Newsletter

Below you will find issues 1-3 in consecutive order. Some of the information will be provided additionally via email and some is distributed within the website. The first three issues are mostly theoretical. The goal is to create for you a new perspective of self-care as a daily practice, a perspective that will allow you to reconsider some of your values and views on life and work, especially those inculcated by medical training (e.g., the heavy emphasis on keeping a busy schedule).

There is an ongoing paradigm shift in science as well as in medicine with an increasing focus on preventative care and self-care as a lifestyle. We will present to you the fundamental tenets and practices that make this philosophy the way of the future.

ISSUE 1

Welcome to the Healthy Clinician Newsletter!

Information is the most important resource of the 21st century. Literally, your life depends on it. From nutrition to mental habits to the self-care and wellness practices you adopt, your physical, emotional, and mental health and resilience depend on choices based on quality information.

You are starting a journey that is both informational and transformational. The destination – to be in full control of your lifestyle and health. This will involve learning about facts and practices that will allow you to improve your functionality and well-being by making small changes in your daily routine. It will also involve increasing your self-awareness.

Some important specifics of the medical profession:

  • It is one of the most stressful and exhausting types of work.

  • Most clinicians have an overloaded work schedule.

  • There is a ubiquitous belief that clinicians should care for others first.

  • Clinicians tend to focus on work-related outcomes at the expense of their own basic needs. They often fail to find ways to offset the negative effects of daily stress at the job.  

  • There is lack of a self-care culture among medical professionals. 

Consequently, there is an ongoing epidemic of burnout and job-related stress disorders (compassion fatigue, depression, opioid addiction) in the medical field.

To avoid the hamster wheel that leads to burnout, your main goal is to make self-care a priority in your daily life. Remember, contrary to common belief among clinicians, being constantly under stress is not normal. The effective clinician is the healthy and happy clinician.

Here is how to navigate through the website www.happydoc.info  

First, read the article on Stress and Burnout. It reviews the current stats on job-related stress and the reasons for it.

https://www.happydoc.info/stress-and-burnout

Second, read the article on Happiness. It reviews the two types of well-being and how they relate to our basic human needs.

https://www.happydoc.info/copy-of-stress-and-burnout

Compliment it with the brief article on well-being below. Also, read the articles “The Science of Happiness” by Craig Lambert and “Opening Up to Happiness” by Mark Upstein (both emailed).

Third, read the article on Self-care. It will show you why self-care is called the third leg of medicine (the first two are medication and surgery).

https://www.happydoc.info/copy-of-self-compassion

Fourth, read the first twelve pages of “Positive Psychology”, the Harvard Medical School special report (emailed).

This first issue has a strong theoretical emphasis and requires more reading than usual. It will create for you an interpretative framework for understanding the topics to come. All articles are short (3-6 pages) but it is best if you space them accordingly so each week you have something to read. Taking notes has always been an excellent tool for consolidating new knowledge and turning it into application.

                                                                         

                                                                                                                                                       Stay safe and well,

                                                                                                                                                          Ivan Ivanov, PhD

 

WELL-BEING

Well-being is a positive outcome that is meaningful for people and for many sectors of society, because it tells us that people perceive that their lives are going well. It includes the presence of positive emotions and moods (e.g., contentment, happiness), the absence of negative emotions (e.g., depression, anxiety), satisfaction with life (e.g., gratitude), fulfillment (a meaningful purpose in life) and positive functioning.  In simple terms, well-being can be described as judging life positively and feeling good. Physical well-being (e.g., feeling very healthy and full of energy) is also viewed as critical to overall well-being. Researchers from different disciplines have examined different aspects of well-being that include the following. Our newsletter covers the bolded categories:

  • Physical well-being.

  • Economic well-being.

  • Social well-being.

  • Development and activity.

  • Emotional well-being.

  • Psychological well-being.

  • Life satisfaction.

  • Domain specific satisfaction.

 

Well-being integrates mental health (mind) and physical health (body)

resulting in more holistic approaches to disease prevention and health promotion. 

Results from cross-sectional, longitudinal and experimental studies find that

well-being is associated with:

  1. Self-perceived health.

  2. Longevity.

  3. Healthy behaviors.

  4. Mental and physical illness.

  5. Social connectedness.

  6. Productivity.

Factors in the physical and social environment.

Well-being is associated with numerous health-, job-, family-, and economically-related benefits.8 For example, higher levels of well-being are associated with decreased risk of disease, illness, and injury; better immune functioning; speedier recovery; and increased longevity. Individuals with high levels of well-being are more productive at work and are more likely to contribute to their communities.

Positive emotions—central components of well-being—are not merely the opposite of negative emotions, but are independent dimensions of mental health that can, and should be fostered.

Health is more than the absence of disease; it is a resource that allows people to realize their aspirations, satisfy their needs and to cope with the environment in order to live a long, productive, and fruitful life.

Individual resources for health can include: physical activity, healthful diet, social ties, resiliency, positive emotions, and autonomy. Health promotion activities aimed at strengthening such individual, environmental and social resources may ultimately improve well-being.

