Richard G. Petty, MD

Career Contentment

I am very happy to report that my friend Jeff Garton's new book - Career Contentment: Don't Settle for Anything Less - has just come out.

As you will see from my review, I just love the book, and it is amazing how Jeff's work and mine fit together.

We are going to be having a panel discussion about the book on www.Business.VoiceAmerica.com on Thursday March 6th at 3PM Eastern, which is noon Pacific time. The discussion is also going to be archived for people in other time zones. I plan to put up a link as soon as it is available.

There is a nice press release here.

I hope that you can listen in: I think that you will get a lot of food for thought!



“Contentment is natural wealth, luxury is artificial poverty.”
-Socrates (Greek Philosopher, 469-388 B.C.E.)

Work, Stress, Vacations and Exotic Drinks with Little Umbrellas in Them

Your humble reporter has often spoken about his brush with burnout. 

Even though I was a recognized expert on stress – and a former meditation teacher, no less! – I got perilously close to the edge. Fortunately someone noticed and I was packed off on vacation. It was remarkable that just a week in the Caribbean followed by an unforgettable one-week retreat in the Catskills was enough to cure me. My resting pulse rate fell from 68 to 48, where it stayed for more than a year, and I never again had any symptoms. The key point was that the short break was enough to interrupt the downward spiral and provoke the cognitive shift that prevented me from ever again making the mistakes that lead to the trouble in the first place.

I still work hard, but trust me when I say that working 16-17 hours a day, seven days a week is preposterous. Neglecting your emotional health and social life is bad enough. But the last straw was to stop engaging in spiritual practices that I had followed since childhood.

For a long time now I have been teaching that most people can make phenomenal changes in a very short period. It may take you a long time to prepare, but once you are ready change can be extremely quick. If you think about it, the actual physical business of an egg and a sperm joining to make a new life takes less than a minute. But the preparation for the event may take half a lifetime. At least I hope for your sake that it takes a lot longer than a minute…

And that’s all that I am going to say about that…

I was thinking about all this the other day when a stressed executive was telling me that he all he wanted was to spend six months sitting on a beach. In fact that would probably be a thoroughly bad idea.

It is not the time; it is the quality of the time, and the energy that you bring to it.

I cannot stress enough that for most people energy management is far more important than time management.

When it comes to beating burnout, the kind of vacation is likely more important than its length.

A summary of ten years of research by a team lead by Dov Eden, an organizational psychologist from Tel Aviv University's Faculty of Management, was presented at last year's meeting of "Work, Stress and Health" in Miami. The event is sponsored by the American Psychological Association and what Professor Eden had to say really supports what we have been talking about.

For the past ten years the team has been studying "respite effects," which measure relief from chronic job stress during and after vacations away from the workplace. They have also been looking at the impact of constant contact: the revolution in telecommunications has kept some people permanently wired into the office while they are supposed to be away putting their feet up and drinking exotic concoctions with little umbrellas in them. So we are losing true "respite relief," and that in turn is a cause of chronic job stress.

One recent study involved 800 professors from eight Universities in Israel, the United States, and New Zealand. The researchers measured stress levels before, during, and after a sabbatical leave of a semester or a whole year. They compared them with people who stayed home, and others who just took a long weekend or a one-week vacation. They found that those who took a long sabbatical break experienced about the same amount of stress relief as people who had taken either a week off or just a long weekend or long-weekend vacation. And all three groups returned to pre-sabbatical stress levels in about the same amount of time: approximately three weeks.

Some of Eden’s other studies have indicated that people who best succeed in uncoupling from work and detaching form its demands, get the most benefit from their vacations and they probably less likely to experience job burnout. It's the ones who cannot detach from the constant flow of job-related demands that are most likely to suffer from burnout.

The key to a refreshing vacation is to create as much space as possible between you and your work life. I once knew someone who spent a week on Tioman Island in the South China Sea. It is reputed to be one of the most beautiful places on earth, which was one of the reasons why it was selected for the filming of South Pacific. For the whole week she spent all day every day working, and every day the hotel’s fax machine got jammed with the 60-70 pages that she sent out. That is not a recipe for a refreshing, life affirming vacation.

This body of research confirms what most sensible managers have worked out for themselves. When someone goes on vacation they should leave their cell phones behind and not check their email. People who feel attached to the office 24/7 are setting themselves up for long-term stress-related illnesses.

I get a lot more email and phone calls than most normal mortals, yet many years ago I made a remarkable discovery.

I had been out of contact for a week, and even after disposing of the spam and junk mail, there were still well over a thousand messages “demanding” my immediate attention. But during that week away, events had moved on, most no longer needed any input from me at all. Matters had been resolved and solutions found. We lost no business, and I have it on good authority that the earth did not fall into the sun.

I came back rested and restored, and firing on all cylinders: everyone benefited.

Quite obviously it is not a good idea to be completely un-obtainable. I have had two friends, one of whom lost her mother and another his wife, and neither heard the sad news for more than a week. So even when I am in some far flung part of the planet I make sure that there is a way for me to be contacted, But only three people know how.

And I am no longer an electron junkie.

Try it the next time that you have a chance. It really is easier than you think.




“Let all bitterness, and wrath, and anger, and clamor, and evil speaking, be put away from you, with all malice; and be ye kind to one another, tenderhearted, forgiving one another, even as God, for Christ's sake, hath forgiven you.”
--The Bible, Ephesians 4:31-32

“Detach yourself from all that makes your mind restless. Renounce all that disturbs its peace. If you want peace, deserve it.”
--Sri Nisargadatta Maharaj (Indian Spiritual Teacher and Exponent of Jnana Yoga and Advaita Doctrine, 1897-1981)

“You must have been warned against letting the golden hours slip by, but some of them are golden only because we have let then slip by.”
--Sir James Matthew (J.M.) Barrie (Scottish Writer and Playwright, 1860-1937)

The Looming Crisis of Alzheimer’s

For those of us who lobby for resources, it is no overstatement to say that Alzheimer's disease has reached crisis proportions in the United States.

As we are getting older, the incidence, prevalence and mortality of Alzheimer’s disease are all rising.

The 2007 Alzheimer's Disease Facts and Figures report by the Alzheimer's Association makes sobering reading. Here are some of the headline facts:

• Alzheimer's disease is the most common cause of dementia
• At the present rate, one in 85 people will have the disease in 40 years
• There are now more than 5 million people suffering from Alzheimer's disease, and the report projects an increase of 16 million cases by 2050 unless preventive measures are taken and/or science is able to come up with a prevention or cure
• One person is now diagnosed with dementia every seven seconds
• One in every four American families is affected by dementia
• The incidence of dementia is one in 1,000 before age 65 and one in 20 after age 65.
• More than $100 billion is spent per year on dementia, which is about 10 percent of all healthcare expenditures

As we have discussed before, the symptoms of dementia may be delayed for 3 to 5 years through healthy lifestyles and behavior modification, and there are many new treatment approaches in the pipeline.

The huge issue is that statistic about one in four families being affected by the disease. And it is a disease: it is not part of normal aging.

Caregivers can suffer terribly.

The Alzheimer’s Association also has some information for those who care for people with Alzheimer’s.

There is also some food information here concerning caregiver stress.

I would also like to direct you to some of the things that I have written here about the wellness of caregivers.

And for everyone, don’t wait until you are thirsty before you dig that well. Work on building you personal resilience and follow the simple lifestyle guidelines that may significantly reduce your risk of developing Alzheimer’s disease.

Career Contentment Radio

Later today I have the privilege of speaking to Jeff Garton and Cathy Yin on Career Contentment Radio, which is broadcast by Business Voice America.

We are going to be talking about one of my favorite topics: Building Resilience.

This program goes out live at Noon Pacific, which is 3PM Eastern, and is rebroadcast at Midnight Pacific time.  It will then be available on demand and podcast ready.

I have already sent out e-card invitations with the links to people on my list. If you did not get one, please let me know.

Later today I shall also be posting a report on "Building Resilience" on my main website with more free resources for you to use.

Optimism and the Brain

Humans have a wonderful ability to expect positive events in the future, even when there is no shred of evidence to support them. One of the key components of resilience is optimism. Though there is data to show that there is a genetic contribution to optimism, it is also a psychological attribute that can flow from life experiences as well as attitude that can be developed. Though the motivational coaches who tell us that putting on a happy face will make you happy and optimistic are probably overstating the truth! A lack of optimism is often a sign of clinical depression so learning more about it, is not just an academic exercise.

New research just published in the journal Nature indicates that there are two regions of the brain linked to optimism.

The team from New York University and University College, London, says that the act of imagining a positive future event, for example winning an award or receiving a large sum of money, activates two brain areas: the amygdala and the rostral anterior cingulated cortex (rACC). The finding ties in with earlier studies that suggested that these brain regions malfunction in depression. (1,2)

The investigators first measured how optimistic 15 volunteers were using a standard questionnaire. They were then scanned using functional magnetic resonance imaging (fMRI) while reflecting on one of a number of potential scenarios.

In one part of the trial, subjects followed specific instructions to recall a negative event in the past, such a funeral that they had attended in the past five years. In another experiment they had to imagine what it would be like to be involved in a car crash in the near future. At other points in the study subjects had to reflect on positive events such as winning an award in the past or receiving a large sum of money in the future.

Reflecting on both past and future events activated the amygdala and the rACC regions of the brain. However, positive events, and particularly those imagined in the future, generated a significantly larger response in these regions than reflecting on negative events.

When imagining happy events, the more pessimistic subjects in the trial had less activation of these brain areas than their optimistic counterparts when imagining happy events.

For some time now, many researchers have assumed that the amygdala and rACC are only involved in negative thoughts and negative reactions, but this research indicates that they have an important role in signaling cheerful thoughts. And, what is more, these are also regions of the brain that have been implicated in depression. Previous research has suggested that patients with depression have decreased nerve signaling and fewer cells in the rACC and amygdala.

Is this why people with depression find it so hard to generate positive thoughts?

This is important work that will likely have a great many practical applications.

“Children are born optimists and we slowly educate them out of their heresy.”
--Louise Imogen Guiney (American-born English Poet, 1861-1920)

“Although the world is full of suffering, it is full also of the overcoming of it.”
--Helen Keller (American Blind and Deaf Swedenborgian Philosopher, 1880-1968)

“No man is so old as not to think he can live one year more.”
--Marcus Tullius Cicero (Roman Political Figure and Orator, c.106-43 B.C.E.)

"The way to become happy
Is to think

And to feel

That the very best is yet to come.”
--Sri Chinmoy (a.k.a. Chinmoy Kumar Ghose, Indian Philosopher and Spiritual Teacher, 1931-2007)

Broccoli and Skin Cancer

This one is going to launch a thousand gags on the late night talk shows, but it is actually quite serious.

Despite what you hear on some of those infomercials, there is a strong link between ultraviolet radiation (UVR) and many kinds of skin cancer. You can even use ultraviolet radiation to induce cancerous change in cells cultures in a Petri dish.

In an article from Johns Hopkins University published in the Proceedings of the National Academy of Sciences damaging effects of UVR can be significantly reduced by the topical application of a broccoli extract called sulforaphane that comes from broccoli sprouts. Sulforaphane was first identified over 15 years ago, and it has been shown to play a role in preventing the development of several types of tumors that can be induced by cancer-causing chemicals. It may also have a role in fighting some established tumors.

The research involved both animal and human studies, and showed that the level of erythema (skin reddening) caused by UVR is substantially reduced when this extract is applied to the skin.

The broccoli extract is not acting like a sunscreen; it does not absorb the UVR, neither does it stop it from entering the skin. Instead it enters the cells and switches on the production of several enzymes that protect cells from UV damage. The result is that the protective effect is sustained for days after the extract has been removed.

The advantage of this is that it is much longer-lasting than any sunscreen - several days, in fact. The scientists said the protection is still there when no extract is present on/in the skin.

The researchers first tested sulforaphane on mouse models of skin cancer, and then on six healthy human volunteers.

Each of the volunteers had small patch of skin exposed to a pulse of UVR. Some of the patches were treated with the broccoli extract while others were not.

At the highest UVR dosages, UVR-induced redness and inflammation was on average 37% lower when the extract had been applied, and the protection was sustained for at least three days. They also found that protection varied greatly depending on the person - protection ranged from 8% to 78%.

These variation may be due to the volunteers' different skin types, dietary habits and genetic differences.

In these trials, the conventional sunscreens did not provide significant protection.

This research is important for several reasons:

• The research re-emphasizes the importance of recognizing inter-individual differences. An approach that works for one person may not help another
• There are many times in life when we cannot do much to prevent something bad happening to us: radiation, stress or somebody being mean. The new approach s not just to prevent exposure, but also to work on resilience: how can we stop ourselves from having a bad reaction? The whole of us, from our cells to our soul?
• It is inevitable that people will start telling you that broccoli is the way to protect yourself against skin cancer, and I am just waiting for the advertisements to start coming in. Do not be fooled! This research involves a specific extract applied to a precise area of skin. As far as we know, it does not apply to eating broccoli

Overcoming Rejection

I am sure that most of us have faced some form of rejection at some time or other in our lives. People with high self-esteem seem better able to take rejection in their stride, but usually only if it is “earned.” Simply trying artificially to build your self-esteem rather than having built it on a platform of past achievement, will probably not work very well.

New research in the journal Psychological Science from UC Berkeley indicates that this does not mean that people with low self-esteem are doomed to respond defensively to criticism and rejection. The key seems to be that people who are better at controlling their impulses are less vulnerable to rejection. 

There were 38 female and 29 male participants in the study. The first completed the Rosenberg self-esteem scale, one of the most widely used self-esteem measure in the social sciences. They then completed a questionnaire on their ability to focus on tasks at hand without distraction. The subjects were arranged into two groups - low self-esteem and normal-to-high self-esteem – based on their scores on the Rosenberg scale.

Each of the volunteers then viewed images showing positive, neutral, negative and rejection themes while being subjected to sporadic loud noises. A startle probe measured the force of their eye-blinks in response to the abrupt sounds. Eye blinks are a good measure of the startle response and correlate fairly well with the activation of the “fight or flight” reaction.

