Enjoy Life!

LAUGHING THROUGH FAILURE

Imagine you fail, fail spectacularly, and fail in front of an audience. How would you handle it?

When you fail, do you cry? Hate yourself? Hate everyone around you? Here is a professional golfer, Kevin Na, who chased his ball into the woods, whacked away at it in thick brush, and recorded sixteen strokes on that hole. Was he angry? Hateful? Devastated? He laughed about it.

Read about his adventure here.

Watch it on You Tube here

The remarkable quality of being able to laugh at failure is an incredible skill.

How do you do it?

Your failures are NOT ABOUT YOU. They feel like it, but that is just an illusion. Your failures are about learning and growing, and the only way you can do that is to fail. Fail joyfully, whole-heartedly, and you will grow and learn. Kevin Na may or may not be a great golfer, but he is an honest, balanced, and worthwhile man.

MORE BAD NEWS ON ANTIDEPRESSANTS

Here are a couple of recent news releases about medications
in mental health. Not great news since the antidepressants
do actually provide some good effects. But are patients
being infomed about these side effects? You have a right
to be well informed about side effects. My experience is
that physicians are NOT informing patients like they ought.

After these two, I provide a few options.

Emory University issued the following news release:

Antidepressants linked to thicker arteries

Antidepressant use has been linked to thicker arteries, possibly
contributing to the risk of heart disease and stroke, in a study of twin
veterans.

The data is being presented Tuesday, April 5 at the American College of
Cardiology meeting in New Orleans.

Depression can heighten the risk for heart disease, but the effect of
antidepressant use revealed by the study is separate and independent
from depression itself, says first author Amit Shah, MD, a cardiology
fellow at Emory University School of Medicine.

The data suggest that antidepressants may combine with depression for a
negative effect on blood vessels, he says.

Shah is a researcher working with Viola Vaccarino, MD, PhD, chair of the
Department of Epidemiology at Emory’s Rollins School of Public Health.

The study included 513 middle-aged male twins who both served in the
U.S. military during the Vietnam War.

Twins are genetically the same but may be different when it comes to
other risk factors such as diet, smoking and exercise, so studying them
is a good way to distill out the effects of genetics, Shah says.

Researchers measured carotid intima-media thickness – the thickness of
the lining of the main arteries in the neck — by ultrasound.

Among the 59 pairs of twins where only one brother took antidepressants,
the one taking the drugs tended to have higher carotid intima-media
thickness (IMT), even when standard heart disease risk factors were
taken into account.

The effect was seen both in twins with or without a previous heart
attack or stroke.

A higher level of depressive symptoms was associated with higher IMT
only in those taking antidepressants.

“One of the strongest and best-studied factors that thickens someone’s
arteries is age, and that happens at around 10 microns per year,” Shah says.

“In our study, users of antidepressants see an average 40 micron
increase in IMT, so their carotid arteries are in effect four years older.”

Antidepressants’ effects on blood vessels may come from changes in
serotonin, a chemical that helps some brain cells communicate but also
functions outside the brain, Shah says.

The most commonly prescribed antidepressants are selective serotonin
reuptake inhibitors (SSRIs) such as fluoxetine (Prozac), which increase
the level of serotonin in the brain.

Other types of antidepressants also affect serotonin levels, and
antidepressants can act on other multi-functional brain chemicals such
as norepinephrine.

In the study, researchers saw higher carotid IMT in both participants
who used SSRIs (60 percent of those who took antidepressants) and those
who used other types of antidepressants.

Most of the serotonin in the body is found outside the brain, especially
in the intestines, Shah notes.

In addition, serotonin is stored by platelets, the cells that promote
blood clotting, and is released when they bind to a clot.

However, serotonin’s effects on blood vessels are complex and act in
multiple ways.

It can either constrict or relax blood vessels, depending on whether the
vessels are damaged or not.

“I think we have to keep an open mind about the effects of
antidepressants on neurochemicals like serotonin in places outside the
brain, such as the vasculature. The body often compensates over time for
drugs’ immediate effects,” Shah says.

“Antidepressants have a clinical benefit that has been established, so
nobody taking these medications should stop based only on these results.
This isn’t the kind of study where we can know cause and effect, let
alone mechanism, and we need to see whether this holds up in other
population groups.”

AND IF THAT WEREN’T ENOUGH . . .
Ken Pope sent this one around:

The *American Journal of Psychiatry* has scheduled an article for
publication in a future issue: “Association of Cerebrovascular Events
With Antidepressant Use: A Case-Crossover Study.”

The authors are Chi-Shin Wu, M.D., M.Sc., Sheng-Chang Wang, M.D., M.Sc.,
Yu-Cheng Cheng, M.Sc., and Susan Shur-Fen Gau, M.D., Ph.D.

Here’s how the article starts:

[beging excerpt]

Stroke is the second leading cause of death and the sixth leading cause
of disease burden globally (1).

Depression is an independent risk factor for stroke and the leading
cause of years lost to disability (1-3).

The prevalence of antidepressant use has increased in many countries,
including the United States (4) and Taiwan (5).

