CHAPTER ONE
I walk down the street.
There is a deep hole in the sidewalk
I fall in.
I am lost . . . I am hopeless.
It isn’t my fault.
It takes forever to find a way out.
CHAPTER TWO
I walk down the same street.
There is a deep hole in the sidewalk.
I pretend I don’t see it.
I fall in again.
I can’t believe I’m in the same place.
But it isn’t my fault.
It still takes a long time to get out.
CHAPTER THREE
I walk down the same street.
There is a deep hole in the sidewalk.
I see it is there.
I still fall in . . . it’s a habit.
My eyes are open.
I know where I am.
It is MY fault.
I get out immediately.
CHAPTER FOUR
I walk down the same street.
There is a deep hole in the sidewalk.
I walk around it.
CHAPTER FIVE
I walk down another street.
—Portia Nelson1
26. Do You Believe It’s Possible to Change?
I think by now you’re starting to understand and value a more holistic approach to healing what ails you. And by now, you’re beginning to take stock of your overall health, according to our new, wider, and wiser definition. Now I want to prepare you to make some real changes. In this chapter, I want to give you some practical, but no less inspirational, tools to take the first steps and address the most common obstacles to getting started: denial, resistance, and fear, the things we feel most often when we’re facing change—even positive change.
Albert Einstein writes, “The world as we have created it is a process of our thinking. We cannot change the world without changing our thinking.”2 So, first and foremost, if you’re going to change, you’ve got to believe you can change. And you’ve got to take responsibility. This means, literally, the ability to respond. You must summon your courage and remember that you have the ability to respond right now. In your choices. In your beliefs. In your actions. The person who falls in the proverbial hole in the above poem might at first believe “it’s not my fault.” But where does such lack of responsibility get you? Out of the hole and back into the light? Sure, maybe someone else shouldn’t have left that hole there for someone to fall in. Maybe someone even pushed that poor, defenseless person into that hole. But what does it matter? No amount of righteous indignation will get your butt back on the street. You and only you have the ability to respond right now. To pull yourself up and out.
The conventional medical system doesn’t allow for that kind of self-motivated boost. It, along with the rest of Western culture, has taught us to be helpless. This “learned helplessness” comes when we humans or other animals undergo an unpleasant event or a series of events that we perceive, either rightly or wrongly, that we can do nothing about. Take an elephant getting shocked by a trainer’s electric prod. At first, she tries to resist. But she soon—often very soon—discovers that she can’t get free of her restraints to avoid the prod. After a short while, she gives up trying. She will just lie down and take the shock, over and over. She might hope that bad things will stop happening to her, but she will not believe she can do anything about them—so she will not even try. This is one of the reasons that despite how powerful they can be, elephants in captivity don’t require massive chains to keep them docile. A simple string will work. Having been conditioned for learned helplessness, as soon as the elephant senses the slightest resistance on her hoof, she will stop trying to pull herself free.
Since the 1960s, countless experiments with rats, mice, dogs, and even human test subjects have proved that learned helplessness happens, and it hurts our chances for improving our current conditions. So if you believe that there’s nothing you can do about your health condition, then you won’t do anything about your health condition. It’s insidious, and it’s a slippery slope as well. Initially you take less care of yourself, but eventually you wind up actively self-destructive. I don’t want to come off sounding judgmental or insensitive, but this is the truth, and what you’re likely to see when you really look in the mirror. Allowing yourself to fall victim to learned helplessness hurts your chances for better health. Sure, the whole rest of the herd might be doing the same thing, but there’s no safety in those numbers.
Correcting for all other contributing factors, people who feel helpless about their medical conditions feel worse, do worse, and die faster.3 It’s a proven fact. And it’s not just a question of some self-fulfilling psychological prophecy—people with learned helplessness face worse health outcomes because their physical conditions deteriorate faster when they are pessimistic about their ability to control their health. There’s intriguing science, for example, showing that tumors grow faster in animals that have been conditioned for learned helplessness.4, 5
So, ask yourself, Do I believe it’s possible to change? Deep down inside, I think you do. But if you’ve been confronted with challenges that were hard to overcome, you might be pessimistic. If so, stay with me. On the other side, if you’re already certain that change is possible, then the next step for you will be to make changes happen in your own life. And that isn’t easy either. So where do you go from here?
The next thing to do is to be honest with yourself. This is not the same as evaluating and judging, but rather just taking a good look, and working on clearly understanding how you got to where you are. There’s no need to place blame. Instead, this is akin to taking an inventory, taking stock in your current predicament so that you can clearly identify what’s contributing to your situation.
When you do this, you’re likely to notice many things, including some flaws and bad habits. Perhaps the most important one of these, however, is any tendency you might have to accept someone else’s measure of your value. The labels that we tend to place on ourselves as a result are most certainly a reflection of our acceptance of someone else’s rules. These can be important, but they’re often not completely accurate, and sometimes they’re intentionally repressive. This is why it’s so important to assess the situation for yourself. The 77 Skillful Questions become a tool you can use for this purpose—to take inventory. With these skillful questions guiding you, you’ll be able to take a good survey of your situation and see where the opportunities for improvement—i.e., alignment—exist.
So examine the question again: Isn’t real change possible? What do you think now? What’s holding you back from accepting responsibility to change yourself? Can you at least give it a chance? If so, you are ready to take the next step: making the change happen in your own life.
A GOOD LOOK IN THE MIRROR
Of course that’s easier said than done. Anyone who’s ever tried to quit smoking or lose weight knows that these habits “do not go gentle into that good night.” Similarly, the nihilism about change can become a habit. So where do habits come from? And how do we finally overcome them?
Often, we’re unaware that we’re getting into a certain habit. Unskillful habits like poor eating and sloth tend to develop gradually, silently, without our intention. In some ways, this makes them more insidious and powerful once they’re set. Speaking as a doctor as well as a fellow human being, I can tell you that ingrained habits are very hard to reverse, but by no means impossible. It’s just that, as Einstein so presciently observed, we have to change the thinking that led to the habit, the thought processes or lack thereof that ultimately sustain the habit. As an example, millions of people who go on diets every year lose weight—sometimes a lot. Yet a full 95 percent of them gain all or most of the weight back within a year.6 Why? Without shifting our thinking, we can’t expect a durable change in our behavior.
Luckily, there’s good news on this front. Strong motivators, both positive (such as rewards) and negative (such as a trauma or chronic illness), can help break even the most deeply ingrained habits. We can use external motivators to help us change habits. We can think about why we want to get better, and keep our eyes on that prize. Perhaps we can visualize lifting our grandchildren for the first time in years. Or breaking the ribbon at the end of a 5K run. On the other side of the equation, we can use a milestone of crisis—such as receiving a diabetes diagnosis—as a motivator for growth and development. True, crises almost never come at a convenient time, and the pain and anxiety they produce sometimes lead us to seek an immediate, Band-Aid solution from outside ourselves—some drug or other treatment. Sometimes this is important or even necessary, just to get us through. But it’s short-lived and, in the end, not enough. However, if we can remain balanced, present, and focused for long enough, we might get a glimpse of something more meaningful on a deeper level, something that helps us make the change we know we need.
But you don’t have to promise yourself a trip to Hawaii for losing fifty pounds—and you don’t have to wait for your first heart attack to break unskillful and unhealthy habits. You just have to be willing to do a careful and honest self-inventory.