As anticipated, all the participants blinked more strongly when the loud noise was paired to such negative images as dead animals or mutilated bodies. However, the people with low self-esteem blinked more forcefully in response to pictures portraying themes of rejection loneliness and alienation. Paintings with negative themes or acceptance themes, such as lovers embracing, did not elicit the same response in low self-esteem people.

In other words the powerful was in which rejection activates the threat system in people with low self-esteem suggests that their fear of rejection runs extremely deep and engages neurological systems involved in reacting to a threat.

On the other hand, those with low self-esteem who scored higher for attention control, which included the ability to focus, were able to modulate their immediate reactions to rejection. 

Some previous work has suggested that self-esteem is part of a primitive emotional warning system that warns us if we are in danger of being socially excluded. While the evolutionary function of this detection system was originally intended to motivate people to stay socially connected, the constant anticipation of rejection can create problems, with the system being triggered by the merest whiff of rejection. They may become hypersensitive and have a brain that generates a cascade of defensive reactions if they sense any kind of disapproval.

Although this is a small study, the evidence is that rather than teaching self-esteem skills, the solution for them might be to improve their abilities to focus, concentrate and regulate their internal states.

In other words develop some specific forms of self-control and resilience.

For many people this may be the most effective way of helping them to cope with disappointment and maintain close relationships.




“No man is free who is not master of himself.”
--Epictetus (Phrygian-born Greek Stoic Philosopher, c.A.D.55- c.A.D.135

“It is not the mountain we conquer but ourselves.”
--Sir Edmund Hillary (New Zealand Mountaineer and Explorer, 1919-

“Mind control is not one's birthright. The successful few owe their success to their perseverance.”
--Ramana Maharshi (Indian Hindu Mystic and Spiritual Teacher, 1879-1950

“The cyclone derives its powers from a calm center. So does a person.”
--Norman Vincent Peale (American Cleric, Writer and Self-Help Expert, 1898-1993)

Evaluating Sense of Coherence

Yesterday we began to look at Aaron Antonovsky's concept of Sense of Coherence.

Here is one of the most widely used sets of questions to determine an individual’s Sense of Coherence, derived from Antonovsky's The Sense of Coherence Quest.

The questions concern a number of aspects of our lives.

Each question has seven possible answers. The person doing the evaluation marks one number from 1 to 7 for whichever one most closely corresponds to their beliefs or  feelings.

1. When you talk to people, do you have the feeling that they don’t understand you?
    Never     1 2 3 4 5 6 7     Always have this feeling

2 In the past, when you had to do something that depended upon cooperation with others, did you have the feeling that it:
    Surely wouldn't get done     1 2 3 4 5 6 7     Surely would get done

3. Think of the people with whom you come into contact daily, aside from the ones to whom you feel closest. How well do you know most of them?
    You feel that they're strangers     1 2 3 4 5 6 7     You know them very well

4. Do have the feeling that you don't really care about what goes on around you?
    Very seldom or never     1 2 3 4 5 6 7    Very often

5. Have you in the past ever been surprised by the behavior of people whom you thought you knew well?
    Never happened     1 2 3 4 5 6 7     Always happened

6. Have you ever had people that you counted on, ended up disappointing you?
    Never happened     1 2 3 4 5 6 7     Always happened

7. Life is:
    Full of interest     1 2 3 4 5 6 7     Completely routine

8. Until now your life has had:
    No clear goals or purpose at all     1 2 3 4 5 6 7     Very clear goals and purpose

9. Do you have the feeling that you're being treated unfairly?
    Very often     1 2 3 4 5 6 7     Very seldom or never

10. In the past ten years your life has been:
    Full of changes without your knowing what will happen next     1 2 3 4 5 6 7     Completely consistent and clear

11. Most of the things you do in the future will probably be:
    Completely fascinating     1 2 3 4 5 6 7     Deadly boring

12. Do you have the feeling that you are in an unfamiliar situation and don't know what to do?
    Very often     1 2 3 4 5 6 7     Very seldom or never

13. What best describes how you see life:
    One can always find a solution to painful things in life     1 2 3 4 5 6 7     There is no solution to painful things in life

14. When you think about your life, you very often:
    Feel how good it is to be alive     1 2 3 4 5 6 7     Ask yourself why you exist at all

15. When you face a difficult problem, the choice of a solution is:
    Always confusing and hard to find     1 2 3 4 5 6 7     Always completely clear

16. Doing the things you do every day is:
    A source of deep pleasure and satisfaction     1 2 3 4 5 6 7     A source of pain and boredom

17. Your life in the future will probably be:
    Full of changes without your knowing what will happen next     1 2 3 4 5 6 7     Completely consistent and clear

18. When something unpleasant happened in the past your tendency was:
    "To beat yourself up" about it     1 2 3 4 5 6 7 to say,     "Ok that’s that, I have to live with it " and go on

19. Do you have very mixed-up feelings and ideas?
    Very often     1 2 3 4 5 6 7     Very seldom or never

20. When you do something that gives you a good feeling:
    It’s certain that you'll go on feeling good     1 2 3 4 5 6 7     It's certain that something will happen to spoil the feeling

21. Does you have feelings inside you would rather not feel?
    Very often     1 2 3 4 5 6 7     Very seldom or never

22. You anticipate that your personal life in the future will be:
    Totally without meaning or purpose     1 2 3 4 5 6 7     Full of meaning and purpose

23. Do you think that there will always be people whom you'll be able to count on in the future?
    You're certain there will be     1 2 3 4 5 6 7     You doubt there will be

24. Does it happen that you have the feeling that you don't know exactly what's about to happen?
    Very often     1 2 3 4 5 6 7     Very seldom or never

25. Many people - even those with a strong character - sometimes feel like sad sacks (losers) in certain situations. How often have you felt this way in the past?
    Never     1 2 3 4 5 6 7     Very often

26. When something happened, have you generally found that:
    You overestimated or underestimated its importance     1 2 3 4 5 6 7             You saw things in the right proportion

27. When you think of the difficulties you are likely to face in important aspects of your life, do you have the feeling that:
    You will always succeed in overcoming the difficulties     1 2 3 4 5 6 7             You won't succeed in overcoming the difficulties

28. How often do you have the feeling that there's little meaning in the things you do in your daily life?
    Very often     1 2 3 4 5 6 7    Very seldom or never

29. How often do you have feelings that you're not sure you can keep under control?
    Very often     1 2 3 4 5 6 7     Very seldom or never

There are no right or wrong answers, but the overall pattern of your scores will give you some useful insights. There is a large research literature in which scores on this scale have been related to everything from career choices to the risk of getting PTSD.

A Sense of Coherence

One of the central concepts of Integrated Health and Integrated Medicine is the idea of coherence. This is not a new idea, but was developed in new ways and formalized by the American/Israeli sociologist Aaron Antonovsky. It is such an important concept that I have mentioned something about it before

Antonovsky developed his theory of health and illness, which he termed Salutogenesis. This model was described in his 1979 book "Health, Stress and Coping", followed by "Unraveling the Mystery of Health" in 1987. I remember its publication, and the strong feeling amongst many of us interested in Integrated Health that it was a most important contribution to understanding the relationship between health and illness. A key concept in Antonovsky's salutogenic theory concerns the way in which specific personal dispositions serve to make us more resilient to the stressors that we encounter in daily life.

Antonovsky identified these characteristics, which he said helped a person better cope and remain healthy by providing "a sense of coherence" (SOC) about life and the challenges we all face. Measures of Sense of Coherence have been developed and tested in more than 30 countries.

The SOC is defined as: “The extent to which one has a pervasive, enduring though dynamic, feeling of confidence that one’s environment is predictable and that things will work out as well as can reasonably be expected.”

So it tries to capture our sense of optimism and control.

SOC has three components:

• Comprehensibility
• Manageability
• Meaningfulness

Comprehensibility is the extent to which events are perceived as making logical sense, that they are ordered, consistent, and structured. Manageability is the extent to which a person feels they can cope. Meaningfulness is how much one feels that life makes sense, and challenges are worthy of commitment.

Professor Antonovsky believed that a person with a strong SOC is more likely to feel less stress and tension, and to have confidence that he or she can meet the demand placed upon them. The SOC was developed to apply across cultures, and versions of the questionnaire have been used in over 30 countries.

The SOC is not the only factor in a predicting outcomes in a person’s life: it interacts with a person’s natural coping style, upbringing, financial assets, mood and social support. The strength and availability of each is a major determinant in the development of a strong or weak SOC.

Research in the growing field of psychoneuroimmunology has supported many of the basic assertions of the relationship between emotions and health contained in Antonovsky's theory of Salutogenesis.

I saw some research (NR691) at the 2007 Annual Meeting of the American Psychiatric Association in San Diego, California last month that was based on a sample of 976 working people in Denmark, found that people with a high sense of coherence perceive less stress and experience less psychological disturbance in the work place.

This all makes very good sense, and it also gives us yet another line of approach for helping people deal with the stresses of life and gain personal mastery.

I shall talk about using this information in the future.

Personal Mastery and the Wellness of Caregivers

Looking after aging relatives can be incredibly difficult, particularly if they have a chronic illness such as Alzheimer’s disease.

There is also evidence that the caregivers of people with Alzheimer’s disease have increased rates of cardiovascular disease and they die prematurely. It has been assumed that the cardiovascular problems are a result of stress causing overdrive of the sympathetic nervous system.

There was some interesting research (NR241) presented last month at the 2007 Annual Meeting of the American Psychiatric Association in San Diego. The investigators did not have to come far: they are from the University of California in San Diego.

The investigators looked at 70 spousal caregivers of people with Alzheimer’s disease and used an experimental task to measure the activity of their sympathetic nervous systems. They also measured the caregiver’s levels of “Mastery:” the belief that one is capable of handing one’s problems. Mastery is one of the components of resilience, a key characteristic of a person who can handle stress well.

What they found make very good sense: the caregivers with the highest levels of personal mastery had the lowest levels of sympathetic activity, suggesting that a sense of mastery may protect against the physiological effects of acute stress.

This provides us with yet more evidence that psychosocial interventions that increase mastery may reduce the risk of cardiovascular disease amongst the caregivers of people with dementia.

Choosing To Be Happy?

For the last two decades, one of the central tenets of the self-help movement has been that we can choose to experience or to be whatever we want.

Many psychologists have also said that human happiness or subjective well-being is largely independent of our life circumstances. Therefore wealthy people are no happier than people of more limited means; married people aren't much happier than single people and healthy people aren't much happier than sick people. The keys to happiness are supposed to lie within us, in our attitudes and perceptions.

If these theories are correct – and they are theories – we would predict that changes in our life circumstances would not have long-term effects on our happiness. This has indeed been the dominant model of subjective well-being: people adapt to major life events, both positive and negative, and our happiness stays pretty much constant through our lives, even if it is occasionally perturbed by some big gain or loss. According to the theory, winning the lottery may make you happy for a little while, but it won't make you happier in the long run.

Not unless you have made the choice to be happy.

Similarly, while a divorce or major illness might throw your life into turmoil for a while, your happiness level will eventually return to where it was before. The idea has been that of sense of subjective well-being has a set point, and that a change in beliefs or attitudes can change the set-point.

But is this true?

New research, and reexamination of old research, is challenging some of the claims of set-point theory.

In this month’s issue of Current Directions in Psychological Science, Richard E. Lucas of Michigan State University and the German Institute for Economic Research, reviews some recent studies suggesting that adaptation to changing life circumstances only goes so far. As he says, "Happiness levels do change, adaptation is not inevitable, and life events do matter.”

To study adaptation, Lucas and his colleagues used data from two large national prospective panel studies, one in Germany and the other in Great Britain. Unlike most previous studies of adaptation, these data were able to capture levels of life satisfaction both prior to and after major life events like marriage, divorce, unemployment, and illness or disability.

Lucas found that not all of life events are created equal. For example, most people adapt quickly to marriage. They have peak in subjective well-being at the time of getting married, but within about two years, their happiness levels return to their previous levels.

People usually adapt to losing a spouse, but it takes a lot longer: on average about seven years. People who get divorced and people who become unemployed, however, do not usually return to the level of happiness that they experienced before. The same can be said about physical debilitation. Numerous recent studies have demonstrated that major illnesses and injury result in significant, lasting decreases in subjective-well being.

But Lucas also found that individual differences play an important role. There is a great deal of individual variation in the degree to which people adapt to what life throws at them. We know that life events run in families: there is a genetic predisposition to having multiple life events. People who are destined to experience certain life events differ in their subjective well-being from those who do not, even before the occurrence of those events. As an example, people who were happy 5 years before their marriage, stay married, and also stay happier than those who are destined to marry and get divorced.

Lucas stresses that his findings do not undercut the importance of adaptation processes. Some degree of adaptation necessarily protects us from prolonged emotional states that may be harmful, and helps us attune to novel threats to our well-being rather than dwell on ones we are familiar with. Adaptation also helps us detach from goals that have proven unrealistic.

So what does this mean to us personally? It is rather like the statement attributed to the German priest and scholar Martin Luther, “Pray as if everything depends on God. Then work as if everything depends on you.”

• Make the choice to be happy, but that choice will, on its own, achieve little unless you also work to change your life circumstances
• The choice to be happy will not be crowned with success unless you really feel that you want it deep down inside: it has to be a core desire
• Not everyone can make the choice because they are not wired that way
• Do not be disheartened if you make the choice to be happy and things don’t quite work out. Some pop psychologists and gurus have told their followers that if they failed to find happiness, then they were inadequate, or did not want it enough. That kind of nonsense can cause needless guilt and suffering. Sometimes life chucks too much at you at once, and it’s okay to be unhappy. It does not mean that you are a wimp, or that you didn’t want happiness enough
• The best way to deal with a world that throws a lot at you is to learn the art and science of resilience and acceptance

But also remember something else: the great sages have always taught that happiness is our natural state, and the art of living is to return to that natural state.

But most importantly, to help others get there as well.

