Wednesday, November 18, 2009

Reflections on Not so Mysterious Medical Findings

This post is about subjective health. By that, I mean how people rate their own health when asked. Medical researchers have found that self-rated health is among the best predictors of mortality, even when compared against so-called "objective" measures of physiological function. Of course, when this was first reported, there was great skepticism among medical researchers. They surmised that the finding was in some way explainable through faulty data or perhaps represented a random statistical aberration. In medical research, it seems, subjective feelings about anything are considered "soft" or unreliable data, just a notch above qualitative research, where individual themes rather than grouped numbers represent the data to be interpreted.

Overall, skepticism about what people think represents the Cartesian incubus of medicine, an expression that blames René Descartes (the 17th century French scientist and philosopher) for the mind-body dualism that has characterized Western medicine for centuries. Descarte's emphasis on studying observable phenenomena is responsible for the bias against studying phenomena that occur in the mind, primarily because such phenomena cannot be reliably measured or verified. While the body and its tissues can be touched, invaded, observed, and otherwise measured and manipulated; the mind represents a special challenge. What goes on there (beyond visual representations of structures and electrical activity), can't be directly seen, so functions must be inferred. The mind remains a vast frontier of scientific challenge. The "medical mechanics" of the body like to focus on the things that can be observed and manipulated. When it comes to the mind, things like feelings create dilemmas. How can science explain and measure what it cannot see and take apart?

In recent years, faced with data that could not be dismissed so readily, medical science has given a grudging nod to the reality of the mind-body connection. Now, the finding that self-rated health has such powerful predictive power when compared to other time honored measures is an inconvenient truth, sort of a scientific fly in the ointment. Moreover, since many studies have confirmed this finding, the dilemma of how to explain it grows more troublesome and begs for closer scrutiny. This finding may be troubling and inexplicable for some, but not for those who, like me, understand the incredible health giving power of human activity.

One very interesting finding related to self-rated health is that when it comes to the factors that seem to explain this phenomenon, it appears that neither pain, nor fatigue nor other such factors commonly described as subjective "symptoms" seem to explain the predictive power of self-rated health. Instead, actual engagement in activity seems to be a major influence on how people rate their own health. Put in other terms, researchers have found that people tend to rate their own health based on the things they can or cannot do rather than on other factors. This makes sense, because what people experience is what they know best.

These findings make one medical philosopher, H.Tristram Engelhardt, Jr., MD, PhD, seem like a very wise man. He is. Years ago, Dr. Engelhardt observed that people are healthy or diseased in terms of the activities open to them or denied them. Stated in other terms, he was saying that participation in life is the manner in which people normally experience health or illness. If their participation is restricted, it follows logically that they are going to perceive that their health is compromised. People know what they are doing in comparison with what they have done in the past and what they would like to be able to do in the present.

And so, the findings about the predictive power of self-rated health end up being not so improbable after all, but rather logical. Given that a strong connection exists between activity engagement and health outcomes, it suggests to me that when health screenings are done, questions about activity participation should be a central part of the data gathering by primary care providers. Perhaps a question that would be more valuable than "How are you feeling today, Mrs Jones?"" might be "What have you been doing lately, Mrs. Jones?" followed by "Are you doing more, less, or as much as you'd like to be doing right now?" Funny, that in everyday social conversation, people often ask each other "How are you doing?" So, if you think about it, (and I do), this common phrase uses "doing" as a synonym for "feeling". Oops, there is that troubling mind-body connection again! It just may be that life activity itself is a tremendous barometer for health and wellness. For years, activity levels have been used to gauge mental health. Now it seems, those same data might be useful measures of overall physical health as well. On that topic, a future post awaits.

Of course, as much as I'd like to have the last word, that is reserved for you. If you are aware of other findings that relate to this topic, by all means share your comments (subjective and objective) below.

Wednesday, October 21, 2009

October Road?

Yo. Here it is, the 21st of October, and it has once again been weeks since my last post. What gives? Part of it had to do with my commuting lifestyle, but the other had to do with enjoying a splendid Summer and early fall in Southern Minnesota, mostly on the bike trails.

I did a little biking, and canoeing, hiking, and even a little (can you believe it?) segwaying. Yep. Segwaying—using that novel two wheeled motor stick that propels you along as though you are riding a push lawnmower! My son Erik and I learned at the same time, and we deigned to take those segways along a few mile stretch of a bike trail outside of Lanesboro. Personally, I think they qualify as motorized vehicles and ought to be forbidden on bike trails, but there are so few of them that I don't think the trail authorities have time to worry about them.

It was a glorious summer, with so many great outdoor experiences that it just went by in a wonderful blur of enjoyment. I hope yours was equally satisfying.

Now, the winterization process begins. Storm doors are being installed tomorrow, and the guy with the compressor blew the water out of the irrigation system this morning. No more mowing— most likely, until next April. A few leaves to rake, perhaps, and a whole lot of memories to reflect are in store as we sip wine in front of the fireplace during the long nights of wintertime in the Northland.

Life is good. We did it well this summer. Next year we'll do it even better.

PS. I titled this blogpost "October Road" from the album (and song) by James Taylor. One of my favorites. Maybe my next post will be about the lyrics to that song, or JT's lyrics in general. Who knows? Share your own stories, I'd love to hear about them. Remember, we live in the shelter of each other.

Thursday, July 9, 2009

Interrupting the Hiatus

It's been awhile since my last post, so one can say that this post is an interruption of an interruption. If you Google the word "hiatus" you will find many definitions, ranging from those anatomical to use of the term in the context of breaks in television production or programming. The word comes from the Latin word for "yawning" (interesting), and also is used to signify an opening.

Lately, I have been considering the notion of hiatus from the standpoint of transitions. Most people have transitions in their lives, and often, but not universally, these transitions are marked by a hiatus that serves as a bridge from the old to the new state (whether this refers to jobs, life stages, parenthood, or other aspects of the life course). A hiatus, of course, can also be defined by a vacation period, or time away from a usual routine.

Transitions are often difficult and stressful. I have frequently found that returning to work from an extended break can be challenging, as though one has to move through the gears to get sufficient torque to overcome inertia and resume customary speed. A well-oiled life, it seems, chugging along with a predictable routine, maintains momentum and indeed, even benefits from that momentum (just as a sleigh moves downhill without the need for additional propulsion).

So, I'm hoping that firing up the cylinders for this post will get me back in the groove so that posts will be more regular for the coming weeks and months. Commentary, of course, helps. So if you stop by, please leave a note and share your thoughts about the events and facets of everydy life that contribute to balance, happiness and of course, success in the projects that engage us.

Friday, May 29, 2009

More on the world's happiest countries

Previous posts have discussed the comparative data among countries using measures of happiness or subjective well being. Sometimes, the fact that two different measures are used causes confusion. One measure, used by Martin Seligman to measure "authentic happiness" as described in his book, is the simpler of the two. It measures happiness by asking people how happy they are. A second measure also asks people how happy they are but adds a second dimension called satisfaction. That measure is called a subjective well being score and is used in the World Values Surveys done at the University of Michigan.

Using the second (subjective well being) measure, the following countries rank in the top five across the globe: 1. Nigeria 2. Mexico 3. Venezuela 4. El Salvador and 5. Puerto Rico. At first blush, it is obvious that these countries have something in common: they each have large numbers of relatively poor people, suggesting that money does not equate with happiness. The list brings to mind another truth, which is this: Happiness is a state of mind, and as such, people have complete control over it. If people make the best of their circumstances, they can create the conditions necessary for happiness. One wonders if there is a cultural characteristic about poverty that enables people to see the best in their circumstances, which in turn influences their sense of well being?

I have two friends, both professionals, who respectively are from Nigeria and Puerto Rico. They are both positive energy emoting people. That is, they bring good feelings to situations, in comparison with others who seem to work hard in the opposite direction. Each of these persons also share the trait of valuing things that make a difference in the longer term, while also taking care to make each moment a particular pleasure for themselves and others.

In future blogposts I will explore this notion further. As always, if you have observations about anything on this topic or others that pertains to doing life well, please share it with us!

Sunday, May 17, 2009

What to do during Spring

Spring for many is the most glorious of the seasons, and it holds true for me as well. It is especially wonderful in portions of the globe where the winters are long and bitterly cold and people are forced from the warmth of their habitats for only the most essential of tasks (such as going to work, worshiping, seeing friends, dining out, attending school or shopping at the grocery or department store). What's left, you might ask? 

