Complementary Approaches to Health

As I mentioned in a recent post, the outer ring of the Wheel of Health focuses on Professional Care, which may include both conventional and complementary approaches to healthcare. A primary goal of integrative medicine is to erase the distinction between conventional and complementary approaches and instead encourage the use of the most effective, evidence-based modalities across the continuum.

 As a public health professional, I absolutely believe in the importance of prevention and primary care services that are typically obtained through more traditional or “Western medicine” practices. However, I also believe in, and have experienced firsthand, the benefits of more complementary approaches, many of which are grounded in more “Eastern medicine” traditions. I have had conversations with many individuals who are skeptical about the effectiveness of complementary approaches. My belief is that if you are open to these approaches and believe they can help you, they will. Whereas if you are skeptical and doubtful of their effectiveness, they likely won’t work for you. I feel fortunate that we all have a choice when it comes to deciding what treatments we seek to help us achieve and maintain our health and wellbeing.

Firsthand experience

I’d like to share my experience with some complementary approaches I have used to help manage anxiety. I have dealt with anxiety since I was a young child. One of the ways my anxiety manifested itself was through a nervous habit of biting the inside of my cheeks. I would chew away as I ruminated on my many worries about school, family, fitting in and all the other concerns of an adolescent trying to find her place in the world. I didn’t think much of it as a kid, but I became more self-conscious about it as I matured. I imagine I looked pretty silly with my mouth contorted to one side or the other. When my husband gently inquired about this habit, it made me realize it was noticeable to others and not something I could keep hidden.

I knew I wanted to break this habit but felt powerless to do so. As anyone who has tried to stop a long-standing habit knows, it can be incredibly difficult to change the behavior. I tried chewing gum to keep my mouth occupied. I tried that bitter tasting chemical that is supposed to help you stop biting your finger nails. I decided to try therapy, to address the underlying issue of anxiety. It helped manage the anxiety to some degree but didn’t break the habit. I eventually decided to see a psychiatrist and try anti-anxiety medication, which to me was a last resort. I try to avoid prescription medications unless absolutely necessary. I started taking a relatively low dose of an SSRI (selective serotonin reuptake inhibitor, a class of drugs commonly used to treat depression and generalized anxiety disorder). I would say it took the edge off a little, but it wasn’t solving the problem I wanted to fix which was the cheek biting. I weaned off the medication after about two years, as it wasn’t doing enough, and I did not feel like trying different medications.

At that point, I felt stuck and resigned myself to living with this habit. Then one day my husband came back from a weekend of camping with some friends and shared some interesting news. A couple of the guys had shared that they were working with a local shaman to help resolve some physical and mental health issues – and that this shaman was essentially a miracle worker, curing their ills. I was somewhat taken aback as these gentlemen are well-educated, highly respected professionals…and the first image conjured up in my mind when I heard the word shaman was “witch doctor.” My curiosity was piqued. My husband gently suggested that perhaps this shaman could help with my cheek biting. I was skeptical at first but willing to try anything to get some relief.

I went for my first visit with the shaman and left feeling like a new person. I had not really experienced energy work before, but I felt like he literally wiped away all negative energy that had been present in my body. It took about three or four sessions to kick the habit, but I did stop biting my cheeks. It felt like a huge weight had been lifted from my shoulders. I did experience an occasional relapse, but I would go in for a booster session and be good as new. The only downside to the experience was the cost – it was several hundred dollars per session and not covered by insurance. For me, it was worth every penny, but I realize I was fortunate that I could afford to seek his services.

I stayed free from my nervous habit for a couple of years but then started to experience more relapses. At this point, our financial situation had changed and we did not have as much disposable income to spend on these services. I sought some less expensive opportunities involving energy work, but they were not as effective at stopping the cheek biting. I felt resigned again to just live with it but knowing that it was possible to break the habit made me continue to seek other options. One day I was doing some internet research about cheek biting and stumbled upon individuals who had success with hypnosis. I was intrigued but skeptical again, as all I knew about hypnosis was the Vegas-style shows where some volunteer from the audience gets hypnotized and does silly things on stage to entertain the crowd. As I read more, I realized that hypnosis was different than that and many people have used it to help stop smoking or to lose weight.