“Action may not always bring happiness; but there is no happiness without action.”
--Benjamin Disraeli, 1st Earl of Beaconsfield (English Statesman, Novelist and, in 1868 and from 1874-1880, British Prime Minister, 1804-1881)

“Forgiveness is the key to happiness.”
--A Course in Miracles (Book of Spiritual Principles Scribed by Dr. Helen Schucman between 1965 and 1975, and First Published in 1976)

“Happiness is the very nature of the Self; happiness and the Self are not different. There is no happiness in any object of the world.”
--Ramana Maharshi (Indian Hindu Mystic and Spiritual Teacher, 1879-1950)

Temptation

Have you ever given in to temptation? Have you ever had a moment of weakness when that jelly donut seemed just too irresistible or you felt that it was about time to tell someone what you REALLY thought?

Sad to say I am sure that we are all guilty of that at some time or other.

What we are talking about here is self-regulation, our ability to inhibit impulses, make decisions, persist at difficult tasks and to control our emotions. We know that our ability to self-regulate is highly variable. It becomes more difficult if we are tired, stressed or working with people who drain us emotionally. There is evidence that our abilities to self-regulate can fatigue in just the same way that a muscle can get tired. It’s like having a limited amount of money, and when it’s gone it’s gone. One of the main factors that help to keep self-regulating is our level of resilience.

It is interesting that when we give in to the temptation to do something unwise, we are often unaware of it at that moment. It is only later that we feel regret.

There is some interesting new research from the University of Kentucky, that was conducted by two psychologists Suzanne Segerstrom and Lise Solberg Nes. Their work suggests that there may be a biological indicator to tell us when we are working hard at resisting temptation and consequently when we are vulnerable to doing things that we hadn’t meant to.

They hypothesized that there would be a link between variations in heart rate – heart rate variability (HRV) - and self-regulation. HRV is emerging as a very interesting tool for examining the health of the autonomic nervous system, and if disturbed, it can be a harbinger of many highly undesirable health problems. The researchers’ reasoning was that many of the same brain structures involved in self-regulation are also involved in the control of HRV.

They did a two-part study to test their hypothesis. In the first experiment participants were told that they were going to take part in test on the "physiology of food preference." They were instructed to fast for three hours before starting the procedure. Then their HRV was monitored while they were presented with a tray of cookies, candy and carrots. The “temptation” was to give in to eating the tastier but the less healthy snack of cookies and candy.

HRV was considerably higher when people were working to resist temptation (eating carrots rather than cookies and chocolate) than when they were not. This suggested that HRV was mirroring the attempt at self-regulation.

In part two of the experiment, after resisting or giving into temptation, the experimenters had the participants attempt to complete difficult anagrams, some of which were impossible to solve. The authors measured how long participants persevered at the anagrams. As predicted, those who had exerted high self-regulation by resisting the candy and cookies were more likely to give up earlier on the task. They didn’t have any more self-control to give.

People with naturally higher levels of HRV were likely to try longer at the anagram task, whether or not they had given into “temptation.”

Now the “temptation” in this study wasn’t much, but the implications are important. There are many people – particularly those with addictions and some kinds of personality disorder – who have major problems with self-regulation. HRV feedback could turn out to be a useful way of helping people realize that their self-control may be about to fail.

It is also important to know that self-regulation is finite, but can be built by building an individual’s resilience (1,2,3,4,5).

By the way, if you have never given in to temptation, would you PLEASE share your secret?

“Watch and pray, that ye enter not into temptation: the spirit indeed is willing, but the flesh is weak.”
--The Bible: Matthew 26:41

“A silly idea is current that good people do not know what temptation means. This is an obvious lie. Only those who try to resist temptation know how strong it is....  A man who gives in to temptation after five minutes simply does not know what it would have been like an hour later. That is why bad people, in one sense, know very little about badness. They have lived a sheltered life by always giving in.”
--C. S. Lewis (British Scholar and Novelist, 1898-1963)

“What makes resisting temptation difficult for many people is they don't want to discourage it completely.”
--Franklin P. Jones (American Businessman, 1887-1929)

“Temptation is an irresistible force at work on a moveable body.”
Henry Louis (H.L.) Mencken (American Writer and Editor, 1880-1956)

Psychological Problems, Stigma and Success

I do a lot of work to try and de-stigmatize mental illness, and to emphasize that all of my experience and all the scientific evidence makes it very clear that most psychological and psychiatric problems lie on a spectrum. We define something as an "illness" only if it is causing suffering or distress.

Because of my work I know about the physical and psychological problems of a great many people in the public eye, but I will obviously not talk about people unless they decide to say something themselves.

When I am speaking to politicians or the media I often show them a list of some of the people with psychological problems who have gone public.

I just found this long list of Deborah Serani's blog. There were a number of names of people whom I did not know had revealed that they had suffered from problems. I am pleased that Deborah offered some references. I have also added a few names from my own research.

If there are any mistakes, please let me know and I shall correct them.

I would like to make three points:

1. Psychological problems and psychiatric illnesses are common and usually treatable
2. Having been diagnosed with one of these problems does not preclude you from outstanding success
3. This list does not include people with substance abuse problems, though these problems are usually as physical as any other

I do hope that you will find it helpful to see just how many terrific people have had their downs as well as their ups!

John Quincy Adams (US President)
Alvin Ailey (Choreographer)
Lionel Aldridge (Football Star)
Buzz Aldrin (Astronaut)
Adam Ant  A.K.A. Stuart Goddard (Singer)
Ann-Margaret (Actor)
Louie Anderson (Comedian Actor)
Gillian Anderson (Actress)
Fiona Apple (Musician)
Diane Arbus (Photographer)
Isaac Asimov (Author)
Drew Barrymore (Actor/Producer)
Daniel Boorstin (Former Us Presidential Adviser)
Zach Braff (Actor)
Art Buchwald (Columnist)
Oksana Baiul (Skating Star)
Kim Basinger (Actress)
Ned Beatty (Actor)
Syd Barrett (Musician)
Ludwig Van Beethoven (Composer)
Maurice Bernard (Actor)
Irving Berlin (Composer)
Danny Bonaduce (Actor/Radio DJ)
Halle Berry (Actor)
Kjell Magne Bondevik (Prime Minister of Norway)
Steve Blass (Baseball Star)
Charles “Buddy” Bolden (Musician)
Robert Borrstin (Political Advisor)
David Bowie (Singer)
Marlon Brando (Actor)
Jeremy Brett (Actor)
Charlotte Bronte (Author)
Robert Burns (Poet)
Willie Burton (Athlete)
Barbara Bush (Former First Lady - U.S.)
Delta Burke (Actor)
Carol Burnett (Actress/Comedian)
Lord Byron (Poet)
Cher (Singer/Actress)
Dick Clark (Producer/Music Magnate)
John Candy (Comedian)
Ray Charles (Musician)
Deanna Carter (Singer)
Helen Caldicott (Activist/Writer)
Dean Cain (Actor)
Drew Carey (Actor/ Comedian)
Earl Campbell (Football Star)
Eric Clapton (Musician)
Jim Carrey (Actor/Comedian)
Melanie Chisholm (Singer)
Naomi Campbell (Model)
Rosemary Clooney(Singer)
Jose Canseco (Baseball Star)
Shawn Colvin (Musician)
Mary Jo Codey (First Lady Of New Jersey)
Judy Collins (Musician)
Dick Cavett (TV Host/Writer)
Courtney Cox (Actor)
Margaret Cho (Actor/Comedian)
Natalie Cole (Singer)
Michael Crichton (Writer)
Francis Ford Coppola (Director)
Sheryl Crow (Musician)
Winston Churchill (English Prime Minister)
Nicolas Cage (Actor)
Sandra Cisneros (Writer)
Patricia Cornwell (Writer)
John Cleese (Comedian/Actor)
Leonard Cohen (Musician)
Paula Cole (Actor)
Shayne Corson (Hockey Star)
Judy Collins (Musician)
Shawn Colvin (Musician)
Jeff Conaway (Actor)
Ty Cobb (Baseball Star)
Pat Conroy (Writer)
Billy Corgan (Musician)
Calvin Coolidge (US President)
Bill Dana (Comedian)
John Daly (Golf Star)
Rodney Dangerfield (Comedian/ Actor)
Charles Darwin (Scientist)
Jefferson Davis (President Of The Confederate States Of America)
Jonathan Davis (Musician)
Sandra Dee (Actor)
Gaetano Donizetti (Opera Singer)
Mike Douglas (TV Host)
Walt Disney (Entrepreneur)
John Denver (Musician)
Dame Edna Everage a.k.a. Barry Humphries (Comedian)
Ellen Degeneres (Comedian/Actor)
Richard Dreyfuss (Actor)
Johnny Depp (Actor)
Paolo Dicanio (Soccer Star)
Eric Douglas (Actor)
Charles Dickens (Author)
Patty Duke (Actress)
Scott Donie (Olympic Star)
Kitty Dukakis (Former First Lady Of Massachusetts)
Michael English (Singer)
Jim Eisenreich (Baseball Star)
Thomas Edison (Inventor)
Ralph Waldo Emerson (Writer)
Robert Evans (Film Producer)
Jules Feiffer (Cartoonist)
James Farmer (Civil Rights Leader)
Edie Falco (Actress)
Betty Ford (Former US First Lady)
Carrie Fisher (Actress)
James Forrestal (Undersecretary Of US)
Eddie Fisher (Singer)
Aretha Franklin (Singer)
Harrison Ford (Actor)
Albert French (Writer)
Sally Field (Actress)
Connie Francis (Singer)
Sarah Ferguson (Duchess Of York)
Sigmund Freud (Psychoanalyst)
Stephen Fry (Actor)
Shecky Greene (Comedian)
Barbara Gordon (Filmmaker)
Phil Graham (Washington Post)
James Gandolfini (Actor)
James Garner (Actor)
Peter Gabriel (Musician)
Kendall Gill (Basketball Star)
Ruth Graham (Writer)
John Gibson (Pianist)
Danny Glover (Actor)
Dwight Gooden (Baseball Star)
Tipper Gore (Former US First Lady)
Galileo (Scientist)
Carey Grant (Actor)
Mariette Hartley (Actor/Activist)
Tim Howard (Soccer Star)
Juliana Hatfield (Musician)
Ernest Hemingway (Writer/ Nobel Laureate)
Margaux Hemingway (Actor)
Audrey Hepburn (Actor/Activist)
Olivia Hussey (Actress)
Pete Harnisch (Baseball Star)
Linda Hamilton (Actor)
Stephen Hawking (Physicist)
Sir Anthony Hopkins (Actor)
Marty Ingels (Comedian)
Janet Jackson (Musician)
Kay Redfield Jamison (Psychologist/Author)
Richard Jeni (Comedian)
Jim Jenson (Newscaster)
Billy Joel (Musician)
Beverly Johnson (Supermodel)
Elton John (Musician)
Angelina Jolie (Actor/Activist)
Daniel Johns (Musician)
Ashley Judd (Actor)
Naomi Judd (Singer)
Al Kasha (Songwriter)
Danny Kaye (Actor)
Leila Kenzle (Actress)
John Keats (Poet)
Franz Kafka (Writer)
Gelsey Kirkland (Dancer)
Margot Kidder (Actress)
Nicole Kidman (Actress)
Joey Kramer (Musician)
Julie Krone (Star Athlete)
Pat Lafontaine (Hockey Star)
Jessica Lange (Actor)
Robert E. Lee (US General)
Jacob Lawrence (Artist)
Vivien Leigh (Actress)
Peter Nolan Lawrence (Writer)
Primo Levi (Writer)
John Lennon (Musician)
Meriwether Lewis (Explorer)
Courtney Love (Singer)
Allie Light (Director)
Abraham Lincoln (American President)
Rick London (Cartoonist)
Mary Todd Lincoln (Former US First Lady)
Salvador Luria (Scientist/Nobel Laureate)
John Madden (Football Star)
Meat Loaf (Musician/Actor)
Camryn Manheim (Actor)
Martha Manning (Psychologist)
Gustav Mahler (Composer)
Alanis Morisette (Singer)
Howie Mandel (Comic)
Bette Midler (Singer/Actress)
Dave Matthews (Musician)
Gary Mcdonald (Actor)
A.J. Mclean (Musician)
Burgess Meredith (Actor)
Sir Paul Mccartney (Musician)
Robert Mcfarlane (Security Advisor)
Sarah Mclachlan (Musician)
Rod Mckuen (Writer)
Gary Mcdonald (Actor)
Les Murray (Poet)
John Stuart Mill (Philosopher)
J.P. Morgan (Industrialist)
Edvard Munch (Artist)
John Mellencamp (Musician)
Paul Merton (Comedian)
Kate Millet (Writer/Feminist)
Carmen Miranda (Dancer)
Claude Monet (Artist)
Many Moore (Singer)
Michelangelo (Artist)
V.S. Naipaul (Writer/Nobel Laureate)
John Nash (Mathematician /Nobel Prize)
Ralph Nader (Consumer Rights Advocate)
Stevie Nicks (Musician)
Vaclav Nijinsky (Dancer)
Sir Isaac Newton (Scientist)
Deborah Norville (Journalist)
Marie Osmond (Entertainer)
Sir Laurence Olivier (Actor)
Rosie O’Donnell (Comedian/Actress)
Georgia O’Keefe (Artist)
Donny Osmond (Entertainer)
Lani O'Grady (Actress)
Eugene O'Neill (Playwright)
Dolly Parton (Musician)
Meera Popkin (Broadway Star)
Charley Pell (Football Coach)
George Patton (US General)
Jane Pauley (Journalist)
Teddy Pendergrass (Musician)
Edgar Allan Poe (Writer)
Elvis Presley (Entertainer)
Ezra Pound (Poet)
Jason Pollock (Artist)
Cole Porter (Composer)
Jimmy Piersall (Baseball Star)
Alma Powell (Wife Of General Colin Powell)
Susan Powter (Motivational Speaker)
Freddie Prinze Jr. (Actor)
Roseanne (Comedian/Actress)
Bonnie Raitt (Musician)
Burt Reynolds (Actor)
Lou Reed (Musician)
Norman Rockwell (Artist)
Theodore Roosevelt ( President Of The United States)
Joan Rivers (Comedian Actress)
Mac Rebennack A.K.A. Dr. John (Musician)
Alex Rodriguez (Baseball Star)
Alys Robi (Vocalist)
Axel Rose (Singer)
Winona Ryder (Actress)
Yves Saint Laurent (Fashion Designer)
Sam Shepard (Playwright)
Tom Snyder (TV Host)
Monica Seles (Tennis Star)
Linda Sexton (Writer)
Neil Simon (Playwright)
William T. Sherman (US General)
Marc Summers (TV Host)
Diana Spencer (Princess Of Wales)
John Steinbeck (Author)
Paul Simon (Musician)
Lauren Slater (Writer)
Willard Scott (Star Weatherman)
William Shakespeare (Writer)
Carly Simon (Singer)
Jose Solano (Actor)
Rick Springfield (Musician/Actor)
Brooke Shields (Model/Actress)
Rod Steiger (Actor)
George Stephanopoulos (Political Advisor)
Barbra Streisand (Singer/Actress)
William Styron (Writer)
Charles Schulz (Cartoonist)
Teresa Stratas (Opera Singer)
Sissy Spacek (Actress),
Dave Stewart (Singer)
Darryl Strawberry (Baseball Star)
Lori Schiller (Writer)
Francis Sherwood (Writer)
Scott Simmie (Journalist)
Earl Simmons A.K.A. DMX (Musician/Actor)
Alonzo Spellman (Football Star)
Nikola Tesla (Inventor)
Spencer Tracy (Actor)
Hunter Tylo (Actor)
Leo Tolstoy (Author)
Ted Turner (Entrepreneur)
Henri De Toulouse-Lautrec (Artist)
Mark Twain (Author)
Peter Illyich Tchaikovsky (Composer)
Anne Tyler (Author)
Tracy Ullman (Actor)
Dimitrius Underwood (Football Star)
Vivian Vance (Actor)
Kurt Vonnegut (Writer)
Tom Waits (Musician)
Mike Wallace (Journalist)
Michael Warren (Editor Canada Post)
George Washington (US President)
Evelyn Waugh (Novelist)
Damon Wayans (Comedian/Actor)
Tennessee Williams (Writer)
Dar Williams (Musician)
Robin Williams (Comedian/Actor)

