Archive for the ‘Managing stress and overcoming obstacles’ Category

Death be not proud

October 10, 2014

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We all know that death is a creepy topic, and we avoid serious discussion of it like the plague (oops, poor choice of cliche!). Well, Halloween is coming, and I highly recommend your listening to this half-hour interview on the subject of death. You will learn a lot, and be entertained as well. Then, to really get into the gory details (and learn a lot more), explore her website and watch some of her short videos.

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Dive in!

September 12, 2013

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This is worth reading:

Diana Nyad and the wisdom of age

Guest Columnist (Vincent P. Ward)
Published: Sep 12, 2013, in The State
http://www.thestate.com/2013/09/12/2974330/ward-diana-nyad-and-the-wisdom.html
The thing that impressed most people about Diana Nyad wasn’t her triumphant emergence from Gulf waters after 53 hours to become the first person ever to swim from Cuba to Florida’s Key West without a shark cage. It’s that she was 64 years old.
The sheer strength, tolerance of pain and discomfort and endurance it took are astonishing. But as Nyad indicated afterward, there’s more to be found by looking deeper. The three things to take from her journey, she said, are “never give up; you’re never too old; and it looks like a solitary achievement but it’s a team effort.”
This was more than breaking a sports record. It was a demonstration of what can be accomplished with the products of aging itself. In a PBS interview the next day, she said that as she ages, “the clock seems to be ticking faster” and “time seems to be running out.” She wanted this to be “a lesson to my life that says, ‘Be fully engaged; be so fully awake and alert and alive.’”
So wisdom was a major factor. She later spoke of the line between acknowledging the possibility of being defeated by things that are bigger than we are, and quitting before we actually reach our limits. It takes wisdom to see, and to live into, that paradox.
Courage is another factor. Nyad braved the water temperature, waves, currents and weather. She braved sharks, swimming without the contraption that keeps them away and marginally eases the water’s resistance around the swimmer. She braved the jellyfish, which had taken her out of action before. She braved the depths, in which unknown critters swim, some of which could rise up to make you dinner.
In other words, she entered the ocean more on its terms and less on hers. This requires another frequent feature of aging: humility, the recognition that in the great scheme of things, you’re not nearly as important as your ego thinks you are. Related is a willingness to surrender to the task, to go with the flow of the sea, rather than determining to conquer it.
Patience is a factor, too. It took four decades of it to hold onto her “extreme dream.” Biding her time while her body aged must have been hard, and probably seemed unwise to many.
Exhaustion, muscle and joint pain, sunburn, swallowed sea water that had to be vomited up, self-doubt, fear, two days without sleep and more. Why would anybody deliberately embrace such suffering? I suspect for the same reason Christ did: for the sake of meaning greater and far more important than safety and comfort.
This swim was in Nyad’s mind for 40 years. She got in the water to start on four occasions, but never finished. But being unable to finish was not the same as giving up. Aging, if you’re paying attention, entails internal change, an emergence, a response to insistent pressure from the inside to become more authentic. So I suspect the meaning of the swim changed over the years and decades, becoming a journey, a process, that occupied a much larger, more central and more profound place in her than just breaking a record. I think it came to represent a destiny of the spirit.
But the time for fulfilling it was not to come until she was spiritually equipped, with the wisdom, courage, humility, interior strength, love that drew supporters to her, and acceptance of the role of suffering in life, which only years can bring. Her journey began decades ago, but I think she had to be 64 to integrate all that and finish this stage of it. “Stage” because the journey is life, and it’s not over till it’s over.
Those of us who are “of an age” had better be paying attention. It wasn’t the goal of swimming from Cuba to Florida that Diana Nyad never gave up on — it was herself. We should be inspired by her to the same journey. Our approaching death is no excuse for giving up on life.
Dr. Ward is a Columbia psychotherapist; reach him at drv-sc@earthlink.net.

Surgery, and airports, could be more user friendly

August 28, 2013

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The other day in the Seattle airport security line I was randomly assigned to an experiment:  I did not have to remove shoes, computers or liquids, and went through the line much faster and happier.

Similarly, surgical prep and post-op could be more comfortable and efficient.  This NPR blog post challenges, among other things, the practice of starving ourselves before and after surgery:

Patients Love a Gentler Approach to Surgery, But Surgeons Balk


Going paperless and getting organized – Part 2

May 10, 2013

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It’s been over 4 years since I last posted on this topic, and I am ready to offer an update.