I was hesitant to take the leap until I found a local practitioner who also happened to be a fellow graduate of the Duke health coaching program I attended. This connection gave me the courage to reach out and make an appointment. Once again, it took a few appointments to completely kick the habit. However, in the past year or so since I first underwent hypnosis, I have only had a couple of minor relapses that were easily fixed with a one-time booster session. The cost of hypnosis is much more reasonable and since I sought the services to help address a health issue (anxiety), I have been able to use our Health Savings Account to cover the cost.

I will readily admit that I don’t know exactly how the energy work and the hypnosis helped me break this habit. When I questioned the shaman about how his therapy works, he really couldn’t explain it. His response was basically “if it fixed your problem, does it really matter how it works?” He’s got a point. From what I have read about hypnosis, it is a way to access a person’s subconscious mind to help implement the desired change. The hypnotist serves as a guide, using suggestions that can help you modify your behavior and achieve your goals. Regardless of how these approaches work, I am grateful that they have helped me when conventional healthcare couldn’t. I encourage you to consider exploring complementary approaches if you are not achieving the results you desire through more traditional means.

Quality vs. Quantity – A New Approach to Weight Loss?

I wanted to take a moment to highlight a new study that was released last week in The Journal of the American Medical Association (JAMA) that challenges the traditional notion that weight loss is only possible through calorie reduction (i.e., counting or restricting the number of calories you eat). In the DIETFITS study, researchers found that participants who cut back on added sugar, refined grains and highly processed foods while focusing on eating plenty of vegetables and whole foods — without counting calories or limiting portion sizes — lost significant amounts of weight over the course of a year.

The study was a randomized clinical trial that included 609 overweight adults, who were assigned to either a healthy low fat (HLF) or a healthy low carb (HLC) diet group. Members of both groups attended classes with dietitians where they were educated about eating nutrient-dense, minimally processed whole foods, preferably cooked at home. A key difference in this study is that it did not set restrictive limits on the amount of carbohydrates, fats or calories that participants could eat. Rather, the researchers emphasized that participants focus on eating whole or “real” foods and as much as they needed to avoid feeling hungry. The emphasis was on the quality, not quantity, of food that was consumed.

The researchers also wanted to test the hypothesis that some people are predisposed to do better on one diet over the other depending on their genetics and their ability to metabolize carbs and fat. A growing number of services offer people personalized nutrition advice tailored to their genotypes. (See this previous post about my experience with one of these genetic testing services). Somewhat surprisingly, they found that participants’ genotypes did not appear to influence their responses to the diets. This is something to keep in mind if you are thinking about pursuing genetic testing for guidance on nutrition.

The general outcome of the study was that after one year of focusing on food quality, not calories, both groups lost substantial amounts of weight. On average, the members of the low-carb group lost about 13 pounds, while those in the low-fat group lost almost 12 pounds. The good news is both groups also saw other health improvements such as reductions in their waist sizes, body fat percentage, and blood sugar levels.

It is important to note that there was variability among the participants – some people gained weight, and some lost as much as 50 to 60 pounds. One key finding though is that the people who lost the most weight reported that the study had “changed their relationship with food.” For example, they no longer ate in their cars or in front of the television. They also started cooking more at home and sitting down to eat dinner with their families. To me, this demonstrates that how we eat is just as important as what we eat.

As with any research study, there are limitations. This was only one study involving a relatively small number of participants. Repeat studies with larger sample sizes should be conducted to see if results can be replicated. This study also just focused on initial weight loss. Maintaining weight loss can be as hard, if not harder, than losing the weight in the first place. Future studies may want to follow participants over time to see if they can maintain a healthy weight following the same approach of focusing on quality, not quantity.

I hope that this study is just one of many that will show that traditional dieting, where people make themselves miserable by counting or restricting calories, is not the best or most sustainable way to attain and maintain weight loss.  Rather, if we shift our focus to the quality of foods we eat and take time to enjoy and savor our meals, we will change our relationship with food and reap the many health benefits that come along with eating a well-balanced diet.

