doing is more of a mindfulness exercise. I mean, it's a hybrid of the two. But I think that there's lots of opportunity for people to engage in these activities across their entire day, you know, when they're eating, we're probably usually just consuming food and it's--
Yeah, the other day, I just picked up a handful of M&M's and I was at a party and I was like, I don't want this. It's just 'cause it was there. And so disconnected from what was happening.
And even when you're eating something that is good for you, a nutritional point of view, to also pay attention to it, how it looks, how it feels, how it tastes, and it's hard to do these things. But they're practice like everything else. So that's another, I don't know if it's a hack, but it's just what being mindful is. It's not just about the practice, it's about how you live, how you interact with everyone around you. And of course, you can't do it all the time. But you have to remind yourself of it when you're sitting talking with someone that you care about that you haven't seen in a while. Maybe also being preoccupied with a text, it's probably not the best way to be mindful of that interaction.
It's just a richer way of being in the world, I find, when I can connect to that, it's like, my experience of life is richer.
Of course, and you naturally grow those things, develop those things that we've been talking about, like empathy and compassion, and wisdom. Wisdom really comes out of experience, but thoughtful experience that you've grown from. And if you're not attentive to it and connected with it, that won't happen. So we need more wisdom right now. I mean, the world needs it. And so I think that is a very important message, that it's not just taking your 20 minutes of a meditative practice, but how you engage in all of your interactions with the world can be mindful.
This is gonna be a little bit of a curve ball. Ready for this one?
So I get asked all the time, and I don't like it 'cause I'm not very good at it, like, you are an accomplished photographer, so what camera should I buy? Or whatever, and to me, they're all just hammers and I feel like I obviously wanna help all my friends who asked this, or whatever. But we've developed classes here at CreativeLive just to help you find what cameras so that we don't have to answer the question anymore. But when I want to ask you some questions that I think are peripheral to your world, not squarely in it, so feel free to punt. But I'm fascinated by the potential connection of what I'm about to ask and your world, so here we go. I'm trying to get the world to pay closer attention to their intuition. We have these gut feelings that I'm just gonna use the common layperson language here, gut feelings, we violate those things and things go wrong. We pay attention to 'em, and my experience is that they pretty much do me right. And what a powerful tool that would be if we could get more people to pay attention to. Like, this whole, I ran down the path of medical school and professional soccer, and all this other stuff. All of those were sort of in violation to this thing that I knew I needed to be a creator, creating, whether it was photographs or paintings, or businesses, or whatever. And I was violating some sort of core principles. And I'm calling that intuition. Is there a world where what you're doing taps into intuition? Is it biochemical, is it physical, is it emotional, is it all these things, and is this stuff that you're working on so baseline that it positively affects all that? So answer that first and then I'll go to part B. And you can punt, too.
No, no, no, I like it because I believe in what you're, I believe, from a personal perspective, putting aside my research and, company focuses. I believe in what you say. Matter of fact, I was asked to give a talk at my old medical school for students. And so I'm sitting on stage in front of a whole room full of MD, PhD students and giving 'em advice. And I thought back to when I was making the decisions at the stage they were, about what I was gonna do. Now I have a medical degree, and a PhD. Am I gonna be a physician, am I gonna be a scientist, am I gonna try to do both? And they're consumed with this complex decision, as I was, as everyone that goes through either of these paths, nevertheless both of 'em, are. And I remembered this process of making like, an Excel chart and like listing geographic regions and the reputation of the school and it was like a four-dimensional thing--
Oh, I'm so glad this is coming out.
And then at the very end after doin' that process, I realized that I didn't want to go to the place that came out on top. I just didn't think I'd like it as much. I like this place more. And I made that decision. And I've made that decision multiple times in my life. And so what I told them was to not just make decisions that feel intellectually-driven, based on data and logic, but to actually start learning how to pay attention to their emotions. And I'm looking at this room and everyone's like, what?
They're like, scientist, PhD's saying this--
What is he saying?