Whether treating depression with antidepressants reverses depression-
related cardiovascular complications remains inconclusive (6-9), and
concerns about the cerebrovascular effects of antidepressants have
increased since a growing body of evidence has shown that
antidepressants (especially selective serotonin reuptake inhibitors) may
induce bleeding complications (10-12) and vasoconstriction of the large
cerebral arteries (13-15).

In this regard, the benefit-risk profile of the cerebrovascular effect
of antidepressant use remains unclear (14).

[end excerpt]

Here’s an excerpt from the Discussion section:

[begin excerpt]

We found that antidepressant use was associated with a 48% greater risk
of stroke, after taking confounding factors into account, and that the
magnitude of associations was greater in high-potency inhibitors of the
serotonin transporter than in low- and intermediate-potency inhibitors.

Our findings are in agreement with those of previous studies showing
that antidepressant use was associated with an increased risk of stroke,
both ischemic (21) and hemorrhagic (22) types.

[end excerpt]

Another excerpt:

[begin excerpt]

One new finding of this study is that the risk of stroke increased with
average daily antidepressant dose.

The increasing trend was significant (p<0.001) across the three
different time windows we used.

Another new finding is that the magnitude of stroke risk with
antidepressant use varied according to the duration of antidepressant
treatment.

[end excerpt]

One final excerpt: “Our results in this study have major clinical and
public health implications deserving careful consideration. Our findings
suggest that antidepressant use contributes to an  increased risk of stroke.”

The author note provides the following contact information: Dr. Gau,
Department of Psychiatry, National Taiwan University Hospital and
College of Medicine, No. 7, Chung-Shan South Rd., Taipei 10002, Taiwan;
<gaushufe@ntu.edu.tw> (e-mail).

OH, WHAT SHALL WE DO?

We do have other options!

Just bear in mind that happiness and lifestyle changes are
underutilized interventions that may be able to impact depression
even more than either therapy or medication.

- Exercise and activity! Walk, jog, bike, or swim. Lift weights.
- Improve eating, eliminate all processed foods and
stick with a Mediterranean diet. Eat red meat twice
a month (NO MORE!) unless it is grass fed.
- Increase your intake of Omega-3 PUFAS. Eat fish or
ground flax seed or both. Take some fish oil capsules.
Generally 4 grams of fish oil a day is a fairly good
antidepressant effect.
- Do more good deeds every day or perhaps once a week on
your “good deeds day.”
- Keep a gratitude diary and tell people you are grateful
to them.
- Reach out: make more friends and spend more time with them.
- Deepen: share more intimate, warm times with close family
members and close friends.
- Improve your sleep: Meditate every day, use sleep hygiene
habits, learn the keys to better sleep. Go on my web site
and get my book on better sleep habits.

ARE HAPPY PEOPLE DUMB?

ARE HAPPY PEOPLE DUMB?

Take a look at this discussion at the Harvard Business Review blog section. The author, Shawn Achor, reviews the common arguments. He finds that among people in the business community, unhappiness is often seen as a sign of intelligence. That is also true in academia. Unhappy university professors are a cliche. There are wonderful comments following the blog.

Actually this argument is quite common. I recall a study I read once about undergraduate students who were asked to read two essays. One was written in a positive “voice” and the other in a more pessimistic voice. Both had the same true facts. The same number of words. Only the tone was different.

As you might predict, the college undergraduates votes the pessimistic essay as the more “deep and profound” and saw it as more insightful and penetrating. Why might this be?

First, recall that BAD IS STRONGER THAN GOOD as Roy Baumeister has said.
Here is a wikipedia entry on the topic.

You might want to read the whole paper yourself. Basically Baumeister shows how negativity has a stronger salience to us. We pay much more attention to bad news. That is one of the core reasons why we need three to five good things to balance out every single bad thing. When we practice positive psychology, we are really balancing out all the bad things that happen to us with many more good things.

I encourage you to teach classes on positive psychology. The Baumeister paper is something that every teacher of happiness ought to master. Bad is stronger than good, and good is greater than bad. If you want to be great, you must be good. If you will be good, you must be happy. The poisonous tree cannot bear good fruit. You cannot get from unhappiness to goodness without going through happiness.

You may think that to get to happiness, you must first fix what makes you unhappy. Not so, my friend. The cure for unhappiness is not fixing yourself but in loving yourself as you are today. You cannot get to Salt Lake City by driving east from Denver. You have to turn your car around and drive west. Toddlers are instrumentally useless. They can’t do anything. Yet we love them as they are and rejoice when they are around us. You are simply a toddler, spiritually, and you deserve to be loved and nurtured as you are today. So do I. That we aren’t always is simply an accident of living in an imperfect world.

IS MINDFULNESS SUPERIOR?

HERE IS AN EMAIL I RECEIVED, MY ANSWER, AND A BIT OF DISCUSSION.

Hi Lynn,

I hope that this message finds you well. I am writing to address a comment
that I heard you make on different occasions via emails in your newsletter and
when I went to one of your workshops. It is a comment that I just assumed to
be true, so I took it for granted and I never questioned it. I am referring to the
times when it seems to me that you have equated Mindfulness Meditation to
Autogenic Training. I offer the following observations in a spirit of respect.