Be the Change You Wish to See

Gun violence. For some it may seem like an odd subject for a health and wellness blog. I debated whether to post about this topic, given the controversy and sensitivity around the 2nd Amendment. In my heart I knew I had to address it, especially in the wake of the latest school shooting in Parkland, Florida. It hurts so much to type those words. How are we here, AGAIN, facing more unnecessary loss of precious lives? Didn’t we say “enough” after Sandy Hook? Charleston? San Bernadino? Orlando? Las Vegas? I know there are other events I’m missing as the Parkland tragedy was reportedly the 18th gun incident involving a school or university since January 1, 2018. Wow – we’re only 54 days into the new year. Something must change.

I grew up around guns – primarily hunting rifles – as my dad, uncles, and brothers were all outdoorsmen who enjoyed the sport.  We had a healthy respect for guns in our house though. My dad kept them unloaded and locked up in a safe place. The only time I ever saw them was when they went on a hunting trip. I preferred it that way as I was never really comfortable around any type of firearm – and I’m still not. Even passing an armed police officer on the street makes me nervous. I think it’s fear of the damage that can be done with such a small piece of equipment.

In my ideal world, there would be no guns. If no one has them, no one has to worry about shooting someone else or being shot. Problem solved. Realistically, I know it’s not that easy. So, if guns aren’t going away, then we need to find some way to address the issue of gun violence and the destruction it causes in this country. As a public heath professional, I am excited to see momentum growing behind the idea of using a public health approach to reducing gun violence in this country. What would that look like? In a nutshell, it would involve using a social-ecological model to better understand violence and the effect of potential prevention strategies.

If there is one thing we have learned in the public health arena, it is that it we are usually more effective trying to change the environment than trying to change people. There are many, many people who just refuse to give up their guns. Not to mention the lobbying power of the NRA and the power it holds over Congress. I mean, if the near fatal shooting of former Representative Gabby Giffords wasn’t enough for her fellow legislators to turn down contributions from the gun lobby or to propose stricter laws around access to assault weapons, I am not sure what will be.

Given these circumstances, many health professionals are proposing that the United States use the same harm reduction approach to gun violence that it uses to treat other public health threats, like car crashes, air pollution and even tobacco use – using a wide variety of methods to reduce the problem. You can learn more about these approaches here:

https://jamanetwork.com/journals/jama/fullarticle/1556167#qundefined

https://gunresponsibility.org/solution/public-health-research

https://www.hsph.harvard.edu/news/features/public-health-gun-violence-vegas

One solution that has been proposed in the last few days is arming teachers and other school personnel so that they can respond in the event of an active school shooter or other threat. I am whole-heartedly against this approach. These learning institutions should not have to spend one iota of their time or resources thinking about how to defend against an armed intruder or other violent event. For those who think it is just a reality of modern times, I say we can and must do better than that. That is a band-aid approach to a more systemic problem. Let’s be proactive rather than reactive and figure out how to reduce or even eliminate the possibility of such threats by focusing on common-sense gun laws and improving access to mental health services for those in need.

I have struggled this past week with how to be part of the solution to this problem. I am encouraged by the actions of individuals – like this gentleman who turned in his assault rifle and more so, the young adults who survived the Parkland shooting and are making their voices heard at the national level. As the title of this post suggests, we must each take steps that will help achieve the outcomes we want for this country, our communities and our families. For me, it will mean donating my time and money to organizations like Moms Demand Action that support common-sense gun laws. It will also mean making my voice heard at the polls this fall and voting for candidates that support a proactive approach to this national epidemic. I must admit that I do not know if any of the state or national candidates I have supported in the past accept money from the NRA. I do know that I will have this information before I vote this fall and I will not support any candidate, regardless of political party or my previous support for their election, if they do. These are just some of the first steps that come to mind for me. I will continue to follow the discussion about gun violence and determine additional steps that I can take to help keep our children and our communities safe.

Addressing gun violence is probably one of the greatest challenges this country will face. I have faith that we can and will succeed, but it will take every one of us reaching into our hearts and finding a way to take action, so that we can finally say – and mean – never again.

What small step will you take today to move us toward that goal?