“Hedonic” well-being focuses on the “feeling” component of well-being (e.g., happiness) in contrast to “eudaimonic” well-being which focuses on the “thinking” component of well-being (e.g., fulfillment).35 People with high levels of positive emotions, and those who are functioning well psychologically and socially are described by some as having complete mental health, or as “flourishing.” 

Based on 2008 Porter Novelli HealthStyles data.

15% of adults felt calm and peaceful all of the time in the past 30 days.

21% of adults strongly agree that their life has a clear sense of purpose.

Our goal is to inform you of ways to improve these categories.

SOURCE: CDC https://www.cdc.gov/hrqol/wellbeing.htm

 
 
ISSUE 2

WILLPOWER

Today, willpower is more important than ever. Studies show that self-control improves almost every aspect of our lives, including: happiness, health, career success, relationships with others, dealing with stress, conflict and adversity, making money, living longer.

Psychologists define the term “willpower” (or self-control) as your ability to hold back any desire or impulsive actions that will have effects on you in the future. It is the rejection of your instant gratification in order to achieve something better. It is also the ability of a person to stick with thoughts, actions and behavior which can lead to success and improvement.

One thing the science of willpower makes clear is that everyone struggles in some way with temptation, addiction, distraction, and procrastination. These are not individual weaknesses that reveal our personal inadequacies – they are universal experiences and part of the human condition.

On the other hand, people who master self-control succeed in all aspect of life. “Self-control is a better predictor of academic success than intelligence, a stronger determinant of effective leadership than charisma (sorry, Tony Robbins), and more important for marital bliss than empathy (yes, the secret to lasting marriage may be learning how to keep your mouth shut).” “The Willpower Instinct”, Kelly McGonigal

Kelly McGonigal, PhD is a leading researcher in the field of willpower and self-control. She is a health psychologist at Stanford University, and works in “science help”, the industry in which scientists try to break down their research so the average Joe can understand it.

Psychologists describe two ways of thinking that humans possess, parallel with two disparate systems in our brain – the first one is part of our mammalian (emotional) brain whereas the other is part of the prefrontal cortex (the planning and analyzing brain). These are called System 1 (automatic, fast, unconscious) and System 2 (conscious, deliberate, reflective). A great read on the topic is Nobel laureate Daniel Kahneman’s “Thinking: Fast and slow”.

According to scholars, self-control (i.e., willpower) is a function of self-awareness or System 2.  If we can be aware enough to predict what we are going to do before we do it, then we will have opportunity to consider our proposed actions and avoid those that might sabotage us on the way to our goals.

Willpower is not something constant, it is a limited resource that can be depleted. In addition, it varies based on a variety of factors (e.g., sleep, food, other temptations). In other words, our ability to win the conflicting poles – long-term consequences and immediate pleasures varies over time or just even from a moment to moment.

Here are Dr. McGonigal’s three key findings.

  1. Willpower comes in 3 different shapes and sizes.

  2. Your willpower instinct can also be called the pause-and-plan-response.

  3. Don’t let past good behavior be an excuse for present bad behavior.

 

Lesson 1: There are 3 kinds of willpower.

Most people think of willpower as the ability to resist temptations.

However, that’s only one third of the deal. McGonigal puts willpower into 3 distinct categories:

  1. “I won’t” power

  2. “I will” power

  3. “I want” power

“I won’t” power is the willpower you already know:

It’s what you use when you resist that cookie on the conference table,

the urge to watch the next episode of Breaking Bad,

or to swing by McDonald’s on your way home.

Question to ask yourself: Which habit is hurting my health, happiness, and career the most?

This will help you determine what you need to use your “I won’t” power the most for.

Second, there’s “I will” power, the force that helps you do what’s uncomfortable, but important to reach your goals. This is the kind of willpower that allows you to delay gratification now, so you can reap the rewards later.

Question to ask yourself: Which habit should I do every day to reach my goals?

Lastly, there’s “I want” power, the force that allows you to remember your long-term goals when you most need to, i.e. in situations where you need your “I will” power.

Question to ask yourself: What is my one goal that I want to spend a lot more of my time on?

Out of these 3, “I want” power is by far the most powerful. It is not so much about the goal itself, but more about having a strong reason and a clear why for delaying gratification now to succeed in the long term.

Lesson 2: The pause-and-plan response is your biological willpower instinct.

Have you ever felt followed by someone and wanted to just run home as quickly as possible?

That’s your fight-or-flight response, and it’s triggered by stress, for example in dangerous situations, or in our modern world, being afraid to miss a deadline.

There’s an alternate version of this though: the pause-and-plan response. This is a state that can be triggered when you’re facing a willpower challenge and will boost your willpower in that particular moment. Essentially, your goal is to switch from System 1 thinking (automatic, instinctive, unconscious) to System 2 thinking (planned, deliberate, self-reflective).

Instead of heightening your senses and releasing adrenaline, like in the fight-or-flight state, this response allows you to pause and reflect, by shifting your attention to your inner conflict. It gives you that short time buffer you need to make the better decision.

This is your biological willpower instinct, and it can be trained.