I have completed the formal Mindfulness Based Stress Reduction program two
years ago and I recently completed a 7 Day intensive retreat for healthcare
professionals lead by Jon Kabat-Zinn and Saki Santorelli. It is likely that it may
be that I am a slow learner that I have come to this realization, but it seems to me
that my experience of moment to moment (“non-judgmental”) awareness in the
present moment–when I am engaging in formal mindfulness practice (such as sitting
meditation, or the body scan, or mindful yoga) is distinctly different from autogenic
training. I do not speak for Jon Kabat-Zinn or Mindfulness for that matter–just my
own experience. The thing that I have learned from formal consistent
Mindfulness practice (especially after doing a 7-Day intensive with Jon and Saki) is
that with Mindfulness I am not trying to get anywhere other than where I already
am–I am not trying to “relax” “let-go” lower my blood pressure, reduce or escape
pain or discomfort, get positive, etc. I am letting my self be where I am in the
present moment without trying to conjure up some kind of unique or special
state. I simply attend to whatever I have chosen to be the object of my present-
centered focus (the breath, and/or the body, and/or sounds, etc.) in a gentle way
–like I said, without trying to get anywhere; I just simply notice. All “comings
and goings” that occur in my mind in terms of thoughts, plans, worries, goals,
evaluations, (and associated emotions) etc. become “background noise” so to
speak. I just notice them or notice that I have gotten “carried off” by them, and
then I simply and gently return back to the object of present focus. Insights
may come–lots of things may come “in my head” but I end up regarding those
like wave activity on the surface of the water while I am just observing from
about 60 feet below the surface (I am not trying to calm the water and I am
not being tossed about by the waves). From the vantage point–so to
speak–of the present moment, everything is complete. I am not trying
to reduce worry, I am just not engaged with it (or anything else that I happen
to notice that comes and goes). I bring my attention back to the breath–back
to the here and now of “abiding awareness.”

Perhaps you are referring to the fact that autogenic training can result in
calmness and relaxation. In that regard, I would agree that autogenic
practice shares a commonality with mindfulness in that it is not uncommon
that the by-product of attending to the present moment (without any
agenda other then noticing “what comes up” without judgment) is a
sense of calmness and peace.

I apologize if this seems lengthy. I do not offer my observations in a
spirit of disrespect.

AND I SAID TO HIM:

Congrats on your lengthy training. I am sure it has given you many benefits.

My core reference for that is Herb Benson’s work. In other words, if you
attended any extended training in any style of meditation, Benson argues you
will receive approximately the same results.

Perhaps we should offer week long intensives in AT? I have not attended
such an intensive in any style, so you have the advantage. But unless you
also did such an AT intensive, you cannot say one is better, you can
only say, as I have always said, that training the brain in good, and
more training is better.

Consider the Carmelite nuns that Richie Davidson tested. Their level
of happiness is like that of Buddhist practitioners with equal years of
experience. So it is not the Buddhist approach per se but rather the
consistent brain training effect.

Admittedly, in the startle response tests, the Buddhist monks were
remarkable, at least two of them, but that doesn’t speak to what
equal training in any other style would do. My old teacher in hypnosis
had a very painful medical procedure using only hypnosis as an
anesthetic. That is likewise remarkable, and in my view equal in terms
of amazement to the startle response tests.

The only people who claim one system is better is the Transcendental
Meditation folks, following their guru, but that hasn’t really shown up to be true.

AND I WANT TO ADD:
Our minds are amazing, and we only have a small glimpse of what they
are capable of doing. I saw a motion picture of Dr. Kay Thompson (my
teacher I referred to above) have an extremely painful dermabrasion
(grinding off the outer layer of the skin on the face) to correct deep acne
scars from adolescence. She did that with only self-hypnosis, no anesthetic
at all. Not only did she appear completely relaxed and comfortable through
the procedure, she also reduced the flow of blood to the face so that there
was no significant bleeding. I have been told that when they did that
procedure, usually there was blood flying all over as the grinding cone cut
into the skin. With Dr. Thompson, that was absent.

(If you want to learn more about her, order these CDs of her work:

http://www.scseph.org/catalog/kay.php

That is NOT an affiliate link; I get no reward for suggesting them.)

The bottom line is that Mindfulness Meditation is a wonderful process,
and has shown remarkable results. So is hypnosis, Autogenic Training,
and many other approaches. Mindfulness emphasizes the spontaneous
appearance of positive results. Autogenic Training is different in that we
do create the outcomes somewhat more directly. But that only makes it
different, not worse or better.

If you want to know more about hypnosis, you can contact:
American Society for Clinical Hypnosis in Chicago.
Unfortunately, their web site appears to have disappeared.

You may also want to contact the Milton H. Erickson
Foundation in Phoenix, Arizona.
Their web site is alive and healthy.

http://en.wikipedia.org/wiki/Milton_H._Erickson

http://www.erickson-foundation.org/

Years ago I was quite active in the hypnosis community. One
of my teachers told a story of doing a demonstration of a psychiatric
interview with a Navaho patient. There were several shamans from
the Navaho tribe watching. My teacher decided to use hypnosis as a
treatment and proceeded to induce a trance and offer suggestions.
The shamans became suddenly agitated and began discussing in Navaho.
My teacher stopped the demonstration and asked them if he had done
something that offended them. They said,
“No, we just did not know that you knew about this.”

