The Pursuit of Change

– by Lee Smith, Ph.D.

Sometimes those of us who work in health care may feel like we’re professional nags and guilt-trippers. For the rest of us, all of the advice, recommendations, guidance and even threats we hear from our physicians and others undoubtedly are efforts to get us to do healthy things. Notice that a whole industry dedicated to our physical and emotional health has grown over recent years, providing all of the information, inspiration, guidance and guilt imaginable. Self-help books, Dr. Phil, the legion of experts on Oprah, and so many others speak to us about the benefits and relief that are just around the corner, if only we try. And here we are, in this article together right now, yet one more example.

Maybe this mass helping industry is popular simply because many of us find ourselves and other human beings fascinating. But more likely, this is because many of us are uncomfortable, even suffering, in many ways. And the suffering may be overwhelmingly vivid or just a notch from known, but it’s there. Even so, notice that the advice just keeps on coming, and that we keep coming back to browse the advice. Hands up those who have a personal library of self-help books.

I don’t know about you, but personally I couldn’t count the number of times that I’ve heard with great interest some healthy idea about what I might do or ingest, only to let the idea slip away. It’s pretty evident that we consume a lot of written and televised material that is directed to getting us to eat better, exercise more, love more and live well. We’re very interested in feeling better than we are. If we cleanse our colons and mental floss our minds, life will be better. The advice can be great, but “just doing it” is the problem.

Putting the ideas and advice from shows and books and each other into real and sustained action is incredibly difficult for us. There’s a great felt need to change, but doing it is tough. In this regard, the business of change hasn’t changed much.

One stumbling point in the pursuit of change comes from what we might call embedded problems. Nested like Russian Dolls, these are problems that began in the service of another problem. Huh? What I mean here is that one problem, like booze or eating too much or getting angry all the time, may have started because there was some quality of the drinking or eating or anger that was softening temporarily some other problem, such as being stressed out by (quick, what came to mind?). It’s hard to deal with one problem when you’re paying attention to something else.

What to practice? Well, for starters it makes sense to get a hold of what it is that is most important to you. Ask yourself, “What is it that I really want? Why?” I’m deeply serious here. No one can answer those questions for you but you. But here’s the twist. I’m suggesting that you continue asking those questions at different times, over and over again, for many days. Keep drifting back to the questions. Let the questions ‘bug you’. It’ll get complicated and the “answers” will shift and change, but the point is to know more about your patterns of feeling and reaction, the stuff that our stress is usually made up of in the first place.

Seasonal Affective Disorder

– by Lee Smith, Ph.D.

The leaves have turned and dropped, and perhaps our minds and spirits have followed as we say goodbye to yet another (alleged!) summer and gradually slip into winter. There are countless ways in which our minds and bodies change with changes in our environment. One of these is due to the fact that the further north we live the less light we receive through the winter. And the further north you go the greater the number of people in the population who suffer emotionally through the winter.

More serious than the winter distress of Leaf hockey fans, but perhaps just as predictable, is a form of depression called Seasonal Affective Disorder or SAD for short.

SAD includes increases in appetite and weight, more fatigue and sleepiness, problems concentrating, irritability, social avoidance and feelings of anxiety and despair. It sounds a little like our bodies are trying to hibernate. SAD may affect about 9% of us and about 25% more grump through winter with a milder form, the Winter Blues. There is no seasonal variation in other mood disorders such as bipolar disorder or post partum depression.

These general, categorical signs of SAD don’t give us a very vivid sense of what suffering SAD is like, just as a neat list of salmonella symptoms doesn’t touch the actual experience. Our experience of anything is always unique. Some people feel too withdrawn and flat to be festive through the holiday season, troubled with the question, “Why?” People say they feel “shut down”, “weighed down”, and “bleak”. It’s like living with an extra 50 pounds in your backpack; it quickly feels too hard to function at all and the wish to drop out of everything can take over.

How come? A brain hormone, melatonin, helps regulate our night-and-day rhythms, among many other things. Light may regulate the manufacturing of melatonin through connections from the eye to the pineal gland in the brain. Also, seasonal changes in retinal function are found in people who suffer SAD. People with SAD don’t build melanopsin, a photopigment chemical in our eyes, as effectively, but extra light seems to correct this genetic difference.

So it seems that light is a drug, an external agent that regulates our inner world. Since Dr. Norman Rosenthal first described SAD 25 years ago (his book, Winter Blues, was revised in 2006), light therapy has been shown to be very effective as a treatment. This involves sitting with a light therapy box that provides bright, full spectrum light for 30 – 60 minutes each day. Light in the morning may be best.