 

 

 

Prevention and Intervention – Focus on the Flu Vaccine

The outer ring of the Wheel of Health focuses on Professional Care, which is just as important as the areas of self-care I have discussed in previous posts. Maintaining optimal health includes seeking routine preventive medical care such as annual physical exams, recommended cancer screenings (e.g., mammogram, colonoscopy) and vaccinations.

You can find the latest recommendations for adult preventive care on the US Preventive Services Task Force website.  I highly encourage you to review the recommendations for your age and sex and discuss them with your healthcare provider. However, there is one recommendation I want to focus on for this post and that is the annual influenza vaccination, better known as the flu shot.

As a public health professional, I am often befuddled by the level of disagreement over getting vaccinated against the flu. I see friends debating it on Facebook. Some get the shot every year, others have never gotten it and never will. I have had friendly debates within my own family about the importance of annual vaccination. I agree with the Centers for Disease Control and Prevention (CDC)’s recommendation which is routine annual influenza vaccination for all persons aged ≥6 months who do not have contraindications. That last part is important – there are some individuals who cannot and should not receive the vaccination. But for most of us, there is no reason not to take this simple step to protect yourself from a potentially serious and sometimes fatal illness.

If you have any access to mainstream media, you are likely very aware of the toll that the flu has taken on communities across the country this year. This flu season is the worst in nearly a decade and we are not out of the woods yet.  Children and adults alike are getting sick, being hospitalized and dying – yes, dying – from the flu and its complications. I know several people who have had the flu and developed pneumonia, requiring hospital stays and heavy-duty antibiotics in order to recover.

I know there are some myths and incorrect beliefs circulating about the flu shot. Some people think they will get the flu if they are vaccinated (they won’t – if they get sick, they were likely exposed before they received the vaccine). Others argue that it is not worth getting vaccinated if the vaccine is not a good match to the virus strains that are circulating. It is difficult to get an exact match of the virus strain each season, as vaccine production must begin months before the flu virus presents itself. However, even if the vaccine is not an exact or even a good match, getting vaccinated will help reduce the risk of flu-associated complications that often require hospitalization. It can also make your illness milder if you do get sick.

Some people claim that they have never gotten the flu shot and have never gotten the flu, thus, they believe they are not susceptible. The flaw in that argument is that the flu virus strain changes every year so it’s likely they will eventually be exposed to a strain that does cause them to fall ill – especially if they decline to be vaccinated. That is why annual vaccination against the flu is so important. The flu is not simply a “bad cold” that someone can weather through. It is a serious illness that should not be taken lightly.

If you’re still not convinced to get vaccinated for your own protection, please consider doing so to protect the people around you, including those who are more vulnerable to serious flu illness, like babies and young children, older people, and people with certain chronic health conditions. If you haven’t yet been vaccinated and are now willing to do so, it’s not too late. I encourage you to act fast though as flu shots are running low due to the heavy flu season.  You can use the Flu Vaccine Finder tool on the CDC website to see where vaccine is still available in your area. The flu vaccine is typically covered by most health insurance plans and many pharmacies offer the flu shot at reduced cost for those who don’t have insurance.

For more information about the flu and how to protect yourself, please visit the CDC website.

 

 

Does DNA = destiny?

Just before the holidays, I received an email from my insurance company promoting discounts on various wellness products. One in particular caught my eye – genetic composition testing designed to “optimize your daily nutrition and exercise routine to help meet your fitness and health goals.” I had heard about this type of genetic testing and was interested in learning more. The timing was perfect as I had been wanting to shake up my exercise regimen, having fallen into a comfortable rut over the last year or so. I decided to take the plunge not only to learn more about my own disposition, but to be able to share my experience here in case any of you have been thinking about exploring this type of genetic testing.

I want to preface this all with a note about genetic testing – I know there is still quite a bit of controversy about direct-to-consumer genetic testing. Many people have concerns about privacy and what these companies do with the data they compile. I’m not here to debate the ethics of genetic testing, but I do recommend that anyone thinking about getting tested do their due diligence and read through the privacy information provided by the vendor. Call me naïve, but I choose to trust that my data won’t be misused by the vendor that I selected. I may be wrong, but I will cross that bridge if/when I come to it.