On both personal and professional levels, I’ve found that sincere self-reflection is one of the most important and skillful steps for modifying behavior. Like all animals, we eat, sleep, and reproduce; we experience sensations, emotions, and perceptions; and we take in knowledge about our external world. Unlike other animals, however, we possess this remarkable capacity for self-reflection. Zen Buddhism refers to our facility for looking in the mirror, or more accurately for self-knowledge, as the “distinguishing mark of authentic human existence.”7
You don’t have to be a Zen master to do this. It’s easier than it sounds. Find a quiet place and consider your health situation, your body, your feelings, your sense of balance and peace—or lack thereof. Be honest. Ask meaningful questions. Am I feeling well? Am I eating well? Am I sleeping well? Am I too reliant on drugs? Am I feeling like a victim? Am I balanced? What hole do I keep falling into—and why? The trick here is not to coddle yourself, not to make excuses and justifications, but to find places for improvement. Then work on gathering the courage to change. You should rely here not on the “experts”—not even on me!—but on your own instincts and judgments about where you are and where you need to go. So you don’t feel overwhelmed, you can focus on one health aspect at a time—the most important thing first.
WHAT WOULD HAPPEN IF PATIENTS STOPPED PLAYING THE VICTIM?
This self-reflection and self-inventory is a far cry from our current way of thinking about our health. Our whole health care system is based on the notion of an unwise patient playing victim to an “expert” doctor. “Help me,” the patient says. “I’m broken.” There’s very little room in this equation for responsibility. The patient isn’t looking in the mirror but at his doctor. Yet the vast majority of chronic health problems we face—the Big 8 and the top killers—are profoundly subject to our own intervention. By and large, they are diseases of lifestyle, not genetics. When genetics does play a part by loading the gun, it’s still our lifestyle choices that pull the trigger. Meaning we got ourselves into this unskillful mess, and we can get ourselves out by looking in the mirror and acting responsibly. By making different decisions along the way, starting today. Change won’t happen passively. It won’t happen by osmosis, and it won’t fall from the sky. It’s in your hands. It certainly won’t happen if you keep avoiding your eyes in that mirror. I know it might feel painful even to think about it, but I promise you that you’ll feel better for it. Certainly, you need some courage to do this. But let’s first look at why you might be feeling uneasy about embracing a new course.
OUR HERD MENTALITY
How do we get in these holes, health-wise and otherwise? Why are we resistant to looking in the mirror? One of the big obstacles to our moving toward extraordinary health—to change in general—is our resistance to autonomy, true freedom from outside influence. It’s a real paradox, because we Americans have come to think of ourselves as rebels, as archetypal rugged individualists who are entirely self-reliant. But if you look around, don’t you find we’re really more like a bunch of proverbial lemmings, lining up on the cliff, ready to follow our fellows into the briny deep? Do you think that’s too extreme? That it doesn’t refer to you? Well, let’s think about it.
We certainly agree that we have this tendency to resist change. And I think it’s reasonable to assert that’s mainly because so many of us are overly concerned with what others—our parents, our children, our neighbor, our spouse, our doctor—might say. As a culture, we’re trained to avoid appearing too special, too novel, too different from the crowd. Yes, our society tolerates a certain amount of individuality and even iconoclasm—especially among celebrities. Lady Gaga can get away with dressing in a meat costume or arriving on the red carpet curled up in a giant egg—she can even make millions of dollars while doing it. But try showing up at your bank that way, or your office, and see what happens. You’ll find that the dominant culture treats most eccentricity (defined as standing out from the crowd) censoriously at best. This is particularly true when we violate social mores or somehow seem to challenge venerable institutions, such as the Catholic Church—or the standard American diet.
There are good reasons for this in evolutionary adaptation: there is often safety in numbers. Tribalism itself has great evolutionary advantages, not to mention that it makes life more pleasant as a rule. We need to band together to survive, and we generally enjoy each other’s company—at least those who are like “us,” not like “them” over there. And surely much moral good has come from agreeing together, more or less, on codes of behavior that serve the individual and collective good—though we know that variously interpreting and misinterpreting these codes causes unending strife as well.
In general, humans have a herd mentality, not unlike that of other animals, and this herd mentality originates in fear. In nature, a wildebeest avoiding a lion best illustrates the nature of this herd behavior. Each member of the herd minimizes the danger to itself by choosing the location and action/behavior that is as close to the center of the group as possible (no wildebeest goes off and lives by his own devices as a rugged individual, because he would be the lion’s first meal).
Experts and the media offer the concept of herd mentality as an explanation for phenomena where large numbers of people act in the same way at the same time, such as in the case of the rioting and looting that overcame London in 2011. In his 1896 work The Crowd: A Study of the Popular Mind, social psychologist Gustave Le Bon set the stage for our understanding of human herd mentality: “Crowds, after a period of excitement, enter upon a purely automatic and unconscious state, in which they are guided by suggestion.”8 This essentially means the group drives the individuals.
Since Le Bon’s seminal work, more modern studies have striven to debunk his theory, arguing vehemently for the idea that crowds are just groups of individuals acting in their own best interest. Evolutionary biologist W. D. Hamilton writes about this subject in a famous paper, “Geometry for the Selfish Herd,” which was published more than three decades ago in the Journal of Theoretical Biology. Hamilton writes that while a herd appears to move and act as one, much like a flock of birds, its pattern actually emerges from the paradoxically uncoordinated behavior of individuals seeking self-preservation. Individually, humans also naturally protect themselves in this way.9
But most sociologists who study crowds still argue that “group identity is a precondition for a riot: People will only riot when they think their actions are aligned with the worldview of the group as a whole.”10 In other words, assuming you are compelled to act contrary to the usual norm—say, by breaking a window with a brick—you, as an individual actor, feel you can get away with this only as long as you’re amid a large crowd where others are also acting unusually. In other words, you’re still relying on the implicit sanctioning by the local “masses” for your individual behavior.
Not that all herd behavior is violent or aggressive. Some herd behavior has innocuous consequences, such as whole groups of high school juniors wearing skinny jeans, thousands mass-Tweeting after the debut of the new season of The Walking Dead, or fans of a sports team jeering the opposing team at a game. However, too often the herd mind-set leads to the excesses of widespread rioting. Why do we go with the crowd, even when we know it might not be in our best interest? As Professor Louis René Beres argues in a recent Washington Times editorial, more than almost anything else, human beings need to belong:
In all cases the individual person feels empty and insignificant apart from his/her membership in the herd. Sometimes that herd is the state. Sometimes it is the tribe. Sometimes it is the faith. Sometimes it is the “liberation” or “revolutionary” organization. But whatever the particular herd of the moment, it is the persistent craving for membership that brings the terrible downfall of individual responsibility and the terrifying triumph of the collective will.11
The key here is “the terrible downfall of individual responsibility.” This makes me think of the rise of the Nazi Party in the 1930s. We’d like to think a Holocaust could never happen again, but couldn’t it? How were the regular people of Germany different from us now? And what happens when followers are misled by leaders who are themselves misguided? Or when there are no discernible leaders besides the mob itself? That’s a good way of looking at many of the decisions we make daily based on what the group around us is doing, even when their behaviors or beliefs violate our own instincts. Looking at each other instead of in the mirror, following the crowd, we keep falling into the same holes—and we keep declaring, “It isn’t my fault.” It takes us a long time to get out.