A study hot off the presses found that light therapy does only some of the job of addressing SAD. How we feel and think about winter itself plays a big role too. Many people just have a cheerless mental set when it comes to winter. This mental set creates a cold environment inside their head, full of chilly grumbling gloom (“friggin’ snow … I can’t stand this … what’s more miserable?”). Reducing our mental bellyaching and self-criticism significantly helps to relieve SAD.

What to practice? Light therapy is a good way to go. Do a little more research and look into the light boxes that are available on the internet market. Get out for a walk in the light of day, every day if you can. Lift your face to the sky and drink in the light. Definitely get more physically active, even if you don’t like it. And check your mind’s commentary and criticism, because SAD may be one more example of our mind making us miserable.

Attachment: Babies and Bonding

– by Lee Smith, Ph.D.

You were born to connect – we all were. The popularity of Twitter and texting attest to our human appetite for connection.

Before this modern time our forebears were a part of the food chain (very different from being a Costco member), and the cruel and relentless reality was that a baby left unattended was a nice light snack for some other creature. Over the millions of evolving years, any wee natural tendency that supported keeping everyone closer meant better safety and survival, and any genetic basis for that tendency was befriended by natural selection. This genetic basket of tendencies, polished through experience from birth, is so much of what is essentially our humanness.

As babies we were never passive. Nature has preloaded us with lots of different brain programs (thanks, evolution!) that help with bonding. Don’t be fooled by those cute, fuzzy blankets because research shows that newborns are working the room and schmoozing within minutes of birth. If flattery will get us anywhere, and if imitation is the highest form of flattery, then you can bet that babies are shameless flatterers. For example, in one study someone stood over 18 hour old babies and either opened their mouth really wide or stuck their tongue way out. The babies were then videoed for the next 24 hours. You guessed it – the newborns imitated what they had seen. Our baby brains ‘know’.

A bunch of studies have shown that babies prefer their mother’s voices. But the schmoozing keeps going. The cries of newborns have an accent! A recent paper reports that the first vocalizations of newborns show that they’ve been listening and learning from before birth. French newborns cry with a rising melodic pattern, and German newborns more often deliver a falling melody, and these melodies are typical of their ‘resident’ language. This suggests that infants are on to elements of language in the womb, and are ‘wired’ to copycat.

Touch is a building block of bonding. A study in the journal Birth followed 176 mom-baby pairs who had different degrees of contact immediately after birth. They found that two hours or less of skin-to-skin contact immediately after birth (as compared to nursery placement or swaddled contact) made a huge difference up to one year later. One year! Those moms and babies were closer and were just getting along better. That simple, quick and early contact during that ‘sensitive period’ is like a super nutrient that gets everything going the right way, right from the outset.

Psychiatrist John Bowlby famously observed in the 1950s that babies were messed up by a separation from mom. Before then, babies were separated from their mothers during a hospitalization just as we leave our cars for service, to be picked up later. Not so hot for a developing self.

Our humanness is shaped by our human connections. The infant-parent bond that begins before birth is our signing on to something like an intense university education with diaper breaks and frequent naps. The course work is all about you and what it means to be human, and the quality of your education is desperately tied to the health and history of your teachers, Mom and Dad, and anyone else who’s there. Decades of research loudly declare that our mental health and emotional intelligence are profoundly influenced from birth by the quality of our relationships with mom and dad. The first year of life greatly predicts the physical, psychological and social roads we go down. The bond, the attachment, is nature’s kitchen, preparing a self.

Imitation, connection, touch – it’s all about love and attention. It turns out that it’s just nature’s way. We’ll come back to this in future articles to look at why attachment and quality parenting matter.

The Importance of Sleep

– by Lee Smith, Ph.D.

Your word for the day is ‘soporific’ , meaning ‘something that causes sleep’. If this column is a soporific for you I’m not offended in the least, because sleep is important and my only intention here is to be helpful. You see, sleep and your brain and your health are intimately linked.

We think of sleep as a kind of shutting down, the opposite of being active. But when we sleep the boss of the show, our brain, is doing anything but sleeping while it’s busy, er, sleeping. Brain recordings during sleep show many distinct types of activity throughout the brain, the most pronounced being the 90 minute see-saw shift between the rapid eye movement (REM) stage and the non-REM stage. This activity is like a continuous 90 minute wave at the home of the Blue Jays, but with lots of other busyness going on at the same time.

Sleep is commonly disturbed by conditions such as pain, depression, bullying, stress and anxiety, by drug and alcohol consumption, trauma and many medical illnesses, making things even more difficult for us.