Well, what's left is enjoying nature, sitting on the deck, walking by the river or pond, and staring at the sunset or the birds in the trees. In the winter there are no squirrels scurrying about in the grass, and birds are not nesting in the trees. There is little bicycling either, nor canoeing, nor kayaking, nor in-line skating, or running. The winter worshipers will be quick to point out that there is ice fishing and cross country skiing and ice skating during their season. But even these sports, fun as they are, find their adherents happy to get inside to relinquish the activity to warm drinks and cozy fireside chats.

Yes. Spring is wonderful not only because of the weather, but because of the blossoming of nature and the general spring fever that overtakes the land. People are happy to be out and about, and so are other animals. Everyone frolics. The seasons ahead bode more of the same enjoyment, as spring gives way to the fullness of summer, and summer recedes to the beauty of autumn.

So, what's to do during spring? Enjoy life through outdoor activity...or inactivity. Just be and bask in its beauty.

Friday, May 1, 2009

Home again

It's hard to believe I have not posted a blog entry for three weeks, and I'm amazed at how fast time has passed. Of course, I've been busy; but then again, so have you. Which prompts a reflection in this post about the perception of time. That is, how it seems to pass so quickly on some occasions and so slowly on others.

As a person well into middle age, I have the distinct impression that time accelerates as we get older.  I can recall endless and interminable afternoons in my desk during the fifth grade (and perhaps on more recent occasions as I endured disengaging lectures). In the sixth grade I was fortunate to have a master teacher and felt constantly engaged; the time passed quickly and I excelled. I now wonder if there was a relationship between the two experiences (my performance and my perception of time).

Of course, there have been scientists interested in this phenomenon, both from a psychological perception perspective and a time use/accuracy of reporting standpoint. Not surprisingly, time use scientists report that perceived versus actual time spent working is inflated, while perceived versus actual time spent in leisure and social activity is underestimated. Go figure.

The whole complex matter of perceived time passage, performance, and happiness is immensely interesting, and invites the possibility that loneliness is associated with depression because of disengagement and the perception that time crawls mercilessly through uninviting terrain—rather than springing, as it should, through more pleasant surroundings. 

I'll have a look at the literature to see if any enterprising (engaged) scientist has cleverly considered these questions and report them if I find anything. Meantime, if you discover something, or have a thought to share, please feel free to post it here. Meantime, I wish you engaging moments.

Thursday, April 9, 2009

Happiness is about meeting needs...

Over sixty years ago, a psychologist named Abraham Maslow began working on a theory of motivation. His questions had to do with what makes people do different "things" at different times? His work, of course, led to the much studied, and widely known "hierarchy of needs". An idea behind this early work was that some needs are more compelling than others, and thus serve to influence behavior more strongly. Another idea was that once "lower level" needs were met, higher level needs would take over as influences of behavior.

Maslow's hierarchy was often depicted as a pyramid, with survival needs at the base and higher order needs at the top. The survival needs were physiological and safety related, in that we need to eat, sleep, breathe and be protected from harm. Above the survival needs were the need to be accepted and loved by others, and to be approved and recognized as competent. These needs seem associated with our group-living characteristics—indeed, we are social animals. Together, these needs (survival and social) were referred to by Maslow as deficiency needs, suggesting that actions taken to meet them were inspired by their deficiency. That's why Maslow called them "D-Needs".

At the top of the pyramid, were needs Maslow described as "being needs". Being needs include our quest for aesthetics and cognition, the realization that we have that beauty and art and music enrich our lives, and our need to understand the world as coherent—to organize the universe and understand it as having order and symmetry. At the very top, a motive that Maslow called "self-actualization", people are compelled to realize their potentials.

These ideas of Maslow have now been supported by many studies, and have been debated and refined over the years. Yet, they have fundamental value in steering us toward understanding the kinds of things we can do to meet our universal needs through the things we do.

In coming posts, some examples of need meeting activities will be discussed, and readers will be invited to provide their experiences and ideas about meeting essential needs.

Wednesday, April 1, 2009

Forgiveness —Something we can do to keep ourselves healthy

Many years ago, I read a piece of advice that truly caused me to reflect. The statement was about letting go of petty grievances and of not harboring resentment. It proclaimed that forgiveness is something we do for ourselves, not others. Each of us, in our lifetime, has experienced an assault on our identity or sense of self (pride), or on our body. We feel we must defend our bruised egos, reclaim who we are, and create a sense of fairness and justice by getting even. We expect that to make ourselves whole, the person who perpetrated the injustice must apologize, or in some other way give of themselves in order to "make things even."

To the extent that we must endure such injustices, we feel abused and hurt, and we feel we cannot go on until that wrong is somehow "righted". All the while, however, this resentment is creating a knot within us, something that represents "unfinished business". We carry this extra baggage along with us, perhaps adding additional baggage over time, and then realizing one day that we have a lot of this baggage weighing us down, and it truly does weigh us down.

There is abundant evidence now about how the endocrine system, the regulator of hormones that flow from our emotions, can yield unhealthy consequences over time if we continue to carry this additional emotional weight. It can and does create conditions that lead to increased risk for physical and mental illness. Yet, summoning the strength to be larger than any particular issue is to truly proclaim one's independence and create the emotional conditions that empower the body and the mind. This is often easier said than done because we are so habituated to acting like a victim when we are assaulted. We often forget that there is sometimes more power in "not doing" as in "doing"— in yielding rather than forcing. That is a principle of Taoism.

So, it turns out that one of the most beneficial "fitness exercises" a person can do is learning how to forgive. Think of forgiving as "giving for health and happiness"—our own!

Saturday, March 28, 2009

Zigs, Zags and Doing

Today's post is a bittersweet testimonial to the power of doing. Cartoonist Tom Wilson, who continues his father's work in evolving the character Ziggy, has written a poignant book called Zig Zagging, in which he describes the bittersweet experiences of his life so far and how his work has helped him transcend life's difficulties. Mr. Wilson has experienced more than the usual burden of challenges, and his book gives us a glimpse into how he coped. One of the take away messages I could not escape was how important his work was to this process.

In the 1981 movie called "Whose Life Is It, Anyway?", Richard Dreyfuss, who plays a paralyzed sculptor (Ken Harrison) who is deprived of his work after a tragic car crash. In a dramatic scene that portrays a dialogue between Harrison and another character trying to offer hope by telling him he can learn to do other things, Harrison's response is that it is the work that matters. His reply reflects the meaning he attached to doing his art and his realization that this could not be simply replaced simply by substituting other work in its place.

There is immense power in what we do, and that power results not from the outcome, but from the process. Perhaps this is a more focussed corollary to the admonition that life is a journey and not a destination.

What do you get from your work?

Sunday, March 15, 2009

More Thoughts on Attention, Gratitude, and Happiness

Recent posts have concerned the importance of truly attending to what we are doing, appreciating its beauty and benefit, and recognizing how fortunate we are to be experiencing each moment. We acknowledged that doing this is not easy for many people, because our minds are constantly bombarded with stimuli, we have too much to do, and the preoccupation of what has or will happen creates a detour for what is happening right now.

How many of us have done a routine, such as dressing, or even driving to work, and finding that we are unable to recall any of the actual details of going through that routine? It's as though our minds were on automatic pilot. We were concerned about the budget, the important upcoming meeting, or the argument we had with our boss. How many people, during those lulls of inattention, forget to notice the dog crossing the street, or the stop sign? Sadly, this occurs on occasion with life altering and tragic consequences.

Yet, those outcomes, as rare,dramatic, and often tragic as they are; are arguably no more problematic than a life gone by and missed through inattention. It is sometimes said that we never fully appreciate what we have, until we lose it. Part of the reason for this, it seems, is that we are not fully experiencing and appreciating what we have. We too soon accommodate to comfort, and in doing so we focus on what we imagine might be missing to make the moment more complete.

A friend shared a humorous clip recorded from the Conan late night show. Although the humorist shown in the clip pokes fun at how blasé we have become in the face of 21st Century hyperchange, he makes an important point about appreciation and gratitude. You can see the clip here.

If we define each moment as the perfect experience that it is, concerns seem to evaporate. This is a principle of Taoism; namely, if we accept what comes to us and experience it without comparing it to another condition or state, we are not evaluative, we simply are, in our all too short, wonderful state of being. By doing so, we create the conditions for happiness at all times.