That being said, I ordered the test kit online and received it in the mail within a week or so. The test consisted of a few simple swabs of my cheeks. The company provided a pre-paid envelope to return the swabs. I sent them off and eagerly awaited the results. Within two weeks I received an email with a link to access the report online in a downloadable PDF format. About two weeks later, I received the printed report via snail mail, which is really nice as I did not want to print out the 40-page document myself (it is nicely done with full color graphics, but they would totally suck up my printer ink).

The letter in the front of the report reminded me that several factors impact health and fitness, including genes, environmental influences and lifestyle choices. Most studies have shown that genetics contribute between 30-40% to the body’s response to food and exercise. There was also a pretty standard disclaimer that the information in the report should not be used as a diagnostic tool and should not replace proper medical care from your healthcare provider. Instead, the vendor recommended using the report as a “guide to identify and implement actions to assist in taking control of my health and fitness.” And honestly, that is what I plan to do. I have taken some time to digest the information and I am working on a plan to determine how to use this information to inform my eating and exercise habits. I thought I would share some of what I learned and how I intend to incorporate the information into my wellness plan.

I have to admit that I was impressed with the amount of information included in the report and I thought it was presented in a simple, easy to read format. There is a Summary of Results page in the front followed by more detailed sections for each category tested. There are color charts, tables and graphics for those who are more visual learners. The nutrition information was presented first, followed by the exercise recommendations. For each category, the report includes information about what genes were tested and how they impact your body. Below are some highlights from my report and my thoughts on how I’ll use the information:

Body Weight and Weight Regain

Two of the most interesting pieces of information for me were related to body weight and weight regain and unfortunately for me, the news was not so good. I am apparently at high risk for both obesity and regaining weight after dieting. This news was not a total surprise as I have struggled since adolescence to maintain a healthy weight. I have definitely experienced the common yo-yo dieting phenomenon, going through phases of losing and regaining weight since high school. I definitely feel like my predisposition is to be on the heavier side. When I look at family photos, there are several obese relatives throughout the generations (think stereotypical fat, Italian grandmothers).

Satiety and Impulsive Eating

I also learned that I am predisposed to impaired satiety, meaning I tend to overeat because I may not sense fullness until I have already eaten more than enough. Again, not surprising to me as I have always been a fast eater. My dad is a very fast eater whereas my mom could compete for slowest eater on earth. I’m guessing I got my dad’s genes here. The good news is I am less likely to eat impulsively as I do not have lower dopamine sensitivity, i.e., I receive enough “reward” from eating tasty foods that I don’t have to overindulge to be satisfied.

The above results pertaining to obesity, weight regain and impaired satiety could cause some people to throw up their hands and give up trying to achieve and maintain a healthy weight. For me, it just heightens my awareness that I may have to work a little harder than others to do so. I learned a long time ago that I was never going to look like a super model – and I’m cool with that. I also abandoned traditional dieting several years ago, after realizing that it was not a sustainable approach to weight management. These days, I am much more focused on a mindful eating approach and listening to my body when it comes to food and eating habits. I believe this will help tremendously with the impaired satiety issue – I have learned that I need to slow down when I eat, so that I can tune into the signals from my body as I begin to feel full. For years, the speed at which I ate led to a consistent pattern of overeating and feeling uncomfortably full after most meals. I have been working on that for the past few years and these test results have increased my resolve to continue doing so.

Inflammation

The news was also not great when it comes to my body’s inflammatory response. I am apparently at high risk for chronic inflammation, which has been linked to several preventable diseases such as heart disease, diabetes and Alzheimer’s. It indicated that I was also more prone to the inflammatory effects of a diet high in sugar, refined carbs and vegetable oils. As someone who grew up on pasta and has battled a major sweet tooth her whole life, I can see some validity in this result. The good news is that there are foods I can eat that have an anti-inflammatory effect, as I discussed in a previous blog post about an anti-inflammatory diet. My family and I had already started making some changes to our diet after I attended that seminar, but I know that there is more work to be done – and I am willing to do it.