Ann Wilson (Singer)
Bill Wilson (Founder Of Alcoholics Anonymous)
Brian Wilson (Musician)
Oprah Winfrey (TV Host)
Jonathan Winters (Comedian)
Ed Wood (Director)
Tom Wolfe (Writer)
Lewis Wolpert (Scientist)
Hugo Wolf (Composer)
Virginia Woolf (Novelist)
Luther Wright (Basketball Star)
W.B. Yeats (Poet)
Robert Young (Actor)
Bert Yancey (Golf Star)
William Zeckendorf (Industrialist)
Renee Zellweger (Actor)


References
Buchwald, A. (1999). Famous, important people who have suffered depression. Psychology Today.

Fonda, J. (2005). My life, so far. New York: Random House.

Jamison, K.R. (1993). Touched with fire. Manic depressive illness and artistic temperment. New York: Free Press.

Shepard, S. (1999). Mrs. gore breaks the ice on mental illness. Wahsington Bureau: The Palm Beach Post.

Shields, B. (2005). Down came the rain: My journey through post partum depression.
New York: Hyperion Books.

______(2005). Health: Celebrities who have admitted suffering from depression. England: Burmingham Post.

People with Mental Illness Enrich Our Lives
http://www.nami.org/helpline/peoplew.htm

Celebrity with Anxiety Disorders
http://www.anxietysecrets.com/celebrities.htm

Famous People Who Have Battled Depression
http://www.funkstop.com/ed/depression

People Watching

For the eighth time in a week your humble reporter found himself at the Atlanta airport. Ahem, I should say, of course, the Hartsfield-Jackson Atlanta International Airport.

It’s a perfect place for people watching. New statistics out today have shown that in 2006 it held its position as the world’s busiest airport, followed by O’Hare in Chicago and London’s Heathrow.

I was chastened to realize that I have been in every one of the top ten airports in the last year or so. For people who like such things, here’s the list of the top ten busiest airports with the number of millions passengers who’ve been through each:

1. Atlanta    84.8
2. O’Hare    76.2
3. Heathrow   67.5
4. Tokyo’s Haneda    65.2
5. Los Angeles International    61
6. Dallas/Fort Worth    60
7. Paris, Charles de Gaulle    56.8
8. Frankfurt    52.8
9. Beijing Capital International Airport    48.5
10. Denver International    47.3

Spending a lot of time in airports can stress the physical, psychological and subtle systems of the body, as well as making it easy to lose touch with your spirituality.

I’m going to let you in on a secret: for over two decades I had learned and then taught methods for building resilience and bouncing back from adversity. But it wasn’t until I started flying a quarter of a million miles a year that I got the chance to test and refine the methods under the most extreme conditions. Engineers often talk about taking their constructions and “testing them to destruction.” I did the same thing with the methods I teach. If they couldn’t help people cope with flights, illness or job loss, then I discarded them and looked for something else. And if they didn’t also have another piece – a way to grow in response to adversity, they were out too.

The result has been a whole raft of techniques and methods that have been tried and tested again and again. Over the next year I shall be rolling out a great many of these techniques in a novel format.

Watch this space!

“Every adversity carries with it the seed of equal or greater benefit.”
--Napoleon Hill (American Founder of Personal Success Literature, 1883-1970)

“From the withered tree, a flower blooms.”
--Zen Buddhist Saying

“How you handle adversity in the workplace tends to have much more impact on your career than how you handle the good stuff. The people who know how to overcome adversity are the ones who rise to the top of the organization."
-- Martin E. P. Seligman (American Psychologist, Professor at the University of Pennsylvania and Former President of the American Psychological Association, 1941-)

“Adversity is the diamond dust with which Heaven polishes its jewels.”
-- Robert Leighton (Scottish Presbyterian Bishop and Classical Scholar, 1611-1684)

“Adversity has the effect of eliciting talents which in prosperous times would have lain dormant.”
--Horace (a.k.a. Quintus Horatius Flaccus, Roman Poet and Satirist, 65-8 B.C.E.)

“Adversity is not undesirable. Because, it is only when you are down and out in life that you can realize its true value.”
--Swami Ramdas (a.k.a. Papa Ramdas, Indian Spiritual Teacher, 1884-1963)

Personality Style, Coping and Posttraumatic Stress Disorder

I have written a fair amount about posttraumatic stress disorder (PTSD) not only because it can be such a nasty problem, but also because it is beginning to give up many of its secrets, and it is one of the illnesses that can really show the benefits of Integrated Medicine.

There is new research just published in the journal Psychosomatic Medicine. The report is a prospective study that was done in Israel.

180 undergraduate students at the University of Haifa were coincidentally evaluated 2 weeks before a terrorist explosion in a bus heading toward their university and reevaluated 1 week, 1 month, and 6 months after the explosion.

The findings were that there were premorbid personality characteristics that predicted the development of PTSD. This is in line with the research showing both genetic and neurological  predispositions to developing PTSD. The research also indicated that some people have more robust coping styles than others. And finally, as expected, there is a relationship to how close people were to the attack.

This is all useful information, and once again shows the futility of trying to psychological reactions to only genes, only the brain, only past experience or only the environment.

Any comprehensive understanding needs us to incorporate all of those factors.

Leg Length and Cognitive Reserve

I recently mentioned the "Barker Hypothesis" which says that fetal malnutrition is associated with many physical problems later in life.

Well the difficulties may not only be physical.

I would like to tell you about an important concept that we call "Cognitive reserve." This can be thought of as our cognitive resilience. This first came to light almost twenty years ago when a post-mortem study of 137 elderly people was published in the Annals of Neurology, and confirmed something that we had suspected for years: there was a large discrepancy between the degree of Alzheimer’s disease neuropathology and the clinical manifestations of the disease. Some people had extensive pathology but they  clinically had no or very little manifestations of the disease. The investigators also showed that these people had higher brain weights and greater number of neurons compared with age-matched controls. This lead to the idea that they had a greater "reserve." This is why building your brain throughout life is thought to reduce the ce of cognitive impaitrment later on.

Studies have shown that childhood cognition, educational attainment and adult occupation all independently contribute to cognitive reserve, and more recently it has been confirmed that education and the complexity of a person's occupation may both slow the rate of decline in people who already have Alzheimer's disease.

Although height is in part genetically determined, shorter leg length has been found to be associated with an adverse environment in early childhood. In a recent study of older Afro-Caribbean people living in London, shorter leg length was significantly associated with cognitive impairment, leading to the suggestion that shorter leg length may be a marker of early life stressors that then result in reduced cognitive reserve.

It is also worth recalling our discussion about the association between growth hormone and intelligence in children and between intelligence and head size.

And nutrition is one of the determinants of growth hormone synthesis and release.

Naturally this does not mean that less tall people will all get Alzheimer's disease. But these observations have a number of practical consequences. They re-emphasize the importance of good nutrition during pregnancy: something that is simply not available to over a third of the world's population. They also help us to identify some of the people who would most benefit from strategies to increase their cognitive reserve and to avoid some of the things that can strip it away from them.

Wishing You Great Learning Opportunities in the New Year!

“The world is the great gymnasium where we come to make ourself strong.”
--Swami Vivekananda (Indian Hindu Mystic and Spiritual Teacher, 1863-1902)

A lot of people tell me that they are pleased to see the back of 2006, and we certainly had more than our fair share of challenges during the year, having lost four members of our family in just a few months. The fact that they were not all human didn’t change the impact one bit.

But for all the people who have told me about their negative thoughts about the year I’ve said the same thing: the year has actually been a terrific learning experience. That’s not to say that we should slap a big smiley face on every pain, hardship and adversity, but it does mean that it is essential for all of us to try and find the meaning in the events that have happened in our lives.

When Nietzsche said “That which does not kill me makes me stronger,” he was giving voice to a peculiarly Germanic ideal of the time: that people need to be tested and tempered like steel. That’s not what I mean at all.

The three best and most effective ways of dealing with adversity are first to extract meaning from the event or situation: “Why is this happening?” “Is it just dumb bad luck or is there more to it?”

The second essential is to learn to detach from an event, so that it no longer has its emotional claws in you.

And the third is to accept a situation. Not in some passive way of letting life bowl you over, but of being able to acknowledge an experience and then using it as the basis for wise action.

Each of these can take a lifetime to learn the hard way, but you can actually master them very quickly with a series of simple steps.

I am going to be sharing some of them with you in the coming months. I am also going to be publishing an eBook on the topic of resilience, because detachment and acceptance come much more easily to the person with robust resilience.

Having recently had to make a number of unexpected trips overseas has delayed our publication schedule by three months, but we shall be back on track by the end of January.

And here's a final thought for you from Healing, Meaning and Purpose: adversity is an invitation to grow. If approached in the right way, apparently negative events can lead to a shift in your consciousness and rapid spiritual development.

In fact the majority of my own teachers could trace their spiritual maturation to major life events that at the time seemed to be the end of the world.

Remember that what the caterpillar thinks to be the end of the world, is, for the butterfly, just a new beginning!

“Trials, temptations, disappointments -- all these are helps instead of hindrances, if one uses them rightly. They not only test the fiber of character but strengthen it. Every conquering temptation represents a new fund of moral energy. Every trial endured and weathered in the right spirit makes a soul nobler and stronger than it was before.”
James Buckham (American Naturalist and Writer)

“The most spiritual human beings, assuming they are the most courageous, also experience by far the most painful tragedies: but it is precisely for this reason that they honor life, because it brings against them its most formidable weapons.”
--Friedrich Wilhelm Nietzsche (German Philosopher, 1844-1900)

“Out of confusion, you invent something permanent - the Absolute, the Brahman or God.”
--Jiddu Krishnamurti (Indian Spiritual Teacher, 1895-1986)

Social Adversity and Schizophrenia

People who are interested in the interaction of genes, environment, brain and mental illness might be interested to look at a brief article posted over at the Psychiatric Resource Forum.

The article summarizes some very important new data on social adversity and the subsequent dvelopment of major mental illness. The research has been looking at a huge puzzle: why are serious mental illnesses so much more common in Afro-Caribbeans and Africans living in England and other parts of Western Europe? It was initially thought that it might all be due to over-diagnosis, but with deatialed work done in England, the Caribbean and Africa it has now become clear that that isn't it.

There may be a contribution from vitamin D deficiency: dark skinned people who are recent immigrants cannot make as much in their skin as they need. But that is not a cause but a potential contrbutor. That being said I am going to have something more to say about causality in medicine in a post in the next day or two.

A second line of research has identified some key brain structures that if abnormal, dramatically increase the change that a "high risk" person will develop schizophrenia. By "high risk" we mean a significant family history of the illness.

This is important material and represents a major step forward in our understanding of major mental illness and a move away from the medical model that has dominated so much of psychiatry over the last 30 years.

A New Understanding of Mood Medicines and Cells

We are in the midst of a revolution in our understanding of how many medicines work. Most students are still taught that the key to their actions is simply a matter of binding to a receptor, and then some magic occurs in the cell. But over the last few years there has been a sea change in how we see the actions of many medicines. In many ways the focus on receptor pharmacology is so 1990s.

Several years ago our group and others began to speculate that one of the ways of modulating the interaction of insulin with cells was to modify the characteristics of the cell membrane in which the insulin receptors sit. If we could change the fluidity of the cell membrane, then we could change the sensitivity of the insulin receptor. We also went a bit further and wondered whether high cholesterol levels might be associated with coronary artery disease because it changed the way in which growth factors interacted with cells in the vessel walls.

One of the reasons that fish oils may yet turn out to be helpful in some mood disorders is because they may change the behavior of cell membranes and therefore the behavior of receptors.

I have admired the work that has bee done by Husseini Manji and his group that is now at the National Institute of Mental Health in Bethesda, Maryland. Their interest is in bipolar disorder and there is a very nice update on the group’s work in the journal Biological Psychiatry.