All cultures have some awareness that altered states of consciousness
are powerful and worth developing. If I have pursued Autogenic
Training, that says nothing about the value of other pathways. Do not
follow my footsteps, but seek what I have sought.

GROWING YOUR BRAIN

Mindfulness meditation has been shown to be very
healthy for the working brain. Richard Davidson at the
University of Wisconsin at Madison has tested the brains
of experienced meditators and found that they are higher
in happiness and intelligence. Since these are people who have
meditated for an average of over 10,000 hours, it isn’t clear
how this would apply to people who aren’t nuns or monks
and have to live in the normal world.

But a new study has now shown that only eight weeks of
mindfulness meditation will produce measurable improvements
in the structure of the brain. The study, titled “Mindfulness practice
leads to increases in regional brain gray matter density,” appeared in
Psychiatry Research: Neuroimaging, Volume 191, Issue 1, 30 January
2011, Pages 36-43. You can read the whole study here:

http://tinyurl.com/4b8h76v.

Abstract of the article.

Therapeutic interventions that incorporate training in mindfulness
meditation have become increasingly popular, but to date little is known
about neural mechanisms associated with these interventions. Mindfulness
-Based Stress Reduction (MBSR), one of the most widely used mindfulness
training programs, has been reported to produce positive effects on
psychological well-being and to ameliorate symptoms of a number of
disorders. Here, we report a controlled longitudinal study to investigate
pre–post changes in brain gray matter concentration attributable to
participation in an MBSR program. Anatomical magnetic resonance (MR)
images from 16 healthy, meditation-naïve participants were obtained before
and after they underwent the 8-week program. Changes in gray matter
concentration were investigated using voxel-based morphometry, and
compared with a waiting list control group of 17 individuals. Analyses
in a priori regions of interest confirmed increases in gray matter concentration
within the left hippocampus. Whole brain analyses identified increases in the
posterior cingulate cortex, the temporo-parietal junction, and the cerebellum
in the MBSR group compared with the controls. The results suggest that
participation in MBSR is associated with changes in gray matter concentration
in brain regions involved in learning and memory processes, emotion regulation,
self-referential processing, and perspective taking.

# # #

When we look at other research on meditation, we would have to admit
that it sounds more and more attractive. Richard Davidson’s well known
original article showed that eight weeks of mindfulness meditation improved
happiness by raising the energy in the left frontal lobes, the happiness center
of the brain. The exercise also improves immune function, which would
presumably improve over-all health. His abstract says:

OBJECTIVE: The underlying changes in biological processes that are
associated with reported changes in mental and physical health in response
to meditation have not been systematically explored. We performed a
randomized, controlled study on the effects on brain and immune function
of a well-known and widely used 8-week clinical training program in
mindfulness meditation applied in a work environment with healthy employees.

METHODS: We measured brain electrical activity before and immediately
after, and then 4 months after an 8-week training program in mindfulness
meditation. Twenty-five subjects were tested in the meditation group. A
wait-list control group (N = 16) was tested at the same points in time as
the meditators. At the end of the 8-week period, subjects in both groups
were vaccinated with influenza vaccine.

RESULTS: We report for the first time significant increases in left-sided
anterior activation, a pattern previously associated with positive affect,
in the meditators compared with the nonmeditators. We also found
significant increases in antibody titers to influenza vaccine among
subjects in the meditation compared with those in the wait-list control
group. Finally, the magnitude of increase in left-sided activation predicted
the magnitude of antibody titer rise to the vaccine.

CONCLUSIONS: These findings demonstrate that a short program in
mindfulness meditation produces demonstrable effects on brain and immune
function. These findings suggest that meditation may change brain and
immune function in positive ways and underscore the need for additional research.

# # #

You can read the whole article here: http://tinyurl.com/35c24a

These studies are very exciting, since they continue to prove to us that
we can change both the way we experience the world and our brain
itself, and in as little as eight weeks of training. While Mindfulness is
a wonderful approach, we should mention that all forms of meditation
seem to have approximately the same results. Dr. Herbert Benson
studied this at Harvard and found that the relaxation response was
present in all forms of meditation and is behind the benefits we see
from them. No particular style of meditation is shown to be any
better than any other style.

My approach to meditation is Autogenic Training (AT). It is a
method of meditation developed by German physicians, Johannes
Schultz and Wolfgang Luthe. There are literally thousands of studies
on the effects of AT, showing strong positive effects on the mind and
body. The purpose of Autogenic Training is to guide yourself into a
deeply relaxed state. Once in that state, you can train your mind and
body in specific applications, such as skills in sports or confidence
in performance.