What does all this have to do with health? To find extraordinary health, you have to be willing to buck the herd, seek your own truths, and avoid the typical traps into which the masses fall on their run across the landscape. Look inside, not out.
27. Are You Happy with Your Body and At or Near a Healthy Body Weight?
STARTING SIMPLY
Let’s begin with the basics: body weight and diet. I start with these because I know they’re on your mind—and in your mirror.
There’s a lot of advice out there about something called your ideal body weight (IBW). You might remember those old actuarial charts from insurance companies, where you cross-referenced your height, age, and gender to find out what you should weigh. Ever since the 1950s, life insurance companies began basing that “should” on the weight above which people of your gender and frame size began to have health problems—like death, the ultimate health problem—that cost them (the company) cold, hard cash. If they could keep you at or below that IBW, they could keep from paying out big benefits to your family. Meantime, if your weight fell above the IBW, they could charge you a higher premium. There’s some truth to this. That extra weight really does cost the system more money in health care costs.
Nowadays, there are more precise statistics backed by the medical establishment, basically determined in the same way as the insurance companies did years ago: What are the weights at which people begin to suffer high blood pressure, heart disease, osteoarthritis, diabetes, cancer, and so forth, the so-called comorbid conditions associated with excess weight? Online IBW calculators abound if you want to see where you fall. However, be warned that many of these formulas are out of date, some are contradictory, and several are awfully confusing. (Do you really have to measure your elbow breadth to figure out your frame size?)
Note that IBW is closely related to another measurement you’ve probably heard of from your doctor or your insurance company: body mass index (BMI). BMI approximates the percentage of body fat on your frame. Again, you can consult a multitude of online tools to help you calculate this ratio if you want to see where you fit or don’t fit.
I don’t reject the notions of IBW or BMI from a statistical standpoint. The truth is, you’re far less likely to encounter significant chronic health problems if you’re carrying less weight—specifically, less fat—on your frame. These formulas can also be helpful from a diagnostic viewpoint. They remind us that obesity (BMI greater than 30kg/m2) and overweight (BMI in the range of 25 to 30kg/m2) are clinical epidemics in the United States, with about 56 percent of the population suffering.12
But I’m going to keep it much simpler for you, with no charts, measurements, or math. Just look in the mirror. How do you look? Get naked. How do you feel? Take a walk. How does your body perform? Does your intuition tell you that your weight and/or percentage of fat is not “ideal” for you? Too much? Too little? If so, are you ready to make a change? Are you prepared to start doing a few critical things differently?
It would be fantastic to feel and look better. Good for your confidence. Your job. Your sex life. For keeping up with your kids. For your tennis game. Across-the-board good. And good on a much deeper level, too. Good for your health and your future.
But I’m living in the real world with you. I’m not going to ask you to strive for a mathematical ideal. Truth is, very few of us can or will achieve that. I’m going to ask you to think about it. Get a feel for where you are. Use your intuition to determine how far off you are from the “ideal,” and be willing to start a process that moves you in the right direction. The most important part is honestly assessing your body and committing to making some changes if necessary (if you’re still reading this book, I’m willing to bet some changes are necessary and you’re willing to make them).
So what’s the slow medicine prescription for weight loss? Do you need to spend hundreds on materials? Do you need to study chemistry and biology, hire a nutritionist? No. It’s super-simple, actually: Chuck the cans, bags, and boxes and eat whole foods (things with one ingredient), with a preponderance of fruits and vegetables. Cut down on excessive meat, fat, and protein. Yes, there’s more to know, but starting here gets you 90 percent of the way. Oh, and start eating a little less and moving a little more. That’s it. With that simple a program, you’ll be on your way to extraordinary wellness.
To remind you, though, you have to make a change. And to do that, you have to believe you can—and should—make a change. Your best tools here are your intuition and your mirror—not your peers in the herd. If you look around at your family, friends, coworkers, and fellow citizens at the mall, you’re going to conclude, logically, that your weight is “average” and therefore okay. But it might not be. As you’re standing there, look carefully at your waistline. Feel for excess “baggage” around your middle, where it can be the most unhealthy. How do you feel when you’re naked? Ask yourself whether you still fit into the pants you wore when you were twenty-two? Twenty-five? Thirty-five? This is the objective reality that should prompt you to action.
28. Do You Maintain a Skillful Diet, Low in Processed and Refined Foods and Animal Products and High in Fresh, Seasonal Fruits and Vegetables?
THE HUNGRY HERD
Putting down the junk food isn’t easy. Let’s talk about why. The fact is, you might have a nasty habit, and you might be a little out of control when it comes to what you eat and how much you eat. We all know the herd has taken us to the trough of unskillful eating, meal after meal, snack after snack, treat after treat, until we’ve become less healthy than past generations, despite—and sometimes because of—the enormous “advances” we’ve made in food science and medicine. On our continent, obesity is now the second leading cause of death.13 For a decade or more, for the first time in history, there are just as many overweight people (1.2 billion) as there are underfed people in the world.14If we don’t step away from the feeding trough, in a little more than a decade, 75 percent of North Americans will be overweight. We might all be in this (sinking) boat together, but that’s cold comfort. All this excess weight:
•raises your blood cholesterol and triglyceride levels
•lowers your HDL (“good”) cholesterol
•raises your blood pressure levels
•increases your heart attack risk
•increases your diabetes risk
•increases your osteoarthritis risk
•saps your energy
•interferes with your sleep
•contributes to your depression, guilt, and shame
If you’re even mildly overweight, your chance of getting diabetes doubles. If you’re obese, the chance triples, which explains why more than twenty-one million people in the United States have diabetes and forty-one million more have prediabetes.15 Type 2 diabetes and overweight are twin-sister conditions: when one increases, so does the other.
Here’s where we must look at the herd around us. The cultural element weighs heavily, pun intended. It starts with our first herd—our family. We think of diabetes and obesity as genetic: my mama had it, so I have it. But that’s an issue not of genes, but plates. Your mama teaches you how to eat. You and your mama are sitting around the same table, making the same food choices.
As a society (a big herd), we’re seeing some pretty alarming trends. We’re consuming five hundred to eight hundred more calories per day than we did in the 1970s (about a 24.5 percent increase). Generally deadly refined grains, sugars, fats, and oils make up more than 90 percent of these extra calories.16 Restaurant portion sizes have at least doubled—and in most cases quadrupled—from their 1950s equivalents, when the Happy Days gang, Richie and Potsie and Ralph, went to the diner once or twice a week (after burning all those calories necking with girls). French fry portions nearly quadrupled from the average portion of 2.4 ounces at Al’s. A hamburger patty has tripled from the 3.9 ounces in the 1950s to the common 12 ounces at restaurants today. The average pasta serving has doubled, as have muffin sizes. And a chocolate bar, which averaged one ounce when Mrs. Cunningham served it to Joanie in the 1950s, is now on average up to eight times bigger!17 Meantime, are we exercising eight times more? You know the answer to that.