The group is unraveling the ways in which effective medicines work at the cellular level and what actually goes wrong in bipolar disorder. We know that people with severe mood disorders may experience regional impairments of what we call structural plasticity and cellular resilience. This means that the cells find it more difficult to learn and respond to environmental changes. We think that this is why some people with severe mood problems fail to benefit from many medicines and also have so many long-term cognitive problems. So the search is on for strategies that may enhance and maintain the normal connections between neurons. The good news is that there are several new strategies on the horizon.

This notion of impairment in the normal plasticity and resilience of the brain is also why psychosocial approaches are an essential component of successful treatment. When they are coupled to the right medicine as well as the strategies that we employ in Integrated Medicine, the effects can often be very gratifying.

The Vagal Path to Compassion

Students of biology or medicine will likely be familiar with one of the largest single nerves in the body, called the vagus or “wandering” nerve. The nerve emerges from the brainstem and is one of the most important contributors to the parasympathetic nervous system, having important effects on the heart, lungs and intestines. The vagus causes the heart to slow, the intestines and kidneys to become more active and the bronchi to constrict. The vagus also has profound effects on metabolism: it has been known for more than a century that stimulating the base of the brain with opiates can cause the release of glucose from the liver, an effect mediated by the vagus. The nerve is also involved in the interaction of the immune system and the brain.

In recent years a technique called vagus nerve stimulation has been found to help some people with intractable epilepsy or treatment resistant depression. Many of the techniques of yogic or Taoist breathing as well as some techniques for inducing altered states of consciousness by eye movements or stimulating specific points on the ears all revolve around vagal stimulation. Some of these techniques have been shown to produce a sustained reduction in blood pressure.

I would like to focus upon the effects of the vagus on the heart. The heart is a physical location of an aspect of our emotional functioning. In Chinese Medicine it is known as the repository of Shen or Spirit. The heart is more than just a pump. It is also an important endocrine gland, and there is some evidence that it is also a sensory organ, with a sophisticated system for receiving and processing information. The neural network within the heart enables it to learn and remember. The heart constantly communicates with the brain, influencing key areas involved in perception, cognition and emotional processing.

You or someone you know may have had a baby. In which case you or they will have had intrauterine cardiac monitoring. Normally the baby’s heart rate varies from minute to minute. Some forty years ago it was discovered that if that variation stopped, it could be a harbinger of doom. Obstetricians knew this, but the rest of medicine forgot about the observation until 1991. Since then there has been enormous interest in the phenomenon of heart rate variability (HRV), because if it is lost, it can be a potent predictor of health problems. HRV reflects the tone in the autonomic nervous system. If this system becomes unbalanced, it can have effects on most of the major organs.

In the Ageless Wisdom the vagus is called our psychic antenna. We all have one, but not all of us have relearned how to use it. Many psychic stressors can produce physical effects via the vagus nerve. When doing acupuncture or energy healing it is very common for the patient to get a slowing of their heart rate and abdominal rumblings, which are sure signs of vagal activity. Psychics often get problems with their intestines while working with people, not from upset, but because they are exercising their skills.

There has been some interesting speculations about the role of the vagus in social behavior. Researchers have found that children with high levels of vagal activity are more resilient, can better handle stress, and get along better with peers than children with lower vagal tone.

There is a project underway at the University of California at Berkeley to see whether the vagus nerve might be the seat of compassion. Dacher Keltner is a professor of psychology and coeditor of Greater Good, a magazine about prosocial behaviors such as compassion and forgiveness. He has been examining the novel hypothesis that the vagus nerve is related to prosocial behavior such as caring for others and connecting with other people.

In his laboratory, Keltner has found that the level of activity in people’s vagus nerve correlates with how warm and friendly they are to other people. Interestingly, it also correlates with how likely they are to report having had a spiritual experience during a six-month follow-up period. Vagal tone is correlated with how much compassion people feel when they are presented with slides showing people in distress, such as starving children or people who are wincing or have a look of suffering on their faces.

Perhaps a key to compassion is to be found in the heart and the face.

Compassion is crucial to our survival. But compassion leavened with wisdom.


“Love and compassion are necessities, not luxuries. Without them humanity cannot survive.”
--The 14th Dalai Llama (a.k.a. Tenzin Gyatso, Tibetan Religious and Political Leader, 1935-)

“Out of compassion I destroy the darkness of their ignorance. From within them I light the lamp of wisdom and dispel all darkness from their lives."
--Bhagavad Gita

True Integrated Medicine

“Our body is a machine for living. It is organized for that, it is its nature. Let life go on in it unhindered and let it defend itself, it will do more than if you paralyze it by encumbering it with remedies.”
--Count Leo Tolstoy (Russian Writer and Philosopher, 1828-1910)

“The cure of the part should not be attempted without treatment of the whole.”
--Plato (Athenian Philosopher, 428-348 B.C.E.)

Have you ever woken up in the morning with a feeling that something’s not quite right, but you couldn’t quite put your finger on it? That is the feeling that we get if something is out of place. Our minds and our brains have evolved with a remarkable ability to pinpoint things in external space: it was once an important survival mechanism. As we became more complex, those same systems began to be able to tell when things were out of place in our internal environment as well as in our relationships. We are social animals and most of the cognitive systems of the brain are designed to aid and abet our social interactions.

The key to health is to have all of our systems working in harmony. It is absolutely true that 70% of human illness is a result behavior born of bad choices. We make those bad choices when we stop listening to our bodies and heeding our hearts.

People love to place us in categories. I am constantly being asked why all my work contains three parts: cutting edge conventional medicine, natural medicine and self-help. I’ve had people in the publishing business say, “Well, is it health OR self-help?” For me, the answer to that is yes!

We cannot attain health and wellness unless we have done some work on ourselves; we cannot heal ourselves and others unless we have something with which to do the healing. If we are fearful, and moving haphazardly through life with little self-control, it is hard to pay attention to your body, mind, relationships, subtle systems or spirituality. A physician too distracted to focus on and respect another person is unlikely to help him or her get better. A therapist without a strong sense of self would find it hard to help a troubled mind, and a spiritual teacher who had no personal experience of the Higher Realms of existence and no clear moral compass, could devastate the spiritual well being of a disciple.

When we talk about Integrated Medicine, people usually assume that we are only talking about integrating different types of treatment. Yet that is only part of it. We are also aiming to integrate the individual: to enable every aspect of the person to be acting in harmony. When all of our systems are in harmony, pulling together in the same direction, when they are listening to each other and communicating with each other, there is a free flow of energy and we achieve a state of coherence.

And it is this coherence that underlies our sense of health and well being.

For coherence is the key to resilience.

“The patient must combat the disease along with the physician.”
--Hippocrates (Greek Physician, c.460 B.C.E.- c.377 B.C.E.)

“Those whose consciousness is unified abandon all attachment to the results of action and attain supreme peace. But those whose desires are fragmented, who are selfishly attached to the results of their work, are bound in everything they do.”
--Bhagavad Gita

Combat Stress

The British Ministry of Defense has announced that it is going to pardon all 306 soldiers shot for cowardice during the First World War.

This is the culmination of a campaign that has been going on for years, after it was discovered that most of these soldiers were actually suffering from “shell shock.” From the historical records it seems highly likely that this was actually post traumatic stress disorder (PTSD). Some people have said that there’s no point in issuing posthumous pardons ninety years after the events.

I don’t agree. It’s virtually impossible for us to imagine the horrors of trench warfare, and I think that it’s important to recognize the terrible psychological consequences of it.

Hospitals in the United States are already beginning to see a great many cases of PTSD from the current conflicts in Iraq and Afghanistan. We know that there are some predictors of who will suffer from PTSD, but that given enough trauma, it can likely happen to anyone.

People Dangerous to Your Health

I found a terrific blog with the title “Warning: Bores and buffoons may endanger your health.”

Our ability to self-regulate is a limited resource that fluctuates markedly, depending on our prior use of willpower, tiredness, stress and our personal resilience.

A new study by a team lead by Professor Eli Finkel of Northwestern University has shown that poor social coordination impairs self-regulation. What does this mean? If you are forced to work or interact with difficult individuals you may be left mentally exhausted and far less able to do anything useful for a significant period of time. In other words, draining social dynamics, in which an individual is trying so hard to regulate his or her behavior, can impair success on subsequent unrelated tasks.

In the research, volunteers were asked to work in pairs to maneuver an icon around a computer maze, with one volunteer giving the instructions, the other moving the joystick. Those operating the joysticks were actors, primed to respond to instructions in slow, stupid, inefficient and generally irritating ways. What was interesting was that the effects were not mediated through participants' conscious processes: they were almost entirely going on below the level of conscious awareness.

There is extensive literature on the consequences of social conflict. But until now, very little research has been conducted on the effects of ineffective social coordination. That has been a big gap in the research literature, particularly given the fact that most of the higher systems in our brains are dedicated to social functions, and since the earliest days of our hunter-gatherer ancestors, tasks requiring social coordination have been the norm. In our day-to-day activities we have to cooperate with other people. Ineffective social coordination consumes a great deal of mental resources and has high costs for subsequent self-regulation. This is so important, because self-regulation is essential to living life well. It is also essential to the existence of a well functioning society.

What to do with this new information?

Identify people who drain you. If you need to work with them, do it in short bursts, and give yourself plenty of time outs.

And continue to build your resilience.

There's also one other piece, that we'll look at another time. Some people may also drain your energy directly. You may have come across "energy" or "psychic vampires." They really do exist, though there is nothing supernatural about them, and they don't have fangs or an aversion to garlic. In another post I'll show you some techniques for dealing with those people as well.

The researchers have done us a great service by putting the entire paper on the departmental website. Access is free.

The Epigenetic Code

In Healing, Meaning and Purpose I reveal some of the extraordinary changes that are occurring in our understanding of genetics and inheritance. Even if you are currently learning genetics in college, it is quite likely that some of what your professors are teaching may already be out of date. I say that with the greatest possible respect: I find that in some of my fields of expertise, I am often having to update my teaching materials every week.

One of the remarkable discoveries that is generating huge amounts of new information is what we call epigenetics. This is the study of a form of inheritance that can occur without fundamental changes in gene sequences. This has to do with the idea that there is a second layer of programming on top of our DNA. A code that can change over our lifetimes in response to environmental change. Diet, hormones, chemicals in the environment, stress and even thought, emotion and behavior, can all change the ways in which our genes are expressed. Some of these epigenetic changes can be passed on to other generations. In other words, there can be an inheritance of acquired characteristics. Something that has been denied for over a century.

Let me give you a simple example. Studies of a particular species of mouse have shown that maternal diet has an effect on the coat color of the offspring. This was the result of what is known as methylation that altered gene expression. These changes in coat color were carried on to the next generation: the grandchildren of the mouse given the special diet. This created quite a stir, because it had been thought that epigenetic changes in cells are erased each time that a cell divides. Obviously that was not happening. We now have many examples of epigenetic changes being passed on to the next generation and the next. There are literally hundreds of scientific papers on the subject.

As I have written before in my last book and CDs, in articles and in reviews at Amazon and elsewhere, the traditional view of genetics has been one of genetic determinism. That we are all little robots whose entire lives are dedicated to nothing more than passing our DNA from one generation to the next. And the genes even dictated how we did that. I still know many gene jockeys who are convinced that the whole of human behavior will ultimately be explained by our genes, and that free will is therefore a myth.

I’m just as sure that they are wrong.

Let me give you an example. Identical twins have identical DNA, yet we have known for fifty years that one twin may get a genetic illness that the other does not. And the brains of identical twins, though they start out identical, quickly become quite different from each other because of the impact of the environment. Twin studies of mental illness have been going on at the Institute of Psychiatry in London since 1960. Every patient coming to the hospital is asked by the clerical staff if he or she is a twin. And there has been groundbreaking research on mentally ill twins at the National Institute of Mental Health for decades. And what have we learned? Though there may be a genetic component in schizophrenia, when we look at people with schizophrenia who have identical twins, only half of the twins have the illness, despite having the same DNA. The key difference is at the epigenetic level.

Marcus Pembrey from the Clinical and Molecular Genetics Unit at the Institute of Child Health, part of University College, London, has been at the forefront of the work on epigenetics. Marcus has had the opportunity to study the unusually detailed historical medical records of the isolated northern Swedish city of Overkalix. He and his colleagues found something astonishing. The grandsons of men who experienced famine during mid-childhood went through puberty earlier and had longer life spans, while the grandsons of men who were well fed in early childhood had an increased likelihood of diabetes. For females, the effect was similar but it was tied to the grandmother, rather than the grandfather. Presumably these responses are designed to adjust our early growth and reproduction to be ready for unpredictable changes adverse events in the environment. I would call this epigenetic resilience.

In a separate study done in Bristol in England, Marcus studied two generations of families, and found that fathers who had started smoking before age 11 had sons who were significantly heavier than average. There was no similar effect on daughters.

There is already some evidence that epigenetic factors may play a role in the development of bipolar disorder and schizophrenia.  Many of us are becoming excited about the potential benefit that may flow from a better understanding of genetic and epigenetic mechanisms in major psychiatric disorders.

There is a new journal called, appropriately, Epigenetics that contains a treasure trove of important information. The editor is Moshe Szyf, form McGill University in Canada, and he recently pointed out that one single gene could have as many as 700 epigenetic programs associated with it.

His own research has linked epigenetic change to social interactions: the way in which we behave toward one another can lead to a change in how our genes operate.

Rats whose mothers groom and lick them when they are young grow up to be much calmer than rats whose mothers neglected them. There is, of course, nothing surprising about that. We all understand the importance of good child rearing. But what was surprising was the finding that epigenetic changes are the cause. By nurturing their young, the rat mothers activated a gene that suppressed the creation of cortisol, one of the stress hormones.

Pups who were neglected did not have that gene activated, so they produced more cortisol and were therefore more stressed out.

Knowing this, the researchers were able to increase the well-nurtured rats' stress by injecting them with methionine, an amino acid commonly found in food supplements.

Here we have proof that the link between food and mood is not just due to transient chemical changes in the neurotransmitters of the brain, but that a chemical in our diet could cause fundamental changes in the way in which our genes work. In this case a rat’s emotions and state of mind. The implications for all of us are extraordinary.

