Archive for the ‘Success stories’ Category

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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.

Clitoris Awareness Week meets National Bike Month

May 7, 2013

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May is National Bike Month and this week is International Clitoris Awareness Week. So, how do the two fit together?

Clitoris awareness, unlike penis awareness, is not a given. Female children and girls are less aware of the details of their anatomy than boys are. And historically the clitoris has been an object of denial, scorn and even violence (as in female circumcision). This article, for example, documents the  psychological harm done by lack of accurate emphasis on this important organ.

So what does any of this have to do with cycling? Aside from anecdotal reports of spontaneous orgasms occurring during cycling (both men and women), there are other effects of bicycle seats meeting female genitalia, as well described in this blog post . Similar problems occur for men (sometimes resulting in impotence), but this is not Penis Awareness Week — one could argue that every week is.

If you find yourself shocked, embarrassed, or snickering about this blog post, you have just demonstrated the need for Clitoris Awareness Week. I admit, I first heard about it on Weekend Update (on SNL, a comedy TV show) and thought it was pretty silly. But further thought has convinced me it is also serious, and worth publicizing.

For all you ever wanted to know about the clitoris, and more, see this web site.

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:

It takes a village to impact obesity epidemic

February 27, 2009

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The results of the latest (and so far best) research on diets are in:  most people won’t stick to them. The New England Journal of Medicine (2/26/09) published the study which has now been widely reported in the news.  Over 800 men and women were followed on various diets for 2 years; the average weight loss was modest (about 9 pounds) and those who attended counseling sessions (an indirect measure of motivation) lost the most.  No one adhered to the diet closely, despite frequent monitoring and much support.  The conclusion is that eating less (calories) is what matters, not the specific content of the diet (in terms of low fat, high protein, low carbohydrate, etc).

These findings are not surprising, but what is most interesting is the accompanying editorial which describes a study in France where entire villages were used to counteract the obesity epidemic.  Here is the summary from the NEJM editorial:

A community-based effort to prevent overweight in schoolchildren began in two small towns in France in 2000. Everyone from the mayor to shop owners, schoolteachers, doctors, pharmacists, caterers, restaurant owners, sports associations, the media, scientists, and various branches of town government joined in an effort to encourage children to eat better and move around more. The towns built sporting facilities and playgrounds, mapped out walking itineraries, and hired sports instructors. Families were offered cooking workshops, and families at risk were offered individual counseling.

Though this was not a formal randomized trial, the results were remarkable. By 2005 the prevalence of overweight in children had fallen to 8.8%, whereas it had risen to 17.8% in the neighboring comparison towns, in line with the national trend.11 This total-community approach is now being extended to 200 towns in Europe, under the name EPODE (Ensemble, prévenons l’obésité des enfants [Together, let’s prevent obesity in children]).12

Like cholera, obesity may be a problem that cannot be solved by individual persons but that requires community action. Evidence for the efficacy of the EPODE12 approach is only tentative,11 and what works for small towns in France may not work for Mexico City or rural Louisiana. However, the apparent success of such community interventions suggests that we may need a new approach to preventing and to treating obesity and that it must be a total-environment approach that involves and activates entire neighborhoods and communities. It is an approach that deserves serious investigation, because the only effective alternative that we have at present for halting the obesity epidemic is large-scale gastric surgery.

The NEJM research article is here: http://content.nejm.org/cgi/content/full/360/9/859.

The editorial is here: http://content.nejm.org/cgi/content/full/360/9/923.

Strong women (2 movies)

December 30, 2008

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4monthslrg1The impact (on me) of these 2 movies about women with forceful personalities was huge. I just happened to see them back-to-back and feel compelled to write this note. The first movie is Happy-Go-Lucky, and the main character, Poppy, is a very determined young woman who insists on a “glass-half-full” approach to life and people. The second movie is 4 Months, 3 Weeks, 2 Days, and its main character, Gabita, is also determined — not to accentuate the positive, but to assert her honest and powerful sense of self in a harsh world (1987 Romania).  Both characters border on being irritating at times, yet I came away admiring them. You may not agree with the choices Poppy makes; and you surely won’t agree with some of Gabita’s decisions.  But you will not soon forget either one.  Warning: while the first movie is a pleasure to watch, the second is very disturbing (it graphically shows an illegal abortion, and many of the scenes will make you extremely uncomfortable).

Give up a car? Get a bike? Maybe.

August 13, 2008

After decades of being a two-car family, my wife and I recently gave up one of them and bought two bikes. Now, don’t think we are being heroic — we are both retired and live in a very convenient in-town neighborhood. We can walk or bike to many stores and restaurants and friends’ houses, and the climate here is pretty good. Still, it is very nice not paying for insurance, taxes, upkeep and depreciation on the car we gave up. We definitely are driving less than we used to, and I go days at a time without driving (my wife often takes the car on out-of-town trips to visit family, and at those times I am completely car-free).