We might feel like sleep is a soft luxury that we can do without, something that some teens treat like a rented mule. But there’s a huge range of bodily and neural processes that depend on sleep which would be beyond the mother of all soporific textbooks to summarize. Here’s a quick survey to highlight the importance of sleep for all of us, from young to old.

The effect of sleep on our well-being starts before we know it. Women who are having sleep problems before they conceive their baby are more likely to have babies with a sleep disturbance. Children with an elevated body mass index may undergo sleep-related changes in hormonal processes that result in yet more fat storage. The possibility that childhood sleep problems may contribute to adult obesity has been noted for quite some time.

Children’s sleep problems may both be caused by and worsen emotional and behavioural problems. Sleep problems in childhood, as in adulthood, may be a sign of unspoken stress, anxiety or depression, or may be a biological marker for the later development of teen substance abuse.

Sleep helps us learn, and learning is crucial to all that we do. We have brain systems to remember what we’ve done, how to do things, for facts, for feelings. Memory first requires that our experiences in life be properly stored, like a book placed in the correct spot at the library, so that we can find it later. Sleep helps this process of learning at those spooky, ‘plastic’ cellular levels, those places that make us who we are. Research shows that sleep helps the brain’s ability to physically change, which is behind the ability to store and learn. Lots of research is showing that, when we sleep less, we are more forgetful and can have more difficulty learning new things. Sleepy people should be put to bed before being asked to make complex decisions, or fly planes.

Long term alcohol abuse harms sleep patterns even after a long period of sobriety.

Better sleep at night reduces that afternoon dip. Older adults experience more fragmented sleep, greater daytime sleepiness and they nap more often than younger adults. Extremes of sleep duration effect immune and inflammatory systems in the body.

There are lots of ways to improve your sleep hygiene and I suggest you continue to educate yourself. Reduce caffeine use – take none after the morning. Avoid napping because it can be like snacking before a meal. Alcohol and nicotine hurt restorative sleep. And establish a regular sleep schedule (brains love rhythms!). Sweet dreams!

Intending to Change

– by Lee Smith, Ph.D.

Guess what? If you apply yourself to practicing juggling there will follow measurable changes in your gray and white brain matter. Truly. Scientists are recording all kinds of ways in which the brain physically changes when we learn anything new. After all, you’re alive, your brain is alive, and your memory and sense of life are alive.

One critical requirement for bringing about change or for developing a skill is to arrange for repetition and then more repetition.

It’s just like getting into better physical condition. Here’s a quiz: Can we get into better physical shape by reading about cycling? Nope. Can we get into better shape by wanting to be in better shape? Nuh uh. Can we get into better physical shape by going to the gym for a week? Hmmm. You get the point. To change our physical condition we have to use our tissue (muscles, lungs, bones) and our tissue dutifully responds. More use becomes more change. And if we’ve been going to the gym frequently for 6 months, can we then stop and remain fit for the rest of our days? You wish! So in this way you can see that physical fitness must actually become a lifestyle in which we keep practicing the activity of exercise over and over and over, always.

Now let’s swap the idea of physical fitness for psychological or emotional fitness (with big acknowledgements to life’s full complexity). In practice we have to reduce this to specific things like better attentiveness or greater patience or changing an addiction or whatever you wish. Here’s the easy truth: We can get better at just about anything that we have the basic potential to do if we practice that ability in the right way, over and over and over and gradually make that practice a part of our lifestyle. For example, there is solid evidence from neuroscience that we can improve our ability to pay attention, to be patient and to love ourselves and others.

Change has to begin with an intention. Once the intention fades you’re back on automatic pilot. The intention is essential and must be preserved and nourished for weeks, months, or always. With an intention we begin to pay attention. As a working example, quitting biting fingernails requires catching yourself in the act or post-act in a friendly way, paying attention over and over again with each nibble. Each time that you pay attention in the moment (and resist lambasting yourself or proposing that it’s hopeless), look at exactly what’s there – perhaps some tension inside, some worry, some boredom, some anger, some physical sensations. As you look you learn (that plastic brain is doing it’s thing), and what you learn are the subtle feelings and thoughts and sensations that are as much a part of the nail biting as the chomping. By repeatedly connecting with the full nail biting landscape, we gradually come to know the nail biting impulse. And with the knowing there develops a sense of having a choice. And there you are! You can begin to regulate your behaviour – your self-regulating brain has done it again!

Neuroscience and clinical research show that complex systems, from our immune system to our emotional well-being, are subject to change. We need not be stuck in depression, anger, shyness and fear. The key is to not surrender your intention because change is truly a live process that takes lots of repetition. Looked at this way, we can practice how we want to live. And take a moment to consider the words of Lao Tzu: “When I let go of what I am, I become what I might be”.