Saturday, March 14, 2009

Importance of Being Where You Are

In several previous posts I have discussed how settings or places influence what we do and how we feel. In one post, I invited readers to share some of their own habits and routines that help them enhance their comfort, well-being or happiness. People create living environments that please them, they decorate with art, with colors and fabrics and even views that are interesting, satisfying or pleasant. So it was not surprising to me that many of the comments related to creating quiet places or adding pleasant scents or music. Some people describe how they surround themselves with sounds and objects, while others preferred quiet, simplicity and solitude. Some people described how they change their locations or conditions to suit their moods and what they are trying to do at the moment.

Thinking about this brought to mind several thoughts. James Taylor, one of my favorite musicians, once wrote a song called "Secret O' Life." The lyrics began with the lines: "The Secret of Life is Enjoying the Passage of Time...any fool can do it, there ain't nothing to it", with the implication being that each person has the power to create their own happiness through what they choose to do, where they are, and who they are with. Of course, how we think about our experiences is also important.

The wonderful book written in 1993 by Jon Kabat-Zinn titled "Wherever You Go, There You Are" emphasizes the important message of mindfulness meditation, or being attentive in the moment as a way of reducing stress, improving enjoyment and contributing to everyday well-being. When we pay attention to creating the world we want by making our surroundings comfortable, it makes sense that we can more fully enjoy them if we are "in the moment" and enjoying every second. We can define each moment as a present and experience it as the term is also defined, as a gift. Life is amazingly short, so dwelling on what is not is squandering opportunity that is lost forever. Another writer, Eckhart Tolle, writes on the same theme in his "The Power of Now." Tolle discusses the habits of mindless thought that get in the way of attention and mindfulness. His message was that being in the moment takes practice to rid ourselves of habits of thought developed over years. Tolle, too, talked about how environment can support such practice. So, we come full circle to James Taylor. When it comes to being where we are fully, any fool can do it, but it takes practice and will to make it happen.

Thursday, March 12, 2009

Looking Out for Our Neighbors- Ayn Rand Revisited

The blogosphere has been buzzing lately with commentary about Atlas Shrugged, the novel written by author Ayn Rand in 1957. Considered one of the most popular US novels during the second half of the twentieth century, Atlas Shrugged tells the tale of a revolt by innovators and others in society whose ideas and work efforts create wealth and opportunity. The books lays out a philosophy that has come to be known as Objectivism, and advocates free market capitalism, objective reality, and enlightened self-interest.

Opponents of the economic stimulus plan, particularly far right conservatives such as Rush Limbaugh, and others, frequently cite Atlas Shrugged as a type of manifesto that justifies their position that people who have lost jobs or are losing their homes should not be helped by the government because this is contrary to free market individualism. Typically, their argument holds that people (which is usually code for themselves) should not be asked to contribute tax dollars toward efforts that are seen as contrary to free market philosophy. Objectivism's emphasis on an individual's right to pursue happiness and self interest without feeling an obligation toward others is central to the current misguided argument used by anti-stimulus adversaries who cite Rand.

So what does this have to do with doing life well? An oft-cited viewpoint expressed in previous posts on this blogsite is that because we are group-living animals, we are interdependent creatures. We each depend on others, and our species requires altruism and cooperation for its survival. Objectivism rejects unbridled altruism, and its principles have been misrepresented by Limbaugh and others as justifying the kind of selfish "look out for yourself only" type of attitude that led to the unprecedented transfer of wealth over the past decade to the wealthiest one percent of the population. Social Darwinism, which is the kind of winner-take-all mentality that characterizes some viewpoints, misses two points. First, it presumes that by accumulating enough wealth, people don't really have to worry about the greater environment because they can enjoy their riches in protected isolation.

They are so wrong about this. Everything that we know about happiness and the enjoyment of life involves sharing experiences with others. Studies consistently show that we need others for our happiness. But more importantly, advocates who use Rand's book as a justification for their selfish philosophy didn't read the book closely enough. Rand does not advocate the kind of selfishness that some use to as justification to deny unemployment checks to people who are out of work for reasons unrelated to their performance. Rather, she advocates reasoned, rational and enlightened self-interest, which is different than the hedonistic, pleasure seeking, "I refuse to share my rice bowl with others" self-interest that typifies so much of the superficial Rand-citing that is moving across the conservative blogosphere these days. In the interest of creating the kind of world we can all share, whether rich or not rich, it is important to set the record straight. Ayn Rand never justified selfishness in the hedonistic sense that anti-stimulus adversaries are now contending. The Irish proverb is worth citing again: "the people live in the shelter of each other."

Tuesday, March 10, 2009

The incredible subway violinist story

On January 12, 2007, Joshua Bell, one of the world's top violinists, strolled into the L' Enfant plaza metro station in Washington, DC, pulled out his $3.5 million Stradivarius violin and began playing. Joshua had, evenings before, played before a sold out crowd in Boston where people gladly paid $100 per ticket to hear him perform. But, on this morning, during rush hour, Bell was playing in this metro station for free.

During his 45 minute concert, nearly 1100 people passed by, and 27 paused to put money into his violin case ($32 and change was collected in all). Only seven actually stopped to listen, despite his world class performance of six extremely well performed classical violin solos.

This event was an experiment sponsored by the Washington Post. The Post was confirming what psychologists (particularly those interested in ecological or environmental influences on behavior) already knew. People's perceptions are greatly influenced by situational or contextual variables. We are apt to expect to hear a great concert in a concert hall, but not in a subway station.

You can see (and hear) a filmclip of Joshua playing his free performance here.

What lessons should we take away from this event, now over two years passed? Well, for one thing, there is the lesson that if we are attentive and in the moment, we are more likely to recognize what is taking place in our lives and to thus benefit from the beauty when it is there. Beyond this, it seems likely that another lesson is that good wine can be sipped and enjoyed from a paper cup, just as poor wine can be found masquerading in elegant crystal wineglasses.

Deception preys on assumption, but truth exists independent of its surroundings. Life is all around us to enjoy. Next time you pass by a performing musician working to supply the air with beauty, take a moment to enjoy them, feed their empty case, and thank them for making the world a more beautiful experience. Everyone will feel better as a result.

Sunday, March 1, 2009

Longevity and Quality of Life

Most of us are interested in living a long life. I recently came across a book called Blue Zones, which described studies, partially sponsored by the National Geographic Society,  involving various locations on earth where the inhabitants seem to have unusually high longevity. In examining the lifestyle factors in these regions, Dan Buettner and his associates came up with some factors that they believe contribute to longevity. These include strong social networks, diets with fruits and vegetables, active lifestyles, and a positive view of aging. The implication is that the people in these regions have a high quality of life. Little is said directly, however, about their levels of happiness.  Can we assume that the scientists posit that happiness and longevity are related? That is, do happy people live longer?

The answer, it seems, is yes, but only if you are healthy. This finding is based on a review in the Journal of Happiness Studies by Ruut Veenhoven. Veenhoven, a scientist at Erasmus University in the Netherlands,  found in his review that happiness in healthy populations added to longevity in a manner similar to being a non-smoker. In populations that have chronic diseases, being happy does not seem to add measurably to life expectancy.

Studies of healthy aging in the United States have focused less on longevity and more on factors that seem to ward off chronic illness. Carol Ryff, PhD, a leading researcher in this area, has shown that various personal factors, including autonomy (our degree of choice and control over our lives), environmental mastery, personal growth, positive relations with others, purpose in life and self acceptance are important for successful aging and resilience. Dr. Ryff  is among a growing number of researchers who are making the case for neuropsychoimmunology,  the science that demonstrates that how we feel influences our immune system (as previous blog posts have outlined). Clearly, it is not difficult to imagine that what we do, and how we feel about what we do, relates to the factors that Dr. Ryff has identified in her research.

So, what is the take away from this post? Do we know what factors that lead to longer lives also lead to happiness? The answer is an equivocal yes, but is based on comparing findings of different studies rather than looking at the question from a single study. Perhaps the MIDUS II (Midlife in the United States) studies now going on under Dr. Ryff's direction will address this issue.

In this blogger's opinion, the question of longevity must always be asked in the context of life quality. The issue for us all, it seems, is not just how long we live, but how well we live. 

Tuesday, February 24, 2009

Life changing books: "How to Want What You Have".

We readers, every once in awhile, stumble upon books that have a profound influence on us, often in subtle ways, as though they planted an idea in our heads that needed marinating or slow cooking before it truly delivered its "full flavored" goodness.

