Tips for Making a Change for the Better!

If you are contemplating making a change for the better, perhaps losing weight, improving your eating habits, getting help for anxiety or depression, or resolving issues in a relationship, you are at a stage of awareness.   But what you need to really move forward and begin doing rather than thinking about change is a level of emotional arousal and emotional energy. Use emotional energy to garner the momentum you need to make the change.  We know from research that knowing facts about a problem or dilemma is not enough to create behavior change. So stir things up a bit.  Here are some suggestions:

Create your own promotional materials.  Film yourself YouTube style and monitor your progress with a succession of videos.  Or paint or draw or create posters that are unique to your goals, post them at home and work and ramp up your emotional energy.

Start a group or join a group. There is a reason why joining and participating with a group of people with similar goals is a successful endeavor for many.  Participation can be emotionally energizing via the support you get from others in the group.

Use meditation, visualization and imagination. Take time out each day be in the moment, to reflect, visualize your goal and imagine how you will feel.   The emotional release you may experience may help you to move forward with the needed momentum so that you will be successful in reaching your goal.

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Control your Anger - Control your Stress!

There are actually healthy and unhealthy ways to control anger in your everyday dealings, whether with coworkers, family, friends or the grocery store clerk! Chronic, poorly managed anger may add to your stress levels by increasing the cortisol in your system, which in turn contributes to more inflammation and poorer health.

What are some unhealthy and healthy responses when you get angry? 
Check out these lists and tips.

Unhealthy Anger Responses

• You deny your feelings.  Instead, you lash out and blame others.
• You are defensive and argue with those who try to help.
• You are disrespectful of the other person (name calling, insulting the person instead of the situation).
• You have physiological sensations – increased heart rate, pounding heart, your face heats up, etc.
• You  act aggressive, hit or strike or throw things.
• You give up and see yourself as a helpless victim.
• Your anger becomes addictive – you easily anger at many different situations and circumstances.

Healthier Responses to Anger

• You admit your denial - You work at expressing your thoughts and feelings (using “I” not “You”) without denial and blame.
• You try to understand the other person’s viewpoint
• You have an attitude of respect even when you feel angry
• You do something constructive and find ways to keep your anger under control
• You are open to learning new things
• You examine your own behavior.
• Your commitment to others grows stronger
• You eventually let go of the anger and feel fine

Sometimes controlling your anger takes real effort and practice

Here are 5 tips for controlling your anger:

• Talk slowly
• Wait - “Take 10” - count to 10, 20 or 30, take deep breaths and think before your react.
• Take a walk; go for a run; workout, instead of reacting poorly to a situation.
• Find humor in the situation.
• Respond with assertiveness; respond don’t reac.

Work on your Assertiveness

When you communicate in an assertive manner, your assertiveness is actually incompatible with unhealthy anger (and the accompanying anxiety).

           

Tips on Assertiveness; use when communicating your anger!

• Use steady eye-to-eye contact but not staring or glaring.
• Stand or sit tall with good postur.
• Maintain a firm steady tone without yelling or drop in tone.
• Use “I” statements – I feel, I need, I would appreciate.
• Use short sentences.
• Use pauses for feedback.

Related articles

• Study Highlights How Moms' Depression, Anger Stresses Kids (nlm.nih.gov)

Keeping FIT is NOT always EASY: Part 3 Are YOU a Social Eater?

Keeping fit is not always EASY!  Do you think you may be a "social eater?"  Why do you eat what you eat and when you eat it? Is eating a social experience for you? Do you find that when you are with a group of your friends, you lose track of what you have eaten and continue to fill up your plate although you are already satiated? That’s a very common experience for some.  In fact, researchers (Nicholas A. Christakis, M.D., Ph.D., M.P.H., and James H. Fowler, Ph.D) have found that overweight and obese people were more likely to have a circle of friends who were also overweight and obese (and therefore probably social eaters also). And we also know that many people are more likely to be successful in reaching weight loss goals if they participate in a group with shared weight loss goals (for example, “the Biggest Loser” on television, Weight Watchers Program, etc.).  So if social eating is your downfall, don’t despair.  Instead, find a group who share similar weight loss goals and you  will more likely be successful in losing the desired weight.

Are you a Type A?