I made the complete switch to Apple products, so our house now has an iMac, Macbook, iPad, Apple TV, and iPhone. There are trade-offs involved, but for me the benefits (one relatively functional system that combines software and hardware) outweigh the costs (moderately expensive, plus I have all my computer eggs in one corporate basket).

I would not have done this were it not for one cloud-based application that is not dependent on Apple: Evernote.

I have been using Evernote for five years, and now it contains all my personal and other information, organized in about 65 notebooks (as of today I have 6495 notes). Each note contains either a single piece of data (e.g., a product on Amazon I am considering buying), or a whole category of data (e.g., all of my contacts with my dentists). A note can be written by me, clipped from the web, a photo, a video, a sound file, an attachment, an email, or any combination.

Evernote works just as well if you use one notebook, or 200. How you organize is entirely up to you. I have my notebooks arranged under main categories, such as Health, Food, People, My Stuff. Under My Stuff, for example, I have notebooks for House, Bicycles, Yard, Computer Hardware, etc. Under Food I have separate notebooks for Wine, Recipes, Cooking Tips, In-state Restaurants, etc.

When you do a search, all notebooks are searched, or you can specify one. You can put multiple “tags” on each notebook and organize/search that way.

Now, if I need information (e.g., a history of an insurance claim), it is super easy to find, and almost effortless to update. What is even better, and essential, is I can access this data instantly on all my devices, or any mainstream device connected to the internet.

This is really my dream system, one I have been hoping would emerge in my lifetime, but never really expecting it to.

With Evernote, I have essentially gone paperless. On my always-present iPhone, I use an application called Drafts to assemble or compose notes, etc., then hit a button to instantly transfer the note to Evernote. Just as often, I email a note (or forward an email) to Evernote. As a Premium Evernote user ($45 per year), I can search any attached document, whether it is a .doc file, a .pdf, or something else (like a photo). The free Evernote program is powerful, too. You can switch back and forth from free to premium with no obligation or penalty.

I use other programs to store and access a variety of information I want to keep, such as Vimeo for videos I create, Flickr and Snapfish for photos, Yahoo for email (also Gmail).

I do keep backup data on hard drives, and Evernote allows me to keep its data (my data) on my devices, so it is available whether or not I have an internet connection.

The main problem going forward is I am increasingly dependent on a corporation (Evernote) and its continued availability and functionality. So far, despite a few problems along the way, it has been dependable, and its future seem assured.

Willpower and Fun: a win-win combination

December 12, 2010

In a few weeks it will be January, and at least half the U.S. adult population will be groaning about how much they overdid the holiday spirit and how much they need to suffer to get back in shape. It doesn’t have to be that way.  Exercising willpower and self-control now can put you way ahead of the game later.  But how to do this and still have fun is the big question.

My take is there is no fun, in the long run, in acting as if there is no tomorrow.  This applies all year long, not just during a hectic holiday season.  Being mindful of the beauty and joy of this, and every other, season is what it takes to truly appreciate what we have.  Eating mindfully allows us to truly savor the good food.  Being fully present, and not rushed or distracted, when with friends and family enhances the good feelings (practicing mindfulness also helps combat depression; see here).  On the other hand, neglecting yourself (eating and drinking too much and not exercising) leads to bad feelings and regrets.

Willpower is a controversial topic, but should not be.  We all have it in varying degrees, and there is a lot we can do to get the most good out of it.  See these previous posts for some ideas.  Mainly, treat your willpower and self-control as a valuable but limited resource.  Don’t expose yourself to extreme amounts of temptation (see this study).  Strive for balance in your life, during holidays and all the rest of the time.  Finally, I suggest, don’t define “fun” as a continuous orgy of indulgence.  What is your definition of “fun”?

What do you want? A three part question.

June 6, 2010

Many years ago, when I was a young psychiatry resident, I went through a period of great confusion, in my personal life and as a neophyte professional. A trusted friend, a psychologist who was older and wiser than me, looked me straight in the eyes and demanded my full attention before asking me, in a tone fraught with meaning, “What do you want?”  I sat there in stunned silence, my mind suddenly clear of the jumble of racing thoughts that had prompted her question.  Instead, I had only one thought, echoing in my mind and making my head hurt:  What, indeed, did I want?

Now, decades later, I often think of that moment and smile at the simplicity of the question and the obviousness of the answer.  But it took me years of trial and error to really grasp the import of the question.  What I want depends on the unstated part of the question:  Right now, in this moment?  Or, in the near future?  Or, in the long run?