I find AT to be both exceptionally easy to learn and quickly beneficial
to over 90% of students. If you want to practice it, there is some advantage
to having a teacher who will guide you through it. On the other hand, if
there is no teacher close by, many students are quite successful at learning
it on their own. I mention that because some sites on the web teach you
must have a teacher, and I do not find this is necessarily the case. In most
cases, a teacher is quite helpful, but not absolutely necessary.

On the website I have a handout that has been quite successful at helping
and guiding people into a state of greater peace and happiness. You are
welcome to download it, or you can buy an AT recording that guides you
through the process.

THE COMPONENTS OF HAPPINESS

FAN MAIL

This is great, here is a nice thank you note I got.

God bless you! Thank you, thank you, thank you!
I’m sharing these stories and other interesting/ inspirational
info. with my 16 year old son, who has a learning disability
and is having a rough time in school. We’ve had great
conversations about your newsletter info. and it makes me
SOOO HAPPY to see that my son truly understands that we
can be happy regardless of our circumstances. He’s even
shared with me some of his “tips” to improve his mood,
deal with stress and stay positive. I’m am MFT who attended
one of your seminars in SF last December. I passionately
believe in positive psychology…and heck, this amazing stuff
is too good to be shared only with clients..(or only use yourself)…
it needs to be shared with everyone! I’m spreading the word, at
work, with my family, friends..My ex has started using more olive
oil in his food and eating better..this is just great, because I want
my son to eat better when he is with his father too…we all benefit.
He has been more cooperative with me in co-parenting, I’m ecstatic..
thanking me for your newsletter info…same with my boss, a clinical
psychologist who loves this stuff..and my other therapist co-workers…

Anyway, thank you once again..your emails are a wonderful a reminder
of just how I want to live my life… in a state of constant amazement…
# # #

Now wasn’t that nice? I get a fair number of these, and they are
always a thrill. Plus, you are practicing gratitude when you thank
me. Be sure to spread that around and be more thankful to everyone
in your life!

WHAT ARE THE COMPONENTS OF HAPPINESS?

Recently we have seen two very important articles on this.

First, let’s do a bit of background. Seligman, the father of
positive psychology studies, originally argued there were
three components of true, authentic happiness.

First, pleasure is of small but some importance. The trouble
with pleasure is that we habituate to it and often we like to
escalate. This is seen with drugs and pornography, where
people want bigger exposure to get the same outcome.

Second, meaning is a large factor. What do I mean by
meaning? How my life impacts other people. My meaning
lies in how I am helpful to others.

Third, engagement is a large factor. That suggests that we
are happy when we are doing what we were born to do. Each
person is born with unique talents and interests, and when our
daily work is consistent with those, we feel we are “in the zone”
or we are engaged in our work. Csikszentmihalyi writes about
the experience of flow.

http://en.wikipedia.org/wiki/Flow_%28psychology%29

Seligman recently announced he has a new book coming out
that revises that theory. He will argue that happiness has at
least FIVE components. Seligman’s new theory posits that
well being consists of the nurturing of one or more of the five
following elements: Positive emotion, Engagement, Relationships,
Meaning, and Accomplishment (abbreviated as the acronym PERMA).

This raises some questions. Is Marty leaving out anything? And,
to the contrary, is the theory getting too complicated?

What about physical activity? There is tremendous literature out
there for that, and Marty has spoken of his own regimen of
swimming a mile or playing volleyball with his grad students every
day.

What about diet? I have come around to this point of view and
think that with the studies by Sanchez-Villega and others, we
have substantial reason to think you shouldn’t eat anything that
your great-grandmother wouldn’t have recognized.

Now here is a very important study that addresses that in a more
comprehensive manner.

http://www.apa.org/pubs/journals/releases/amp-ofp-walsh.pdf

This article by Roger Walsh speaks of therapeutic lifestyle changes,
TLC interventions. He argues we in mental health have been far too
reliant on strict language based interventions.

Here is the article’s abstract:

Mental health professionals have significantly underestimated
the importance of lifestyle factors (a) as contributors
to and treatments for multiple psychopathologies, (b) for
fostering individual and social well-being, and (c) for
preserving and optimizing cognitive function. Consequently,
therapeutic lifestyle changes (TLCs) are underutilized
despite considerable evidence of their effectiveness in
both clinical and normal populations. TLCs are sometimes
as effective as either psychotherapy or pharmacotherapy
and can offer significant therapeutic advantages. Important
TLCs include exercise, nutrition and diet, time in nature,
relationships, recreation, relaxation and stress management,
religious or spiritual involvement, and service to
others. This article reviews research on their effects and
effectiveness; the principles, advantages, and challenges
involved in implementing them; and the forces (economic,
institutional, and professional) hindering their use. Where
possible, therapeutic recommendations are distilled into
easily communicable principles, because such ease of communication
strongly influences whether therapists recommend
and patients adopt interventions. Finally, the article
explores the many implications of contemporary lifestyles
and TLCs for individuals, society, and health professionals.
In the 21st century, therapeutic lifestyles may need to be a
central focus of mental, medical, and public health.

That should give you something to think about!

Notice Walsh agrees with me, always a good sign.
He emphasizes exercise (which I would rather call
“Activity” because it might upset people less to be
active than to exercise) and nutrition.