How To Want What You Have by Timothy Ray Miller is one of those books. My take away from the book included the inescapable thought that we are "conditioned" by culture to be discontent, to constantly want more— to want to be happier, prettier, wealthier, smarter, or more popular. Miller provides an explanation for this, describing that the nervous system is wired for stimulation, and that we adapt so quickly to new circumstances that we are often soon looking for something different to counteract our boredom. We truly believe that more is better—and perhaps because we are optimists— we tend to think that just around the corner there is a better situation, a nicer car, a more beautiful partner (or self), or a bigger house that will make us happier. Of course, because we adapt so quickly to change, that new house soon becomes inadequate in our insatiable quest for happiness based on more, bigger, or better. Believing that more will lead to happiness is akin to thinking that the mirage of the green oasis in the middle of the desert will quench our thirst. Of course, it is an illusion, it has no water at all.

The "bigger house" habit pattern exhibited by millions helped get us in the economic situation we are currently in—but I digress. Dr. Miller makes three fine, life changing recommendations for addressing these insatiable (and we'd now have to say potentially destructive) habit patterns. It turns out that they are interconnected—each tends to reinforce the others.

First and perhaps most importantly, Miller recommends that we learn to adopt and practice the essential characteristic of attention, or being in the moment. There is so much good and beauty in the world, so much to appreciate about living, that we cannot hope to live it fully, to breathe in all of its goodness and wonder, without paying attention to what is around us to appreciate. Perhaps like many others, during my youth I was always focused on the days ahead, impatient to move into the future with the over confident swagger and naivete of a sophomoric boy scout who knows a little, but does not appreciate how inadequate that "little amount of knowledge" is, or how many more important lessons are waiting to be learned in the world "out there". Attention is at the heart of many eastern philosophies, and described well in "The Power of Now" by author Eckhart Tolle. To be attentive, Tolle points out, usually means counteracting the tendency of the mind to fill itself with unnecessary concerns and distractions beyond the immediate.

Second, since we are paying attention to what's around us, we should practice being grateful for what we have, what is around us. We are now learning that things can get worse and it a good principle never to take anything for granted in this life. We have multiple examples every day about the fragility of life. This makes obvious the importance of gratitude, or appreciating what we have now and not squandering the moment worrying about what we do not have.

Finally, Miller recommends that in recognizing that things happen unexpectedly, any one of us can find ourselves in "deep sneakers" before we know it. We all make mistakes, live in proverbial glass houses, and are human (at least for the time being, before the androids depicted in A.I. begin to be manufactured!). Therefore, it is an expression of our humanity for us to recognize that we are one among many others, and that we live in the shelter of each other (love that Irish proverb!). If we display compassion for others, we demonstrate that humanity. Compassion is an essential ingredient in a supportive community. It is at the heart of charity and philanthropy, a key basis for volunteerism. It is a moral foundation for kindness and the cooperation that is necessary for group living humans to survive. Compassion, in my view, has been in short supply in some parts of the United States for many years. Hopefully, it will see a comeback in the coming days and months when we really need to be in top form as we support each other.


So, the essential message here is: attention gratitude, and compassion are important characteristics, and they are linked to each other. When we practice these, good things happen— in many ways—and in ways that are good for us as well as for others. The bonus, however, is that these greater rewards cost us nothing and have the power to make us happier while making our communities stronger!!! And in these times, we all can use a bargain that leads us to greater happiness!

"When the student is ready, the teacher will appear."—Buddhist Proverb

Sunday, February 22, 2009

What makes a good health care experience?

With the fast appointment, and equally sudden withdrawal of Tom Daschle as Secretary of Health and Human Services, what had been growing momentum behind long overdue health care reform was derailed, and we hope only temporarily sidetracked. Daschle, a veteran of Congress and one who had experienced many attempts at health care reform, was viewed as a very solid and informed choice for the post. Those who have read his book, know that he is an advocate for practical and doable change, recognizing that what many see as the ultimate destination, a single payer system, may require some interim steps. His plan would amalgamate existing government care programs, require that everyone be covered with affordable insurance for a basic level of health care services, and remove politics from decision making by creating a federal health board with confirmed appointees (like the Federal Reserve Board) to oversee the system.

Personally, while some of Daschle's plan characteristics have merit, I am a proponent of going for the whole enchilada now and proposing a single payer system to get rid of greedy profit motivated health insurance companies now. Why allow profit at the expense of health and life? And why spend even one more penny on marketing, advertising or competition when the money can and should go to delivering care and prevention?

Let's do what we have to do now to make the system affordable, accessible, fair, accountable, universal, portable, and responsible. By responsible, I mean a system that devotes resources to health promotion and prevention, a system that aims to promote well-being rather than just ameliorate disease after it has occurred, and a system that recognizes that responsible lifestyle change is more than half the battle in keeping people well. Health is related to happiness and happiness is related, inextricably, to doing what makes life worth living, with those we love, and in supportive communities. Beyond these basic philosophical changes, why not pay providers more for keeping their patients healthy? Rewarding them for listening to and counseling their patients about lifestyle (not just exercise and nutrition) might also be a nice addition.

Think about your idea of a good healthcare experience. I have had primary care delivered by angels and by robots. By people who listened and believed I knew my own body, and those who were so focused on arriving at a diagnosis, (or getting to their next appointment) that they cared little about my experience of illness. Incredibly, the Washington Post had an article recently about an Ethiopian-born physician who is also a novelist (Abraham Verghese) who proposes that medical schools teach their students about the importance of the life stories of their patients. This advice is, on the one hand, good news— and on the other, incredible in its acknowledgment that medical curricula are woefully out of touch. I doubt it is coincidental that my favorite primary care practitioners are physicians who were first trained as nurses, pharmacists or therapists. In fairness to medical schools, (not that any is really warranted) it is incredibly difficult to change the curriculum in a medical school, even a smidgeon.

So, what characteristics do you think make for a good health care encounter? Share them here, and perhaps a medical educator or two who believes in the importance of the humanities will stop by and take note.

Tuesday, February 17, 2009

The Self-Fulfilling Magic of Belief and Perception

For years, psychologists have known that each person's own "reality" is created through the lenses of their own experiences, personality, and beliefs. Because experience is such a powerful teacher, including the experiences we observe in others, we can be passive participants and still be influenced. This is particularly true when we observe social approval for some acts and disapproval for others. Social approval is one of the most powerful sources of motivation. This explains why so many people are like sheep in determining what to wear, what to do, and sadly, even what to like, dislike or believe.

Additionally, as I have blogged previously, our bodies are known to respond physiologically to the feelings we attach to our perceptions and beliefs. We can signal our bodies to release good hormones or harmful hormones based on our emotions and beliefs. That's "Why Zebras don't get ulcers" as Robert Sapolsky wisely noted. Zebras don't spend time worrying about the consequences of what has happened in the past, or the possibilities of what might happen in the future. They live in the moment. By doing so, Zebras release stress hormones only when it is necessary for their survival.

Which brings me closer to the point of this post. Part of the reason the world economy is tanking is because people are spending so much time behaving as though they believe the sky is falling. The economy will only worsen if group think leads to the emotions and behaviors that make it so. A recession is the opposite of the unbridled euphoria of an economic bubble. People bought property because they believed it would lead to greater wealth. As soon as those beliefs changed collectively, and it was perceived that Armageddon was upon us, people began behaving in ways that began to create the outcomes they feared, and that we now have.

How does the world turn around a collective perception of doom to one that leads to behaviors of investment and optimism? That, my friends, is the central task confronting political leaders everywhere. Can each of us help? Certainly we can, by taking actions ourselves that signal optimism. Need a new washing machine? Buy it. You'll never get a better deal. But purchase it with money saved, not money borrowed. How about the Rolex? On that one, perhaps don't make the purchase. A Rolex is a high priced functional watch. It doesn't keep time better than a less expensive watch, and it's an unnecessary indulgence. Displaying this new purchase will not be greated with much glee in the current environment. But more to the point, such a purchase will not do much to stimulate the economy.

So, what is the intended take away message for today? It is simply this: We can do ourselves and our world a favor by shedding the current mindset of doom and gloom and adopting a self-fulfilling belief that brighter days are ahead. In fact, through our beliefs and behaviors, they can be created just around the corner.

Sunday, February 8, 2009

What Happened on the Happiest Day of Your Life?

Have you ever stopped to think about the happiest day of your life? At least so far, that is. Or do you imagine the happiest day of your life is ahead of you? Dan McAdams, whose work in studying life stories has been mentioned in this blog before, describes certain archetypal or characteristic patterns to people's versions of their life story. Some describe their lives as rising from adversity, while others mention bad breaks that sent them into an unexpected crash landing from which they have never quite seemed to recover.