A huge bonus is that we have found we love cycling around town, and I went in with a friend who has an SUV to buy a very good bike rack, so we can sometimes take the bikes to other places for a change in scenery.

To really see what is possible (and difficult) when you become car-free, check out this blog.

If you have found a way to cut down on driving, and increased your use of more healthy forms of transportation (for you and the planet), let us know.

The power (and controversy) of self-change

August 4, 2008

I have written before (here) about self-change and its relevance for adopting a healthy lifestyle. This recent article in Scientific American Mind summarizes the issues (and controversy) quite well. In case the link to the article goes away, here is the article:

Do-It-Yourself Addiction Cures?

Former drug and alcohol users can show impressive results without professional treatment, through the phenomenon of self-change

By Hal Arkowitz and Scott O. Lilienfeld

July 31, 2008

“To cease smoking is the easiest thing I ever did. I ought to know because I’ve done it a thousand times.”—Mark Twain

Samuel Clemens (Twain was his nom de plume) humorously mocked his inability to end his nicotine-fueled habit. But he might have gone for Quitting Round 1,001 had he had the benefit of recent research.

In 1982 Stanley Schachter, an eminent social psychologist then at Columbia University, unleashed a storm of con­troversy in the addic­tions field by publi­shing an article showing that most for­mer smokers and overweight people he interviewed had changed successfully without treat­ment. He also cited a study that repor­ted even higher rates of recovery among heroin users without treatment.

A particularly controversial finding was that the success rates of his so-called self-changers were actually greater than those of patients who underwent professional treatment. Schachter discussed two possible explanations. First, treatment seekers may be more severely addicted than self-changers. Second, studies typically examine only one change endeavor, whereas his interviews covered a lifetime of efforts. Perhaps it takes many tries before a person gets it right, he suggested.

Schachter’s findings were met with intense skepticism, even outright disbelief, particularly by those who believed in a disease model of addiction. In this view, addictions are diseases caused by physiological and psychological factors that are triggered by using the substance (drugs or alcohol); once the disease is triggered, the addict cannot control his or her substance use, and complete abstinence is the only way to manage the disease. Proponents of this model did not believe that so many people could change their addictions at all, let alone without treatment. Other criticisms came from researchers who questioned the scientific value of Schachter’s work because it was based on a small and selective sample and relied on self-reports of past behavior, which often are not accurate pictures of what really happened. Nevertheless, his findings served as a catalyst, encouraging many researchers to study self-change in addictive behaviors. Let us examine what the research tells us about how widespread successful self-change is for problem drinking and drug addiction.

Rates of Success
Psychologist Reginald Smart of the Center for Addiction and Mental Health in Toronto recently reviewed the findings on the prevalence of self-change efforts among problem drinkers. We draw the following conclusions from his review and from our reading of the literature:

  • Most of those who change their problem drinking do so without treatment of any kind, including self-help groups.
  • A significant percentage of self-changers maintain their recovery with follow-up periods of more than eight years, some studies show.
  • Many problem drinkers can maintain a pattern of nonproblematic moderate use of alcohol without becoming readdicted.
  • Those who do seek treatment have more severe alcohol and related problems than those who do not.

Although fewer studies of self-change in drug addiction exist, the results generally mirror those for problem drinking. In summary: self-change in drug addiction is a much more common choice for solving the problem than treatment is; a substantial percentage of self-changers are successful; a significant percentage of those who were formerly addicted continue to use drugs occasionally without returning to addiction-level use, and they maintain these changes fairly well over time; and those who seek treatment usually have more ­severe problems than those who do not.

The experiences of Vietnam veterans are especially instructive. Sociologist Lee N. Robins, then at the Washington University School of Medicine in St. Louis, and her associates published a widely cited series of studies beginning in 1974 on drug use and recovery in these veterans. While overseas, about 20 percent of the soldiers became addicted to narcotics. After discharge to the U.S., however, only 12 percent of those who had been addicted in Vietnam were found to be in that state at any time during the three-year follow-up. Fewer than 5 percent had overcome their addiction through therapy. Additional findings from Robins’s studies suggested that abstinence is not necessary for recovery. Although nearly half the men who were addicted in Vietnam tried narcotics again after their return, only 6 percent became readdicted.

The results of Robins’s studies suggest the power of self-change in drug addiction, but they also have been the target of many criticisms. For example, most men who became addicted in Vietnam had not had that problem before their tour of duty, suggesting that they may be unrepresentative of the general population of drug addicts. Moreover, their drug use may have been triggered by the stress of serving in Vietnam, making it easier for them to stop when they returned home. This last criticism is weakened, however, by the finding that most men who continued using some narcotics after discharge did not become addicted and by the fact that the return home was also very difficult because of the popular sentiment against that war in the U.S.