Exercise and Fitness

As I mentioned earlier, I was more interested in the results related to exercise and fitness and what I learned was pretty fascinating. Apparently, I have the capability to excel in both power and endurance activities, i.e., a mix of sprinting and distance events. My whole life I have always struggled with activities requiring short bursts of energy. For example, I have always disliked sports like tennis and basketball because I was too lazy to run back and forth. I also tried sprinting when I was on the track team in high school but fared much better as a middle-distance runner. I just thought I didn’t have it in me, but I am rethinking that mindset with this new knowledge. Perhaps I just never had the proper training to build up the capacity for power activities. I may give it a try and still find out that I don’t like those activities, but at least I won’t count myself out without first giving them a chance.

Two other results that kind of go hand in hand relate to the best type of exercise for fat loss and the tendency for muscle soreness. Not too surprisingly, the results indicated that I need a combination of strength/resistance and cardio exercise for the most effective fat loss. Many fitness experts promote this combined approach for anyone looking to lose weight and/or improve their fitness level. However, I apparently have the tendency to deposit fat under the skin rather than in the muscle and to lose weight, I would benefit from an approach such as high intensity interval training (HIIT). Interval training generally consists of a warm up period, then several repetitions of high-intensity exercise separated by medium intensity exercise for recovery, then a cool down period. The recommendations in my report advised against training only on pure cardio or endurance activities only…which is something I admit I’ve been doing for the last few years. Oops. Guess it is time to mix things up a bit.

Perhaps the reason I tend to avoid strength training or resistance activities (such as lifting weights, doing push-ups, etc.) is the association with DOMS – delayed onset muscle soreness. You know – that achy feeling you get a day or two after engaging in muscle-building activities. My genes leave me more likely to experience this soreness according to my report. I’ll admit I have kind of a love-hate relationship with muscle soreness. On one hand, it usually makes me feel like I’m accomplishing something in my workout, but it can make me wimp out and not want to continue training. The good news is there are several strategies to help minimize the soreness, including rest days, stretching, and the occasional over the counter pain relievers if needed. Being aware that I may experience muscle soreness more than the average person will help me prepare for it and adopt ways to minimize the aches.

So what’s the verdict?

Bottom line, I am glad that I did the test. I think the information is one tool of many that can help inform my approach to health and fitness. I know that it is not the end all, be all and I don’t believe that my DNA is my destiny. But in my case, I learned some things that are making me rethink some preconceived notions I have had, especially about my physical abilities. I realize that I may give another go at tennis and still not like it or be good at it, but at least I am willing to try.

Note: I purposely am not sharing the name of the vendor I used for the genetic testing as I don’t want it to be seen as an endorsement of one company over another (especially since I only tried one vendor). If you would like this information, you can email me at Janice@everbetterihc.com and I will gladly share the information offline.

Mind-Body Connection

This area of the Wheel of Health relates back to the inner ring of Mindful Awareness. It focuses on mind-body practices that can help you be more present and enhance your physical, mental and emotional health. It includes techniques that activate the body’s relaxation and healing response, such as breathing practices, meditation, yoga, and guided imagery.

History of mind-body connection

Awareness of the mind-body connection is not something new. For centuries, almost every system of medicine throughout the world treated the mind and body as a whole. But during the 1600s, the Western world started to see the mind and body as two distinct things. In this view, the body was considered more of a machine, with no connection to the mind at all.

There were some benefits to this Western viewpoint, including advances in surgery, trauma care, pharmaceuticals, and other areas of mainstream medicine. However, it also reduced scientific inquiry around humans’ emotional and spiritual life, and downplayed their innate ability to heal. Fortunately, this perspective started to change again in the 20th century. There was an increase in research related to the mind-body connection and scientists were able to demonstrate the complex links between the body and mind. In addition, this research confirmed the medical and mental benefits of meditation, mindfulness training, yoga, and other mind-body practices.

How does the mind-body connection work?