But here we recall the events that mark the peaks or represent the peaks we hope to achieve. What makes a "happiest day" experience? Is it personal accomplishment after a long, sustained effort? Or is it the promise of a new relationship? Does a happiest moment represent a capstone of previous experiences, or the beginning of a new journey?

For most of us, there have been many happy days, and we hope there will be many more. Perhaps what creates happiness at the beginning of our lives is different than the causes of those joyous moments in midlife, or as we mature in later years.

What are your thoughts about the events, or doings, that have characterized your memorable moments? Please share them here! The hope is, of course, that by understanding our own happiest moments, we can create the conditions to make them happen again! We can create the lives we want.

Saturday, February 7, 2009

The Ecology of Living —Share your personal efforts to live life well!

One important dimension of "doing life well" involves creating environments that are comfortable, satisfying and relaxing. Over the years, I have been a keen observer of the habits and practices of others that are directed toward creating comfortable experiences, wherever people find themselves.

The intention here is not to discuss or describe architectural or decorating features of environments, but rather to describe the objects and conditions that enable us to create the most comfortable person-environment fit that will suit our individual tastes regardless of where we are and what we are doing. Examples would include friends and colleagues who cherish the visual appeal of flowers to enhance their offices and homes, or the colleague who routinely carries the small comforts of home (traveling place mats and goblets) to enhance the experience of eating "on the go" when take out is necessary when traveling. Doesn't wine always taste better in real glass than from plastic or paper cups?

Some may regard these efforts as unnecessary or even silly, but I understand them as attempts to make the experience of everyday life more comfortable and enjoyable. Why not, I ask? Isn't this really part of the overall effort to live life to the fullest?

A colleague, occupational therapist and neuroscientist, Winnie Dunn, has written an interesting book about the senses, called Living Sensationally. In this delightful book, Dr. Dunn provides a clever and readable way to understand our senses, emphasizing that our unique sensory systems are a very important key toward enhancing our experience of living. After all, for each of us, perception defines our reality, and our perceptions, or experiences, must be processed through the senses, whether we are seeing, hearing, touching, feeling, smelling, or using a combination of these at the same time—as we typically are! Sometimes, our sensory systems get overwhelmed, but other times, we seek sensation, especially sensations that we find pleasing.

How do you please your senses and enrich your life? I invite readers to offer examples of their own personal routines and practices that improve and enrich the enjoyability and comfort of their personal spaces or make their travel experiences as comfortable and stress-free as possible.

Thursday, February 5, 2009

Cost Does Not Equal Value

This is not a post about the economic stimulus package in the United States.

Rather, it is about thinking clearly about the distinction between cost and value in all areas of our lives. When the current crisis is behind us (and it will be sooner or later), thoughts will turn to other items on the national agenda. The most pressing of these from the standpoint of both cost and value is the health care "system" in the United States.

In many ways, health care, and the sad state of the non-system we have, mirrors the economic system. We have, as a nation, refused to make the hard choices in the moments where integrity was needed. Much like the hungry traveler who opts for the big mac when the salad might be the better choice, we have chosen the hamburger again and again.

Soon, during the discussions about health care reform, we will have the choice again. This time, we will have the opportunity to invest in a health care system that not only provides more value for cost, but does so in a way where public health programs focus on lifestyle change. The big mac is sold as part of a value meal, but here the relationship between cost and value are mistaken. The value of choosing prevention and health promotion programs is unmistakable. We must insist on value in the choices we make for our new system.

Tuesday, February 3, 2009

Health Care Reform and Well Being

Were it not for the constraints of time, this could be a longer post. The topic of health care reform in the United States prompts many passionate reactions from citizens. Abroad, people must wonder how we have tolerated the system we have for this long anyway? In the midst of economic chaos in the United States, the issue has been temporarily put on the back burner. Yet, President Obama knows very well that the costs of inaction, in human terms and in dollars saved, are greater than the cost of reform—and growing every day.

The irony is that attempts at national reform in the United States have been tried several times during the past century. For example, most people don't appreciate that President Harry Truman tried valiantly to reform the system, without success. Then there are the better known efforts of President Kennedy (leading to the compromise that became Medicare and Medicaid), and the failed Clinton effort. In each case, the complexity of the issue, special interest groups protecting their "rice bowls", and an effective disinformation campaign by the health insurance companies linking a national approach to "socialism" or socialized medicine, were able to derail the efforts. Meanwhile, like a patient in critical condition, the system is in need of urgent life support and getting worse.

So, what does this have to do with "Doing Life Well"? It's simple, really. Important requirements for doing life well include being informed about issues, making wise choices, and advocating for conditions in our communities that support our ability to participate in activities that contribute to our health. Former HHS Secretary nominee Tom Daschle has advocated for a compromise solution that would create a Federal Health Board and unify both private and public systems, requiring everyone to have insurance. Personally, I think the best system is a single payer system that enables choice and limits profits that are based on human illness or suffering. Why profit from services that people have no choice but to accept? Isn't that a grand perversion of monopoly? But, the important thing is to make progress in reforming the system. Whatever we do, however, we must have as a principle of reform that lifestyle-related prevention and health promotion initiatives and funding are part of the solution. The value of such efforts is unmistakable, and can save millions (not to mention the advantages of helping people feel better about themselves and making them happier and more productive). Most people would rather live their lives well and be active and engaged than to have health care money spent on keeping them "alive" at the end of life, hooked to tubes and merely surviving rather than flourishing.

Albert Einstein, a wise and learned man, once observed that not everything that can be measured counts, and not everything that counts can be measured. The dialogue about health care must include a discussion of issues not easily measured, like value. There is a wide difference between the meanings of cost and value. We must ask the question: How is the system to support efforts that address people's quality of life?

Thursday, January 29, 2009

Optimism and its global Importance — Especially Now

A recent article describing Sir David Tang's observations about optimism as the cure for the global economic meltdown is one of the most important messages delivered in the past three months. You can read it in its entirety here. It deserves far more exposure, in my opinion.

Sir David makes several wise observations, including the need to distinguish value and cost, to recognize that size and importance are not the same thing, and to appreciate that productive work is one the most important "assets" we have. Notice that productive work is not the same as making money. People who trade paper derivatives on wall street make money, but their work is not productive in the sense that it adds much value to the world.

There are not more educated people as a result of trading derivatives, no new houses, roads or labor saving products as a result of the work of those financiers, and no entertaining poems, or beautiful planted trees to decorate the landscape. Nor, indeed, are there well made clothes, shoes, or cars that provide useful benefits to society as a result of such work. If work is done only to make money, no real tangible wealth is created. It's just paper that can be traded for products and services that represent real work. Often, this wealth comes at another person's expense.

Work that produces something of value for the world is work that gives the doer a sense of contribution and pride. When that work goes away, people lose meaning and become depressed. People without productive work are among the unhappiest people in the world, not because they lack money, but because they lack the work itself. As a result, they can lose hope and become pessimists.

Sir David Tang notes that pessimists have a way of creating more pessimism. And when people are pessimistic, they often create a self-fulfilling prophecy. If they believe there is no future, they begin to act in ways that creates that dismal outcome. On the other hand, laughter and optimism are equally contagious and inspire hope and actions that create better futures. Humans in groups have the power to create optimism or pessimism.

There is abundant research in the psychological literature that demonstates the value of optimism. Few if any of these studies discuss optimism and economic outlook, but many show that optimistic people are more resilient, live longer, and are able to influence their own healing. Studies show that optimists make the best salespeople. While their mood probably makes them seem more approachable or engaging, their belief in making the sale also makes them more engaged and persistent. Sales success requires persistence.

Besides, optimists are more fun to be around. Economic stimulus packages that create jobs double the return on their investment. Why? Because the result can not only be people with the ability to earn money for rent, food and clothes, but more importantly people who feel better about themselves and their futures because they are doing productive work.

Monday, January 26, 2009

A Post on Karma as "Doing"

This post is different than recent offerings. For one thing, it is (slightly) shorter. Another difference is that it pertains not to traditional "Western" ways of living, but the culture of Asia. A third difference concerns its topic area, which pertains to spirituality.

Note that on this blogsite, being spiritual does not necessarily equate with being religious. When we are spiritual, we contemplate ideas that are beyond this world, such as "Why do I exist?" or "What happens when people die?" Often, we contemplate these ideas within the context of formal religions. A religion can be described as a formal, organized way for thinking about spiritual matters. But many spiritual people don't adopt or govern their lives according to the "rules" of organized religions. In other words, according to this view, it is possible to be spiritual without being religious.