Having a "Type A personality" is marked in popular literature and media by a person who is an overachiever and fills his or her schedule to the maximum with work and status related activities and commitments.  Popular notions of Type A personality are based on published scientific research undertaken by cardiologists, Meyer Friedman and RH Rosenman, while researching the possible causes of coronary disease. http://www.sfms.org/AM/Template.cfm?Section=Home&SECTION=Article_Archives&CONTENTID=1732&TEMPLATE=/CM/HTMLDisplay.cfm

In the 1950’s, Friedman and Rosenman studied over 3,000 healthy men aged 35 – 59 and observed a higher prevalence of clinical Coronary Heart Disease (CHD) in men who exhibited two specific traits: time urgency and free floating hostility.  They labeled this disorder Type A behavior pattern. Subsequent studies challenged the hostility factor; ongoing research continues to help us understand the relationship between Type A Behavior and Coronary Heart Disease in both men and women.  In 1981, The National Heart, Lung and Blood Institute published a critical review that identified Type A Behavior as an independent risk factor for CHD.

Current research is helping to identify issues and difficulties in measuring Type A traits in the individual. Researchers have concluded that time urgency and hostility measures, usually completed by the patient through a self report questionnaire are not as reliable as the clinician's observation and evaluation of the person’s psychomotor traits. Recognizing these psychomotor traits in an individual takes specific training over the course of several months to years.

Some of the signs and symptoms that may indicate hostility or time urgency and a Type A Behavior pattern include: chronic facial tension, tic like elevation of the eyebrows, tense posture and abrupt, jerky movements, rapid speech, hastening the speech of others, frequent loss of temper (i.e., yells or gets upset while driving), sleeplessness because of anger or frustration, disbelief in altruism, easily provoked irritability over trivial errors, facial hostility, and a hostile laugh.

Health psychologists treat individuals who exhibit these characteristics and through lifestyle change interventions, including behavior modification, cognitive – behavioral interventions, stress management and mindfulness training, and talk therapy, help the person with Type A Behavior patterns to modify his or her unhealthy patterns of time urgency and unresolved hostility. Research has already established that the degree of lifestyle change is positively correlated with positive changes in coronary atherosclerosis and other CHD predictors.  If you want to read more detailed and clinical literature on these studies, the Preventive Medicine Research Institute is an excellent resource:  http://www.pmri.org/research.html.  If you recognize yourself or a loved one as possibly fitting the description for Type A Behavior patterns, learn more and ask for help. Become heart healthy and feel better.

Keeping FIT is NOT always EASY!

Who are the people who are most effective at getting fit and healthy, and staying that way over time?   And who are the ones who no matter how hard they seem to try, continue to struggle with getting or keeping healthy?  Researchers continue to investigate these very questions and have come up with some key points about achieving and maintaining health and well-being.  Here are some pointers on getting and keeping fit and healthy.

Keeping fit and healthy– including daily and weekly exercise and eating a nutritious diet is NOT always EASY!  We know that in our busy world of work, commuting, family responsibilities, social events and the stress that accompanies all of this, maintaining a healthy lifestyle can be a huge challenge.  Have you ever commented on an acquaintance that seems to always manage to keep fit, look great and maintain a positive attitude - that he or she “doesn’t have to work very hard" at looking and feeling great?  Think again!  Chances are, if you interviewed that person, you would find out that a considerable commitment has been made to keeping healthy.  You would also find out that such a commitment comes with a price – be it time away from social events to work out or refusing delicious but incredibly unhealthy restaurant meals when out with friends or colleagues.

Keep a diary. Include what, when and where you eat and what, when and how you exercise.  Keep track of your stress levels and stressors during those times. Researchers know that when you keep track, you become more aware of your stress points, your habits, your emotionally vulnerable times as well as your caloric intake and time in exercise.  How does this help? Once you know your stress patterns, eating patterns and exercise patterns, you can establish a BASELINE and then develop your short and long term goals, based on your history and stress patterns.

Keep it fun.  We also know that if you do not ENJOY your workout, or consider at least a portion of your exercise regimen to be FUN, you won’t maintain your routine.  If you have friends who are runners and they love running, they will tell you that running is a rewarding and fun experience. In turn, if you run and positively hate it, the thought of it,  and dread going on a run, you are not likely to maintain your exercise regimen. In fact, you are probably adding more stress to your life by doing something you don’t like!  If you’re not sure what might work for you, try out different activities and give yourself a few weeks to decide.  Join yoga or Pilate’s group. You may enjoy dancing, hiking, playing tennis, taking long walks, or swimming.  Whatever  it is that brings enjoyment, do it and forget about routines or activities that cause you stress. Don’t forget variety in your workouts – include two or more activities into your routine - such as weight lifting and swimming to optimize your health.