What about the “time in nature” factor. I haven’t
written as much as I should about that, yet it is a
robust and positive intervention. Have your ever seen
the book, Last Child in the Woods?

Well, there is much more to be said about this.

Give it some thought and see how you can implement
TLCs into your own life.

STRESS AND HAPPINESS

It has been a while since I posted something. Well, I warned you
that I don’t send things out on a schedule, but when I find interesting
things to discuss. Here are a couple of worthy studies.

First, let’s look in more detail at the role cortisol plays. Note
at the end there is a comment about some people being low in cortisol
and therefore inappropriate for antidepressant use. We now know that if
you take antidepressants for several weeks, they lower cortisol. But right
after this announcement, you will see how physical activity will also
lower cortisol, and unlike the majority of antidepressants, they do not
raise your blood sugar level, a great advantage.

The University of Montreal issued the following news release:

Simple spit and blood tests might detect burnout before it happens

Your blood and the level of a hormone in your spit could reveal if
you’re on the point of burnout, according to research undertaken by Dr.
Sonia Lupien and Robert-Paul Juster of the Centre for Studies on Human
Stress of Louis-H. Lafontaine Hospital and the University of Montreal.

In addition to professional and personal suffering, burnout puts
distressed workers at further risk of physical and psychological
problems if ignored.

This is significant, as burnout, clinical depression, or anxiety related
to the workplace affects at least 10% of North Americans and Europeans,
according to estimates prepared by the International Labor Organization.

“We hypothesized that healthy workers with chronic stress and with mild
burnout symptoms would have worse physiological dysregulations and lower
cortisol levels – a profile consistent with burnout,” Juster explained.

Cortisol is a stress hormone involved in our bodies stress response and
naturally as part of our body’s daily rhythm. Cortisol levels are often
high in people suffering from depression, while it tends to be low in
cases of burnout.

Too much cortisol can be as bad as too little when it comes to both
mental and physical health.

Chronic stress and misbalanced cortisol levels can exert a kind of
domino effect on connected biological systems.

The term “allostatic load” represents the physiological problems or
‘wear and tear’ that ensue in these different systems related to risks
for diabetes, cardiovascular disease, and immune problems.

By looking at various factors such as insulin, sugar, cholesterol, blood
pressure, and inflammation, an allostatic load index can be constructed
and then used to detect problems before they occur.

“The strength of the allostatic load model is its flexible inclusion of
numerous biological systems that get strained by chronic stress.

Complementary use of saliva samples and validated questionnaires allows
us to go beyond measuring susceptibilities to, say, metabolic syndromes
or heart problems, but also into the realm of mental health,” Juster said.

The results of this first pilot study were obtained by testing thirty
middle-aged participants.

In addition to undergoing routine blood measures that assessed
allostatic load, participants were instructed to collect saliva at home
and during a laboratory paradigm.

They also filled out questionnaires related to their current stress
levels as well as symptoms of depression and burnout.

This research is part of a greater effort to develop personalized
medicine in this field.

Personalized medicine targets the customization of treatment according
to the needs of the individual.

“In an effort to advance person-centered approaches in prevention and
treatment strategies, we have to investigate the biopsychosocial
signatures of specific diseases,” Lupien said.

“For conditions like burnout where we have no consensus on diagnostic
criteria and where there is overlap with symptoms of depression, it is
essential to use multiple methods of analysis. One potential signature
of burnout appears to be fatigued production of the stress hormone
cortisol and dysregulations of the physiological systems that interact
with this stress hormone.”

Critically, people with burnout are often treated with anti-depressant
medications that lower cortisol levels.

If cortisol is already lower than it should be, this course of treatment
could represent a therapeutic mistake.

# # #

OK so lets look at exercise. There is a new study just published showing
how exercise can increase the size of the hippocampus. If you don’t recall,
that is the memory center.

“Exercise training increases size of hippocampus and improves memory.”

The authors are Kirk I. Erickson, Michelle W. Voss, Ruchika Shaurya
Prakash, Chandramallika Basak, Amanda Szabo, Laura Chaddock, Jennifer S.
Kim, Susie Heo, Heloisa Alves, Siobhan M. White, Thomas R. Wojcicki,
Emily Mailey, Victoria J. Vieira, Stephen A. Martin, Brandt D. Pence,
Jeffrey A. Woods, Edward McAuley, and Arthur F. Kramer.

For a reprint, contact .

If you don’t know where to get grass fed beef, look at my friend’s
ranch: http://www.bar10beef.com/

Or you can find it at local farmers’ markets.

WHY FREE MEDICAL TESTS ARE TOO EXPENSIVE

My wife saw that a local hospital was having free screening. We went. Big mistake.

I probably should have known better. I was listening to a radio interview of a physician who is against screenings. He argues that if you do not have symptoms, any theoretical problems the screening discovers are statistically very unlikely to develop into real problems. But the treatments that will be proposed are actually dangerous. I was shocked when he included PSA, prostate specific antigen blood testing. His data showed that more people will be treated unnecessarily and suffer and even die from the treatment than the lives that are saved. He refuses to get PSAs for himself. I found the interview disturbing but fascinating.