In the United States and Europe, people consume an average of about 3,550 calories daily. By contrast, people in Asia consume on average 2,648 calories daily. The diet in these Eastern countries seems to rely mostly on whole grains and vegetables, with far less meat than we consume. In Western countries, meats and fats make up a significantly larger portion of the diet.18 Which culture do you suppose is fatter, less healthy, and unhappier? It probably won’t surprise you to know that as Western influences like McDonald’s settle firmly in the East, people there have begun to look and feel more like us. What a terrible legacy.
What led us to this? What leads us to make these kinds of choices? Is there some other hollowness we’re trying to fill besides our stomachs? I believe there is. We as individuals are no longer eating strictly from physical hunger. And we as a culture certainly don’t have to worry about famine and starvation anymore. Our problems have a lot more to do with excess than lack. So what’s behind the decisions we’re making? Next time you want to reach for the doughnut or cookie, try employing a little more common sense and wisdom. Use your mirror. Ask yourself, Am I really hungry? Or am I feeling useless in my career? Am I feeling unloved and unattractive to the world? Am I feeling unfulfilled in my creative endeavors? Am I trying to build a barrier between an uncaring world and my sensitive self? Am I, in short, treating feelings with food? None of these questions is pleasant, I know. But neither are illness and needless early death after years of pain. Many of these questions and their answers fall under the umbrella of a syndrome called emotional eating. Overeating has long been associated with depression, anxiety, loneliness, boredom, anger, low self-esteem, and a host of other emotional states, in addition to all its negative effects on the physical body. I understand how tempting it is to keep denying and resisting the change. But I also know how unskillful that is.
Let me be clear: it’s not fair to oversimplify the challenges you face, or to categorize you in any way. I’m not judging you, but asking you to look deeper into the personal and cultural factors that might have led to the health state you’re in—and the one you want to be free of. With the right questions, I hope you might finally understand the emotional elements that influence you and your health choices, and gain the clarity you need to take the necessary steps to becoming healthier. I’m saying that something else out there will make you feel more full than a pint of rum raisin ice cream. It’s not for me to dictate what exactly that something is, but I think that the vast majority of times, it has a lot less to do with physical hunger than with the spiritual, emotional, and soul-level hunger I discussed earlier. When you learn to properly care for and feed those aspects of your life, your stomach tends to stop grumbling.
All of this makes me think of my patient Barry. He told me he had been successful twenty-one times in losing weight, a remarkable achievement, on the one hand. Unfortunately, he also relapsed twenty-one times, so typical of the roller-coaster ride of dieting. But Barry was no slouch. He was intelligent and well-meaning, a wonderful man. He was also very well versed in the lingo of dieting. In fact, he could recite the ten most popular diets off the top of his head, with all the details and instructions as clear as I’ve ever heard them. He was not failing for lack of information or intention. He was simply in a rut, familiar to so many. Like others, he also subscribed to the simple formula of calories in/calories out. So he exercised a great deal. But he was still overweight and suffering from it. He was working hard and getting nowhere. When I met him, he was very down, experiencing even more frustration and depression as a result of all his “failures.” This only contributed to his pain. Like most, Barry was barking up the wrong tree—constantly looking for answers and the next great approach that would finally solve his problem.
I sat Barry down, as I do with all my patients, and asked him to identify all the pieces of his health puzzle, from his physical symptoms to his feelings about his relationships and work. I asked him a question that simply blew him away: I said, if I were a magician and could simply restore your weight (and resolve every ailment and problem you’re experiencing), what would you do with your newfound health? What would you do with your life? In other words: Where are you going? What’s your purpose? After he wiped the tears from his eyes, he knew what he needed to do. He needed to get his life in order. Not his weight. His life.
Several months later, with the puzzle pieces in place, Barry was a new man. It wasn’t the result of a newfangled diet. It was the guidance within that steered him to fulfill his purpose, a real purpose. Meaning returned to his life and he was back on track. Months after that, without nearly the effort he had put in previously, he shed the weight. He has never looked back.
You, too, could follow the crowds to the buffet, or you could turn to look inside, the way your instinct tells you that you must. You know something needs to change. But to ready yourself for real change in your health, you’ve got to buck that crowd that has given you permission to overeat and eat the wrong foods. The herd of your family. The herd of the Wal-Mart culture. The herd of TV ads that declare “I’m lovin’ it!” Loving what? Diabetes? Heart attacks? Early death? No—loving the taste. The mouth feel. The surge you feel when you first ingest that kind of stuff. It’s no accident: a lot of careful planning and high-tech science makes sure you feel a strong kind of high when you eat junk food. The idea is simple: junk food is a drug. I don’t mean metaphorically, but literally. Sugar and fat and artificial chemicals work the same way on brain chemistry as drugs like cocaine do. Pile in that mac and cheese, full of butter, salt, and highly processed white flour, and the brain very soon gets a boost of dopamine. Of course we all know it crashes soon after, then sends us in search of another quick fix. Studies show we’ll ignore almost all other impulses in order to get it. We feel secure somehow, once we get this junk food fix, and we really suffer without it.
There’s a reason they call it comfort food; things that feel good (like sex and eating) are supposed to be good for us, supposed to ensure we survive and reproduce. But science has short-circuited this process. So now our brains interpret the feeling we get from sugar, fat, and other junk as security to counter our inherited fear of famine. But of course, we’re far from famished.
Contributing to our chemical quest for that quick fix is a pervasive psychological problem: the constant peer pressure we undergo from family, friends, and the media. We hear constant enabling messages: Have another drink. Splurge a little. You deserve a treat. This pattern often begins with our mothers, I’m afraid to say. What does love smell like? Isn’t it Mom’s chocolate chip cookies, or her gravy, or her [insert your mother’s specialty here]? Is it any wonder so many of us are emotional eaters who confuse food with feelings?
I love food, but food is not love. No amount of pepperoni pizza will make up for a dearth of love in your life. In fact, the pizza is much more likely to make you feel further depressed.
Try whole foods. Prepare them yourself, or with loved ones, carefully, lovingly, and slowly. Celebrate the meals. Feel grateful for the bounty. Fill yourself throughout your life with all the joys of living, whenever you can. Don’t look to fulfill your spiritual and emotional hunger with fat, protein, and sugar. There’s no love at the bottom of a bucket of chicken—just grease and regret.
DENIAL
When the solutions are so simple, why is it so hard to make real changes? One reason is that old enemy of change: denial. We’d like to pretend that everything’s okay. It’s a built-in defense mechanism.
In his transcendent poem “The Marriage of Heaven and Hell,” William Blake writes, “If the fool would persist in his folly he would become wise.” For many of us, the paradigm shift toward wisdom never occurs, and we persist in our folly until we fall into the hole again and again, never choosing to walk down the other street instead.
The struggle to learn from our experiences seems to be the root cause of a broad range of problems afflicting society, from substance abuse and obesity to the widespread mistreatment of the planet and exploitation of its resources. Think about it: Don’t you think it’s a good bet that most hardened alcoholics, drug addicts, bullies, and polluters are aware of the harm their actions are causing? Many subtler forms of self-destructive behavior also go on despite a general recognition of their damaging effects. Yet we persist in hurting others and ourselves despite the consequences. Why? Why do so many of us deny the problem and fail to alter our behavior? Why do we fear the mirror?
Maybe it’s because we know on some level that looking in our own eyes will reveal that we’ve made some unskillful choices—that it’s all on us. We can’t really blame “Mom” or “society” or “genetics” or “the media.” And maybe it’s because we know that real change demands continuous hard work.
