Archive for the ‘Planning and goal setting’ Category

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September 12, 2013

Swimming_0195

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.

Parents, remember these numbers: 5210

July 29, 2012

Five-two-one-zero (5210) is a reminder of what our children need each day in order to be healthy. Here is the breakdown:

5    = Five or more servings of fruits and vegetables

2    = No more than two hours of recreational screen time (no screen time under 2 yrs old)

1    = At least one hour of physical activity

0    = Zero servings of sugary drinks (drink water and fat-free or 1% milk instead)

[To remember the numbers I think “five to ten”]

For more information see http://www.letsgo.org

Here is a short video to use as a teaching tool for children: http://youtu.be/TluNJeM6HAI

Here is a more detailed video for help in designing a 5210 program in a community: https://vimeo.com/29985972

Make your New Year commitments now

December 16, 2010

ist2_1141718_desk_calendar_january_1st_with_clipping_path1

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” last year, so I will make amends this 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, such as setting a goal to walk 30 minutes a day, or to stop buying fat-and-sugar-laden snack foods to keep in the pantry.  An annual review and re-commitment can be helpful, but I suggest the best time to do this might be December rather than January.

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!

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?

How many times a day should we eat?

May 26, 2010

I stated in my last post that we cannot trust “hunger” as a cue for when to eat. But how do we know when it IS time to eat?  For me, and I suspect for many others, the three-meals-a-day “rule” works well.  In fact, I believe that for most people who struggle with weight control, eating more often, “grazing,” or snacking between meals only adds to the problem.

Now, many of you believe that six or more small meals per day, or three meals plus two or three snacks, is best (e.g., see comment by Personal Trainer on my last post).  And for some people there is a medical reason for eating more often than three times per day (e.g., people with dyspepsia, GERD, hypoglycemia, etc.).  Some of these medical indications are valid, and some are not.  I won’t get into that here.  What I do know is that the more we snack, the more likely we are to consume excess calories (see this research report).

A survey reported this year in the American Journal of Clinical Nutrition found that in the thirty years between the 1970s to the early 2000s, for adults and children, the average time between eating occasions shrank by one hour (most recently, 3 hours apart for adults and 3.5 hours apart for children).  Daily calories for both groups increased from roughly 2,090 in the 1970s to 2500 in the 2003 – 2006 period.

Calories from snacks more than doubled: for adults, from 200 calories per day in the 1970s to 470 calories in the recent time period; for children, from 240 to 500.  A significant portion of snack calories came from beverages.  It can be assumed that these numbers are underestimates, since surveys usually under-report the number of calories consumed.  [The above research was described in the May 2010 issue of Nutrition Action Health Letter]

It makes sense to me that the more often one eats, the more one is exposed to temptation and calories.  Also, we know that “willpower fatigue” occurs, so that the more often we have to decide what and how much to eat, the less “willpower” we are left with by the end of the day.

One known cause of overeating, which is also closely related to snacking, is “emotional eating.”  The solution to that problem is mindful eating, plus tending to emotional issues in a more appropriate way.

Personally, one of the most effective things I have done over the years to maintain my weight in a healthy range is to eliminate snacking.  It takes some getting used to — for example, eating dessert just before bed was a long time habit for me — but it really makes a difference.  And I haven’t developed hypoglycemia, insomnia, or any other health problem as a result.

If eating three daily meals (assuming the portions are reasonable and the food is mostly “healthy”) works to maintain weight, would two meals be even better?  Apparently not, according to several studies.  People who skip breakfast, for example, tend to weigh more than people who don’t.

Lose weight with your iPhone

November 8, 2009

iphone scale

If you own an iPhone (or iPod Touch), this simple program will help you maintain or lose weight, if that is your goal. Even if you don’t own one of these devices, the basic approach of this program may give you some good ideas. David Pogue of the New York Times writes:

Lose It! This beautifully designed weight-loss app has an astounding number of followers, if the outpouring of enthusiasm on Twitter is any indication. You tap to record everything you eat. It’s actually kind of fun, because the program contains every food item you can imagine, including brand-name packaged food and restaurant-chain menus. For each one, the app lists the complete nutritional information.