However, since willpower is like a muscle,

it does get exhausted over time.

This is why your decisions get worse later in the day.

According to the results of experiments, people who have exerted

too much willpower on one situation will have a hard time in doing

it for the second time. The conclusion based on the experiments is,

he willpower of a person gets tired as well just like a muscle.

 

Some ways to stock up your willpower to the maximum are:

  1. Eating healthy food, especially low-glycemic foods.

  2. Meditating for as little as 11 hours over several sessions.

  3. Exercising regularly.

  4. Getting a good night of quality sleep – every night.

  5. Spending time with someone who has strong willpower.

Lesson 3: Past good behavior can’t be an excuse for present bad behavior.

Let’s say you’re trying to quit added sugar and you do incredibly well all week. You resist the temptation to eat a chocolate bar on Wednesday, you get through your gym workout the day after, and are highly motivated to lose those extra pounds.

So on Sunday, what do you do?

You reward yourself with a cookie, because you’ve done so well.

This is the worst thing you could do.

Giving yourself a reward that drives you away from your long-term goal is counter-productive and not a good strategy to win. As your reward for taking 7 steps forward, you’re taking 1 step back.

The message is to be aware of your attitude, because when you do well, you get lazy.

That doesn’t mean you can’t be proud of your accomplishments, but don’t use your past successes as an excuse to fail today.

How to increase discipline and self-control

Here are some evidence-based micro practices that work.

You have to do these every day for two weeks:

  • Track your eating habits with a journal

  • Sit up straight every day

  • Pay attention to your mood (and negative thoughts)

  • Cut back on sweets

  • Squeeze a handgrip

  • Speak only in full sentences

  • Avoid swearing

Research indicates seven important macro habits that support willpower:

  1. Reduce stress. Stress is the archenemy of willpower and can undermine it completely (see the Stress-reduction module).

  2. Sleep – 7-8 hours of sleep is optimal. Less sleep is perceived by the brain as a major stressor and depletes the limited willpower resources of the prefrontal cortex.

  3. Meditate (see the Mindfulness module). 10-15 min a day has been found to have dramatic positive effects on willpower and a host of other aspects of well-being.

  4. Use affirmations. “I am not doing this” (e.g., I am not eating this…) works much better than “I won’t do this”.

  5. Be present and mindful, with your focus on one thing at a time. Multitasking can be very depleting and it’s an illusion that it saves us time. On the contrary, it fragments and fatigues the brain (uses up our cognitive resources). On the other hand, doing things mindfully and with dedicated attention enhances our brain power and fills up the tank of our willpower.

  6. Eating habits. What you eat can also affect your willpower (see the Nutrition module).

  7. Exercise. Physical activity has a powerful effect on the brain. Regular exercise is one of the main factors for good health, including willpower (see the Physical exercise module).

In several clinical studies, successfully picking up these new habits resulted in an increase in discipline, which in turn lead to more willpower. This is due to you overriding your autopilot behavior, and taking charge. The act of making a conscious effort gets your brain juices flowing and helps you increase willpower.

Exercise 1: Cold shower

Start with 30 seconds of cold water and then turn to hot/warm. When you do that, you tell yourself it’s worth to wait through the period where cold water hits your skin, because you might rinse with warm water afterwards. Once you actually get to the warm water part, it will feel rewarding and you will give yourself the feedback: I did it. I am able to sit out the first part and delay that reward. This trains your willpower and the ability to delay gratification.

Your ability to create a successful life, whatever that means to you, hinges on you being able to trust in yourself. Delaying gratification a little bit every day is like turbocharging that trust.

Exercise 2: Modify your routine

You can have more willpower by exercising self-control and discipline, which are in turn a result of delaying gratification. Remember, self-control comes when you do things mindfully.

Step 1: Pick a habit you already do every day.

Here are some examples, I bet you do most of these daily: getting up and leaving your bed (do not leave bed right after waking up), drinking water (drink a full glass rather than half), brushing your teeth (use your non dominant hand), showering (start with cold), breakfast (try something new), getting dressed (change order).

Step 2: Make it harder to execute by making it more difficult, taking longer or shorter to complete it, or completing it in a better way, which requires you to be more thorough.

Step 3: Do the Spartan version of your habit for 7 days in a row. Do not quit before you reach 7 days in a row.

Step 4: Decide whether you want to keep the Spartan version of your habit, or let it go, and go back to step 1.

 

Techniques to Fight Temptation

Here are 4 techniques that can help resist the temptation of instant gratification:

  • Hide the temptation (put things out of sight, make them not accessible).

  • Delay the temptation: the 10-minute rule. When you have a craving, make yourself wait 10 minutes. After 10 minutes, if you still want it, you can have it, though you may find your craving has subsided by then.

        If you have an "I will" willpower challenge, use the 10 minute rule in reverse. Start the activity and tell                yourself that after 10 minutes you can quit if you want. Assume that the long-term benefit is already                  yours, and ask yourself if you are willing to give it up for instant gratification today.

  • Trick yourself with loss aversion. Assume that the long-term benefit is already yours, and ask yourself if you are willing to give it up for instant gratification today.