This is why I'm asking. And I don't remember, this is like probably, this is the equivalent of just losing your mind on a show like this talking to a scientist saying, I can't remember this study but I know it's out there. So I'm committing preventional suicide right now here in this conversation. But somewhere that this intuition is the body's ability to storing data our whole lives, but it's in a different type of memory, not this sort of active memory, that it's at a cellular level, like subtle stuff. We're taking billions of points of data in at a time.
Yeah, there's a lot we don't understand about memory and decision-making and emotion, more than we don't understand than we understand. So let's just put that in context. But I do believe that there is a lot that we gained by learning how to go internally, not just on the emotional side, but on all fronts. And this is just part of the same conversation. That's what mindfulness is all about, if you have this better control of where you direct those limited resources you have. And one of the places that you learn how to direct it is internally, to understand your emotional part of your life and the logic part, and how they all come together. You'll have better decision-making. And that is the essence of wisdom, in my mind. And so, yeah, I think that it is an eventual goal of ours to help develop things like intuition more precisely. But in the meanwhile, as I described when we talked about creativity, developing better attention and cognitive-control abilities will help all of that. It is the foundation upon which all those other things live. If you can never have the ability to turn your focus internally, and to carefully understand what you're feeling, you're missing out on so much that goes into having a quality life. My message for them was, if you only make those logical decisions, there'll be a day at some point in your life where you're getting up too early in the morning for something you really don't like doing and you will fail and you will quit. And it happens all the time. So I think that intuition does have to be part of our decisions.
Yeah, in Tony Robbins-speak, achievement is ultimately a science. You can deconstruct what other high-performers do, recreate that in your language, in your world, to find success. But it's the other half of that same coin, which is the art of being fulfilled, and sort of, what part of, in my world does creativity and empathy, what part of that is the part of the life that you're trying to lead? And if you're only making data-driven decisions, maybe even empathy and creativity, they have a data component to it, but it's those two things in conjunction. Science or achievement, art of fulfillment.
Interesting, where I learned that, and how I learned that was through photography also. I don't know if you know, but I'm also a photographer. I actually had a photography company at a point in my past, called Wanderings, nature photography, only nature. I'm actually rejuvenating it right now. So that was 20 years ago that I started that.
I love this, I didn't know this.
'97 I started nature photography, started a company in '99, a website called comewander.com that I'm re-releasing at the end of this month. I've been working on it all year with all the 10 years of photos that I didn't release. It was through nature photography that I learned how to read my emotions better. 'Cause what I discovered when I'm out in the field shooting something that looks beautiful, that if I objectively went on the decision-making process of, that is like, a classic scene of how a tree should be balanced against a sunset and has a bird, it's perfect, that those pictures fall flat. But if I pause and evaluate my own emotional interaction with that scene, and decide whether or not I'm feeling something, those are how I learn to make better decisions about what I captured as a photographer. So to me, nature photography and what I've done in the lab for 25 years are really the same thing. They're like an exploration of nature. But on the photography side, it's much more of a connection with the emotional response, the aesthetics of it. So they're like two parts of my life that are joined, different but more similar than not. And that's when I first started paying more close attention to that part of my mind.
Your internal space. So I wanna take a small right turn and go down brain-drug world. We talked about molecules and that's our culture's sort of recent history and how we deal with things is we prescribe a drug. And it turns out, as you mentioned earlier, that those drugs have a lot of side effects, or can, some obviously more than others. I don't wanna be too overly general. I'm mindful of talking with a scientist here.
They pretty much all have side effects.
They pretty much all do, right? So we talked about neurotropes and drugs like Adderall and Ritalin and Provigil, things that are used by fighter pilots, and university students in finals, and creators in the final push before their art show. Talk to us a little bit about it, the pluses and minuses. And you can talk about them being illegal or not, or prescription, I don't really care. I'm interested in the name of the drugs and your belief, or lack thereof, in it.