You also indicate what exercise you get each day, using a similarly complete list of activities. Finally, you tap in your weight each day. Probably because the app focuses you so well on staying true to your goals, its fans say it truly works. (Free)

You may read the New York Times article here. And you can download the app and read more about it here.

The computing “cloud” – an update

October 5, 2009

Blackberry-Curve-8300

One year ago I posted on my transition from using a Palm handheld to using a Blackberry Curve (here) — this is a follow-up. This will be a very short post, but the main point is that I am happy with the transition. “Cloud computing” remains somewhat controversial, but has been widely accepted as inevitable. I love it.

Now, when I want to save a tidbit of information (such as medical information, travel plans, online purchases, chapters of my book, etc etc) all I do is post the tidbit in “the cloud” and it is saved for me. The best part about this is it is available to me on my iMac, my PC laptop, or any other computer I happen to have in front of me, including my smart-phone (although I would need to get a newer model to get full functionality).

What I want to share with you now is that the most amazing software for saving these tidbits in the cloud is a free program called Evernote. Check out their site for more information (here). I am in no way associated with that company, except as a customer (I upgraded to the premium version which is not free).

By the way, I have not posted lately because I am writing another book (more about that much later).

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:

Looking your best in 2009

January 1, 2009

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For my first post in 2009, I am passing along to you a sure-fire 9-step program to help you lose weight and/or accept yourself. It is straight from the January 5 issue of The New Yorker (by Amy Ozols):

People say that obesity is an epidemic in America, but I’m determined not to become part of the problem. That’s why I’ve spent years perfecting the secret to a trim and attractive physique. My foolproof system involves just nine easy steps.

Step 1: Avoid what psychologists refer to as “emotional eating.” This is hard, because many people have a tendency to experience emotions. To solve this problem, consume increasing dosages of psychotropic medications until you cease to feel emotions of any kind.

Step 2: Visualize yourself as a thin person. This is very important, because the body often takes its signals from the brain. Each time you take a bite of food, imagine that you are a thin person taking a bite of food, chewing the food, then spitting the food into a napkin, then tucking the napkin into your backpack or purse. After you’re done visualizing these things, start doing them.

Step 3: Get rid of your “fat clothes.” Keeping your closet stocked with unflattering garments will only distract you from your quest for a slender body. To complete this step, shred or burn everything in your closet, including any hangers or shelving that a fat person may have touched. Refrain from donating anything to charity, as this could cause underprivileged people to become obese, which would be unsavory and possibly even illegal.

Step 4: Refrain from consuming food.

Step 5: Surround yourself with thin people. This will naturally encourage you to emulate their healthy habits. Weigh your friends on a regular basis, then weigh yourself. Do you have a friend who weighs less than you? If so, consider gastric bypass surgery.

Step 6: Drink plenty of water. As you’ve probably heard, water functions as a natural lubricant in the body, flushing toxins and fat cells from the digestive tract. Water is also a delicious replacement for higher-fat liquids, such as milk. Try pouring water on your cereal or in your coffee. If you’re a baby, try pouring water into your mother’s breasts.

Step 7: Buy a pet. Having a pet will force you to take walks, which are a form of exercise. This is true unless you make the mistake that I made, which was buying an iguana. Iguanas walk very slowly and smell strongly of turds. I really cannot dissuade you strongly enough from buying an iguana.

Step 8: Vigorous sexual intercourse burns up to two hundred calories per hour. Therefore, if you are not currently promiscuous, it is essential that you begin “boning” immediately. Start by having sex with every person you know. Then have sex with numerous people you have never met. Continue doing this until you are thin.

Step 9: Self-confidence is the most attractive trait a person can have. For this reason, strive to love yourself and accept yourself exactly as you are. This will be difficult if you are overweight, on account of your loathsome physical appearance and compromised value system, but do your best. And, if the going gets tough, remind yourself: every person is beautiful on the inside, provided that they are also extremely attractive on the outside.

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

December 31, 2008

ist2_1141718_desk_calendar_january_1st_with_clipping_path1

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!