New Year's Resolutions: Discipline vs. Devotion

It's that time of year again. People everywhere are making New Year's Resolutions. I plan to take a different approach in 2010: devotion instead of discipline, as recommended by Bonnie Gintis, DO.

We're all familiar with the discipline approach. In my case, I have tried to regulate my behavior by setting arbitrary rules for myself. Again and again, I embarked on new exercise programs because I thought I should. When I didn’t stick with a new regimen or integrate classes into my routine, I felt guilty and beat myself up for my lack of willpower. As can be expected, behavior modification -- the "carrot and stick" approach -- did not work for me.

Now consider the alternative: devotion to caring for oneself. Gintis (2007) suggests choosing movement based on an “appreciation and desire for health and pleasure” – out of joy instead of out of punishment. Just reading her instruction “to be movement and not simply do exercise” makes me feel lighter and less burdened. This actually sounds fun. I am more likely to be active if it’s fun. Rewards and incentives are forms of external motivation. Real change comes from within. The challenge for me is to let go of arbitrary goals and agendas and to embrace movement experiences with “open-ended hope” (pp. 140-143).

So what will devotion look like for me? Here are some thoughts:
1. Begin each day with gratitude. Count my blessings.
2. Center myself each morning through meditation.
3. Connect with friends and loved ones.
4. Be present. Feel and express emotions.
5. Have fun every day.
6. Move more.
7. Get plenty of rest.

Happy New Year!

Reference
Gintis, B. (2007). Engaging the movement of life: exploring health and embodiment through osteopathy and continuum. Berkeley, CA: North Atlantic Books.

Yes, Virginia, there is a magical elixir... and it starts with "E"

One February, in honor of National Heart Month, I attended a lecture at our local hospital. The cardiologist asked the crowd of mostly seniors, "If I could prescribe one thing that would make you healthier, would you take it?" The crowded nodded excitedly and said, "Yes," without hesitation. Dr. R-- told us that the one thing is... exercise. The crowd was visibly disappointed. We expected to learn about a miracle cure -- the latest statin or some other drug. We wanted a pill. Dr. R-- recognized this and told us that if he could bottle exercise and get people to take it, they would see amazing results. The crowd wasn't buying it.

If you think of disease as a battle to be fought, then exercise is the silver bullet. If you see health as more of a journey, then exercise is one of your tools, like GPS or mapquest.com.

How much exercise do I need?
Many studies have been conducted on the benefits of exercise. Staying with the cardiovascular theme, let's look at the American Heart Association (2007) recommendations.

To promote and maintain health, all healthy adults aged 18 to 65 yr need moderate-intensity aerobic (endurance) physical activity for a minimum of 30 min[utes] on five days each week or vigorous-intensity aerobic physical activity for a minimum of 20 min[utes] on three days each week. Combinations of moderate- and vigorous-intensity activity can be performed to meet this recommendation. For example, a person can meet the recommendation by walking briskly for 30 min twice during the week and then jogging for 20 min on two other days.

Where do I start?
Even combining forms of exercise or breaking it up into increments of 10 minutes apiece can still sound daunting. How do we encourage others -- and ourselves -- to get the exercise that they (we) need? I'm not the first to suggest that exercise has to be FUN. If it's a chore or drudgery, we just won't do it.

What would be fun for you? Dancing, playing in the dirt (gardening), swinging on swings?
Here's an example of how one group encourages people to take the stairs -- by making it fun. As the organizers posted, "We believe that the easiest way to change people's behaviour for the better is by making it fun to do. We call it The fun theory. http://www.thefuntheory.com"
Enjoy!
http://www.youtube.com/watch?v=2lXh2n0aPyw

References:
Haskell, W.L. et al. Physical activity and public health: Updated recommendation for adults from the American College of Sports Medicine and the American Heart Association. Circulation. 2007;116;1081-1093. Originally published online Aug 1, 2007. DOI: 10.1161/CIRCULATIONAHA.107.185649. Retrieved from http://circ.ahajournals.org

http://www.youtube.com/watch?v=2lXh2n0aPyw

Feeling SAD?

Lots of us get the holiday blues. For some, it's more than that. The shorter, darker days can bring on Seasonal Affective Disorder (SAD), a form of seasonal depression.