Well, let's just, we could do this more general, but let's be more specific about attention-improving drugs like the ones you named that we use to treat ADHD, we use to treat Alzheimer's too, Aricept acts on the cholinergic system, I would say it acts more on the attentional system than actually the memory system. Modafinil, used for jet lag and narcolepsy. And I would say that the message, just to create the bigger picture, is not so different than the drugs that we use to help with emotional regulation, whether it be antidepressants or anti-anxiety drugs, same idea is that these molecules act very generally in neurotransmitter receptor systems. And the dopamine system, the serotonin system, the cholinergic system. And so they're powerful. They have this really profound ability to shift mental state in all sorts of directions, undoubtedly. The problem is that how our higher order abilities work, they're very selective. When you are doing a certain cognitive operation of focusing your attention versus switching your attention versus making a decision or trying to recall a memory, different networks are activated. And we don't have a molecule that activates a network selectively. We have never developed one. For 50 years, we have been trying to develop more selective molecular approaches to targeting the brain. We don't have one. And that's why we have side effects. It's not that complicated, it's because they're blunt instruments. And what we found, as physicians, that in order to get the effect we want, we have to increase it to a dosage that generates that effect. But then invariably, because of the lack of selectivity, we get other effects that we don't want.
It's trying to do surgery with a hammer.
Exactly, that's what the side effects are. And we just have not overcome that problem. And everyone knows it, the FDA knows it, the pharmaceutical companies know it, the doctors, the families that are treated with them. And so we have a major problem that we relied on a system too heavily. Now before I'm too negative about it because I do see nuance here, it doesn't mean that these can't play a valuable part in our future. The mistake has been to build silos around them and treat them as holy grails. That you could give someone a molecule to correct something as complex as depression or an attention problem, it's sort of absurd. That is the more balanced thinking that I have, is that potentially we could reduce the doses, to just use them as activators, not as sole treatments, minimizing the side effects, and then use interactive experiential treatments to have the selectivity and see how they work together. And then maybe you can take the drug away completely in a period of time after you've optimized the system.
So you're saying that maybe there's a drug application in the future that combined with the technology that you're creating around experiences, in this case, video games, to provide radical new--
Radical. And I think that we do not understand yet the limits that we're capable of improving the human mind because we have not tried hard enough to do it. And this will open up an entire new future. I mean, take the concept of a video game with a small dose of Adderall, which we don't understand yet, it's just a hypothesis, and then think about how a small dose of a psychedelic and a virtual reality experience come together. I mean, that's way beyond where we've gone yet. But that's more interesting to me than thinking about a molecule alone.
The best way for me to talk about this idea that's fleeting is I heard that if aspirin were invented today, it would not have passed the FDA because it's too general of a panacea. Respond to that.
How the FDA really works is that you need to have a clinical indication, which is associated with a population and a condition. What we're getting approved, hopefully, with the data that we just generated as a treatment for inattention and ADHD, can't necessarily just be applied to inattention and depression. We have to do those studies. And so that's really what you're responding to. You really need to have a very fine-tuned indication. This is a challenge because these studies are very expensive and take a long time. And they're complex for so many reasons. But what I hope is that once we start figuring out how to create a new category of medicine, which is what we're really talking about here, that will, because side-effect profiles are so much better, we will figure out a way to do this more effectively, more efficiently, and deal with all these challenges that are introduced by having a technological medicine. Software iteration takes place rapidly. Does every change need a whole new study? No. What does, what doesn't? This is like the really complex decisions that we have coming up in the future.
Wow, you're literally inventing an entire new genre of medicine.
I do believe that. And I think the thing that's even bigger than that is that it becomes a new genre of education too. Because these approaches don't necessarily have to just be applied to those that have deficits. They could be applied to just the healthy developing mind and keeping everyone's mind at a highest level possible throughout our lives. So that's even the bigger potential.