We went anyway. I knew my BMI, the body mass index was high-normal. Some of that is fat around my middle, and some of it is muscle, since I do some weightlifting. So that didn’t surprise me. My blood sugar was in a normal range, and my cholesterol was quite low, 141. These are screening tests and not very reliable, but my cholesterol has always been low. Still no surprises.

Then we went in for the free electrocardiogram, an ECG. Mine suggested I had experienced a heart attack. I was shocked and dismayed. The cardiologist who read the ECG tracings said it didn’t look serious, but I should see my primary care physician.

My what now? My primary care doctor had tragically died of amyotropic lateral sclerosis more than two years before, and I hadn’t really had a primary care doctor. A surgeon told me not to get another one. He thinks they cause more trouble than help. But when I got the ECG, I thought I had to have one.

Now you might be thinking, “Johnson, you fool, you don’t have symptoms. You can run a mile or two without problem, you can bike for thirty minutes or more, you can ski all day. Why do you need to worry about this supposed heart attack? It makes no sense. You eat right, exercise, and have low cholesterol. It is more likely a false positive.” Tests always have some false negatives (they say “no problem” when there is one) and false positives (they say there is a problem when there is none). All tests are imperfect. This was likely a false positive, but no one seemed to consider that.

So I found an internist, had a quick physical and got a blood draw. He looked at the free ECG and said it didn’t look like anything serious but I should have a stress eco-cardiogram. This is a stress ECG associated with a heart ultrasound.

I had to be at the cardiac lab at 7:30 AM. That morning I was hearing contrary intuitions. None of this made sense. I have a high deductible insurance and I hate to spend money foolishly. I am also ethically opposed to over-using medical services. Medical doctors have told me that at least half the visits people make to doctors are unnecessary. I kept thinking I should back out. But I showed up and checked in. I was led into a small room with a treadmill on one side of the examining table and an ultrasound on the other. First I was hooked up to the ECG and then they did a baseline ultrasound of the heart. Next I got onto the treadmill and the technician raised the incline and the speed until my heart reached 140 beats per minute. I was supposed to run at that rate until I wanted to stop. My heart reached 157 and I was getting pretty out of breath. The two techs, one for the ECG and one for the ultrasound, kept asking me if I wanted to stop. They seemed so worried I thought I probably should stop. Immediately they took the ultrasound and then tracked my heart as I cooled down from the run. After my cool down I put my shirt back on and was taken to another examining room where I sat and read a magazine about fly fishing. A nurse practitioner came in and gave me the bad news. The test had been a waste of time. She refused to call the screening ECG a false positive but it clearly was. I had no signs or symptoms of ever having had a heart attack. My heart was fine.

Doggone it! I had now flushed away probably $1500 from my health savings account and I was no better off. People ask me “Don’t you feel better knowing that you didn’t have a heart attack?” Yes, I admit I feel better, but it was the medical establishment that made me afraid in the first place. The whole thing was a scam.

At the end of his time as President, Dwight D. Eisenhower warned America of the danger from the military-industrial complex. Our army is too big and too expensive, he was saying, and we should beware. John Kennedy ran on a supposed “missile gap” that turned out to not exist. He won, started monkeying around in Vietnam, and when his life was tragically taken, his successor foolishly upped the ante and got us into a miserable war. The military-industrial complex got rich.

Today we fact a medical-industrial complex. Articles are now appearing in the scientific literature about the danger of identifying and treating “diseases” that are really not disease but normal variations that don’t cause problems. On my stress ECG they identified an occasional premature heart beat. I was asked, does it cause you problems? I replied I didn’t notice anything about it. So it is a normal variation. Treating it would cause more problems than it solves.

Thirty years ago I asked my internist – the one who later died – if I should have a stress ECG. After all, I was running four to six miles a day, and wondered if I should be checked. He replied that no, absolutely not. He said I didn’t have any real symptoms so any problem they discovered was not serious enough to cause concern. He said that any treatment for such a problem was more dangerous to me than leaving the problem untreated.

Oh, Jim, I should have listened to you.

THINKING ABOUT CHANGE

Friends, here is a dialog I had with another clinician on line. She was asking about help for a client of hers, and I will post my answer.

The point of this is to help you think about how you might make changes in yourself. Let me know if you find it helpful..

First, her Subject line was: What measures have been effective for reducing cynicism and abrasiveness in an otherwise kind client ?

So you have to know that because my comments are around how we frame or define problems. I don’t want to define a problem in a way that makes it harder to solve. Behind this notion is a theory that problems don’t really exist Out There, but rather they exist in our own ways of thinking.. We use words to make sense of the world, but our words also limit what we can actually see. So be careful how you use your words.

Now here is my colleague’s question:

“I am reaching out for your effective strategies as I am a little stumped.

“As a Productivity Consultant ( who is finishing her Masters in Psych) I am working with a CEO of a small business to be more effective as an individual and as a CEO.

“Here’s the part that is stumping me :

“He is smart, very thoughtful to some people yet incredibly quick to catch himself and others doing wrong.
His employees understandably are unempowered and the business is doing badly.