For example, if I am at a restaurant surrounded by people I enjoy and having a grand time, do I really want to order another martini?  It would taste good, and the rush would certainly feel good.  But, past experience tells me I would not sleep well that night, and would feel less than my best the next day.  In the long run, if I regularly doubled my alcohol intake, I might put on some unwanted pounds and suffer other negative consequences.  I have never regretted NOT having a second martini, but have often regretted having one.  So the answer is obvious: No, I do not want another martini, thank you.

Little decisions mount up to big ones.  And big ones, of course, may come at us all at once, as in “Do I want chemotherapy?  Do I want to marry this person? Do I want a divorce? Do I want to adopt a baby?”  I contend the same three parts apply: immediate gratification, short range implications, long term likelihoods. We may have to delay the decision pending some research, or the counsel of others.

What makes this point worth writing about is that so often, in my psychiatric practice and in my life, I have seen people fooled into thinking what they WANT is immediate gratification.  The denial of that (saying “No, thanks” to the offer of a second martini) is not seen as what they want, but as what they SHOULD do, or what they KNOW, but not what they WANT.  That, to me, is ridiculous, because there is no reason to define what we want, really-honestly-deeply want, as simply what is tempting in the moment.

Stating our decisions as what we WANT is a way of taking full responsibility for ourselves. That is why I say so often in this blog that the secret to happy, healthy living (at least that part we control) is re-framing our thinking from what we should do, to what we want to do — in the moment, for the short term, and for the long run.  Striking a balance among the three versions of “want” can be tricky; no one promised it would be easy.  Do you WANT that bag of french fries, or don’t you?  What about that puppy?

Good grief?

February 5, 2010

Is there a right way to grieve the loss of a loved one? The answer, I believe, is NO, but some ways seem less healthy than others.  For example, grieving in isolation may deny a person much needed social support.  Also, rigidly expecting certain “stages” to occur, or time-lines to be followed, can lead to crippling disappointment and guilt feelings.  For a good update on this topic, see “Good Grief, is there a better way to be bereaved?” in The New Yorker (here).  Also, you may want to check out my earlier posting on this topic (here).

What can you learn from your life?

January 21, 2010

Five years ago I began writing down stories from my life. Actually, the process began earlier, when I tried to write the stories of my parents and grandparents (and even great-grandparents).  Newly retired from the full time practice of psychiatry, I had time to explore old photos, letters and records, and to interview surviving relatives.  I wrote about some of what I discovered and sent it to family members.

But, I realized the one person I knew the most about was myself, mostly in the form of jumbled half-memories.  So, I decided to write my life experience as an autobiographical story, and attempted to discern patterns and lessons for myself, and perhaps for my children and grandchildren.  The more I wrote, the more memories I recovered and, as I tried to put them in story form, the more sense they made.  I saw connections between events, people and feelings I hadn’t appreciated before.

Five years later, I have a 250 page book, with 18 chapters, covering 65 years.  And I have learned a lot.  For example:  I am a product of multiple generations of struggle to survive and thrive, including various traumatic events that affect me still; I suffer from some degree of survivor syndrome, with the attendant guilt and impulse to rescue others; my repeated attempts to rescue loved ones have generally failed, but my career helping others has provided some compensatory satisfaction and redemption; my love for, and attachment to, my wife, children, and grandchildren has been enhanced by the process of self-examination; I am beginning to learn what is most important and meaningful in life; I can celebrate my own courage in facing some formidable obstacles; I hope, now, I can draw on this courage as I face challenges ahead.

Why am I telling you this?  To suggest that you, too, may benefit from writing your life story, even if no one else ever reads it.  Don’t have a clue how to begin?  Here are some resources that have helped me (and there are many others):

An update on the history and current status of memoir as literature:  “But Enough About Me” in The New Yorker.

An inspiring book about a way to conceptualize your life:  The Writer’s Journey

Two practical books on how to start your own memoir:

Your Life as Story

Writing Life Stories

Writing as a way of self-healing:  Writing as a Way of Healing

How to write funny stuff about your life:  What Are You Laughing At?

A website containing useful articles and tips about memoir writing (type “memoir” in the site’s search box):  Guide to Literary Agents Blog

Learning self-control and delay of gratification

May 22, 2009

New Yorker marshmallows

A now classic psychology experiment from the late 1960s demonstrated that four-year-old children who were able to delay the gratification of eating a marshmallow became more successful in later years than children who could not exercise as much self-control. In an update of the research on this topic, Jonah Lehrer (writing in The New Yorker recently) quotes the original researcher and many others discussing how we learn to control our brains when it comes to resisting temptation and applying ourselves to a task (such as controlling what we eat or exercising more).