Next Steps
We need more and better research on the potential for self-change to conquer problem drinking and other addictions. Studies suffer from differences in the definitions of important terms such as “addiction,” “treatment” and “recovery.” The use of reports of past behavior and relatively short follow-up periods are problematic as well. We also do not know of any studies on self-change with prescription drug addiction. Finally, we need to know if recovery from drug addiction leads to substitution with another addiction. At least one study revealed that many former drug addicts became problem drinkers. Because of these caveats and others, the percentages we have reported should be taken only as rough estimates.

Although we have reviewed some encouraging initial results from the literature, it is our impression that many addictions professionals do not view self-change as very effective. Their conclusion may be largely correct for those problem drinkers and drug addicts to whom they are typically exposed—treatment seekers.

Generalizations from those who seek treatment to the population of problem drinkers and drug addicts as a whole may be incorrect for two reasons, however. First, those who seek treatment have more severe problems than those who do not; second, they may overrepresent those who have failed repeatedly in their attempts at self-change.

We may learn a great deal from people who successfully change addictive behaviors on their own. Whatever they are doing, they are doing something right. In addition to the work with problem drinkers and drug addicts, we are beginning to make headway in the study of self-change in other problem areas, such as problem drinking, smoking, obesity and problem gambling. Greater knowledge about self-change and how it comes about might be used to help people who are not in treatment find ways of shedding their addictions as well as to enhance the effectiveness of our treatment programs.

Note: This story was originally printed with the title, “D.I.Y. Addiction Cures?”.

ABOUT THE AUTHOR(S)
Hal Arkowitz and Scott O. Lilienfeld serve on the board of advisers for Scientific American Mind. Arkowitz is a psychology professor at the University of Arizona, and Lilienfeld is a psychology professor at Emory University

Weight loss strategies

July 16, 2008

This research report appeared in the current news summary from medscape.com. The study only shows associations and not cause and effect, but is worth noting because of the large number of people surveyed.  Though not conclusive, the report reinforces the advice to self-weigh regularly, eat breakfast daily, and avoid fast-food.

July 8, 2008 — Overweight or obese adult patients with type 2 diabetes who followed various weight-loss interventions had lower body mass indexes (BMIs), according to the results of the Action for Health in Diabetes (Look AHEAD) clinical trial reported in the July issue of Diabetes Care [2008;31:1299-1304].

This is a cross-sectional study within an ethnically diverse population with type 2 diabetes from 16 US centers (the Look AHEAD study) to correlate eating patterns with BMI and to describe the most common weight-control strategies in patients with type 2 diabetes.

“Intentional weight loss is recommended for those with type 2 diabetes, but the strategies patients attempt and their effectiveness for weight management are unknown,” write Hollie A. Raynor, PhD, RD, from the Brown Medical School/The Miriam Hospital in Providence, Rhode Island, and colleagues from the Look AHEAD Research Group. “In this investigation we describe intentional weight loss strategies used and those related to BMI in a diverse sample of overweight participants with type 2 diabetes at enrollment in the Look AHEAD. . . clinical trial.”

Study Highlights

  • The Look AHEAD study included 5145 patients aged 45 to 74 years with type 2 diabetes with a BMI of 25 kg/m2 or more (or 27 kg/m2 or more for those receiving insulin), with 33% of participants from ethnic minority groups.
  • Excluded from this analysis were those with inadequate control of diabetes and with underlying diseases that influenced lifespan.
  • Weight-control practices included a list of 23 behaviors that participants chose from, expressed as a percentage of participants using each practice and duration of use of each practice, up to 52 weeks.
  • Those who self-weighed weekly had a lower BMI (35.3 kg/m2) vs those who weighed themselves once a month.
  • Those who consumed 6 or more breakfasts weekly had a lower BMI of 35.6 kg/m2 vs those who consumed 3 to 6 days per week (36.7 kg/m2).
  • Overall, participants consumed 1.9 fast-food meals per week.
  • BMI was 35.1 kg/m2 for those reporting no fast food per week vs 36.9 for those reporting 3 or more fast-food meals per week.
  • The 3 most prevalent weight-control practices by duration of use were increasing fruit and vegetable intake, cutting out sweets and junk foods, and reducing consumption of high-carbohydrate foods, with duration of practice from 20.3 to 26.5 weeks.
  • Overall, a larger amount of intentional weight loss, self-weighing less than once weekly, and more fast-food meals consumed were associated with a higher BMI, whereas consuming more breakfasts was associated with a lower BMI.