Karma, a word from Sanscrit associated with Buddhism, can be translated into English as "doing." In Buddhism, and Hinduism, there is a belief that the sum total of one's "doings" in the physical life (or previous lives) determines their destiny, or what happens to them in future lives.

Without getting into a discussion about religion, the notion of how our acts today determine our fate or destiny tomorrow (or in the future) seems common to many formal religions in cultures around the world. The late Joseph Campbell observed this in his writings on myth contained in "The Hero with a Thousand Faces."

But when you think about it, there is another point of view that deserves mention here. That is, we can create the lives we want (and thereby influence our futures) by acting in certain ways now that may not have anything to do with spiritual or religious teachings. Some people "seize the day" and create their opportunities. They believe they can influence what happens to them by organizing and directing their actions in purposeful ways. To me, there seems to be a certain logic to this. Perhaps this is what the sports apparel maker Nike suggests when it uses the advertising slogan "Just do it!"

So, the fact that the word Karma translates into "doing" invites many interesting thoughts from this blogger. I'd be interested in reading yours also!

Saturday, January 24, 2009

Obesity and Lifestyle Change - Thinking About Activities

In previous posts we have discussed how people use time, their patterns of activity, and how these relate to their well being. These discussions have focused a great deal on how activities influence mood, or how they can serve to reduce stress. Less has been said about how activity influences our heart, lungs, nervous system, bones and muscles and other physiological systems.

I hasten to point out that this is not a post about exercise and physical fitness. The body is a complex system, with many individual subsystems working together to explain that complexity. Ordinarily, we think of the brain as the control center. But we seldom think of the back office systems that influence how the brain works. One of these back office systems is the endocrine system. This system regulates the chemicals in our bloodstream that carry messages to the nervous system. It influences metabolism, tissue growth, development and mood. Scientific discussions about how stress harms the body focus directly on this system of alerting or message sending through hormones. This brings us to the main topic of this post—obesity

Obesity is a significant health problem and it can be described as a kind of banner or symbolic indicator of how activity and lifestyle in the 21st century can influence health in both beneficial and harmful ways. Obesity is an epidemic, and if you visit the website of the Centers for Disease Control (CDC), you will see a dramatic illustration of how the incidence of obesity has spread across the country over the past two decades. The data clearly suggest that obesity is not just a regional phenomenon, nor a socio-economic phenomenon. It is a lifestyle phenomenon that is related to how people spend time to consume and expend energy. If you notice in the CDC chart how the prevalence of obesity has spread, states where there are more outdoor opportunities for hiking, skiing and kayaking, or more farming and ranching— seem to be the last places where the obesity epidemic arrived. That suggests environment (and activity opportunity) influences obesity. But we are getting ahead of ourselves here. There is another important factor related to weight gain—hormones. Especially hormones resulting from living stressful lifestyles.

Without going into too much detail or repeating information available widely on the Internet, most diets (the usual approach to battling weight gain) fail. Why? Because hormones signal our body to store energy (or calories) so that we can survive famine conditions. These systems are ancient, biological survival mechanisms that evolved over millions of years when humans were hunters or gatherers. Animals in the wild have the same systems, but they spend their awake hours in a quest to find food just as humans once did. They may go for days in their quest for meals, burning more calories than they are able to replenish. Contrast this with the modern life of humans in the U.S. and other developed nations: Going for hours without a meal is often viewed as a starvation diet!

Thus, animal species (including humans) are biologically wired to store calories and resist efforts to expend them. All dieters know that as soon as they begin reducing their food intake, their body reacts by increasing its efforts to hold on to those life sustaining calories. That's what makes dieting so difficult. But food intake is only half of the equation.

The other part is energy expenditure. As modern conveniences are developed, technology becomes our enemy. We move less, watch TV or surf the Internet more, and there is little calorie burning to offset our increased consumption. Moreover, eating itself is an activity, and a pleasurable one. Generally, people would rather eat than work out on the treadmill. Eating is also typically a social activity. When people get together to enjoy themselves and each other, food is often involved.The result is increased body weight. Exercise intentions expressed in New Year resolutions are, well— well intended. But habits and routines are hard to break. People need stimulating reasons to live their lives differently. They need to be motivated to move more and eat less.

But the story doesn't end there. Stress (and there is a lot of that around lately!) produces hormones that signal the body to conserve energy. So metabolism (calorie burning) slows as a result of stress too. Some scientists attribute the obesity epidemic as much to increased levels of stress (and the influence of stress hormones on slowing metabolism) as they do to lifestyle patterns that are characterized by sedentary activities and increased food consumption.

So, at long last, we get to the point of this post about obesity. Obesity is more than weight gain. It is a condition of lifestyle that is affected by factors that have nothing to do with eating. The interesting thing is, these factors involve human activities, and the most natural solutions have to do with the activities people do as they live their everyday lives. If those activities help people burn more calories and eat less, so much the better. But if they give pleasure, reduce stress, and stop signaling the body to store energy, they provide a double benefit. The bottom line: Activity is more than exercise!

Wednesday, January 21, 2009

Use of Leisure Time - Implications for Health and Well Being

The American Time Use Survey, reports from which are featured on the Bureau of Labor Statistics website, reveal some interesting data about how people spend time. Of particular interest here are two activities, television and Internet usage, that consume significant portions of available leisure time. For example, watching TV accounted for half of the leisure time available to men and women (2.62 and 2.88 hours per day on average). As might be expected, young people from 15-19 spend more leisure time on computers than people of other ages. The average for this age group was around 50 minutes per day. In contrast, leisure activity involving sports, exercise or other types of recreation averaged slightly less than 30 minutes per day.

The implications of these statistics for health should be apparent. Sedentary activities may be interesting, but they don't provide the kind of movement necessary for maintaining fitness, including strength, endurance, and proper body mass index (percentage of fat) to avoid risk of obesity, heart disease and other chronic conditions. Movement burns calories, and regular exercise coupled with moderate and appropriate food intake helps to maintain weight within healthy limits.

How people use time, obviously, not only has significant consequences for physical fitness, but it also influences other types of "psychological fitness", such as how interested or bored they are, and how challenged or motivated they may be to participate in activities that lead to skill development, accomplishment, and improvements in self-esteem or self confidence. Research shows that when people are successful in new activities or projects, they are more inclined to undertake additional challenges. These cumulative successes create the sense of meaning that we need to live our lives with energy and purpose .

Unfortunately, time use surveys have not yet begun to gather data on qualitative factors, such as the feelings one might have that are associated with doing a particular activity. Part of those feelings, of course, are based on the context in which an activity is done ( that is, who is with us, what motivated us, what need will be served, etc.); but time use scientists generally feel that the opportunity exists for gathering more qualitative data in such surveys.

As time use science evolves, there will be more objective evidence to provide guidance to people on how to design their lives for optimal health and happiness. This is just another part of the interdisciplinary science of everyday living.

Tuesday, January 20, 2009

Seratonin and Mood: Evidence that Activity and Happiness are Connected

Serotonin, a hormone, is known to be an important chemical messenger that influences brain activity related to a wide range of functions, emotions and behaviors. These include circadian rhythms, moods, and thought. Disorders related to seratonin have been linked with impulsive violence, anxiety, and depression.

Higher levels of seratonin are associated with feelings of happiness and well-being. Too little seratonin is implicated in depression. But too much seratonin can be toxic and fatal. What is needed, it seems, is efficient regulation, which relates to having the right levels of seratonin and the right number of brain structures to use it appropriately. Current treatment approaches typically involve drugs that attempt to increase or decrease seratonin levels or improve its processing in order to achieve a satisfactory balance and the proper mood.

Because depression is a growing worldwide public health issue, new approaches to understanding this brain-mood-behavior phenomenon is in everyone's interest. That's why a recent editorial by the editor of the Journal of Psychiatry and Neuroscience is of interest here. The editorial, by Simon Young, suggests that new evidence supports the use of non-drug interventions in mood disorders related to seratonin.

Without going into the highly technical specifics of the science here, what Dr. Young suggests is that exposure to light, exercise, diet, and activities that lead to improved mood may all be examples of lifestyle- related strategies that can be used to address seratonin imbalances and prevent depression and its consequences. His article cited several promising studies that provide evidence for his "non drug intervention" proposal. I like this line of thinking, because it shows again that through lifestyle related interventions, people can influence their health and well-being. More emphasis on population-based approaches to preventing or treating health related disorders through lifestyle change must be a part of health care reform. Population based lifestyle intervention is smart, synergistic, humanistic, and economical.