Keep it a priority.  Whatever it takes to keep your health regimen a priority, do it! Schedule workout times into your Outlook calendar.  Make your food diary easily accessible; download an App if that makes it more do-able. Find ways to stay consistent and realize that you will have to sacrifice at times in order to maintain.  Soon you will realize what researchers know - keeping fit to counter stress – both psychologically and physiologically will help you to cope and feel good more often. Keeping fit to maintain your health, your sense of well being and your physical appearance will be the best reward of all.

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Making Changes for the Better: 5 Tips!

When you consider your health in the New Year, what changes do you want to make for the better?  Below are five broad areas for you to consider. When wanting to set goals and make changes, most people spend a great deal of psychological and emotional energy at the pre-contemplation and contemplation stage. They know they want to move ahead, but they struggle with identifying and creating a plan.  The first step in overcoming this barrier is to IDENTIFY what it is you want to change.  For many, a great place to start is with the Number One area listed below. You can then find success in achieving goals summarized in the items Two through Five. Even though it might sound simplistic, once you move ahead and begin with discovery and identification of your current status, you have accomplished a big step in becoming healthier and happier in 2011.

1. Obtain Baselines and learn about my health status.
This involves moving past denial and includes learning all you can about your physical health. It involves a visit to your primary care or other physician to establish medical measures and baselines on your health status and includes weight, BMI, blood pressure and cholesterol levels, and other tests determined by your physician.  This should also include identifying your family risk factors, identifying your social support needs, identifying your psychological challenges, identifying the stressors in your life and your coping challenges and style.

2. Achieve Improved Medical Measures and Outcomes. 
Once you know your health status and baselines, including BMI, weight, cholesterol, blood pressure readings, etc., you can now move toward establishing goals for improvement where needed.  This may include lowering your cholesterol, lowering your blood pressure, reducing your risk of stroke or cardiac illness, reducing familial risk factors.

3. Improve Levels of Exercise and Fitness
If you are like most people, your intention is to make exercise and fitness a priority, but the busyness of your life gets in the way.  Identify your exercise routines and activities, including how many days, minutes and type of exercise you are currently completing.   Keep an exercise and activity diary for 2-4 weeks. One you have a numerical count of what you actually do during the week, you can then decide on areas of improvement. This might include any or one of the following:  getting more exercise, getting regular exercise, doing aerobic activities, joining a yoga class, achieving a good fitness level,  increasing strength, increasing endurance, increasing flexibility, increasing energy levels.

4. Make Better Eating and Nutrition Choices
This might include eating smaller portions, eating out less frequently, eating less fast food, learning more about nutrition, eating more freshly prepared foods and meals. This also includes beginning with establishing your current eating lifestyle. Keep a food diary and include what you eat, when you eat, where you eat. Include when you feel hungry and what you are doing.   Once you have done this discovery process, you will be able to establish clearer and more doable goals in this area.

5. Improve Your Quality of Life
This might include learning new cognitive and behavioral strategies for coping with stress, taking small and healthy risks, reaching out to others, practicing authenticity, and using meditation and prayer to release your worries and achieve a sense of well-being.

The Mind-Body Connection and You

There is now both reliable and valid scientific evidence from the fields of behavioral medicine, neuroendocrinology, neuroimmunology, neurobiology, and nutrition science to support the conclusions that our autonomic, endocrine and immune systems are not autonomous, but instead work in concert with each other.  These systems engage in interactive dialog with each other, and communicate with our limbic emotional system and perception/sensation systems to maintain health and also fight disease.

Research over the past 30 years has seen considerable advances into the scientific understanding of the immune system.  Science has now established the knowledge that the mind (psychology), the brain (neurology) and the body’s natural defenses (immunology) communicate with each other in a bidirectional flow of hormones, neuropeptides and cytokines.  This growing field of research is called psychoneuroimmunology (PNI).     Consider this: there is now irrefutable evidence that all of the body’s defense systems are under the control of the central nervous system (CNS).   In other words, every idea, thought and belief has a neurochemical consequence.  Neuropeptides flow from the CNS, impinging on specific receptions on the leukocytes, thus regulating their function.  What researchers know then, is that the CNS has the potential to critically inhibit or enhance immunity through two major neuroimmunomodulatory pathways:  the neuroendocrine and the autonomic nervous systems.

What can you do as a patient, whether you are struggling with a chronic illness, newly diagnosed with a threatening disease or health and working toward goals to improve your overall health and well-being?

