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.
Archive for the ‘Managing stress and overcoming obstacles’ Category
This is worth reading:
Diana Nyad and the wisdom of age
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:
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.
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?
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).
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:
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
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  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.
- watch a brief video of the marshmallow test;
- listen to a Public Radio discussion of the New Yorker article (45 min.);
- check out sayyestono.org, an organization devoted to increasing self-discipline in children;
- read the article in The New Yorker and this Boston Globe article.
- in one recent study, obese women were found to have less ability to delay gratification than obese men and normal-weight people.
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!