  • Pre-commitment, or "burn the ships". For example, buying an expensive annual gym membership could pre-commit you to exercise.

 

When you feel a temptation or craving, follow these 4 steps of acceptance:

1. Notice you are thinking about temptation or feeling a craving.

2. Accept the thought or feeling without judging yourself or trying to suppress it.

3. Realize that thoughts and feelings are not always controllable, but you can choose not to act on them.

4. Remember your goals.

 

Willpower and emotions. Shame is the enemy:

When you give in to a bad habit and you feel shame and remorse, you may fall into the “what the hell” effect. Since you already failed, you’re more likely to give into temptation again. But then you feel even worse which will make it even more likely that you will fail to use self-control again. Luckily, you can break this vicious cycle if you forgive yourself. Self-compassion increases self-control (see the Self-compassion module).

Scholars have found that while the feeling of guilt is usually productive and makes us correct our mistakes, the feeling of shame is always detrimental, leading to avoidant and destructive behavior.

Be aware of these general human tendencies:

-   If you do something good, you will then be more likely to do something bad. You will give yourself permission to give into temptation or a bad habit.

-   We often choose to do the things that make us feel good in the present, even though in doing so we sabotage our long-term goals.

-   Social proof has a big influence on our behavior. We are more likely to do what the people close to us are doing. These can be good or bad behaviors. Thus, the level of self-control of the people around you can influence your own. Poor self-control and high self-control are both contagious.

Hyperopia

While most people have challenges delaying gratification, a few people have the opposite problem and constantly delay pleasure because of a compulsion to work and accomplish things.

Dr. Ran Kivetz, a researcher at Columbia University, calls this condition hyperopia meaning "far-sighted." These future-obsessed workaholics have a hard time enjoying themselves in the present, and must pre-commit to leisure. One way to do this is to reframe leisure as mental and physical restoration to do more work.

ADDITIONAL TIPS FROM WILLPOWER EXPERT LARRY LAW (OPTIONAL)

A study showed that those who said “I will!” were far less determined and motivated to exercise compared to those that asked themselves “Will I?”

  • Willpower is your power of choice. Once you are aware of the choices in every decision that you will make and begin to consciously select what you want to decide on, you will create enough amount of willpower.

  • Be aware of the scenarios or events whenever you feel the lack of choice or you lack the willpower. It would be best to write it down in order for you to remember each situation.

  • Allow yourself to feel good for conquering a part of your big task.

  • Move to the next level when you find yourself successful in accomplishing small tasks. Go to bigger decisions. Make sure that after accomplishing your small task, you need to reflect on it and feel good about it.

 

  • Fight the idea of being lazy. You have to do your best in overcoming habitual procrastination through deciding at this very minute that you are a person who is hard working and capable of doing anything whatever you set your mind into.

  • You have to give attention to the long term benefits from using your willpower.

  • Make sure that you complete the tasks as it comes your way. Waiting for something to transpire in order to relieve you from the tasks will only weaken your mind to thinking that you cannot do what you have to do.

  • Come up with a list of small daily goals that you need to accomplish for the day.

  • Find a way to have fun while accomplishing a task.

  • Be accountable. Create structures that will prevent you from making excuses. Hire a couch, join a group, work with a partner.

  • Create a structure on how to lessen your temptations and distractions gradually.

  • You have finite willpower at the start of the day. Arrange to accomplish the important tasks in the morning while you’re still with a full tank.

  • Remove unnecessary decisions. Prioritize the important ones.

  • Create powerful routines and habits.

  • Start the day with a 60-minute powerful routine in order to achieve emotional, physical, and mental state that will carry you for the rest of the day.

3 ADDITIONAL FACTORS THAT AFFECT WILLPOWER

1. Psychological Pain: Depression, anger, stress and anxiety are negative emotions that cover psychological pain.

According to researchers, psychological pain is the crucial factor that affects your loss of control in all pleasure-seeking behaviors such as drugs, sex, gambling, eating, smoking and drinking.

2. Deprivation. It will increase your power to desire something. Avoid full deprivation and rather use moderation.

3. Availability: If the temptations are not within your reach, willpower is not an issue. It means you need to set-up the environment such as making your house like a desert island. It is crucial that you try your best to distance yourself from the things or situations that attract you. Answer this question, “What are my temptations?”

BREATHING PRACTICES

Taking just a few moments each day to practice some deep breathing exercises can decrease stress, relax your mind, body and can help you sleep better. Breathing correctly is important for your overall well-being.

A review of the available science literature shows that the regular practice of breathing exercise (pranayama) increases parasympathetic tone, decreases sympathetic activity, improves cardiovascular and respiratory functions, decreases the effect of stress and strain on the body and improves physical and mental health.

A 2011 review article in Health Science Journal identifies some of the potential health benefits of deep breathing techniques, particularly for breathing from the diaphragm. 

EVIDENCE-BASED BENEFITS OF SLOW DEEP BREATHING

  • Increases energy level – Due to increased blood flow, we get more oxygen into our blood. Increased oxygen results in increased energy levels.