When I'm talking to people about CreativeLive, for example, what we see as off-the-charts engagement, without goin' into the weeds, sometimes I write the number three on the board, if I'm talkin' to other people who aren't familiar, and I point out and say, we have really high engagement. And people say, oh my gosh. A media company, I was in New York and they're like, how do you keep people's attention for three minutes? And I was like, that's hours. You know, we have people sitting down and consuming CreativeLive for almost three hours at a pop, sometimes on the desktop. And when I'm hearing you talk about our ability to direct our attention for educational purposes and not helping someone who's at a deficit, but just like, of course you would. Why wouldn't we, if there's so much time, we got PE to train our bodies, we know that movement, like why wouldn't we layer in this to our learning?
It's amazing how long it took me to make that leap. Because as a physician, I always thought about the things we were building were medicines. But as I started giving more and more public talks, I started hearing more of this question about why not for all kids? And then I remember, I was actually in a meeting at the White House, of all places, talking about video games as tools to improve attention and well-being, and someone there said, why isn't this just part of education? And I was like, huh. And that was really the moment of click for me. And what I realized at that point was that we don't really assess cognitive abilities in young people, in kids, unless we think they have a learning disability.
Then we'll test them.
Then we'll test them. And when we find out that they do have a problem with attention, then we drive that. We don't actually try to fix their attention. Nor do we assess it in the B-student that it could do better in some aspect of their cognition. We don't know. You could ask a teacher, who's the best kid in your class in math or reading? They know instantly. Who has the best sustained attention? Who has the best working memory? Who has the best emotional regulation? These things are not assessed. And because they're not assessed, they're not prioritized, they're not targeted. So our education system misses this whole ability to actually optimize how young brains perform and not just giving information or trying to build skills, but actually building the foundations. Once that happened in my mind, I just couldn't let it go. It's the biggest win, bigger than just the medicine way.
It's like performance. And you've also referenced kids a lot, but I'm assuming that that's because it's a population that you are focused on around the video game world right now. But continuing education adults, ongoing?
Most of our research at Neuroscape, so I wear these two main hats here as the co-founder of Akili, but the director of Neuroscape, which is our research center at UCSF. Most of our research is on adults and older adults. And matter of fact, the game that's being tested on ADHD came from it, as you remember, as our Nature paper, which was on older adults. So I'm really interested in improving cognition, especially at end of, not end of life, but like 40's onward, a very neglected population in terms of maintaining abilities, independent of things like dementia, just how do we continue to keep our brains at the very highest level, which is what really matters as you go through life. So that's actually the biggest part of my research program.
Wow, well, two things, one, if people wanna follow along, where do they do that? What's the best way to follow you and your work? You're very active socially, so people should know that. Are you AdamGazzaley, is that--
AdamGazz, yeah, AdamGazz on Twitter, two Z's. And Neuroscape.ucsf.edu, that's our center website. And we have a mailing list, we update people. All of our publications, my talks we put on there, new piece, we really try to keep people up-to-date on what's happening there.
And for what it's worth, a little bit of backstory. There's so many people who've been guests on this show who are huge followers of Adam and his work and his labs and Akili, the company, because I think there's a lot of belief in accelerating in human performance. And so if getting better and being smarter, and you heard things like cognition, recognition, active memory, creativity, all of these things, you need to pay attention to Adam's work. So last question is, what's next? You've got this huge announcement and what are the next six months look like for you?
Neuroscape's gonna keep goin' about its path, we now have five longitudinal studies on MediTrain, Arithmeticity, and Body Brain Train, a new game called Engage, to see if we could create new tools. And Akili is gonna continue the march to move our first product into clinical practice for pediatric ADHD with an FDA submission, coming up in the near future.
And that's A-K-I--?
A-K-I-L-I. And Akili'll keep moving forward on that. And then we have numerous studies in the mid-phase on depression, multiple sclerosis, to get other conditions to have treatment. So those are the two big pathways that'll be happenin' this year.
Thank you so much for being on the show, man.
It was great, man.
I am so grateful for your time.
Awesome, thank you so much.
You guys know how to pay attention to Adam. Thanks again for tuning in. We'll see you again, hopefully tomorrow. (upbeat music)