The marshmallow researcher, Walter Mischel, says, “Once you realize that willpower is just a matter of learning how to control your attention and thoughts, you can really begin to increase it.”

Teaching children (and adults) simple ways to master their thoughts and behavior (through “strategic allocation of attention”) may be a crucial ingredient in increasing success in many activities.  For example, the children who were successful in resisting the marshmallow temptation

distracted themselves by covering their eyes, pretending to play hide-and-seek underneath the desk, or singing songs from “Sesame Street.” Their desire wasn’t defeated—it was merely forgotten. “If you’re thinking about the marshmallow and how delicious it is, then you’re going to eat it,” Mischel says. “The key is to avoid thinking about it in the first place.”

Mischel and other researchers are very interested in studying the people who have become “high-delaying adults” (exercising self-control) even though, as children, they failed the marshmallow test.

Some researchers (e.g., John Jonides at University of Michigan, and others) are focusing on the exact locations and functions in the brain associated with self-control and delay of gratification:

Yale University researchers found that delaying gratification involves an area of the brain, the anterior prefrontal cortex, that is known to be involved in abstract problem-solving and keeping track of goals.  … The brain scan findings from 103 subjects suggest that delaying gratification involves the ability to imagine a future event clearly, said Jeremy Gray, a Yale psychology professor and coauthor of the study in the September [2008] edition of the journal Psychological Science. You need “a sort of ‘far-sightedness,’ to put it in a single word,” he said. [reference]

Mischel, the original marshmallow researcher, adds:

The key to delaying gratification may lie in the ability to “cool the hot stimulus,” he said in a telephone interview.

Over and over, research is showing that the trick is to shift activity from “hot,” more primitive areas deep in the brain to “cool,” more rational areas mainly in the higher centers of the brain, he said.

There are many ways to cool a hot stimulus, said Mischel, who is president of the Association for Psychological Science. Say you are determined to resist the chocolate cake at a restaurant. You must distract yourself from the waiter’s dessert tray. You can also focus on long-term consequences and make them “hot” – by vividly imagining your future tummy and hip bulges – or think of the cake in the cooler abstract, as a thing that will make you fat and clog your arteries.

In the marshmallow test, he said, “the same child who can’t wait a minute if they’re thinking about how yummy and chewy the marshmallow is can wait for 20 minutes if they’re thinking of the marshmallow as being puffy like a cotton ball or like a cloud floating in the sky.” [reference]

A large-scale study is now underway, involving hundreds of schoolchildren in Philadelphia, Seattle, and New York City, to see if self-control skills can be taught.

More resources:

Please, don’t Resolve to “get healthy” in the new year!

December 31, 2008

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There is nothing wrong with setting a goal to walk 30 minutes a day, or to stop buying fat-and-sugar-laden snack foods to keep in the pantry. The problem with New Year’s Resolutions is that they are usually reactive and rarely work.  By reactive, I mean they tend to be the result of a feeling that “I have overindulged” or “been bad” in December, so I will make amends next year.  This kind of thinking is self-defeating.  Diets don’t work, and Resolutions don’t work.  What does work is a full time commitment to practicing specific, realistic behaviors.  The idea of an annual review and re-commitment is not bad, but I suggest the best time to do this might be December 1 — certainly not January 1.

Here is an excerpt from Weight Management for Your Life that may give you some idea why I think December, with all of its “special occasions,” would be a good time to review and renew your healthy-living plan:

If you have been successfully working on changing your eating and exercise patterns for some time, you will encounter situations where someone will say to you “This is a special occasion, so go ahead and eat that cake!” The cake is not the issue, but the implication behind the statement is. People observing your healthier lifestyle will assume you are in a constant state of self-deprivation, and will want to see you “loosen up.” It is important to them to feel okay about
their own “indulgences.” The problem with your buying into that theory is that it discounts the fact that you already are eating (and exercising) the way you want to. You are not depriving yourself – in fact, by doing what you want, you are indulging yourself. Your ongoing healthy lifestyle is its own reward.
Another problem with going back to old unhealthy habits, even temporarily, is that such “special occasions” come up frequently: out-of-town trips, weddings, graduations, birthdays, holidays, cruises, office parties, etc. etc. Add the special occasions with their special “indulgences” or “rewards” up over the course of a year and you have put on an unwanted five to ten pounds. … Special occasions are even more special when they don’t throw you off your chosen path.

Happy new year!