  • Improves focus.

  • Reduces symptoms of asthma.

  • Improves migraine symptoms.

  • Decreases fatigue.

  • Helps stress management.

  • Reduces blood pressure and hypertension.

  • Improves blood flow – when we take deep breaths, the upward and downward movement of the diaphragm helps remove the toxins from the body promoting better blood flow.

  • Natural painkiller – when you deep breathe, the body releases endorphins, which are the feel good hormones and a natural pain killer created by the body itself.

  • Breathing relaxes mind and body – when you are angry, tensed or scared, your muscles are tightened and your breathing becomes shallow. Your breathing constricts. At this time your body is not getting the amount of oxygen it requires. Long deep breathing reverses this process, allowing your body (and mind) to become calmer. It has been advocated for the treatment of anxiety disorders as it attenuates cardiac autonomic responses.

 

ANECDOTAL BENEFITS OF SLOW DEEP BREATHING

  • Improves posture – believe it or not, bad posture is related to incorrect breathing. If you don’t believe, try it yourself. Try to breathe deeply and notice how your body starts to straighten up during the process.

  • When you fill your lungs with air, this automatically encourages you to straighten up your spine.

  • Reduces inflammation – a lot is said that diseases like cancer only thrive in bodies that are acidic in nature. Deep breathing is said to reduce the acidity in your body, thereby making it alkaline. Stress also increases acidity level in the body. Breathing also reduces stress and thus the acidity.

  • Stimulates the lymphatic system – as our breathing is what moves the lymph, shallow breathing can lead to a sluggish lymphatic system which will not detoxify properly. Deep breathing will help you get the lymph flowing properly so that your body can work more efficiently.

  • Improves digestion - deep breathing supplies more oxygen to all our body parts including our digestive system, thus making it work more efficiently. The increased blood flow due to deep breathing also encourages intestinal action which further improves our overall digestion. In addition, deep breathing results in a calmer nervous system, which in turn also enhances optimal digestion.

HOW THE BREATH CAN REGULATE OUR MIND AND EMOTIONS (Psychology Today Article Summary)

  • Different emotional states are associated with distinct respiration patterns.

  • When we are anxious or afraid, we breathe more quickly and shallowly and when we feet happy, we breathe slowly and fully.

  • We can change how we feel using our breath. If you breathe a certain way, you will start to feel the emotions that correspond to the breathing pattern.

  • Since it is so difficult to "talk" our way out of our feelings, we can learn to "breathe" our way through them.

  • Several studies suggest that controlled yogic breathing has immediate and positive effects on psychological well-being, as well as on physiological markers of well-being, such as blood pressure and heart rate.

  • Within minutes you will feel better and place your body in a significantly healthier state. The long-term effects of a daily breathing practice are even more pronounced. By activating the part of our nervous system associated with “resting and digesting” (the parasympathetic nervous system), breathing practices may “train” the body to be calmer.

  • Regularly practicing breathing exercises lowers one’s level of cortisol.

  • This TEDx talk by Dr. Emma Seppälä, PhD reveals the details of the above research. https://www.youtube.com/watch?v=Uvli7NBUfY4

 

ABDOMINAL (DIAPHRAGMATIC) BREATHING

Our breath is a window into regulating our mind-body. It is an important switch

influencing the communication between brain and body.

It’s sometimes easier to change our breath to relax than to change our thoughts.

When we breathe in, our heart rate goes up. When we exhale, our heart rate goes down.

By having a longer exhalation than inhalation, we can slow our heart rate more,

and we can also stimulate the vagus nerve.

Breathing into our lower belly (abdominal breathing) stimulates the sensory pathways

of the vagus nerve that go directly to our brain,

which has an even more calming effect. Dr. Stephen Porges, an expert in understanding

the vagus nerve, has shown why there is a strong link between the vagus nerve, breath,

and feelings of social safety. Many mind-body techniques naturally stimulate the vagus

nerve, sending our brain those critical safety signals.

Several studies have shown that focused breathing (belly breathing or alternate nostril)

can lower heart rate and blood pressure, improve cognitive abilities, and prevent disease.

How to do it: Breathe in through your nose, allowing the air to fill your lungs.

Let your abdomen expand fully. Then breathe out slowly through your mouth.

Read more about it here:

https://www.healthline.com/health/diaphragmatic-breathing#limitations

This is short TEDx talk by psychologist and founder of The Breathing Class Dr. Belisa Vranich on the importance of belly breathing.

https://www.youtube.com/watch?v=1sgb2cUqFiY

MAKE IT A LIFESTYLE

Lifestyle modifications are universally accepted not only as the first step in the management of hypertension and other health issues but also as a way to prevent them. Research shows that as low as 5 minutes of slow deep breathing a day can dramatically improve your health and well-being.

Tips to get started and to keep going.

  • Do your exercises in the same place every day. Somewhere that’s peaceful and quiet.

  • Don’t worry if you’re not doing it right or enough. This may just cause additional stress.

  • Clear your mind of the things that are stressing you out. Focus instead on the sounds and rhythm of your breathing or the environment around you.