We can think of this as our herd’s collective tendency toward languor and laziness when it comes to changing behavior. We’re biologically hardwired to seek maximum benefits from minimal effort. So perhaps our resistance might be the natural response to the realization of how hard the work is. Why bother? It’s so much easier to turn on the TV and settle in with a box of cookies.
This form of laziness often manifests as denial. We justify. We talk ourselves into believing that it’s okay to maintain the status quo. This is especially true when we look around and see most everyone else doing the same things we are. Laziness might also be a reflection of a deep-seated feeling we have that fundamentally we’re not worthy of a better life. We look in the mirror and we see a lost cause, and a cause unworthy of saving. Either way, we experience a self-fulfilling prophecy as our unskillful behavior and unhealthy choices continue to contribute to our low self-esteem and worsening health, and so on in a downward spiral.
Furthering this challenge is that as we lose faith in our ability to take care of ourselves, as we continue to consider ourselves unworthy of real health, we keep looking elsewhere—to the herd and its leaders—for solutions.
Meantime, we keep hiding in our holes. Even when well-meaning doctors try to help us ask the right questions—How much do you drink? Are you taking your medicine? Are you engaging in risky sexual behavior?—we find ourselves embarrassed by the questions and ashamed at the answers we’re hiding. It’s profoundly paradoxical that we approach our doctors as victims incapable of saving ourselves, but at the same time, we lie through our teeth to them! Or at least we regularly omit certain facts, concoct stories, and shade the truth to make our behavior seem more acceptable. Patients routinely lie to their doctors about whether they’re taking their medications, understate how much they eat, overstate how much they exercise, feign illnesses to get appointments faster, and ask their doctors to hide information from their insurance companies.19
Why do we do this? Because our intuition tells us that we’re making unskillful choices. We’d rather deny them than change them.
In fact, denial seems to be the normal state of affairs in our modern society. We deny everything: our finances, health, relationships, habitat destruction, disease, and even the fact of death. We deny problems outright, look for scapegoats, replace uncomfortable emotions or feelings with “appropriate” ones (this is called reaction formation), project our anxieties onto someone or something else (displacement), and/or generally shut out information (suppression) when we find it inconvenient or distasteful.
There’s a second interesting paradox at work. While we frequently deny certain things about ourselves, we can deny them only once we have, on some level, recognized and acknowledged them. If you have chest pain every time you walk up a hill, for example, you’re aware of your condition. But if you choose to ignore it, if you don’t share this information and seek solutions, you’re denying its existence, at your peril.
Or, when we do finally recognize something, too often we choose to ignore the implications. “Sure, I’m a hundred pounds overweight, but otherwise, I’m healthy.” “Yeah, my wife and I don’t talk anymore, but that’s just the way it goes in a marriage.” Perhaps this happens to us when we feel helpless to solve big problems. In times of war and repression, entire communities can become incapacitated by denial. For many years, German Jews closed their eyes to the looming threat of Nazism because they convinced themselves that as loyal and assimilated citizens they were safe. Not to mention the denial on behalf of the non-Jews: What did they think all those trains and smokestacks were for? Did they really think all the Jews, Catholics, Gypsies, and homosexuals were away at summer camp?
Sometimes denial serves a purpose. Because our minds can’t possibly attend to everything in our inner and outer worlds, denial of certain conditions and situations helps us focus on our immediate needs. Some people use denial as a coping strategy, and it might even keep them temporarily sane. However, when the issues that lead to denial become recurrent or habitual, then denial becomes an albatross. In my medical practice, I often see heart patients deny that they’re feeling lousy, sometimes with serious medical consequences. Such denial, some research has shown, may be a more powerful predictor of heart attacks than familiar risk factors such as smoking, high blood pressure, and diabetes.20
Look—if a friend were talking to you about her health, and it emerged that she had serious, chronic issues, would you encourage her to deny them? “Don’t worry, Sue. It’s just heart disease. Why don’t you just ignore it!” Of course you wouldn’t. So why don’t you deal with your own chronic conditions with the same clarity of understanding, the same respect and attention?
29. Is Your Water Intake Adequate?
Feel like you don’t have the energy to face that truth? Too tired to tackle real health change—or any change for that matter? Well, let me shift gears and relieve you of the mounting pressure you might be feeling and return to something much less provocative. Part of the “laziness” that gets in the way of change could be physiological. It might sound overly simple and even silly, but if you want to be ready to make a real change in your health, you’ve got to consider whether you’re hydrated for it. The body is between 60 and 70 percent water by mass, and water is necessary for every vital organ and process. It flushes out toxins, it lubricates joints, it carries nutrients to cells, and it helps the blood flow. Of particular interest to us is how water can help ease inflammation, the issue at the root of the Big 8.
Yet, as a nation—perhaps as a species—we’re chronically dehydrated. We lose water constantly through our breath, our sweat, and our bathroom functions. And we need more water now than ever, to dilute the load of salts and chemicals we consume. So this one’s very simple: you must replenish those fluids. You’ve all heard that you should drink eight eight-ounce glasses of water per day. Recently, there’s been some backlash against that advice, because it’s not necessarily supported by hard science. But good sources such as the Mayo Clinic and the Institute of Medicine recommend that men in temperate climate zones drink about thirteen eight-ounce glasses a day, women about nine eight-ounce glasses a day.21 My advice is similar, but I’d like to provide you with a simple suggestion for ensuring you’re getting close to the amount you need based on your weight. Drink enough so that you pee every two or three hours during the day. Your pee should be light-colored and clear. In all likelihood that will require at least eight glasses a day, so starting there makes sense after all. Obviously, if you’re exercising and sweating a lot, or if it’s particularly hot and humid, you’re going to need more water. And when I say water, I mean water—not soda, not diet soda, coffee, milk, or fruit juice. A little tea is okay if you want some extra flavor. An occasional glass of wine with dinner is okay, too. But generally, when you think “drink,” think water.
Proper hydration will help you look and feel better. It makes the skin less dry. It prevents headaches and cramps. It will grease your rusty wheels and get you ready for real change. And in the scheme of things it’s simple. When do I water my garden? I make sure my plants get the water they need at all times. I’ll wait while you pour yourself a glass.
30. Do You Stretch Regularly?
In the same way that you would stretch before a bout of physical activity, you should prepare to get ready for the stresses of the average day. Just as a cat or dog does first thing in the morning, you should give your major muscle groups a good stretch when you wake up, or after long periods of inactivity, such as when you’ve been sitting in front of a laptop for hours. It feels good and it’s good for you: stretching helps with flexibility, range of motion, stress relief, back pain, posture, coordination, blood flow, and overall energy. It might even prevent strains and other injuries.22 On another level, think of the physical stretching of your muscles as preparation for “stretching” yourself toward change in your life.
There are lots of good resources online and in the bookstore to help you with a stretching routine, but much of it is just common sense. A few suggestions, though:
1.Stretching should push (and pull) your muscles to their natural limits, but it should not hurt. If you’re feeling pain, dial it back. Slowly increase your stretches over time to increase flexibility and range of motion.