The mind-body connection is closely related to stress and how you deal with it. The body’s response to stress begins in the brain and spreads through the autonomic nervous system causing the release of powerful hormones, particularly cortisol and adrenaline. The autonomic nervous system controls involuntary body functions such as breathing, blood pressure, and heartbeat. It has two components: the sympathetic and the parasympathetic nervous systems.  The sympathetic nervous system functions like a gas pedal in a car – it triggers the “fight or flight” response, providing the body with a burst of energy so that it can respond to perceived dangers.  On the other hand, the parasympathetic nervous system acts like a brake – it promotes the “rest and digest” response that calms the body down after the danger has passed. Each of these responses has a different impact on the body.

The hormones released during the “fight or flight” response have an impact on many systems within the body, including the immune system. Research has demonstrated that prolonged exposure to stressful events or situations contributes to serious diseases such as high blood pressure, heart irregularities, anxiety, insomnia, persistent fatigue, digestive disorders, mental health issues, and diabetes. In addition, stress can also impact lifestyle and behaviors that affect one’s health and wellbeing. For example, many people are more likely to eat poorly and neglect healthy activities, such as exercise, when they are under stress. The good news is mind-body therapies and practices can help reduce or even prevent the stress response from occurring in your body.

As mentioned above, mind-body practices involve techniques that activate the body’s relaxation and healing response.  When you are exposed to a stressor (say, rush-hour traffic), your response to the stressor determines how your body reacts. You might normally get tense, angry and honk or yell at other drivers who cut you off. However, you can deliberately change your response, through simple techniques like taking some deep breaths and relaxing the muscles in your neck and shoulders.  This response engages the parasympathetic nervous system, which decreases your heart and breathing rate, blood pressure, and muscle tension.

Examples of mind-body practices

There are many strategies to help reduce stress and promote the relaxation response. Below are some of the more common techniques. At first, it may seem challenging or awkward to engage in these activities, but they are skills that develop over time with practice. It may also take some time before you experience positive changes, so patience is key. Try a few different approaches until you find the one(s) that feel most comfortable to you.

Progressive muscle relaxation: This technique involves slowly tensing and then releasing each muscle group in your body, starting with your toes and finishing with your head (or vice versa).

Meditation: The two most common forms of meditation in the United States are transcendental meditation and mindfulness meditation. In transcendental meditation, students repeat a mantra (a single word or phrase). In mindfulness meditation, students focus their attention on their moment by moment thoughts and sensations.

Paced breathing: When we are stressed, we tend to take shallow breaths. We can change this constricted breath and stress response by changing our breathing pattern. The 4/7/8 pattern is one example of paced breathing. To practice, breathe in through the nose for a count of four. Hold for a count of seven. Exhale through the mouth for a count of eight. Repeat these steps four times.

Guided imagery: This technique is a way of focusing your imagination to create calm, peaceful images in your mind, thereby providing a “mental escape.”  You can use an instructor, tapes, or scripts to help you through this process. You can achieve a relaxed state when you imagine all the details of a safe, comfortable place, such as a beach or a garden.

Sources:

University of Maryland Medical Center Complementary and Alternative Medicine Guide

University of Minnesota Taking Charge of Your Health & Wellbeing

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Mindful Parenting

I recently had the opportunity to facilitate a program on Mindful Parenting. I thought it might help to share some of the highlights, for those of you looking for a calmer, less reactive approach to raising your children.

The need for Mindful Parenting

How many of you have experienced any of the following:

  • You’re trying to make dinner, surf Facebook and answer your kid’s questions about homework all at the same time?

 

  • You’re reading your child a bedtime story while in your mind you are making a list of things to do after she goes to bed?

 

  • After arguing with your teen to come out of his room, get off his phone and engage with the family, five minutes later he calls you out for responding to a work email on your phone?

As author Kristen Race shares in her book “Mindful Parenting,” modern life is different than a generation ago. Many parents are struggling to juggle multiple roles. There are multiple electronic devices to distract us 24/7. Parents and their kids have demanding schedules, with little “down time.” For many of us, there are lingering financial worries as we continue to recover from the most recent recession. It’s no wonder she coins us “Generation Stress.”  And unfortunately, that stress is contagious – studies have shown that our children pick up on our stress even if we think we’re doing a good job concealing it.