What should I do if I suspect SAD?
Get more light. Spend time outside when the sun is shining.This will help boost vitamin D levels, also. If it's gloomy outside, consider sitting in front of a full spectrum lamp -- the kind that mimics the sun's light. You can read, draw, knit or do any number of indoor activities while basking in the lamp's glow.
Do not -- I repeat, DO NOT -- use a tanning booth. I spent one winter in sun-deprived Seattle and started "tanning" to get what I thought would be a healthy glow. A few years later, I developed a melanoma. Fortunately, the dermatologist removed it before it could do any serious damage; but, I still have the scar to remind me. Yes, this is anecdotal (n =1); nonetheless, I strongly caution against tanning booths.

What else can I do?
Get some exercise. It is well documented that exercise is an effective treatment for depression and just about anything else you can think of. More about exercise tomorrow. For now, while the sun is shining in the East Bay, take a walk.

What does Healing mean?

What's the difference between curing and healing?

Two Bay Area holistic health experts have opinions.

Which one resonates with you?

Dance pioneer Anna Halprin (2002) made an important distinction between curing and healing:

To “cure” is to physically eliminate a disease… To “heal” is to operate on many dimensions simultaneously, by aiming at attaining a state of emotional, mental, spiritual and physical health. Healing also addresses the psychological dimension and works with belief systems,whether they are life-enhancing or destructive. It is possible, therefore, that a person with a terminal diagnosis may not be cured, but can be healed, and inversely, that someone can be cured, but not healed (p. 15).

Len Saputo, MD (2009) said: “Curing is focused on eliminating symptoms. Genuine healing moves us along toward peak health… of the body, mind, emotion and spirit” (p. 146).

To learn more about their work, check out their web sites.
- Anna Halprin and the Tamalpa Institute, http://www.tamalpa.org/
- Dr. Len Saputo and the Health Medicine Center, http://alternativehealth.com/hmc/

References
Halperin, A. (2002). Returning to health with dance, movement and imagery. Mendocino, CA: LifeRhythm.
Saputo, L. (2009). A return to healing: Radical health care reform and the future of medicine. San Rafael, CA: Origin Press.

Mindfulness-Based Meditation and Stress Management

Mark your calendars: PBS will be running a program on Mindfulness-Based Meditation in the new year. This Emotional Life with Dr. Michael Baime will air January 4-6, 2010.

Based on the work of Jon Kabat-Zinn (1994), “Mindfulness provides a simple but powerful route for getting ourselves unstuck, back into touch with our own wisdom and vitality” (p. 5). Sounds good, doesn't it?

In many ways, this work is responsible for my choosing a path in Holistic Health Education. In 2004 I attended a Mindfulness-Based Stress Reduction class in which we read Kabat-Zinn’s Full Catastrophe Living and learned the basics of meditation. The awareness that I developed has helped me resolve some issues and, ultimately, make a career change.

Mindful meditation can help with stress reduction and pain management, to name just two. The many benefits of this practice are too numerous to mention in a single blog entry. I have a feeling I will return to it again and again.

Is meditation right for you? Check it out and see for yourself. Here's a link to a segment from This Emotional Life:
http://www.youtube.com/watch?v=DdyQ9y5IUck


Reference
Kabat-Zinn, J. (1994). What is mindfulness? Wherever you go, there you are: Mindfulness meditation in everyday life (pp. 3-7). New York, NY: Hyperion.

Type C and Cancer

Scientists believe that we all have cancer cells in our bodies, but only some people develop disease. Why? Who are they? It turns out that many people who have cancer also have Type C personalities.

In his Anticancer book, David Servan-Schreiber (2008) summarized Type C personality traits, which were first reported by Temoshok. Briefly stated, Type Cs are "really nice" people who try to live up to the expectations of others in an attempt to win approval and love, putting their own needs "on the back burner." When this backfires, they may experience chronic stress and feelings of "helplessness, despair and abandonment" (p. 136).

If I'm a really nice person who is under constant stress, am I more likely to develop cancer? Not necessarily. Studies on mice showed that stress alone does not promote the development of cancer. Instead, "it is the persistent perception of helplessness... that affects the body's reaction to disease" (p. 137).

Candace Pert and colleagues (2005) addressed helplessness in a discussion of the effects of emotions on health. Repressed emotions, such as unexpressed grief or anger turned inward, may result in feelings of helplessness, which in turn are correlated with "serious perturbations of the healing system" (p.70). It follows that "emotional expression, disinhibition and self-actualization would strengthen the healing system," and studies support this (p. 71).