2.For general purposes (not for specific sports performance or enhancement), stretching should be static, not ballistic. This means you shouldn’t “bounce” the muscles, but rather slowly and steadily stretch them. Reach forward until you feel the tension in your muscle, then hold that stretch for a few seconds. If you’re training for soccer or some other athletic activity, consider more dynamic stretching, and consider a professional trainer to help you avoid injuries. Remember, stiffness in the body is often a consequence of a rigid mind. Therefore, stretch your mind, too, daily. Learn new things. Remind yourself to consider new possibilities regularly and reach out.
31. Have You Let Go of Fear in Your Life?
FINDING THE PATH AWAY FROM FEAR
Despite the great simplicity of the questions in this chapter, there are reasons that so few of us practice them. Learning to live skillfully, for all its benefits, can be scary. Asking yourself deep questions about the quality of your life and your potential futures, good and bad, can be particularly frightening. In fact, I’ve found that fear is at the heart of many of my patients’ real health challenges. The good news is, you can work on alleviating fear, starting with the fear of change, and separate yourself from the herd on its way to slaughter.
Fear is a powerful force in the way of our getting better. A culture that’s all about following the herd, a medical system that encourages us to come to “expert” doctors as “victims,” a system that conditions us to expect quick solutions to difficult problems, a society that doesn’t believe we can learn much from challenges, a culture overreliant on technology and the latest advancements—all of that’s a recipe for hopelessness in the face of chronic health difficulties. Out of hopelessness is born fear. Fear that we are not in control. Fear of making major changes. Fear that we might suffer needlessly until we die. Fear of death itself.
I know what you may be feeling. Your health problems make you feel like you’re in the dark, in a plane that’s lost its engines, and you’re plummeting toward the ground. A fire breaks out. People are screaming, and you’re screaming, and the pilots up front seem to have given up. The 77 Skillful Questions are like the lighted arrows that show you the way up the aisle, ultimately guiding you to the exit doors. By illuminating the underlying nature of health and reminding you of your own deeper purpose, they even show you how to fly the plane yourself. They give you all you need to know to bring her in safely. Having clear instructions helps you eliminate the fear that limits you. If you believe, truly, that you can get better, and you understand the path to get better, you will get better.
Fear persists in large part because of the absence of good (and wise) leadership—instead, we rely on “solutions” that address only the short term. If you’re obese, for example, and have suffered a chain of health consequences related to obesity, you might get somewhat better by tackling the obvious behavioral changes your conventional medical professionals have suggested, including decreasing caloric intake and increasing activity. I’m offering the same advice! But clearly there is more to it—otherwise you and many millions of our fellow Americans would have succeeded long ago. That’s why it’s important to ask the most skillful questions that go as far as possible beyond conventional medicine.
Let’s go back to an early question: Do you understand the causes of your chronic condition? As you think about this again, you are probably beginning to understand that the conventional approach barely scratches the surface, actually serving to lull us to sleep rather than waking us up into a real awareness of why we do what we do and how it hurts our health.
Exploring the questions will help heal any number of areas in your life, so you’ll feel less fear about your present circumstances and the future, even as you begin to get a better handle on your physical condition. When you feel you’re gaining more control of your life, you’ll very likely begin to take more responsibility for your health choices.
The point is, you’ve been on the wrong street looking for treatments. First, as we discussed in chapter 1, the street you need to be on is the one heading to your purpose, your special role in this life. Once on that path, you’ll find things like overeating and underactivity less tolerable. In other words, clarity is both the antidote to fear and the beginning of a treatment plan for the physical condition. Once this light goes on, the way out of the crashing plane becomes easier to navigate. You feel less fear. So, yes, it might be uncomfortable at first to face your fears, but, ultimately, you must do so in order to conquer them.
Even if you’re dealing with a seemingly more dire problem, say an inoperable brain tumor, the questions and self-reflection will help you, too, by alleviating fear in a similar way. By working on all aspects of your overall (mind, body, spirit) health, you’ll experience less anxiety. You’ll improve many facets of your life, especially your relationships and your emotional state. Nothing could be better for the body, even in the face of something as aggressive as late-stage cancer. Your sense of control and other factors of well-being will rise exponentially. The quality of your life—even if it is to be foreshortened by disease—will improve dramatically, in part because you won’t be so afraid.
A main reason fear creeps into our consciousness when we begin to ask questions about our health is that on a fundamental level, we know that some, if not most, of our suffering is caused by our choices and attitudes. We feel bad about ourselves, full of guilt and shame, wandering aimlessly, living sloppy, unskillful lives. Many of our choices are setting us up for a big fall. We know we’re not living our lives in a way that’s very grounded or stable; we sense that our relationships are messy; we hate our jobs; we don’t feel appreciated by our families; we haven’t fulfilled our dreams and wishes; we don’t feel connected with nature or a grand plan; so we naturally worry—we panic—that we’re going to run out of time before we get our houses in order.
Another reason we live in such fear is that we’re overwhelmed with information and thus overwhelmed with choices. Indeed, we live in an unprecedented age of information, which is awe-inspiring in many ways. We Americans collectively consume 1.3 trillion hours of information annually, an average of twelve hours per day per person from newspapers, TV, books, the Internet, video games, and so on. Our total consumption is the equivalent of 3.6 zettabytes per day. How much is a zettabyte? It’s 1021 bytes, a million million gigabytes, or the equivalent of about 10,845 trillion words. The average person consumes 34 gigabytes of information per day (that’s longer than this book), 365 days a year. From 1980 to 2008, information consumption grew by 72 percent.23 In one recent year alone, it grew four times. God knows what we’re up to today. And by the way, this does not include all the information we consume at work!
All this information is bound to inspire a lot of fear. Our hyperawareness of every impending peril causes great anxiety in all but the most “Zen” of us. We know enough to worry too much, and this includes all we know or think we know about our health. The media doesn’t help, of course, with every teaser for the evening news going something like this: “Can disposable diapers cause cancer? Tune in at eleven.” We crave this kind of stuff. A few years back, there was a bestselling book called Everything Is Bad for You: An A–Z Guide to What You Never Knew Could Kill You, and it included things from sneakers to holy water to rain.24 It can seem as though the entire universe is conspiring to do you in—but in fact, when you live in harmony with nature and universal laws, the very opposite is true. We’re addicted to information but bereft of wisdom. It’s this wiser perspective that’s been lost in the sea of digits and words and images galore—and it’s something we must recover if we are to have any hope of achieving the clear state of mind that will help us overcome our inordinate tendency to be afraid.
When it comes to fear, I want to leave you with an important realization. If your thinking about health often focuses on annoying symptoms; if it takes the form of, “Oh my God, I have to get this thing removed/excised/ablated/irradiated/‘cured,’ ” then you’re going to have to accept living in fear much of the time. When you begin to understand what truly constitutes your health, you realize there are many things you can do—and many other ways you can think—that will maximize both your sense of wellness and your actual physical health. You can work on improving the quality of your relationships (your spouse, kids, parents, friends, workmates, and community). You can concentrate on contributing to society as much as possible (by volunteering, tutoring, rescuing animals, just being nice to people, and so on). When you do these kinds of proactive things to improve the general quality of your life and the lives of others, your sense of purpose—not to mention your sense of control—gets a workout, and your fear will subside. What blooms in its place is a strong sense of assurance that many people would call well-being, and what I define as extraordinary health.
So, even though you’ve heard much of this before, it’s time for you to act to gain clarity, then act on the clarity you gain.