Disengaging auto-pilot

Due to the many demands that we face in our day-to-day lives, many of us move through life on “auto-pilot.” Think about your daily commute to work – have there been times when you left home and arrived at work only to think “How did I get here?”  You know the route so well that you don’t have to consciously think through every turn along the way. You can tune out and run through that never-ending “to do” list in your mind. This automatic, mindless mode is not always a bad thing – it can be very helpful in establishing healthy habits like brushing your teeth or completing simple tasks like tying your shoes. It would be burdensome if we had to think through the steps every time we performed those tasks. But when autopilot takes over in more important areas of our lives, like how we engage with our children, it can lead to frustration and disappointment – for us and our children.

So how do we learn to disengage the auto-pilot and live more consciously? In one word: mindfulness. Jon Kabat-Zinn defined mindfulness as “paying attention in a particular way: on purpose, in the present moment and non-judgmentally.” It’s about awareness and intention. The folk singer Jewel (who has practiced mindfulness from a young age) describes it as “the gap between perceiving a thought and acting upon a thought, so that you can choose your action rather than have a reaction.” It is a way to create space so that we are less reactive to whatever life throws our way.

There are many ways to practice mindfulness, but they are typically broken down into two categories: formal and informal practice. Formal practice consists of dedicated time that you set aside to focus on awareness. Examples may include sitting meditation, breath awareness exercises, yoga, mindful walking and mindful eating. Informal practice refers to times when you are completely engaged in moment-to-moment awareness in a less structured way. Examples may include watching a sunrise, drinking a cup of tea, brushing your teeth, or washing dishes. Using an exercise analogy, think of formal practice as going to the gym or working out for a designated amount of time, whereas informal practice is like taking the stairs instead of the elevator or parking further away at work. It helps to include both in your mindfulness practice and you may find that the more you engage in formal practices, the more you find yourself being mindful in your daily activities.

Mindful Parenting

It’s probably no surprise that mindful parenting begins with you, the parent, committing to a mindfulness practice. In doing so, you will model positive behaviors for your children and you will approach your interactions with them in a different way. To modify a popular quote by Mahatma Gandhi: “You must be the person you want your children to become.”  If you’re feeling skeptical, there are studies that have demonstrated positive outcomes from this approach. Most notably, in a study conducted at UCLA, parents who practiced mindfulness for one year reported being dramatically more satisfied with their parenting skills and interactions with their children even though they had learned no new parenting practices. In addition, over the course of the year, their kids’ behavior also changed for the better. They got along better with siblings, were less aggressive and their social skills improved.

In preparing for my presentation, I relied on two main sources of information – the book by Kristen Race I referenced above as well as a book by Carla Naumburg, PhD, called “Ready, Set, Breathe: Practicing Mindfulness with Your Children for Fewer Meltdowns and a More Peaceful Family.” Both books have helpful tips about how to build your own mindfulness practice as well as numerous examples of ways to engage your children in a mindful fashion. Below are two of my favorites – one for younger children and one for older children.

For younger children, consider trying “Stop, Drop, and Breathe.” This is an easy, quick and fun way to disrupt a difficult situation and breathe your way back into the present. Whenever you find yourself or your child spinning out of control, lost in thoughts or overwhelmed by emotions, remember to stop, drop and breathe: stop, drop whatever you are doing, and breathe deeply and intentionally. You can literally drop to the floor, which may get your children laughing, regardless of how grumpy anyone feels.

If you have older children (tweens and teens), does it drive you crazy how much they use the words “like” or “ya know” when speaking? It can be a challenge for all of us to eliminate filler words from our speech. Try an exercise to help focus on mindful speaking. You can even turn it into a game, in which family members gently remind each other when they mindlessly pepper their speech with filler words.

Getting Started

The key to mindful parenting is establishing a mindfulness practice that works for you. Many people ask how much time they should devote to formal practice. It is based on what works best for you, what you will do consistently. This is a skill to be learned – it will take practice. You can start small, maybe 5 or 10 minutes a day, and build up from there. Feel free to include a combination of formal and informal practices and most of all, remember there is no right or wrong way to do it. Give it a try and see what happens.