Saturday, December 2, 2023

Life with Chronic Conditions: The Mind and Chronic Health

 


I’ve followed the research of Harvard psychologist Ellen Langer for years now, which shows that how we think impacts our bodies. I believe strongly, this is a big statement, but that virtually all of our problems, whether they are physical, interpersonal, professional, global, the result indirectly or directly of our mindlessness, which means that by these simple changes, we can produce vast improvements in every aspect of our lives. 

 

Essentially, people have been brought up in a world that believes in mind-body dualism. You have a mind, you have a body, then the question is how do you get from this fuzzy thing called a thought to something material called the body? So I look at this and I say, “Oh, they’re just words.” Let’s put mind and body back together. And if we treat it as one, then wherever the mind is, so too will be the body.

 

Note: At the end of this post I’ve included several video interviews of Langer. Feel free to skip to them.

 

Langer has a new book out “Mindful Body: Thinking Our Way to Chronic Health.” She demonstrates through various research studies that what you think directly impacts how you look, feel and act. These are just a few of her studies:

• Housekeepers that were told that their work was actually exercise, when compared to other housekeepers not given that information, lost weight, lowered blood pressure and felt better.

• In a study of wound healing, it was shown that people healed quicker based on perceived time versus real time. This was also true for sleep where perceived amount of sleep was more of a factor than real time when it came to feeling fatigued. 

• Elderly men spent a week at a retreat in a place outfitted to resemble living as they did when much younger. Afterward, they were found to have made significant improvements in hearing, memory, dexterity, posture, and general well-being. It was as if being in a place signaling their younger days made them physiologically “younger.”

• Giving people information about their (fictitious) level of risk for obesity affected their metabolism and how they felt about exercise and hunger (regardless of their actual level of risk).

 

These studies definitely call to mind the “placebo effect.” Now, placebos ..are actually, I think, our strongest medicine. And if you think about it, you know, if you take a placebo, by definition it’s inert. It’s a sugar pill. So, you take this nothing and then you get better. Well, why are you getting better? You know, you’re actually doing it yourself. And so, all of my work is designed to bring that control to us much more directly. Now, when you are given a diagnosis of some chronic illness, for example, people say first chronic as something you can’t control, that you can’t beat. And I question that. And second is the assumption that the symptoms are going to stay the same or just get worse. Well, it turns out, that nothing moves in only one direction. There are always little blips where now you’re a little better, now you’re a little worse, and so on. And by attending to when you’re a little better, when you’re a little worse, several things happen. First, by saying, oh, you’re a little better, there’s hope, and you realize that it’s not a one way ticket downhill. Second, by looking for why am I a little better right now, you’re engaged in a mindful search. By actively looking for new things, noticing new things, you’re going to be improving your health. And third, you’re much more likely to find a solution if you’re looking for a solution.

 

Langer’s recommendation is to set your phone, your smartphone to ring in an hour and ask yourself the question, how am I now? Is it better or worse than before? And why? And then set it again for three hours, an hour and a half, vary the times. And over time, I think that most people will see improvement, but it’s also in a social psychological sense.

 

When it comes to how medicine is practiced today, she’s not a fan. It’s most important for people to understand that medical data, like all science, only gives us probabilities. And those probabilities are translated in textbooks and in talks, magazines as absolute facts. And it’s very important because when you’re given a diagnosis, it’s really a maybe, it says most of the people who look like this are victims of this or that set of symptoms. Not, you will experience this.

 

I particularly like her take on stress. Stress, I think, is the number one killer. Most people take stress as just the way things are, I don’t. But if you said to yourself, stress relies on two things. First, a belief that something’s going to happen, and when it happens, it’s going to be awful. So whatever you’re stressed about, give yourself three, four reasons why it might not happen. And then all of a sudden the world opens up, hey, maybe I won’t get fired. Maybe he or she won’t leave me, what have you. But then go to the next step and say to yourself, let’s assume it does happen. How is it an advantage?

 

If you are someone who sees the glass as half empty, Langer says, You’ve organized your whole life around this pessimism, so it buys you something. 

 

What Langer means by “mindfulness” is not meditation but rather simply the act of noticing new things. When we notice or create novelty, we come to recognize that answers are context-dependent.  You might find it useful to check out 9 Ways to Be More Mindful from The ‘Mother of Mindfulness,’ Ellen Langer 

 

Langer recommends adhering to some basic principles:

1.    Question Authority:  Don’t follow all recommendations just because an expert tells you to. Life is uncertain, and we are individuals, with our own unique makeup.

2.    Recognize that risk varies from person to person: One size doesn’t fit all. Hiking up a mountain, while great fun for one person, is thought to be risky by another  (falls, snakes and ticks). A medication that works for one patient may not yield the same results in another. 

3.    Approach predictions with skepticism: If things are looking bad, you shouldn’t assume you’re on a trajectory that will only get worse. Treatments change as do risks. For example in the 1980s, fat came under fire, and low-fat or fat-free products became a dietary staple. But today, nutrition experts largely agree that dietary fat should have a spot at the table. The debate in the dairy case may come down to limiting overall fat intake.  

4.    Understand how our choices are never completely “right” or “wrong:” Regardless of the decisions you made, look for the positives. You order an entrée that you immediately dislike. However, as you taste the sides that come with it, you find there is one  that’s delicious. 

5.    Avoid social comparisons or ranking yourself: Focus on finding meaning in what you are doing, regardless of what others may think or say. I’ve never made much money in the work that I do, however, it gives me purpose and meaning as well as being fascinating. 

 

“When we make these shifts in our thinking, our relationships with others and ourselves improve, and our stress lessens, all in the service of improving our health.”

 

Being mindful means to be aware of our everyday experiences. Notice the variations in how you feel, be it pain, mood, energy level or feeling happy, healthy or symptom free. By noticing them it’s possible to break out of rigid, fixed beliefs about being ill.  “Paying attention to variability helps us see that symptoms come and go, which helps us home in on the situations and circumstances that might contribute to these fluctuations so that we might exert some control over them.” If eating onions and garlic causes diarrhea the next day, omit them when possible from your diet. 

 

“Once we recognize that mindless decisions from the past are limiting us, there is little stopping us from redesigning the world to better fit our current needs rather than using yesterday to determine today and tomorrow,” 

 

 



 



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