32. Do You Have Faith in a God, Spirit Guides, Angels, or Some Other Power Beyond Yourself?
33. Do You Actively Commit Time to Your Spiritual Life?
DO YOU HAVE TO HAVE FAITH?
This brings us to the subject of faith, not the preacher’s version, but your own sense of goodness in the world and in this life. Surely you have it, otherwise you wouldn’t be reading a self-help book. But, this is once again a charged subject. Even if you’re skeptical, please read on, on the off chance you might be surprised.
Indeed, if you want to get healthier, I would strongly urge you to consider delving more deeply into the spiritual realms. It might be no more involved than considering nature and its wonder, or a practice of gratitude. But it’s worth it for the following reason: Wouldn’t this life be easier if you were not alone?
Perhaps our discussion of leaving the herd has left you in a little bit of a predicament. Who’s walking the path with you? Can you count on your best friends, your family, your spouse? Perhaps so, but maybe not entirely. The truth is, it’s worrisome to feel alone. I think we each need to restore some appreciation for God and maintain a faith in something beyond ourselves, or we’re destined for depression and ill health. If we feel loved and supported, connected to something greater than ourselves, it’s easier to make real change, to commit in a real way.
If it fits into your belief system, your commitment and faith might fall toward God or your house of worship. Although statistics show recent increases in atheism,25 a vast majority of Americans still believe in God, a majority of us pray daily, and nearly half of us attend a religious service weekly.26 And here’s where it gets interesting, from a health perspective. It turns out that people whose lifestyle incorporates their religious faith are reaping some real health benefits over people who have little or no faith.27 In fact, a vast majority of the hundreds of studies that have looked at religious beliefs, faith, spirituality, and health, have concluded that people who believe in God or some other force greater than themselves tend to live healthier lifestyles. They are physically stronger and actually need less health care from doctors, hospitals, and drugs.28 In other words, they’re healthier.
Just how powerful do you think faith can be in self-healing? A Johns Hopkins University study concluded that people who attended religious services monthly more than halved their risk of death from chronic diseases such as heart disease, emphysema, cirrhosis, and some cancers.29 Another study showed that frequent church attendance led to self-reporting of levels of well-being higher than those who went to church less: more frequent attendees had fewer disabilities, fewer days sick, and fewer physical symptoms of chronic diseases.30
Still skeptical? Then this might really blow your mind: one famous study found that patients on a coronary care unit fared better than others when complete strangers in a different room prayed for their recovery—even though those heart patients didn’t even know they were receiving prayers!31 One analysis stated, “The magnitude of the possible impact [of faith] on physical health—particularly survival—might approximate that of abstaining from cigarette smoking, adding seven to fourteen years to life.”32
Some religions include as part of their practice a focus on health. Buddhism, for example, urges adherents to purify the mind, extinguish desires, and practice healthy (essentially vegetarian) eating, all of which can benefit one’s health. Several studies of Buddhist practitioners support this notion.33 Seventh-Day Adventists are famously healthy, mainly because of that sect’s emphasis on healthful eating—also mostly vegetarian, and often vegan. Similarly, Christians, according to one study in Singapore, “[regard] the body as the temple of God so they [value] their bodies and [follow] the prescriptions and proscriptions linked to health protection sanctioned by Christianity.”34 Some of the strict dietary laws of Judaism and Islam also make sense from a health perspective, especially if you were living thousands of years ago when they were codified.
Practicing your faith and spirituality, regardless of religion, is also an important factor in achieving extraordinary health. The Singapore study reported that mere “involvement in religious-oriented activities seems to direct . . . energies in a constructive and meaningful way, preventing [people] from being consumed by trivialities and loneliness.”35
But it’s important to note here that “faith” doesn’t necessarily mean “God” in a traditional sense, and “practice” doesn’t necessarily mean religion, per se. It means a powerful belief in things unseen, and more or less unproven. Maybe you have a traditional concept of God. Or, maybe you’re wondering, to paraphrase the Joan Osborne song, what if God is just a slob like one of us, just another passenger on the Greyhound of life? Or perhaps you find your faith among the spirits of your ancestors. Angels. Guides. It doesn’t matter. What matters is the feeling that you’re not in this alone. That there are forces out there in which you can put your faith, on which you can rely, in which you can take comfort, on your journey toward change. Forces, unlike the herd, that have your best interests in mind. Forces aligned with the natural order of things.
And what matters is your regular practice. If you want to achieve extraordinary health, you should make appointments with yourself and your faith, be it meditation or Mass or a sweat lodge. Put these appointments on your calendar as you would a doctor’s visit—and stick to them.
And, finally, perhaps you can develop more faith in your own intuition. Maybe those voices that tell you what feels right and wrong are coming from outside yourself after all.
It all seems so simple. Eating well. Drinking enough water. Breathing deeply. Stretching daily. Believing in something beyond yourself. All of that is entirely within the grasp of even the oldest, sickest, fattest, most out of shape person out there. And yet, if you practice the lessons of this chapter alone, you’ll be radically healthier than the herd around you, with very little effort and no expense. That’s amazing. But even more important, you’ll have set the groundwork for deep and vital change that will lead the way to extraordinary health. You’ll be walking around those holes you’ve previously fallen into. You might even be walking on another street entirely!
PRACTICAL PRESCRIPTION 4: TAKING A BREATHER AWAY FROM THE MOB
Picture gazelles again on the Serengeti plain, grazing on grasses and looking, to the casual observer, more or less at ease. Suddenly, all their heads pop up, their ears prick, they stand for a millisecond, inclined and at the ready, with the muscles of their thighs twitching and an eye toward the nearest escape. Before you can blink, they’re all off, seemingly as one solid unit, dodging whatever snake or cheetah one of them noticed. An observer would be very hard pressed to identify, even with a slow-motion camera replay, exactly which gazelle kicked off the panic and set the whole herd on a beeline for the escarpment. The point is, all the individuals in the herd responded to the stress with a flight instinct.
We humans are just as susceptible to receiving unconscious and often instantaneous transmissions of stress from our hominid herd. Are we supposed to experience a lovely inner peace after riding the El in Chicago during rush hour? Should we be cool and collected when our workplace herd is terrified of the King of the Jungle who works in the corner office? Is it reasonable to expect that we can maintain a sense of inner calm and balance when our family is close to tearing out each other’s throats? You know the expression, “You could cut the tension in that room with a knife”? Stresses of the herd are palpable, and have real effects on our individual minds and bodies.
Think about what happens in your body when you’re stressed and feeling uptight. Indeed, you literally tighten up. The muscles of your neck and back constrict, your limbs all get stiff. Even your face scrunches up—a common cause of headaches, jaw tension, and dental problems. And that’s just the tightening that occurs near the surface of the body. Inside, your glands and organs send a set of powerful chemicals, such as adrenaline and cortisol, surging through your system to prepare for flight, in response to whatever pain, fear, or other stress you’re encountering in your environment—or even just in your mind. In evolutionary terms, this is a critical survival mechanism. We humans, just like the gazelles, have to be ready to stop munching and flee instantly if a lion shows up. And we have to be able to sense that imminent flight of the other members of our herd, so that the individual who detects the lion isn’t the only one who survives.