Since 2003, a consortium of public and private firms in Europe has been working on the first Human Epigenome Project (HEP), and it hopes to have completed 10% of the map by the end of this year. As you can see, it is a lot more complicated than mapping the human genome, and epigenetic codes are constantly moving targets. The first reports from HEP have indicated that at least 20% of the genes studied so far can have their behavior modified by the environment. The food that we eat, the chemicals that we ingest and the attitude of our parents and peers can all change the way in which our genes function. As Marcus Pembrey has said, “Child care has a whole new meaning.”

This is all crucially important, because one of our most important discoveries has been that human beings have been undergoing extremely rapid physical as well as psychological and social change, and that is one of the reasons why the Laws of Healing have been changing over the last century.

Beating Burnout

I have been getting a number of requests to re-post some of my materials about burnout.

This is a summary of some of the information that we cover in our corporate wellness seminars. For people who are interested, we have also created a Powerpoint slide set, together with reference materials which are available for purchase from our website.

So let us begin at the beginning and ask:

What is Burnout?
This may seem such an obvious question, since the term “burnout” has become part of everyday language, but it is still the topic of a great deal of research.

The best definition of burnout is “a prolonged response to chronic physical, emotional and interpersonal stressors at work.” It is defined by three dimensions:

1. Exhaustion
2. Cynicism
3. Inefficacy

It is more than just an individual experience of stress: it has to be seen in the larger organizational context of people’s relationship with their work.

It is often the case that individuals miss all the signs in themselves.

So what are the main symptoms of burnout?

1. Worrying, particularly at night
2. Trouble sleeping
3. Feeling unappreciated or “used” at work
4. Feeling less effective or competent than you used to
5. Easily angry or irritated
6. Dread of going to work
7. A feeling of being overwhelmed
8. Recurrent stress-related physical symptoms like headaches, or back pain
9. Watching the clock and counting down toward the end of the work day
10. Rigidly applying riles without considering more creative solutions
11. Automatically expressing negative attitudes
12. Finding excuses to be absent from work
13. Alcohol or substance abuse

We need to ask questions about conditions at work. For instance whether individuals are asked to work extra long shifts, go without breaks and lack clear guidelines.

Who is at greatest risk?
Helping professionals and people who have great responsibility for others, such as  airline pilots and air traffic controllers.

Although there are some psychological predictors for who are more likely to suffer from burnout, with enough stressors just about anyone can become a victim of it. Some people have claimed that burnout is a physical illness resulting from exhaustion of the adrenal glands, but the research doesn’t show that. Burnout is primarily a problem of the system in which you work, interacting with your body and your mind. So now let’s look at how to transform yourself from victim to victor.

The major risk factors are:

1. Feeling powerless
2. Being caught in conflict
3. Having inadequate information
4. Lack of central visions
5. Incoordination of the team
6. Overload
7. Boredom
8. Alienation
9. Ambiguity
10. Conflict of values

What are the Solutions?
Dealing with burnout needs the help of all workers and the organization as a whole. Sometimes it also needs the help of an outsider. I was once working in a very unhappy place, in the days long before I realized that I had the power to change things myself. A psychologist friend working in the then new field of systems theory, told me that the problem was not with individuals, but that the whole system was “sick” and disorganized and what was needed was a system overhaul.

The opposite of job burnout is job engagement. If you feel that you are engaged in doing something valuable, for which you are appreciated, you are far more likely to have a satisfying life and enjoy doing your job well. There is good evidence that participation, engagement and autonomy are powerful predictors of health outcomes.

First, at the personal level:

The keys to preventing burnout are represented by the acronym REAP:

Resilience
Engagement
Autonomy
Participation

1. Evaluate your personal goals and priorities: what do you really want to get out of life, and even more importantly, what do you want to put in to life
2. Ensure that you have established your own core values, your purpose and your meaning. (My book and CD series Healing, Meaning and Purpose spends a lot of time on helping you do exactly that.)
3. Attend to your own health, through exercise, nutrition and sleep. (I have worked with countless individuals with burnout, whose problems largely evaporated once they were diverted from the coffee, soda and snack machines. Remember the close relationships between food and mood.)
4. Make sure that you have some outside interests. Not just things that further drain your energy, but something that you enjoy.
5. Learn some specific stress reduction techniques. (I also have some suggestions for doing so in my book.)
6. Are you a micromanager who has to do everything yourself? If so, then it is a really good idea to learn to delegate. And don’t take on responsibilities that are not yours. (It took me years to learn that one: I was such a slave to perfectionism, that I always thought that I had to everything myself. Bad mistake)
7. If your find yourself expressing negativity, work on substituting a positive word for every negative one.
8. Learn to forgive yourself if things are not going well, and use reversals as the fuel to power you to achievement: it’s what I call “silver-lining:” How to find the positive in any negative situation.
9. Try to form a support group or see if you can arrange for an outsider to some in and help you.
10. Are there some specific skills that you need to build and develop?
11. Can you tailor or change your job?
12. Develop detachment

Second, at the organizational level:

1. Evaluate overall work performance: if it declining, it may be an early sign that staff members are being afflicted by burnout.
2. Consider changes in managerial practices, to move away from the dominator to a partnership model.
3. Research has indicated that there are six key areas in which mismatches may lead to burnout: workload; personal control; appropriateness of rewards; sense of connection; sense of fairness and a conflict of values. So it is a good idea to break down any analyses and interventions along these lines.
4. All the evidence suggests that a combination of managerial change and education are the best way to head off and to deal with burnout.
5. There is also some research showing that a values-based spiritual program to prevent and deal with burnout. The recommendations include a short time for silence, visualization, reflection, active listening, appreciation creativity and playfulness.

What is very clear is that burnout is not just a personal problem; it is something that can affect an entire organization, and has to be tackled as an organization. If it is not, then in these difficult times in health care, we are going to have ever more tired and disillusioned people trying to care for sicker and sicker patients, and just not having the resources to do so.

Transcending Overload and Burnout
There is an important notion that is rarely even talked about. Why does stress and burnout exist? Is it simply bad overloaded wiring in the brain and bad overloaded wiring in our relationships and in our places of work? Well, yes, that is of course correct. But there is also something else: burnout occurs because multiple sets of systems are failing. Nature abhors a vacuum, so from the ashes of these failed systems a new and improved you can emerge. Remember the ancient story of the Phoenix that emerges from the flames. And you might know the statement by Richard Bach: “What the caterpillar calls the end of the world, the master calls a butterfly.”

We need to discard broken systems so that our true self can emerge.

I would like you to think about burnout as a state of consciousness that you are ready to outgrow. You can practice the psychological band-aids, or you can accept the invitation to grow.

There will inevitably be some transition pains, but that is to be expected as the new you is being born. This is also a good time to do an exercise that I recommend in Healing, Meaning and Purpose, and it is to establish where each part of you - Physical, Psychological, Social, Subtle and Spiritual – lies in terms of the Memes of Spiral Dynamics. If you do this exercise every few months, and at times of transition, it can provide powerful proof that the burnout is actually presenting you with a unique opportunity to grow.

Artificial Light and the Biological Clock

Many of the things that we do to babies and young children have been called into question in recent years.

The debate about doing an excessive number of fetal ultrasounds and high tone deafness seems to have gone away for now. Though not disappeared: there is a paper in the week's Proceedings of the National Academy of Sciences that revisits this important issue. Then there was the realization that doctors were not good at recognizing and dealing with pain in very young children.

And now there is another one that has worried me for years: what happens to babies who are exposed to constant high levels of light? Doesn't it damage the development of normal circadian rhythms?

I have just seen a study that seems to confirm some of those fears.

Investigators from Vanderbilt University in Nashville examined the impact of exposing babt mice to constant light. The main biological clock is in the brain, and is located in a region called  the suprachiasmatic nuclei (SCN). It is responsible for orchestrating an orderly internal physiological and behavioral cycle. It influences the activity of virtually all our organs, including the brain, heart, liver and lungs. It egulates the daily activity cycles that we call circadian rhythms.

When the mice are exposed to normal variations in light the cells of the SCN quickly become synchronized, and a normal circadian rhythm is established. Constant exposure to light disrupted the development of the SCN and prevented the animals from developing normal circadian rhythms.

This is far from being an academic exercise: each year around 14 million premature babies are born worldwide, and many are exposed to artificial lighting in hospitals. If their biological clocks are not allowed to develop normally, we would anticipate that they would, in later life, have less psychological resilience, and to be prediposed to sleep and mood disorders.

I could conceive of a way to test that experimentally by looking at records of people wth those problems. Secondly, we need to see if reducing unnecessary light exposure would have a real benefit for babies, and for the children and audlts that they will become. I would be astonished if exposing babies to a natural spectrum of light and a natural light cycle did  not have enormous benefits for them as they grow up.

Friendship and Psychological Distress

“To lose a friend is the greatest of all losses.”
Publilius Syrus (Syrian-born Latin Writer, 1st Century B.C.E.)

Severe and persistent mental illnesses are one thing, but there are many, many more people who are miserable and unhappy, without that unhappiness necessarily getting to the level of an “illness.” The offices of primary care physicians and therapists are full of people in genuine distress for all kinds of reasons.

I first began to think about this many years ago when a woman came to see me and promptly announced, “I’ve come for psychotherapy. I’ve been in therapy for seventeen years, and I want some more.” I wasn’t being in the slightest bit flippant when I responded by asking her if, after seventeen years, she really felt that it had offered her anything? She looked at me blankly, and it soon became very clear that what she needed was not more therapy, but a friend to talk to.

There has been another puzzle: why is it that women are more likely to develop depression than men? The most profound gender difference in mood disorders begins to emerge after puberty, so it would be easy to attribute it all to hormones. But that would be a mistake.

I recently pointed out that there are some fundamental differences in the ways in which men and women interact: women tending to be more relational and men tending to be more transactional. The female sense of self tends to be more entangled with her relationships, while a man’s self-worth and sense of self is more often associated with his achievements. Most of these differences begin to emerge in early puberty: when girls talk to their friends, their conversation tends to be more emotional and to be concerned primarily with relationships, while boys tend to be more reserved and to discuss facts, statistics and achievements. There is some evidence from research in different cultures that these different styles seem to be the norm throughout the world. Yes, there are of course plenty of people of both genders who behave differently, and so it is more accurate to relate these differences to the male and female factor or essence, rather than getting it confused with anatomical differences.

Emotional language tends to put more strain on a relationship, and it is well-recognized that girls’ relationships turn over much more rapidly than boys’ ones. An interesting hypothesis proposed some years ago by Professor Sir David Goldberg, is that this high turnover in relationships may lead girls to experience more disappointing experiences in their social networks, and it is this string of disappointments that predisposes young women to depression.

A happy, healthy, dynamic network of friends is a cornerstone of developing and maintaining psychological resilience. Without them you become progressively more vulnerable to the reversals that affect all of us from time to time.

“A friend might well be reckoned the masterpiece of nature.”
--Ralph Waldo Emerson (American Poet and Essayist, 1803-1882)

“To know how to live in a brotherly way with those around us is to be rich, for each of us, with our face, eyes, voice and thoughts, contributes something alive, something warm, which nourishes everyone.”
Omraam Mikhaël Aïvanhov (Bulgarian Spiritual Master, 1900-1986)

Social Supports, Sense of Coherence and Recovering from Depression

After writing about the importance of trying to establish a personal sense of coherence, I was just able to look at an important piece of research.

The authors are from Sweden, a country in which, from my experience, there is still a great deal of social cohesion, despite all the experiments that have been going on there in recent years.

So unlike countries in which there are terrible social supports for everyone, they had the opportunity to study the good and the bad.

Though only a small study, the conclusions are unsurprising but important. They were looking at people with a first episode of major depression, and 71% of the patients had recovered at follow up.

The sense of coherence scores were low at baseline, although the patients who recovered significantly increased their sense of coherence. Another factor of importance for recovery was a significant increase in social support.

It is intuitively obvious that social support is an important part of the restoration of a person's sense of coherence. It can be used in interventions that include the patient's family or close social network in combination with support to assist the patient to view his/her situation as comprehensible, manageable, and meaningful, thereby promoting or improving health.

The bottom line: professionals need to identify people's strengths and weaknesses so that the support and interventions provided can be tailored to meet the needs of each individual.

And one of the best ways of staying healthy is to maintain your social supports, to provide them for other people, and to work on increasing your own sense of coherence.

Resilience, Misfortune, and Mortality

Much of the development of the ideas of Integrated Medicine has been driven by the idea that a truly effective holistic medicine does not simply integrate different modalities to achieve health and wellness, but is also aimed at integrating all the different aspects of a person into a coherent whole. That was the real reason for choosing the term “Integrated” medicine in the United Kingdom, though “Integrative” and “Integral” medicine are ultimately all aiming for the same thing.

This is quite different from simply adding some acupuncture, an herb or some relaxation therapy to a conventional medical program. Its aim is not so much getting someone better, as to give the whole person – physical, psychological, social, subtle and spiritual - what he or she needs to be able to get themselves back on an even keel, so as to be able to deal with future challenges as they arise. And not just deal with them, but to use challenges as springboards to growth and development.

The whole idea of this system of medicine included an extra dimension that had often been left out: the interaction between the person in trouble and the practitioner. We are social animals, but even more than that it looks as if we are highly interconnected from cell to soul. We have to take into account the impact of a therapeutic interaction on the clinician, as well as the influence of the clinician’s psychological, subtle and spiritual makeup on the individual.

The development of this system of medicine had many parents. One was the American-born Israeli sociologist Professor Aaron Antonovsky who first generated the idea of salutogenesis: the study of the factors that support human health and wellness. He was one of the first to show that people who were relatively unstressed were far more likely to be able to resist illness, compared with stressed people. His interest was not just in what causes disease, but what are the roots of health.

He returned to and discussed, developed and applied an idea that had been around since the work of Sigmund Freud and Roberto Assagioli: that was that our experience of well-being constitutes a Sense of Coherence (SOC). He defined the sense of coherence like this:

"A global orientation that expresses the extent to which one has a pervasive, enduring though dynamic feeling of confidence that one's internal and external environments are predictable and that there is a high probability that things will work out as well as can reasonably be expected."

Two recent studies seem to indicate that this concept of coherence is fundamentally correct.