“I want to play to his strength of being so thoughtful in certain areas to ‘ catch him doing right’ and use that strength to learn to be thoughtful and kind in his dealing with his staff ( and himself).

“Any ideas ??

“Thanks so much”

Here is my answer:

Rivka, a couple of simple ideas:

Your heading is a hint. I wouldn’t want “cynicism” to be the problem, since it is more of a personal disposition, and the danger is the person will identify with that. “Oh, well, I am just a cynic.” If you didn’t use that word with the client, so much the better, But if you think it, you start with your own cognitions, and challenge and reframe. I would like something like, “Oh, this quick criticism is just a simple bad habit. Everyone had bad habits.”

So if you can frame the problem as a habit, it is easier to solve. Next, accumulate examples of times when he overcame bad habits. Find several examples. Look for common elements. Then apply those to this criticism habit.

SUBSTITUTIONS: Negative goals (quit doing X) are hard without a substitute. As the old joke goes, “I’m going to quit drinking so much, as soon as I find a better way to get it down.” What is the opposite of criticism? Perhaps appreciation, finding the good and analyzing it. “How did you do that so well?”

You may have to do a Pro / Con analysis.

Advantages of criticism / Disadvantages of criticism

Advantages of appreciation finding / Disadvantages of appreciation finding.

This may smoke out hidden assumptions about the value of fault-finding.

Do the DAS (Dysfunctional Attitudes Scale) and look at the Perfectionism scale. You may have to put special emphasis on pros and cons of perfectionism, or maximizing versus satisficing / satisfying.

I have attached my handout on Criticism. It may or may not be of any value.

# # #

Now some comments: If a person identifies with a word, like ‘cynic’ then that automatically makes a change much harder. So you always want to think about bad as simple habits, not as having any underlying meaning.. It is possible, even likely, that you could analyze this man’s criticism as having a history of cynicism that comes from a critical and cynical family, and he has identified with that and so on. Well, that makes it very complicated. Try to keep your thinking as simple as possible, because a complicated way of thinking about it makes thinking of a solution much harder.

The Pro / Con analysis is a good way of stepping back from the trap of “Is this thought True?” and looking at it as “Is this belief helpful?” Beliefs can come and go, and some are more useful than others. A belief that gives me more flexibility is always better than a belief than limits and constricts me. We over-identify with our beliefs. But beliefs are temporary. When you were young, you may have believed strongly in magic or Santa Claus or whatever. As you got older, you changed your beliefs. Yet you were yourself then, and you are yourself now. So you are more than your beliefs. Beliefs should serve us, we should not serve them.

Maximizing versus satisfying. Some people are limited by the idea that everything they have Must Be The Best. They want to wear a fancy watch, stay at the luxury hotel, and drive the nicest car. Ironically, this Maximizing approach to life actually backfires. People who practice it are much more insecure and unhappy. On the other hand, people who figure, “This is pretty good, and that is good enough” are actually happier and more productive. A Rolex is actually less accurate than the free time report on my cell phone. If you need a watch, get a good one, not the best, and you will be happier. So this is a thinking habit that had some significant down sides to it.

Finally, when you try to quit something, ask yourself, “What would I do INSTEAD?” If you increase the Instead behavior, the negative behavior generally goes away. So when you set a goal to lose weight or stop smoking, or stop criticizing as in this case, figure out what the opposite will look like and do more of that.

ON DOING THE RIGHT THING

Bob Greene posted an elevating story here http://tinyurl.com/5r5wtca about General Peter Chiarelli and White House advisor Valerie Jarrett. It seems that General Chiarelli, a four-star general and second highest ranking officer in the U. S. Army, walked in to a recent Washington dinner. He was in his full-dress uniform. Jarrett, was seated and he was standing behind her. She saw his striped trousers and, apparently mistaking him for a waiter, asked him for a glass of wine. While some people would take offense as such a slight, General Chiarelli poured her a glass. At that point, she realized her mistake and apologized.

The point here speaks to the General’s character. Throughout history as people rise to positions of importance, they often become caught up in a feeling that they are important.

In reality, no one is more important than anyone else. We occupy positions of importance, such as when I used to teach graduate students. We should honor the position and the responsibility we have, but the position is not us.

The position was there before we came along. The position will be there after we are gone. Every country needs a leader, every army needs a general. It is a profound calling to be in the position of leadership, but it is not us. We are not the position.

Greene has done something truly worthy. He has collected two other stories about people of character, individuals who were at a critical moment passed the test. Read his article and see if you agree that these people pass a kind of test.

Perhaps that is the key here. A friend of mine used to say, when he saw someone do something foolish, “Life is an I.Q. test.” One day I said, no, that is not true. Life is a test of character, not of intelligence. It matters very little how smart I am, but it is of tremendous importance how good I am.

I love intelligence. I love to learn, love to teach, love the life of the mind. Science and knowledge have improved our living conditions immensely. I appreciate and value my store of knowledge, and put a lot of work into that part of my life.

At the same time, the moments I recall, the moments I treasure are when I have done something kind for someone in need. I treasure moments when I have lifted someone, inspired someone, and helped someone.

Don’t you?