  • Do breathing exercises at least once or twice daily. Try to do them at the same time each day to reinforce the habit.

  • Do these exercises for about 5–20 minutes at a time.

EXERCISES

EXERCISE 1: Breathing for relaxation (evidence-based).

Benefits:

  • reducing anxiety

  • helping a person get to sleep

  • managing cravings

  • controlling or reducing anger responses (strengthens your willpower)

How to practice:

  • empty the lungs of air

  • breathe in quietly through the nose for 4 seconds

  • hold the breath for a count of 7 seconds

  • exhale forcefully through the mouth, pursing the lips and making a “whoosh” sound, for 8 seconds

  • repeat the cycle up to 4-8 times (start with 4 and gradually increase)

Dr. Andrew Weil recommends using the technique at least twice a day to start seeing the benefits sooner. He also suggests that people avoid doing more than four breath cycles in a row until they have more practice with the technique.

A person may feel lightheaded after doing this for the first few times. Therefore, it is advisable to try this technique when sitting or lying down to prevent dizziness.

The total number of seconds that the pattern lasts for is less important than keeping the ratio.

See this video by Dr. Andrew Weil for visual instructions:

https://www.youtube.com/watch?v=gz4G31LGyog&feature=youtu.be

Breathe is a free app for Apple products, which helps people practice the 4-7-8 breathing method. Overall, the app has good reviews from people who have installed it. It also includes a feature to set reminders to use it regularly during the day.

A free app called Prana Breath: Calm & Meditate is available from the Google Play store. It helps users practice breathing cycles and different methods of breathing for relaxation.

EXERCISE 2: Alternate nostril breathing (evidence-based).

Let’s learn more about the ways that oxygen impacts your being through a specific technique called alternate nostril breathing. This kind of practice can restore balance and calm your mind as well as support peace and clarity. You may notice that, at any given time, one nostril is dominant (that is, air flows more smoothly through one nostril and only partially through the other). The dominant nostril alternates throughout the day. Preliminary research suggests that breathing through the right nostril oxygenates the left side of the brain, while breathing through the left nostril oxygenates the right side of the brain. One of the reasons alternate nostril breathing may induce its calming and balancing effects on the mind is that it gently allows for airflow through both nostrils.

Practicing the alternate nostril breathing technique activates your parasympathetic nervous system, calming you down and even lowering your blood pressure. Pay attention to your breath throughout the day and what impacts the way you’re breathing. How does your breath influence your emotions and vice versa? What breathing techniques help you to cultivate calm?

How to practice:

Place the index and middle finger of the right hand on the center of the eyebrow, and place the thumb on the right nostril, and the ring finger and pinky on the left nostril. The left hand rests on the lap, palm facing up. Take a slow deep breath in and, closing the right nostril with your thumb, breathe out through the left nostril. Then take a deep breath in through the left nostril, close the left nostril with your ring finger and pinky at the end of the inhale, and exhale through the right nostril. Take a deep breath in through the right nostril and, closing the right nostril with the thumb, exhale on the left side, and start over. Do this with your eyes closed for about five minutes. Notice the effects on your body and mind.

EXERCISE 3: Sukha pranayama (evidence-based).

This practice can reduce blood pressure and lower heart rate. It produces a balanced state in the body by an increase in parasympathetic activity and a decrease in sympathetic activity. It is highly beneficial for people with hypertension.

It is a simple type of breathing that is done by consciously regulating the inhalation and exhalation to an equal ratio, with internal awareness of the complete breathing process involving all sections of the lungs. This pranayama can be done at the rate of 6 breaths/min by using a timed count of 5 for inhaling and exhaling. Hold for two seconds in between breaths.

The pranayama is done through both nostrils in a calm and regular manner with a conscious effort to use the lower, middle, and upper parts of the lungs in a sequential manner for both inhalation and exhalation. This practice is simple, cost-effective, and may be easily added to your daily self-care routine.

Repeat this for about 10 to 20 minutes and see how you calm down.

EXERCISE 4: Kumbhak pranayamic breathing (evidence-based). This is similar to the alternate nostril breathing.

This exercise is another excellent tool for relaxation and stress reduction through increased parasympathetic activity. It is performed in the following steps:

  1. Close one nostrils (e.g., left nostril) by your thumb and slowly breath in through the opposite nostril while counting 1 to 6 in his mind in 6 seconds.

  2. Close the other nostril by the index finger (now both nostrils closed) and hold your breath for 6 seconds and then open the left nostril to slowly exhale in 6 seconds.

  3. Breathe in through the left nostrils (with right nostrils closed) over a period of 6 seconds and then close the left nostril (now both nostrils closed) and hold his breath for 6 seconds, then open the right nostril and exhale over a period of 6 seconds.

 

These 3 steps completed one breathing cycle, and these cycles were repeated continuously for half an hour (about 40 cycles).

EXERCISE 5: Breathing for anxiety

 

Aimed at lowering anxiety and stress levels, this technique is another quick way to calm yourself. Begin by relaxing your shoulders. Constrict your throat slightly so you can hear your breathing. Use your fingers to cover your eyes and ears. Keep your lips and teeth slightly open and when you exhale, make a slight sound. Repeat this exercise 10 to 12 times.