Researchers in Cambridge in the United Kingdom have reported a population-based cohort of 20,921 men and women completed a postal assessment of their lifetime experience of specific adverse events and a measure of their sense of coherence. Those with a weak SOC reported significantly slower adaptation to the adverse effects of life experiences, compared with those with a string SOC, and were more likely to die prematurely. Although the size of the effect was not large, the results suggest that SOC is a potential marker of an individual's adaptive capacity to deal with social stress, which is predictive of mortality

The second study was a systematic review from Finland. I like the way in which the study was done, and it came to this conclusion:

“SOC seems to be a health promoting resource, which strengthens resilience and develops a positive subjective state of health. Salutogenesis is a valuable approach for health promotion.”

So what does this mean for you?

Developing a sense of coherence is a most critical factor in creating and maintaining robust health and ability to adapt to change, be it in health, stress, your relationship or at work.

How do you do that? Healing, Meaning and Purpose spends over a hundred pages or several CDs explaining the most up to date ways of doing exactly that using a process known as Creative Self-Integration.

I do hope that you take the opportunity to sample some of the techniques for yourself.

Creativity and Resilience

“No great thing is created suddenly, any more than a bunch of grapes or a fig. If you tell me that you desire a fig, I answer you that there must be time. Let it first blossom, then bear fruit, then ripen.”
--Epictetus (Phrygian-born Greek Stoic Philosopher, c.A.D.55- c.A.D.135)

I have written several articles about resilience, and I have begun to talk about some of the methods for developing psychological resilience and also some of the potential consequences of not developing this essential psychological strength.

I’d also like to share with you another aspect of resilience: it is essential ingredient of creativity and of innovation.

I’ve had a longstanding fascination with the creative process, and one of the most robust findings in the research on extraordinary creative achievement is that even the greatest performers in their fields seem to produce the same ratio of undistinguished works to notable ones through their careers. The great chess player wins more often than the average one, but only sometimes produces a truly great creation. Even the best engineers and scientists conduct many unsuccessful experiments. The stories are legion of artists who produce many paintings and works of music that never win recognition and may not even be much good. Many great actors, directors, cricketers and companies have a great many failures behind – and sometimes in front  - of them.

Amongst the many attributes of the high achiever in each of these fields is a remarkable ability to bounce back, to detach from the apparent failure, to see it as an education, and to understand the importance of persistence and perseverance. To take a risk, to take a step back and to learn and adapt if at first it doesn’t succeed. This never means repeating the same strategies over and over again, it means being smart and not being fazed by failure

“Unless you are willing to try, fail miserable, and try again, success won't happen.”
--Phillip Adams (Australian Broadcaster, Filmmaker, Archaeologist and Satirist, 1939-)

I was once working with a company that had just tried to launch a promising new medicine. The initial effort had been a flop and at the time that I became involved, the company had just fired the entire marketing team. Neither the company nor the recently departed team had had the chance to find out what had gone wrong and how to build something new and different. The new team had to start from scratch and, living in constant fear, was burning out at an astonishing rate. The real problem was the inflexibility of the company that was stifling creative solutions to problems. Once that was fixed, things began to improve very quickly.

If anyone ever says that they and the company never accepts failure, it is laudable but impractical.

It’s different if an enterprise fails because people are not pulling their weight; or failing to meet deadlines; or being overly rigid in interpreting rules or just goofing off. But if everyone is trying to help, learning, and being dynamic and flexible, then it’s best not to send them on their way, but instead to see how we can learn from a failure.

And the key for you personally and the key for your company is to learn to develop personal and corporate resilience. Then creative answers have the chance to start flowing.

“Results! Why, man, I have gotten a lot of results. I know several thousand things that won't work.”
--Thomas Alva Edison (American Inventor, 1847-1931)

“No one succeeds without effort.... Those who succeed owe their success to their perseverance.”
--Ramana Maharshi (Indian Hindu Mystic and Spiritual Teacher, 1879-1950)

Going to College with Attention Deficit Disorder

I’ve recommended www.attitudemag.com before: it always contains a treasure trove of practical tips for people who have or whose family members have attention deficit disorder (ADD) or attention deficit hyperactivity disorder (ADHD).

This month features an interesting article by Marissa Kantor on planning for college. This is a tough time for everyone. The structure of high school and home life are replaced by a far more free wheeling life style where mom and the school teachers are no longer there to act as surrogate frontal lobes. Marissa lists seven essential life skills. Her list is terrific, but I would like to extend it to what I see as the Fifteen Essential Skills that anyone with ADD or ADHD needs to master before he or she can head off to college. The keys to success are organization, stability and resilience.

1.    Learning to manage not just time, but energy: what to do and when, and also how much effort to put into individual tasks: people need to be taught how to use and organizer and how not to lose it!

2.    Having good sleep habits: getting enough and waking up on time: There is more and more evidence that people with ADD and ADHD are prone to sleep disturbances that may increase the risk of a mood or anxiety disorder

3.    Managing money

4.    Taking regular physical exercise is an important aspect of living a balanced life: many people trace their adult inactivity to their college days

5.    Being able to cook simple, nutritious meals

6.    Doing laundry on a regular schedule

7.    Being able to keep track of appointments

8.    Remembering and fulfilling deadlines

9.    Being able to keep on target with academic assignments

10.    Working with teachers, tutors and counselors: who must all be aware that the person has a difficulty which may need some special help

11.    Using medications – or other treatment strategies - appropriately and getting medicines refilled before they run out: we studiously avoid making medication changes during school time, and particularly when exams are looming; another good reason for not stopping and re-starting medicines during vacations

12.    Avoiding the temptations of alcohol, substance abuse and relaxed attitudes toward sex are really important and also the most difficult to achieve: have a look at my article about some of the potentially disastrous consequences of untreated ADD/ADHD; even with treatment, young people are likely to be a least somewhat predisposed to these problems

13.    Maintaining healthy relationships: it is very valuable for young people to learn about the impacts of positive and negative inter-personal relationships before they leave for college. They may well meet toxic people in college, and we can help them identify, void and detach from them

14.    Maintaining a spiritual life can be very helpful to the young person with ADD/ADHD: they may well have had an active spiritual life while at home, and it’s a good thing to encourage some continuing form of spiritual awareness or spiritual practice. Not only is it a stabilizing factor, but it is important for people to be in the habit of thinking about thing outside themselves

15.    ADD/ADHD is not all bad: we don’t want to romanticize a very real difficulty, but before the young person leaves for college it is well worth getting into the habit of seeing that there may be some positive aspects to the illness. Does the person with ADD/ADHD have a particularly entrepreneurial or creative flair, or an affinity with nature or with animals? Consciously thinking about the positives years in advance can pay enormous dividends during the early years in college.

Each of these items could easily fill a whole article. But something for family members to keep in mind is this: ADD/ADHD can be a serious problem that requires serious treatments. It can be a Labor of Hercules to keep young people on track, but remember that if you are a parent, you will likely have some leverage, particularly if you are helping them financially.

Technorati tags:Attention deficit disorder Attention deficit hyperactivity disorder Coping strategies Psychological resilience

Psychological Reslience and Adult Support

Most of us would agree that it is very difficult to try to reduce human behavior to genes alone: one of the most important breakthroughs in our understanding of many genes is the way in which they interact constantly with the environment. This has been known for years with the genes involved in metabolism, but we now also know that the main function of genes in the brain is not to determine behavior, but to predispose us to the way in which we handle the environment.

There is a good discussion of this distinction in a paper posted by someone whom I am sorry to say that I do not know, called R.J. O'Hara, that endorses our point: even if you have genes that could predispose you to a bad long-term outcome, if you had strong, positive support from an adult, it could significantly reduce the impact of "bad" genes.

It leaves us with an important question: how late in life can strong social supports and a positive mental attitude cancel out some of our genetic predispositions?

My answer? "Biology is not destiny, and we can help people make a new start at any age or at any time in life."

Technorati tags: Psychological resilience Genetic predisposition Biology is not destiny

Posttraumatic Stress Disorder, Resilience and the Brain

There has always been a puzzle about posttraumatic stress disorder (PTSD): why do some people get it and others don't? It has always seemed that if the stress was bad enough, and particularly if it was unexpected, then pretty much anyone could get PTSD. But in between the mild stressor that makes one person fall apart and suffer terribly, while others scarcely notice, and the severe trauma that catches almost everyone, is a great unexplained mass of suffering people.

Six years ago research by Tamara Gurvits and her colleagues from the VA in Manchester, New Hampshire first suggested that people with PTSD may have some subtle neurological problems that couldn’t be explained away by alcohol abuse or injury. Now the same group has published a new study that adds significantly to our knowledge about this issue. A study of twins lead the investigators to conclude that the neurological abnormalities predated the PTSD and most likely predisposes patients to it.

The researchers studied 49 pairs of identical male twins in whom one twin had been exposed to combat during the Vietnam War and the other had not.

In 25 pairs the combat-exposed twin had a current diagnosis of PTSD, while the remaining 24 twins did not have the problem.

All the subjects were tested for what we call neurological “soft signs.” This is not a good term, and refers to subtle neurological disturbances, usually involving some complex systems of the brain. They include things like an impaired sense of direction, being able to do rapid, complex motor actions, copying pictures and movements. The combat veterans with PTSD scored higher on the soft signs tests than did the veterans without PTSD. But now it gets interesting: the identical twins of people with PTSD also had high soft sign scores. In other words there appears to a familial vulnerability to developing PTSD. This is consistent with a fascinating new paper on the neurological circuitry involved in fear. We can now map out some of the neurological vulnerabilities involved in PTSD as well as some of the neurological consequences of severe PTSD. Nobody knows if we can reverse them with psychological or other approaches, but we now think it is very possible.

There is a lot more work to be done. But as a first suggestion: someone who has this kind of evidence of vulnerability to PTSD should be the first to get advanced training in developing resilience. We already know that even the most limited efforts to bolster and develop resilience can have marked effects.

The key is to start building your resilience starting today.

“Always plan. It wasn't raining when Noah built the ark.”
--Richard C. Cushing (American Roman Catholic Cardinal, 1895-1970)

Technorati tags: Posttraumatic stress disorders Brain Vietnam veterans Resilience

Stress, Depression and Resilience

“Patience in calamity, mercy in greatness, fortitude in adversity; these are the self-attained perfections of great saints.”
--The Hitopodesa (Sanskrit fable from the Panchatantra, the “Five Chapters,” Translated as the “Good Advice” c.1100 A.D.)

We are all different in the way that we respond to emotional and physical stress. It is not enough to focus on one single reason why one person handles it and another does not. I have often made the point that we need to consider the physical, psychological, social, subtle and spiritual contributions to any illness or challenge.

New research is shedding light on the interaction between two of these: genes and environment. A multinational research effort assessed the impact of stressor on mood in 275 pairs of female twins. 170 sets of twins were identical: they have exactly the same genetic makeup.

The research indicates that only 12% of individual differences in reactions to stress can be attributed to genetic influences. This is stunning, and should have been reported far more widely: 88% of the differences in the way a person reacts to stress are not genetic, but personal and environmental. This is of great importance in problems such as depression. If genetic factors play such a small role, then paying attention to the development of personal resilience - as well as dealing with social factors – is more likely to be effective than anything else. And, as has been discussed elsewhere one of the ways in which some medicines help people with depression, bipolar disorder and schizophrenia is probably by increasing their resilience.

I have already started showing you some of the techniques for improving psychological resilience and in a future publication we are also going to start work on physical, subtle and spiritual resilience and how to develop more resilient and dynamic relationships.

"Never allow anyone to rain on your parade and thus cast a pall of gloom and defeat on the entire day. Remember that no talent, no self-denial, no brains, no character, are required to set up in the faultfinding business. Nothing external can have any power over you unless you permit it. Your time is too precious to be sacrificed in wasted days combating the menial forces of hate, jealously, and envy. Guard your fragile life carefully. Only God can shape a flower, but any foolish child can pull it to pieces."
--Og Mandino (American Motivational Speaker and Author, 1923-1996)

Technorati tags: Resilience Depression Stress Environment Genetics

Re-Writing Our Life Stories and Developing Resilience

“Every man’s story is important, eternal and sacred.”
--Herman Hesse (German-born Swiss Novelist, Poet and, in 1946, Winner of the Nobel Prize for Literature, 1877-1962)

In Healing, Meaning and Purpose, I spend a lot of time discussing the nature of memory – that it does not work like a video recorder, but is a dynamic process – and the value of re-writing your life story. This is a remarkably powerful technique.

What is particularly interesting and useful is to uncover events in our lives that have had two characteristics. First, is that they had a strong subjective impact. And second, that they generated meaning. Breaking up with a partner might generate a lot of emotion and lead you to believe that you are not good in relationships or it could make you think that the other person didn’t appreciate you. Losing a game of football may be painful, but will likely not generate much meaning. Unless your team is on a thirty game losing streak….

A recent study from Quebec published in the Journal of Personality, studied events that we use to define ourselves. Researchers looked at the subjective impact and the meaning-making effect of these self-defining events. This is what they found. When we remember events in our lives that we feel had a major impact on our life story or on our sense of identity, we tend to downplay the negative and emphasize the positive.

When we are asked to think back to those events, we tend to report less sadness and more pride than we actually felt at the time. For positive memories, people reported equally intense positive emotions – for example love - and less negative emotions – such as fear - compared with how they recalled feeling at the time.

What this means is that in the face of change, adversity and opportunity, we are always trying to maintain a positive and coherent sense of self. This is a component of psychological resilience. Someone with clinical depression loses the ability to maintain this positive and coherent sense of self.

This work is also important for people trying to fashion a more positive view of him or herself. While it is usually a good idea to cultivate a positive mental attitude, there are some people for whom such an approach can be disastrous: they are the ones who thrive on negativity. Which one are you?

Simply deciding to change your view of yourself will likely have only a very short-term effect unless you identify and work with cardinal life events. Some forms of psychotherapy revolve around trying to identify the key events that have fashioned our sense of self and that have contributed to our identity. You can begin that process for yourself.

But that is only one part of the equation.