Begin by examining your stress levels. How do you manage?  Do you feel good about how you cope or do you know that you are frequently stressed beyond your ability to cope? Ask for help.   Examine your health beliefs and ask questions of your health care providers.  Ask for psychological support for stress management, or help with depression, anxiety or other diagnosis.  Read and learn all you can about the biopsychosocial aspects of your condition.  Rely on scientific evidence, scientific based websites and reputable publications.  Question and learn about complimentary and adjunct support and discuss with your health care providers, including your medical doctor and your psychologist.
For an excellent academic overview on this topic:  Mind-Body Medicine: A Clinician's Guide to Psychoneuroimmunology; edited by Dr. Alan Watkins ISBN:  0 443 05526 2

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The mind-body connection

Current research fully supports the notion that  psychological treatments of people who seek help in a medical setting can make a significant difference in their overall health.  In the 1980's, estimates were that approximately 25% of visits to a primary health care practitioner are for psychological and mental disorders, masked by physical symptoms. This estimate has increased to 30-50% today. And estimates today suggest that more than 60% of emergency room visits involve a psychological component.  We also know that up to 80% of medical patients overall, struggle with various levels of psychological distress. What does this all mean?  Most importantly, statistics now clearly demonstrate that illness is not only physiological and that the psychological component is an important contributor to health, well-being and therefore illness.  The biological, psychological and social are intertwined in a complex and powerful manner.  What can be done?  Physicians and physician's groups need to continue to increase efforts to include psychologists in their treatment plans and willingly refer when the patient might benefit from psychological intervention.  And patients need to increase their awareness of the mind-body connection, examine their own psychological struggles, talk to their health care providers about their physical and psychological status and ask for help and psychological support when they need it.

Why Exercise?

What are some of the psychological benefits of regular exercise?  Results of studies on men, women, children, youth, mid-life and the elderly point to the benefits of overall improved sense of well-being.  Specific studies on the effects of exercise on clinical depression have shown that it is a viable treatment option for some people.  A sense of self-efficacy and confidence is another benefit for the far majority of people who keep up an exercise regimen and get physically healthier as a result. These are just a few of the psychological benefits of regular exercise.

What is it then, that keeps people from exercising? Why not just go out and do it?  The benefits are numerous, from physiological benefits of managing and preventing diseases like diabetes and high blood pressure and cardiac illness to greater quality of life to extending ones' longevity to improving your overall mood, and keeping depression under control.

If you ask most sedentary people why they don't exercise, they may tell you that regular exercise is too hard and they really don't like it!   If you fit in this category, consider re-thinking your attitude.  First of all, replace your idea of 'exercise' with 'activity.'  What activities do you like or did you like before you became sedentary?  Going dancing, playing on a softball team, playing with your children or grandchildren, walking hiking, swimming and gardening  - are all an improvement over a sedentary lifestyle.  Remember that as few as 30 minutes a day of moderate activity - brisk walking for example can not only help you become physically healthier but also  psychologically healthier.

How to start? Identify an activity that you consider to be enjoyable. You are much more likely to keep up the activity if you enjoy doing it in the first place!  Find another person or a group who like the same activity.  Other like-minded friends can help you feel and stay motivated and supported as you work toward your goal of increasing enjoyable activities (and exercise) into your lifestyle. 

Finding Happiness

For many of you who have lost jobs or are struggling with the downturn in the economy, this has been an especially difficult year. The distress you experience can have an undermining and negative effect on your sense of well-being, health and happiness. Even smaller stressors - small daily hassles, if they are frequent and we don’t feel in control of them, may contribute to poorer health and a diminished sense of well-being. Consider beginning right now to counter the stress in your life by making some positive changes.

How to start? Begin by taking some time out to contemplate and reflect on who you are and what really matters to you. Reflect on the positive people, relationships and experiences that have been most memorable and meaningful to you. Research supports the notion that for most people, having meaningful relationships and experiences with family, friends, loved ones and significant others are key to experiencing a sense of well being. Work on becoming mindful of your distress and when you experience it, stop and take time out to reflect on your positive relationships and experiences. Practice switching to this positive frame of reference several times each day.

And then consider this. Did you know that happiness may be contagious? In the published article in Behavioral Medicine Journal (Dec. 2008), entitled Dynamic spread of happiness in a large social network: Longitudinal analysis over 20 years in the Framingham Heart Study, Fowler and Christakis’ findings suggest that the relationship between people’s happiness extends up to three degrees of separation (for example, to the friends of one’s friends’ friends), and that if you are surrounded by many others who are happy and these people are central to your circle of friends, you may be more likely to become happy in the future.

Is there anything valuable you can take from this research? Yes! Begin with working on your own positive attitude. Remember to take time out for meaningful relationships and events. And surround yourself with those who have a more positive approach to life and you may find that you too have an improved sense of well being and happiness.