Monday, January 19, 2009

Aligning Believing and Doing - Another Feature of Balanced Lifestyles?

A recent story on the NPR series called "This I Believe" featured an essay by a seven year old (Tarak McClain) of Austin, Texas. Tarak shortened his original list of 100 beliefs into a radio-ready list of 30, which he read on the air.

Aside from the remarkable fact that this very young man was thoughtful and wise enough to compose this list, (and poised enough to do an exemplary job of recording his interview), the notable feature of his story relates to his acting in ways that are consistent with his beliefs. Tarak has a commendable list of service projects to his credit already. This made me think about my recent posts on life balance, and one of the papers given at the life balance symposium I attended. This particular paper was about life balance as acting in accordance with personal values.

Values and beliefs are closely related. But few of us always stop to think (except on Sundays if we are church going Christians, or on other days if we practice other faiths) about how our actions align with what we profess to believe. For example, I believe in sustainability and conserving energy so that future generations will enjoy a high quality of life. But when I think about the actual things I am doing that are in alignment with this belief, I am embarrassed that the list is shorter than I would like. Perhaps this is why the phrase, "talk is cheap", was coined.

Tarak and I share some significant beliefs, and I suspect, that given the way 7 year old young men come to form their beliefs, that his parents have similar sentiments about community, peace, service to others, living in harmony and other values. But in the end, when it comes to making our communities and world better places, when actions and beliefs are aligned, we create the world we imagine. As Gandhi said "We must be the change we hope to see in the world."

I invite you to share your beliefs about living life well on this post, and to comment on the actions that reflect those beliefs.

Saturday, January 17, 2009

Life Balance, What is it?

One of the aims of this blogsite is to promote dialogue about aspects of living well, focusing on how human activity, or how people use their time, contributes to their happiness, health and well-being. When it comes to lifestyles, daily routines can be regular, predictable and peaceful, or they can be volatile, unpredictable and stressful. Most of us experience lives that show characteristics of each extreme. Which is better? Should we be striving for steady state, and what would that be like? Is the journey through life best viewed as a highway metaphor where we try to maintain a course in the middle? How do we define that "middle ground"?

An earlier post in this series alluded to balance, pointing out that Michelle Obama, the incoming first lady, sees work-family balance as an important public health and family issue. Because lives out of balance are typically stressful, imbalance can be said to contribute to illness and chronic diseases, as pointed out in the post on resilience.

Most people intuitively understand that regular, predictable, and stress-avoidant routines are related to their well being, and thus they have a personal view of what life balance means, or what type of lifestyle works best for them.

Eighteen months ago, I had the privilege of participating in an international conference in Canada that brought together scientists and other experts from many disciplines for a discussion about life balance from theoretical and scientific perspectives. Although there were many interesting ideas expressed about how to define, study and otherwise understand life balance, another perspective examined during the meeting was philosophical. Is life balance a valid concept, or is it just another name for similar "positive states"? For example, is it the same idea as "well being" or "quality of life" with just another name?

My view is that all three concepts have features in common. However, life balance seems unique because it focuses specifically on how activity is organized within a life to help us achieve the outcomes we desire. I surmise that there is no one "life activity formula" that works for everyone, but that a successful formula must include certain characteristics or reflect identified principles.

What is your idea of a balanced life? What lifestyle characteristics do you think social scientists should consider in studying this concept? I look forward to reading your posts.

Wednesday, January 14, 2009

Sleep - Another type of healthful activity

It may not seem obvious, but in our daily round of activities, sleep must be counted among the most important. Recent reports have shown that teens in North America are sleep deprived, averaging less than seven hours per sleep per night when they require almost nine hours. Surely, cell phones, computers, online gaming, and television are part of the cause for this; but it would be too simple to say that teens don't sleep because they are absorbed by a more engaging activity.

In normal, healthy people, sleep is regulated or influenced by internal clocks, or circadian rhythms. The most germane of those rhythms that influence sleep is known as the rest-activity cycle. This cycle is influenced by hormones that are triggered by daylight, and a tiny gland in the skull known as the pineal gland has been implicated in explaining this. Humans evolved to be able to sleep during dark and be active during the day. Why? Because evolution works to maximize survival of species. Since humans see poorly in the dark, we are better off sleeping and being active during the daytime.

There is much to learn about sleep and how it serves to keep people healthy and mentally alert. We do know that it is vitally necessary to sleep. Extreme sleep deprivation can lead to death. We also know that normal sleep involves stages, and that the fourth stage, or Rapid Eye Movement (REM) stage of sleep, is thought to be the most important for its restorative properties. REM sleep is that stage of sleep during which we dream. If we don't achieve REM sleep, our sleep is of lesser quality. Normal humans go through several cycles involving all stages of sleep each night. People who sleep and say don't dream are simply not recalling their dreams.

Getting a good night's sleep (full of dreams) involves many factors. The most important factor for good sleep hygiene is having a rest-activity cycle that is entrained, or synchronized with what is happening in the social world. People need regular routines and activities to keep their internal clocks synchronized with the world. Jet lag after long distance air travel is a condition that places our internal clocks at odds with the social world around us when we fly to a new environment. Ordinarily, it can take as long as 30 days for the body to fully recover from jet lag.

Of course, shift workers are also at risk of insomnia caused by disentrainment, since shift workers must be active at night when their body tells them they should be sleeping. Of course, some adjustment does occur, as long as the shifts do not vary frequently. Some countries have laws that regulate shiftwork as a public health safeguard for such workers.

So, let's return to the issue of teens and sleep deprivation. It is likely that at least some of the sleep debt being accumulated by teens has less to do with the effects of more and more distracting late night activity than it does on the effects of such shiftwork on the internal clocks of the teens. It is likely that, like shift workers, teens' internal clocks have changed so that their rest-activity cycles have adjusted, so their body tells them they need to sleep until noon; while their parents and schools are telling them to get up at seven to begin classes or catch the bus! Thus it seems, their sleep deprivation is less about distracting activities, than it is about modified internal clocks.

Tuesday, January 13, 2009

Fyodor Who? on Activity and Happiness

Those avid readers among us will no doubt be able to quickly note that the title to this post refers to Russian author Fyodor Dostoyevski. Dostoyevski is among the most famous authors in history, and lived from 1821-1881. During his sixty year lifespan he wrote two fiction classics that are included on most great books lists, including The Brothers Karamozov and Crime and Punishment. In addition to being a great writer, Dostoyevski is sometimes credited as being one of the originators of the philosophy of existentialism.

So what does Dostoyevski have to do with this blogsite? Well, because doing is so important to our happiness and well being, those who love to read (and read and read) will certainly enjoy the works of Dostoyevski. But he appears in this blog not for that reason, but because he wrote an interesting passage about activity and happiness in a book of occasional writings. The excerpt is as follows:

"Our passion for some sort of activity reaches a point of feverish and uncontrollable impatience; we all long for some serious occupation, many of us are full of an ardent desire to do good, to be of some use, and we gradually begin to realize that happiness is not the same thing as being able to afford to sit about twiddling one's thumbs or just to do something for the sake of a change when the occasion arises, but consists of continual and tireless activity and the development of all faculties and capabilities in practice."

This observation by Dostoyevski is blogworthy here because it makes some interesting observations about activity and happiness. Reading along and between the lines, one might claim the following existential interpretation:

We serve our well-being best when we make choices about what we do that are consistent with our values and sense of self, and when those activities help us grow and become more competent. Indeed, it might be said that we create ourselves (our identities) through doing activities that are genuine, that allow us to express the joy of being and our uniqueness through creating or producing something that expresses some purpose or has meaning. Dan McAdams, whose studies of people's stories has been mentioned in other blogs and whose work is listed on this blogsite, coined the expression "selfing" to refer to this type of activity that serves self expression and beingness.

Think about what you do, and how many of those activities are done because of others, and how many were initiated with careful thought by you, the doer, to challenge and engage yourself, to help you realize your unique potential, and to truly make you feel "alive". Those kinds of activity choices are among the most important decisions we make.

What are you doing among your regular activities currently that makes you feel authentic? That may be a hard question to answer, but if you care to give it a try, please share it with others on this blogsite. And if you've a mind to, visit the wdydwyd? website to get a taste of how others express their authenticity.