EXERCISE 6: Breathing for energy

 

Breathe in deeply through your nose. Exhale 20 times in sharp quick bursts through your mouth. Keep your lips shut slightly. A sound may emerge from your mouth when you exhale. 

See the video below for instructions.

This is a TEDx talk by Lucas Rockwood, founder of YOGABODY Naturals, an internationally renowned nutrition, education, and publishing organization. He also founded Absolute Yoga Academy in 2006, one of the top 10 yoga teacher training schools in the world.

https://www.youtube.com/watch?v=_QTJOAI0UoU

This is a short video lesson by Johns Hopkins University that teaches you the 4x4 breathing exercise.

https://www.youtube.com/watch?v=Wemm-i6XHr8

Calm breathe bubble https://www.youtube.com/watch?v=uxayUBd6T7M

You can use this image as a scaffold for your breathing practice.

This is a must see TEDx talk by a doctor (neurologist) who used mindfulness and breath work to overcome burnout and become more functional and successful as a clinician.

https://www.youtube.com/watch?v=slKAFdJ8ZHY

MOTIVATIONAL EMPHASIS (OPTIONAL). This is a TEDx talk by Max Strom who is a global well-being & yoga teacher, speaker, and author, and is known for profoundly inspiring and impacting the lives of his students for over two decades. You may know him from his inspiring books, A Life Worth Breathing, published in five languages, and his recent book, There is No APP for Happiness.

https://www.youtube.com/watch?v=4Lb5L-VEm34

SPIRITUAL EMPHASIS (OPTIONAL). For those of you with spiritual inclination, this is a TEDx talk by writer Christian de la Huerta. There is some overlap with the other talks but there is a unique element of breath as our connection to love, humanity, and spirit.

https://www.youtube.com/watch?v=VLAziEkvUT8

TURMERIC AND CURCUMIN

SCIENTIFIC EVIDENCE: I reviewed three meta-analyses from leading international peer-reviewed journals. There are over 18 000 publications on the health benefits of turmeric/curcumin and 691 clinical trials.

PERSONAL EXPERIENCE: I started using curcumin supplements ten years ago and my chronic knee pain completely disappeared. My dad’s rheumatoid arthritis’ symptoms also subsided significantly.

Turmeric is a flowering plant, Curcuma longa of the ginger family. It is used as a spice and a coloring food compound. Its primary active component is Curcumin. Turmeric is one of the best researched plants with multiple health benefits affecting virtually every organ system in the body. Everyone should have it at home in the form of cooking powder or supplements. These are the reasons why:

BENEFITS:

  • The preventive and therapeutic properties of curcumin are associated with its antioxidant, anti‐inflammatory, anti-bacterial, anti-aging, and anti-cancer properties.

  • Curcumin has protective effects against many chronic diseases. It can modulate gene expression, suppressing certain illnesses such as cancers, arthritis, allergies, atherosclerosis, aging, neurodegenerative disease, hepatic disorders, obesity, diabetes, psoriasis, and autoimmune diseases.

  • Supports immune function.

  • Improves brain health and cognitive function.

  • It is used for preventing and treating Alzheimer’s disease.

  • It has been shown to attenuate oxidative stress.

  • Curcumin can alleviate anxiety symptoms. Furthermore,

  • it can improve depressive symptoms in people with depression.

  • The antidepressant properties of curcumin seem to be based on serotonin and dopamine release as well as on suppressing inflammation (inflammation has been linked to the development of depressive symptoms).

Consumption of turmeric and curcumin is safe and well-tolerated in general.

Curcumin has poor bioavailability owing to its poor absorption, fast metabolism,

and rapid elimination from the body. This problem can be overcome when

curcumin is combined with black pepper.

How much turmeric should you take per day?

Look for dosage between 1000-2,000 mg of turmeric per day.

This dose comes in the form of an extract, which contains much higher

concentrations of curcumin that you’d find in turmeric root powder or food.

Popular turmeric supplements often contain a mixture of 150-250 mg of curcumin

per serving, with the rest of the capsule filled with turmeric root powder.

Any product within this dosing range should be acceptable for daily use.

The best time to take turmeric supplements is morning or evening with food.

Precautions and Adverse Effects

The side effects of turmeric are rare and weak. Keep the following in mind when deciding on whether or not curcumin is right for you.

  • Turmeric is a blood thinner which can increase the risk of bruising or bleeding. Discontinue use of curcumin at least two weeks before any surgery or if you are using anticoagulants.

  • Be extra careful if you’re using turmeric for diabetes as it may cause blood sugar to drop too low.

  • Turmeric may inhibit iron absorption. If you have an iron deficiency, you may want to avoid curcumin.

  • If you are pregnant or breastfeeding, you should not use turmeric. There is not enough reliable evidence to confirm the safety of curcumin during pregnancy.

  • Curcumin may also increase the risk of kidney stone formation and can worsen symptomology associated with gallbladder disease.