What can we do? To me the message is clear. Be authentic. Feel your feelings. Express yourself. Nurture body, mind and spirit.

Interested in learning more? Check out Servan-Schreiber's book, Anticancer: A new way of life, and his blog: http://www.anticancerways.com/


References
Servan-Schreiber, D. (2008). Anticancer: A new way of life. New York, NY: Penguin Group Inc.
Pert, C. Dreher, H. and Ruff, M. (2005). In M. Schlitz and T. Amorok (Eds.). (2005). Consciousness & healing: Integral approaches to mind-body medicine. St. Louis, MO: Elsevier Churchill Livingstone.

We are what we think

Placebos and Nocebos
Our thoughts and beliefs influence our health in powerful ways. We've all heard of the placebo effect: the fact that treatment will work if the patient believes it will. What about the nocebo effect? This is the flip side: a patient will respond poorly to treatment if she thinks she should. For example, someone who is convinced she will die from a heart attack probably will. (Robison & Carrier, 2004, pp 91-94.) The mind and body are linked in ways we may not have realized.

Meaning and Healing
As health educators, we can ask clients (patients) to share their stories. It's important to listen to the meaning that a person dealing with illness shares. We are not telling them what to think or feel, but helping them to inquire and discover for themselves. It's up to them to determine their own meaning for suffering, pain, etc. We are there to support and acknowledge. If you've ever dealt with a serious illness, you know that a strong support system is an important part of the healing process.

My Story
On a Sunday evening in September 2008, I drove myself to the E.R.; I had a nagging pain (dull ache) in my abdomen that wouldn't go away. I had appendicitis but didn't realize it. By the time the surgeon removed my appendix (the next afternoon), it had burst. I spent the next 9 months in and out of hospitals. It seemed as though every time I went off antibiotics for a few weeks and was starting to feel better, the infection would come back. After a 2nd surgery in March 2009, my recovery took hold.

What is the lesson to be learned from my illness? It's not as if I purposely willed myself to be sick. (Who wants to be ill? Not me.) However, this period in my life was a time when I was grossly out of touch with my body. I spent most of my time "in my head," on the computer. I wasn't exercising much, and I missed any early warning signs of a physical problem. I was also "stuck" at work. My personal values of community, making a contribution and learning something new were not being met. I was in the wrong job and I wasn't willing to admit it. Nothing like a life-threatening illness to send a wake-up call: "Pay attention! Change your life or else!"

So what did I learn? Much as I love reading, learning, communicating, I am now aware, at a more visceral level, that I need to nurture all aspects of myself -- body, mind, spirit. Also, I learned that it's possible to reinvent myself at midlife. I am very excited about pursuing a new career in holistic health education.

What is Health? And why blog about it?

Background
In October 2009, I started the master's program in Holistic Health Education (HHE) at John F. Kennedy University in Pleasant Hill, California. I am committed to being proactive about my own health, and I would like to help others be proactive about theirs. The program will prepare me to teach people about wellness, disease prevention and so much more. I look forward to gaining knowledge of holistic health practices, including nutrition and stress management.

What is Health?
As I wrote in my application to JFKU, to me, health is well-being. It is a state when all systems – body, mind and spirit – are functioning fully and well.
Similarly, the World Health Organization (WHO) defines health as “a complete state of physical, mental and social well-being, and not merely the absence of disease or infirmity.”
Health promotion (aka HHE) is not about “pressuring people to change their lifestyle habits but helping them to explore the issues underlying their behavioral struggles.” As health educators, we will be engaged in “creating health... which comes from hope.” (Robison and Carrier, 2004, p. 69)

Why blog?
This blog is a place for me to journal about what I'm learning in class. I am excited to share some “pearls of wisdom” with you, and I look forward to your comments. How do you define health?

Want to learn more?
Visit the American Holistic Health Association, http://ahha.org. Check out the Principles of Holistic Medicine available at http://www.holisticmedicine.org.

References:
WHO (1948). Preamble to the Constitution of the World Health Organization as adopted by the International Health Conference, New York, 19-22 June 1946, and entered into force on 7 April 1948. Available from WHO Web site: http://www.who.int/en/

Robison, J., & Carrier, K. (2004). The Spirit and Science of Holistic Health. Bloominton, IN: Authorhouse.