As always, if you have a different perspective or a comment to add about anything written here, by all means, do it! Please share it here and now.

Sunday, January 11, 2009

Thinking and Doing in Ways that Protect Health

This blogsite is about doing, so the key points in this post will not come as a surprise to readers. In a previous blog I promised to address the issue of resilience, or the body's ability to ward off the harmful effects of stress.

Many websites have lists of characteristics that are counterproductive to successful coping. Negative thinking, over-eating, obsessing, self blame, overworkiig and other detrimental behaviors and attitudes are widely known and may seem obvious as detriments to effective oping or health.

However, most web articles on this topic, including one from the highly acclaimed Mayo Clinic, overlook an important factor that is key to successful resilience. That factor is having engaging, meaningful, purposeful activities. If important preventive factors include a positive self concept and having opportunities for interacting with friends, it seems clear that doing things we enjoy with people we enjoy doing them with is likely to be a useful approach to promoting two critical dimensions of resilience: meaningful social relationships and a positive self concept. There is abundant literature to show that enjoyment in doing, which often comes from mastering challenge and doing something well, leads to better self esteem, improved positive feelings, and the release of hormones that are good for our immune system.

The theories of coping include strategies that have been called "active coping". Typically, these involve direct problem solving actions to address barriers that are frustrating, or dilemmas that are particularly stressful. What this post suggests is something different. What is suggested here is finding satisfying, engaging and meaningful activities that help us spend time enjoyably, have fun with others, and perhaps develop skills or a sense of completion that makes us feel good about ourselves.

I also recommend the strategies contained in this useful article by Tamar Chansky published in the Huffington Post. Dr. Chansky's recommendations offer more detailed variations on DLW's themes; namely, how we as individuals can create our own resilience through what we do (or avoid doing!).

Doing is not a universal elixir. But doing the right things helps us by keeping our immune systems stronger so that we can avoid the biological consequences of stress. Most importantly, if we build these practices into our daily lifestyles, and not just when we feel stressed, we will be making a habit of doing life well.

Friday, January 9, 2009

Stress is not good for you...not that you thought it was!!

If there is anything that can be said about life in the United States these days (or the world, for that matter), it's that there are lots of things going on that can cause worry or concern. It is a scientific fact that the most unhappy people in the population are those who are unemployed, so it should be seen as a societal concern that the unemployment rate is rising to levels not seen for decades. The new administration understands that the cost for not doing something will be far greater than the cost of an economic stimulus package, no matter how large. Why? Well, it's not just because people need to earn a living and buy things to get the economy back on track. It's also because economic downturns can affect public health by making the population more susceptible to illness.

But this blog post is not about politics or economic stimulus proposals. It's about stress and what it does to our bodies over time. We all generally perceive that being stressed out is not a good thing. But perhaps many of us feel that as long as we can get beyond the stressful periods and have some time for R&R (rest and recuperation), so to speak, we can shake off the consequences of stress and there will be no harm done.

The truth is, however, that over time, the effects of stress add up. It takes a toll on the body. And scientists now have a way of measuring that "toll" through objective means. These tests, which include blood pressure, cholesterol, and several other measures of "physiological" fitness, are collectively called "allostatic load". When the body responds to stressful circumstances, that process is called allostasis. Medical and psychological understanding of how stress shortens our lives and makes us susceptible to acute illnesses and longer term chronic diseases has now advanced rapidly. Scientists now have a better understanding of how the process works, and the area of "psychoneuroimmunology" or PNI, is where this knowledge is being gained.

The theory of how our worries activate hormones to tax our immune systems is too involved for this blog, but I recommend that interested readers take a look at a good book written in an interesting, understandable way called: Why Zebras Don't Get Ulcers, by Robert Sapolsky, PhD. The title of the book is a shorthand way of communicating the relationship between stress and health. Part of the reason we overtax our immune systems is because we worry about things that have happened to us or might happen to us. That worry signals our body to activate stress hormones that are good when they are needed, but harmful if they are around when they aren't needed. Dr. Sapolsky uses the example of the fire station that runs out of fuel and fresh men when it is constantly responding to false alarms, and compares that fire station to our immune systems, which are supposed to stamp out germs and other invaders to keep our bodies healthy. Immune systems get worn down by high and persistent levels of stress.

So...as my son once told me: "chillax". That was good advice. People who are able to chill and relax, are more resilient to the adverse consequences of stress. They experience less wear and tear on their bodies, and chances are, they will be more likely to live longer and healthier lives...and thus be able to "do life well." It turns out that resilience, or the ability to endure stress with fewer adverse consequences, is related to happiness. But that is a topic for a future blog post. Stay tuned!

(For readers interested in a readable but more complete and scientific account of allostasis and allostatic load on the web, go here.)

Tuesday, January 6, 2009

More on Happiness...

My recent blog on happiness prompted a reader to send a link to the WebMD website and an interesting article on happiness. You can link to that article by clicking on the title to this post. The article identifies six barriers to happiness, citing work by the author of a recent book on Happiness by Darrin M. McMahon, PhD.

The six barriers explained in the WebMD blog include the following:
  1. Complexity
  2. Breakneck pace
  3. Negativity
  4. Despair
  5. Suppressing Sadness
  6. Navel gazing
Each of these barriers has a solution, and rather than make it easy for you by reiterating them here, I am going to suggest that readers imagine what they are. Then, go to the article and read them for yourself.

While some are obvious, others are more challenging, and not surprisingly, most involve changes in attitude or behavior that are wholly under our control. Thus, it seems, the keys to being happy are entirely within us; we can use changes in attitude or behavior to unlock the power within us to create the lives we want.

All of this, of course, is apparent to psychologists, students of positive psychology, and life coaches, and to them it probably seems obvious. But, sadly, it seems that so many people are held captive by their external locus of control, which is a fancy way of explaining that to many people, what happens to them is the result of forces outside them: they have rotten luck, they are victims of chance or downtrodden by the ruthless behaviors of others. People who feel this way assign the reasons for things that happen to the universe, to some external entity, or, in some cases, to "God's will.

Albert Einstein, a pretty smart cookie by any standard, once observed that "God does not play dice with the universe." Reading about Einstein is surprising to many. He was a brilliant physicist. And being a scientist, given to the precision of numbers and formulas and all, one might think he was less inclined to contemplate beauty and the spiritual mysteries of a complex universe. But the truth is, Einstein was very contemplative and spiritual—perhaps because his appreciation for the complexity of things convinced him that the world or the universe could not be readily explained by chance.

This blogsite is about doing. And one of the things we can "do" to improve our lives is to take control of them. January is a perfect month to resolve to do things differently. Attending to overcoming the barriers to personal happiness seems like a worthy pursuit and a great place to start. So, if you have a mind to —be happy— begin doing it now.

Monday, January 5, 2009

Changes in Routines

It has been a long dry spell since my last post, as I got out of my customary routine. This lapse got me thinking about things like routines and habits, and how people typically spend their time, and the patterns of their time use.

Given its universal application to everyone, the truth is, when it comes to the "science of everyday living", not much is known about how people live their lives, particularly when it comes to patterns of daily activity. This topic (patterns of everyday living) is of interest to some "occupational scientists" (those who study humans and their everyday occupations—which includes most everything we do and not just work). Some have called these patterns lifestyles.

Clearly, daily lifestyles for most people have a certain rhythm or sameness to them. Part of this sameness is dictated by the rhythms of nature (seasons, night and day, etc), and others are influenced by our biological rhythms. In the human, the rest-activity cycle is probably the most influential of these.

But, beyond natural and biological influences on daily life activities, we are also "moved" by regular or customary routines. Some of these routines are also influenced by habits. It seems that only when we experience a change in routine or want to break a habit that we notice these patterns of living at all.

The public will no doubt be reading more about habits in the months ahead as the new U.S. president strives to break his smoking habit. One thing that seems evident is that changes in environment (geographic location) can be useful for breaking habits and routines. People who experience "cabin fever" during the long winter months often "get away" to break the monotony of their routines and re-energize their bodies and spirits. This same type of change can be useful for making wanted changes in aspects of our lives that we see as problematic.

I'd be interested in your observations on routines and how the environment can change them. if you have a personal anecdote, strategy or armchair theory about changing what you do, please share it here. Or, if you have links to reports of research done in this area, by all means share it with us here at "DLW".

On Meaning and Well Being

I'm back. For the past three years (has it been that long?) I have been distracted by my long distance commuting job, writing book chapt...