The problem is, as we humans have evolved, most of our lions are not the real kind with razor-sharp teeth and meaty paws anymore, but the metaphorical kind: the kind who cut us off on the highway; the kind who say mean things to our kids; the kind who undervalue our efforts at work; the kind who send shivers down our spines as we listen to the anchorman at six o’clock. But the brain and the body haven’t quite adapted to this new normal yet. For them, stress and fear are stress and fear.
Once you find yourself in that heightened, aroused, ready-to-head-for-the-hills state, your rhythm and flow is interrupted. Just as the gazelles stop grazing, you must stop what you’re doing, too. The stressed state veers you off the course of your activities, whether work or play. It will take you a while—sometimes a long time—to get back into a peaceful, steady state of mind, so you can accomplish your goals and feel good again. If you’re like most people, this happens so often that “stress” becomes a chronic condition, creating in the body a perpetual state of unease, a permanent state of worry that a lion’s about to bite off your head.
The question, then, is how to come back to a state of better balance and harmony. There are a few key ways:
1.Spend time whenever you can putting things into perspective. Your boss is not a hungry lion, as much as it feels that way sometimes. Unless you’re in a few particular lines of work—such as the bomb squad—your life is not really in danger. If you think about it, even your job is probably not in danger in this very moment. An angry boss might be unpleasant, but it’s not the kind of impending extinction the gazelle’s got to worry about, 24/7.
2.Whenever possible, leave the immediate environment. I suggest this because in our herd we tend to foster and encourage our stresses, rather than relieving them. When you can, spend a short time alone and meditate calmly on your reaction to the event or person that stressed you out. Why are you so worked up? What good is it doing you? What other strategies can you employ to ease tensions, to deescalate stress rather than escalate it by relating it to others and seeking their support and approval for your pain, fear, or anxiety? A short bathroom break might be enough. If you can’t get away, shut your eyes for a moment and mentally move away from the herd to look at the scene in the bigger picture.
3.Get some physical activity. This is as healthful and appropriate a response to that feeling of being wound up than “unwinding” by sitting on a couch in front of the TV.
4.Perhaps the most readily accessible—and most effective—relief can be found in the very act of breathing. Believe it or not, by breathing a certain way, as simple as that sounds, you can reverse the ill effects of both immediate (acute) and long-term (chronic) stress states.
34. Do You Breathe Abdominally for at Least a Few Minutes a Day?
Frankly, any and all of these practices can help you manage stress now and ready yourself for real health change down the road. But nothing could be more fundamental than the breath. Ever notice a baby breathing, or a dog at rest? Perhaps you can remember a time when you, too, were lying comfortably in a carefree state, and noticed how relaxed your chest and belly were, how effortless your breath was. That feeling—that’s the goal.
Contrast this to moments when you’re stressed: Can you feel how tight your chest becomes? How high in your chest you’re breathing? How shallowly? In fact, this kind of breathing might feel more akin to panting if you were to contrast it to that same dog you saw lying on the lawn last night, mellow and relaxed.
There’s been a millennia-long debate among philosophers and, more recently, neuroscientists about which comes first—the emotion or the corresponding body state. At the end of the nineteenth century, the philosopher and psychologist William James argued that the fear (emotional state) upon, for example, seeing a bear, does not cause the body’s reactions (physical state), such as rapid heart rate, sweaty palms, and dilated pupils. He argued instead that it’s the physical feeling itself that causes the emotional state. In other words, if you see a bear, then tense up your stomach, ball your fists, squint your eyes, and run for your life—then you will begin to feel an emotion (fear) associated with that physical state.36
The lesson here is that you can control your emotional state—you can move from stress and fear to relaxation and calm—by working first on your physical state. In other words, if you calm your breath, you can calm your nerves. Athletes, firefighters, police, and soldiers have employed this technique to stay focused in the midst of very high stress, even life-or-death situations. These people report—and studies back them—that when they focus on breathing to get ready for the potentially stressful event, they perform better, with more confidence and calmness. So you can practice this in bed before you wake up, in the shower, in your car on the way to work, in the elevator, or at your desk before your big meeting.
Specifically, the object of this breathing exercise is to find a way to get out of the typical shallow breathing you do high in the chest when you’re stressed—and expand more of the chest and belly. Ideally, you should do this without effort (without straining or causing yourself any further stress). Many call this technique “abdominal breathing.” It’s the most skillful way of breathing, because it works the deep connection between your physical and emotional states. As you tune out the herd, you tap back into your life. Indeed, once you get the hang of it, for these moments at least, you are living skillfully.
So how do you do it? The key is to slow down and be as still as possible. First, take one or two intentional deep breaths, focusing on your exhaling as much as your inhaling. And with each subsequent breath, try to gently extend the length of the exhalation. Eventually, work on releasing the effort it’s taking to breathe and see if you can just get into a new groove, gently but deeply breathing in and out. To do this, some people focus on a slow, rhythmic song in their head, or they listen to something like the wind or waves around them. You can also try a portable audio device with some gentle music or natural sounds. Once you get good at this, you can do it in the middle of a crowded and noisy subway car, just by focusing on nothing but the gentle breath. If you actually think about the breath—how it feels, how it sounds, how long it takes—your mind will quiet itself of other stresses. If you find your mind wandering or ramping up stress, don’t beat yourself up. Just refocus by concentrating on the next breath again.
The next step is to get your whole body involved. Take a little survey of your arms, legs, shoulders, neck, and back. Notice any tension in those areas, and with each exhalation, relax each of these areas, one at a time, staying in your groove. Some people like to picture warm water or blue light bathing each area—use whatever technique works for you. The key is to release the tension by first becoming aware of it, then tying the relaxation to your breath.
One place we hold a particularly large amount of tension is our abdomen—so pay attention to it. We’re trained to “suck it in.” We’re always pulling in our stomachs, and as a result, breathing high in our chests. Again, think of that unselfconscious baby or puppy—they breathe from their bellies and chests, and they benefit greatly from it.
Finally, you can add a mental component to the exercise. In the relaxed, deep-breathing state, your subconscious mind is very open to suggestion. In all cases, this suggestion should be positive. So, you can visualize success, and try to use your other senses, too. Focus on your purpose, and try to avoid thinking about achievement or things. Instead, visualize living in harmony with the world around you; see yourself as an important contributor to a more beautiful and peaceful planet; see yourself living with extraordinary health.
In less than two minutes, you should be back to center and ready to go. Try to maintain your clarity. If you have more time, use it. A half-hour of breathing practice daily will dramatically change your life and health. You can do this anytime, especially in the middle of the day when you need to relax and recharge. But if you adopt a standard daily breathing practice, such as first thing in the morning or right before bed, you may find that your stressful “blowups” become less frequent and less disturbing—clearly a sign that you’re moving in the right direction.
So, why not get started? Try it now.
QUESTIONS FOR FURTHER REFLECTION
35. Are You Free from Anger Toward God?
36. Is the Home You Live in Harmonious?
Obstacles. We can find them wherever we look. Indeed, there’s so much out there to interrupt and obstruct our “path” and “flow,” and this causes great frustration. But what if we can find amusement in the challenge, wonderment in all that happens, as the majesty and mystery of life unfolds beneath our feet? While this might not be so easy to do on the spot, Skillful Living is defined by the relaxing of our tight hold on expectations and timelines. Let them go, let life flow.