Any long-term change will also involve the attitudes and expectations of other people: none of us lives in a vacuum. I have known countless supremely self-confident musicians, artists and even scientists, whose careers have never got started, because nobody agreed with their evaluation of themselves.

There are a number of ways of presenting yourself in a way that will inspire confidence in other people, and I shall discuss some of those in one of my future programs.

“Every story can be told in different ways.”
--Greek Proverb

Technorati tags: Memory Resilience Story

Revisiting Resilience

“I don't measure a man's success by how high he climbs, but how high he bounces when he hits bottom.”
--General George S. Patton (American General, 1885-1945)

Resilience is the process of being able to adapt and to thrive in the face of adversity, stress, trauma, tragedy or threats. A resilient person is les likely to succumb to any of these life events and is less likely to develop mental illness. But resilience is more than a passive strength or resistance to the slings and arrows of outrageous fortune: it is a dynamic capacity that not only protects us, but enables us to turn adversity into strength and an opportunity for growth.

Despite our extraordinary health care system and a multi-billion dollar antidepressant industry, the rates of depression are increasing throughout the Western world. A recent book has suggested that boredom was unknown before about 1760: the beginning of the Industrial Revolution. All this tells us that something is seriously wrong with our resilience.

“The measure of a man is the way he bears up under misfortune.”
--Plutarch (Greek Biographer and Priest to the Oracle at Delphi, A.D. 46-c.120)

In Healing, Meaning and Purpose, I pointed out some of the incredible changes that have taken place over the last one hundred years, and their impact on health. To try and apply the principles of the past to the problems of the present and future is unlikely to be crowned with success. We need to adapt. Buddhists do not normally eat meat. Except for Tibetan Buddhists, who need to eat some meat in order to survive at the high altitudes of the Himalayas. I have a good friend who created the finest integrated medicine clinic in the world, the Hale Clinic in London. Normally an abstemious vegetarian, when she was embroiled in business meetings, she would often take some meat to remain grounded. I have done the same thing myself for years. I prefer not to eat meat. I have not had a steak in more than thirty years. But if I am to do a lot of traveling and need to work with politicians and business people, a bit of chopped up fish or poultry can be essential.

The changes in our lifestyles over the past century have dramatically reduced the level of physical activity necessary to provide life's basic resources: our effort-based rewards that are intimately involved in the regulation of mood. If you think about it for a moment, if your great-grandparents wanted to eat, there was probably a lot of effort involved. Our brains still contain a huge number of circuits that evolved to play roles in sustaining the kind of continuous effort that would be critical for the acquisition of resources such as food, water and shelter. So what happens when we suddenly on longer need much physical activity to obtain those resources? What happens to those parts of the brain that have millions of years evolving? There will be reduced activation of those brain regions essential for reward, pleasure, salience, motivation, problem-solving, and effective coping strategies. The practical consequence of that is that these systems will not sit there idling: if under-stimulated, since these systems are so heavily involved with our emotions, we would expect to see people becoming depressed. And we know that depression has been increasing throughout the Western world. Of course, many people need to stimulate these regions of the brain artificially, as with drugs, pornography or extreme sports.

Effort-based rewards are an essential component of resilience to life's stressful challenges. Purposeful physical activity is important in the maintenance of mental health. It therefore makes sense to put more emphasis on preventative behavioral and cognitive life strategies, rather than relying solely on psychopharmacological strategies. Our strategy is geared toward protecting people from developing depression, and compensatory behaviors. One of the very interesting new ideas in pharmacology is that antidepressants and antipsychotics may act to enhance resilience at both the cellular level and in the whole person. This is a very different concept from thinking of medicines as chemicals that simply block symptoms.

Our aim is to improve resilience and gradually to increase activation of all those under-used systems of the brain to treat and then to prevent problems. All the things that mother always said were good for you: healthy exercise, meditation, a balanced diet, charity and kindness, and actions aimed at fulfilling your personal and Higher Purpose have already been shown to treat and to protect.

Here are some proven methods for improving resilience:
1.    Learn to be adaptable: the heart of resilience is the ability to take things in your stride and to be able to surf the ocean of change, rather than trying to hold the hold it back.

2.    Be aware of the blockages in your mind or in the subtle systems of your body that are preventing you from bouncing back form adversity

3.    Attitude: avoid seeing a challenge as an insurmountable problem

4.    Accept that change is part of life: you can do little about it, but you can do a great deal about how you react to change

5.    Ensure that you have meaningful goals that are consistent with your core desires and beliefs, and that you are moving toward them

6.    Do all that you can to work on establishing your own Purpose in life. You can create a purpose for your life, but also be aware that there is a Higher Purpose in you life

7.    Take decisive actions: even if the first action may not be the best one. Any action is usually better than denying that problems exist, and hoping that they will evaporate while you are asleep or watching television

8.    Develop and maintain close relationships. Even if you are not a sociable person, relationships are one of the most potent way of protecting yourself from life’s ups and downs

9.    Look for opportunities to learn more about yourself, and how you react to situations. This doesn’t mean becoming an introvert or a rampant narcissist, but it does mean taking a moment each day to review where you are and what you can learn form things that are or have happened in your life. This is a big subject, but there are many good ways to answer the question, “Why is this happening to me  again?” and from preventing habitual problems and routine self-sabotage. (I shall be publishing an eBook and CD about this crucial topic in the very near future)

10.  Work on developing a positive self-image. I have had some harsh things to say about the excesses of the self-esteem movement, but it has now been replaced by something far more valuable: the science of positive psychology. We have a great deal of empirical data on how to improve a person’s happiness and resilience. Again, we can speak about that some more if you are interested.

11.  Maintain hope for the future. We have done research that has shown that one of the best ways of predicting a positive outcome with major mental illness, or of reducing the risk of recurrent substance abuse is to instill hope. Again, there are techniques for doing this, even when the whole world seems to be against you.

12.  Maintain perspective: do not blow things out of proportion, and remember that this too shall pass.

13.  Take care of yourself, physical, emotionally and spiritually. Listen to yourself: what does your body need? What do you need emotionally? What do you need from a relationship? What do you need spiritually?

14.  Are you giving others what they need from you? If you have a nagging sense that you are not giving a child or a spouse that they need and deserve, it can dramatically reduce you resilience.

15.  Rather than just thinking about and worrying over your problems, or problems that may turn up in the future, get into the habit of thinking of yourself not just as an individual who is going through problems, but as a boundless spiritual being who is learning a lesson.

16.  Never forget to think about the legacy that you are going to leave. Not just to your family, but to the world at large. If you can’t think of one, this is a good time to begin to create one. That is an enormously  powerful perspective on the world and on your problems.

“I am an old man and have had many troubles, most of which never happened.”
--Mark Twain (a.k.a. Samuel Langhorne Clemens, American Humorist, Writer and Lecturer, 1835-1910)

Technorati tags: Resilience Life event Life balance Legacy Stress management

Capacity

There’s a nice article at a website that I like a lot. This one recommends adopting an approach of examining our capacity for work in four different ways: physical, intellectual, emotional, and spiritual.

There are powerful reasons for using multidimensional perspectives to help people not just function at their best, but also to be resilient in the face of adversity. I would like to add two things to this article.

First is an exceedingly useful concept is the “complexity quotient” (CQ), which measures our ability to adapt to changing complexity. It is another way of thinking about a person’s “capacity.” Successful leaders, winning athletes and healthy individuals are extremely flexible and have a high CQ. They can raise their game and adapt quickly. On the other hand, they also have the ability to let go when the pressure is off. After recovering from a mental breakdown, the psychologist Carl Jung was known not only for his remarkable scholarship, but also for his extraordinary ability to relax and to become childlike and to think up all sorts of games for his children. These are signs of a well-rounded, balanced and integrated personality. Sometimes we see people in whom this ability goes haywire, and they overcompensate with drugs, alcohol or risky sexual behavior.

Second, I think that it’s valuable to also add the capacity of your relationships and your energy. Robust, dynamic and supportive relationships can enhance your capacity for work and play, and they buffer you from the slings and arrows of outrageous fortune. We do not usually think about the capacity of the subtle systems of the body, but they are there and very real. Strengthening them with techniques such as breathing, yoga or qigong, can dramatically improve your quality of life and capacity for effectiveness and enjoyment.

Technorati tags: Capacity Complexity quotient Subtle systems Biofield

Happiness and Resilience

For more than two decades, my main focus has been on ways to help people become more resilient to the slings and arrows of outrageous fortune. To enable people to withstand anything that's thrown at them: physically, psychologically, socially and spiritually. And not just to withstand them but to use adversity as the impetus for growth.

Adversity is a fact of life: it cannot be controlled. But we can control how we react to it.

This is such an important concept.

So many people try and make themselves stronger and stronger, yet there will always be something that can overwhelm the most powerful defenses. I knew of two martial artists in Hong Kong who claimed that they could defeat anyone. They were incredibly strong and had exquisite technique.

Which did not help them one bit when some villains shot them from behind by.

I have come across others who have spent their lives eating and exercising and still dying prematurely. What was the problem? They had not learned the arts of resilience, which include adaptability, flow and seemless integration with the Universe.

Over the next few days I am going to introduce you to some of the techniques that we have developed for enhancing psychological and physical resilience, before going on to reveal some of the secrets for strengthening the subtle fields of your body, and how to maintain dynamic relationships, not just with another person, but with your Higher Self.

One of the manifestations of resilience is happiness, so before we start, I would suggest that you try this small test that was published by the BBC by arrangement with Professor Ed Diener, from the University of Illinois who designed it.

Technorati tags: Resilience Happiness Flow Relationships

Climate Change and Your Health

When I hear the continuing arguments about climate change, I often fancy that I can in the far distance hear Nero playing his lyre while Rome burns. In March the BBC reported faster than expected warming of the Antarctic over the last 30 years. This report was based on a paper in the journal Science by a team from the British Antarctic Survey.

Gradual climate change is drawing particular attention in Europe, where the climate is exquisitely dependent on the Gulf Stream. In some places records have been kept for centuries, and there seem to have been genuine changes in a short space of time. A few years ago I was in Stockholm in the week before Christmas, and it was so warm that I was able to walk around in my shirtsleeves. That made it the warmest December in almost 800 years. People notice things like that, and governments and populations are eager to do something before the Arctic is reduced to a puddle.

Even if we are just seeing a natural climatic cycle, the consequences could be disastrous. Leaving aside the obvious matter of a rise in sea level, there is also the impact of global climate change on health. Earlier this year the BBC reported a speech by Professor Paul Hunter from the University of East Anglia in Norwich, to the Society of Applied Microbiology at the Royal Society in London. He pointed out that global warming, with hotter summers and more frequent and heavy rainfall and storms, would create the right conditions for an increase in food poisoning and other gastrointestinal upsets caused by microorganisms.

Global warming could also create conditions favorable for a return of malaria to the United Kingdom. Professor Hunter has published papers on this important topic before. He is no alarmist, and his work underscores the way in which our environment and we are closely interlinked, and even small climatic changes may have major effects on illness.

We could discuss this topic in a great deal of detail. Suffice to say that it is more important than ever for all of us to get into the habit of washing our hands, ensuring the cleanliness of food, and even more so of the water that we use, and that we do all that we can to build our resilience.

There is also another matter of equal importance, and that is the dwindling supply of fresh water around the world. The number of us is growing fast and our water use is growing even faster. A third of the world's population now lives in water-stressed countries, and it is expected that this will rise to two-thirds by the year 2025. The cruelty of the situation is that there is altogether more than enough water available for everyone's basic needs. The water is in the wrong places and much of it is unusable.

The United Nations recommends that people need a minimum of 50 liters of water a day for drinking, washing, cooking and sanitation. Global water consumption rose six-fold between 1900 and 1995 - more than double the rate of population growth - and goes on growing as farming, industry and domestic demand all increase.

As important as quantity is quality - with pollution increasing in some areas, the amount of useable water declines. Each year, more than five million people die from waterborne diseases, which is 10 times the number killed in wars around the globe. Most of the victims are children.

Seventy percent of the water used worldwide is used for agriculture. Much more will be needed if we are to feed the world's growing population, which is predicted to rise from about six billion today to 8.9 billion by 2050. And consumption will further increase as more people expect Western-style lifestyles and diets. Here is a useful statistic: one kilogram of grain-fed beef needs at least 15 cubic meter of water, while a kilo of cereals needs only up to three cubic meters. Many futurists are already predicting that water will become as much of a strategic issue as oil is today, with wars being fought over the water supply.

As of today, we should all start thinking about ways in which we can reduce our own water consumption and make provision to collect and purify water ourselves.

“Everybody talks about the weather but nobody does anything about it.” -- Charles Dudley Warner (American Author, 1829-1900)

Technorati tags: global warming, water, Environment, Climate Change, pollution

Using your Core Values for Rapid Stress Management

“The cyclone derives its powers from a calm center. So does a person.” -- Norman Vincent Peale (American Cleric, Writer and Self-Help Expert, 1898-1993)

As a professional speaker, I often forget that glossophobia - fear of public speaking – is the most common phobia in America today. I have a whole toolkit of techniques that I use for helping people with this problem, but I am always interested in new methods that can work quickly.

A study of 80 UCLA undergraduates published in the journal Psychological Science suggests that taking a few minutes to contemplate your personal values (Click here to take an online assessment of your personal values) in the moments before a tense situation, like making a speech, an examination or a visit to the dentist, can keep stress levels low.

People in the study who affirmed their values before delivering a speech had significantly lower levels of one of the stress hormones – cortisol – than did the control group, and psychological measures also indicated that they were less stressed.

“People can't live with change if there's not a changeless core inside them. The key to the ability to change is a changeless sense of who you are, what you are about and what you value.” --Steven R. Covey (American Author and Businessman, 1932-)

Reaffirming your core values is one of the keys to the development of resilience, and that is what was happening in this study. For anyone who is interested in dealing with fear of public speaking or in developing personal resilience, we shall be putting new articles on my website in the next few days.

“Remain calm, serene, always in command of yourself. You will then find out how easy it is to get along.” --Paramahansa Yogananda (Indian Spiritual Teacher and, in 1920, Founder of the Self-Realization Fellowship, 1893-1952)

Technorati tags: stress, stress management, core values