  • In a small number of individuals using higher dosages, turmeric may cause stomach pain, nausea, vomiting, diarrhea, allergic reactions, or constipation.

You can find a useful table linking effects from curcumin to supporting studies.

https://examine.com/supplements/curcumin/ (scroll down)

These are two additional articles that offer useful details on the specific

effects of curcumin on various conditions.

https://lyfebotanicals.com/health/turmeric-dosage/

https://foodrevolution.org/blog/health-benefits-of-curcumin/

This page gives you the brands with highest amount of curcumin extract.

https://www.theglassbabybottle.com/highest-amounts-of-curcumin/

CHI MACHINE

 

The Chi Machine is a passive aerobic exercise device, developed and first manufactured in Japan by Skylite Industry company president and engineer, Keiichi Ohashi, in 1988.

In 1927, Katsuzo Nishi created 'The Nishi Health System', a series of six exercises, one of which was the basis for the motion of the modern day Chi Machine. This specific exercise of the body was adopted in the martial art of Aikido and known as "goldfish exercise".

The concept for the original Sun Ancon Chi Machine device came from Japanese scientist Shizuo Inoue, Chairman of Japan's Oxygen Health Association, who studied the effects of oxygenation of the body for 38 years and believed that lack of oxygen in the body is a primary cause of disease.

The Sun Ancon Chi Machine holds US FDA approval as a Class 1 Therapeutic Massager, and is registered as a medical device in Canada, Australia, and Japan

RESEARCH

In 2000, the company contracted with Flinders University in Adelaide,

South Australia to conduct clinical trials focusing on secondary lymphedema

and venous oedema of the legs. Results showed a reduction in test subjects'

weight an average of 1.45 kg (approx.. 3 lbs) in 3 weeks.

The results showed that "After a three-week treatment period there were

statistically significant reductions in total leg volume and fluids,

whole body extracellular fluid, weight and subjective leg symptoms."

BENEFITS

  • Muscle pain relief

  • Increase in local blood circulation and oxygen via gentle motion of the entire body

  • Energy increase

  • Mental focus

  • Stable back support alignment (used lying flat)

  • Promotes lymph drainage

  • Internal massage

  • Relieves fatigue and stress as well as physical and mental tension

  • Promotes deeper, improved breathing, balance of the autonomic nervous system and relaxation

Here is an informative video from The Doctors Show that explains how the machine works and how to use it

https://www.youtube.com/watch?v=YqfQL0CIu0Q 

PERSONAL EXPERIENCE

I’ve been using my Chi Machine for thirteen years and find it very relaxing and in the same time rejuvenating. I use it daily, usually after waking up or before sleep, preferably both. There is definitely a blood circulation effect and tension release.

Although chi machines are not extensively researched,

they are worth giving a try considering that Sun Ancon

gives you a two-week free trial. Here is the company’s website.

https://www.chimachine4u.com/chimachine.html

RECOMMENDATION

There are cheaper options that may be worth giving a try

but make sure you get a machine that provides 140 oscillations

per minute (+/- 5) and that the company has good reputation

and reviews.

HOW TO USE

Start with 3-5 minutes per day and gradually increase to 15-20

minutes. Be sure not to jump right up when you finish

but rather stay on the floor for two minutes and feel every part

of your body. The Chi machine sessions are great for combining

with affirmations, mantras, visualizations, and breathing exercises.

https://www.youtube.com/watch?v=ypp4MiSrA38

ISSUE 3

This issue focuses on three fundamentally important ways to improve your health, well-being, and quality of life. Mindfulness is essentially attention training. Researched extensively for over forty years, it is a set of techniques and attitudes that reduce stress, sharpen your mental skills, and bring presence and joy to your life. 

Gratitude is one of the core elements in the Positive psychology paradigm. Researched for over fifteen years, it is a powerful tool for triggering the relaxation response of the body and putting it into rest, digest, and repair mode. Gratitude and mindfulness go hand in hand since the former requires mindful attention and deliberation.

My review of the Gut and Microbiome research revealed stunning facts that even I was not aware of although I've been taking probiotics and enzymes for years. For example, the genes of our microbiome are 150 times more than our human genes and largely determine their expression. It is more important what microbiome we inherit from our parents than the genes they pass to us. I cannot stress enough the importance of this topic and how instrumental our gut is to every aspect of our physical, emotional and mental health.

 

INSTRUCTIONS

1. Read the articles on Mindfulness and Gratitude on the main page.

2. Open the Mind-Body Exercises module in the Members area and you will find a variety of mindfulness and gratitude practices that you can try.

3. Read the sections (pp. 17-20, 25-29) on Mindfulness and Gratitude in the Positive Psychology Harvard Medical School Special Health Report (emailed).

4. Open the Gut and Microbiome health module and read the materials there.

5. Review the additional articles on Gut and Microbiome health (emailed) in case you want to go more in depth. Some of them are on conditions such as Leaky gut and IBS so you should read them only if they are relevant to your health. The rest of them have some overlapping information so I have put in yellow the relevant parts.

6. Read the article on Probiotics (emailed).