Unwinding Anxiety

Unwinding Anxiety — Judson Brewer

Dave is a cardiologist. He sees heart patients all day, holds lives in his hands, and by every external measure is doing fine. But there is something happening every evening that he cannot explain and cannot stop.

He gets home, opens the refrigerator, and takes out a bottle of white wine. He doesn't sit down and pour a glass intentionally. He doesn't think: I deserve this, or I need to unwind. He just opens it, and an hour later he's looking at a bottle that is half empty. This happens on nights before surgery. It happens even when he has promised himself it won't. He has tried the "just one glass" rule. He has tried willpower, journaling, exercise, meditation apps, cognitive behavioral therapy. All of it collapses somewhere around the third glass.

By the time Dave shows up in Judson Brewer's office at Brown University, he has tried everything a well-informed, intelligent professional can think of. He is not an alcoholic in any clinical sense. He is a cardiologist who is anxious, and wine has become the thing that makes the anxiety go quiet for a while. The drinking is not the problem. It is the solution, and that distinction is the entire book in miniature.

In the first twenty minutes of their conversation, Dave says something that Brewer has heard from nearly every patient with anxiety, regardless of what form it takes. "I know it's bad. I know it doesn't actually help. And I still can't stop."

Brewer, who is a psychiatrist, a neuroscientist, and the founding director of the Contemplative Studies program at Brown, has spent twenty years studying why that sentence is so universally true, and what can actually be done about it. His answer is not another productivity framework. It is not about willpower or positive thinking or breathwork. It is about how the brain actually learns, and how you can use that learning mechanism to unlearn the habit of anxiety, the same way the brain created it.