communication

Wellness Wednesday: How to Tell if You’re a Workaholic

Most people say they are busy. But are they ? Americans are famous for being workaholics (fully 25 % of us). How busy is too busy ? 

I would like to present my thoughts on the issue. Then I would like to present some other sources which are more authoritative.

It is important to understand what is not too busy. If you work full time, but have no time to work out or see your spouse, and yet you have time to game, watch TV or get a professional pedicure, you are not too busy. 

You are not too busy if you find that working at your desk leads to hours of randomly surfing the web or checking social media. You can only assess yourself once you have cut all the unintended time wasting from your life. If you are mindfully watching a film, or checking specific things in social media for a few minutes, that is fine and does not count as time wasting. 

So let’s say you have optimized the way you work and spend your time (a topic for another day). Let’s say you have reviewed your schedule and have decided that everything on it is important and nothing can be cut. Then you have met the “ inclusion criteria” and can ask yourself these questions: 

  • Am I getting less than 7 hours of sleep on a regular basis ? 
  • Do I feel a constant sense of frustration at not getting things done ? 
  • Do I lack time to work out for 30 minutes per day ? 
  • Do I lack time to eat three healthy meals and snacks ? 
  • Am I getting sick too often ? 
  • Is the quality of my work getting lower and lower ? 
  • Am I neglecting important relationships ? 

 

If you met the inclusion criteria and you answered yes to any of these things, you should consider thinking about whether you are overcommitted. These would be the relevant endpoints for me, after 54 years of living with, working with and being an overcommitted person. 

WEBMD

http://www.webmd.com/balance/features/are-you-a-workaholic?page=2

This article places workaholism in its psychiatric context. It is a compulsion to go work, combined with discomfort when not working. So it is much more than working hard, or working a lot. They site signs like trouble delegating, thinking about work while on vacation, or neglecting one’s nonworking life. They indicate that cognitive behavioral therapy and support groups can be helpful. 

US NEWS 

http://money.usnews.com/money/careers/slideshows/17-signs-you-might-be-a-workaholic/2

This feature described signs you might be a workaholic. Noteworthy signs including having no hobbies, working through lunch every day, coming to work when sick, being accessible to work all the time, and consistently overbooking. 

The WORKAHOLICS ANONYMOUS site is a real eye opener. 

http://www.workaholics-anonymous.org/10-literature/24-twenty-questions

Surprises in their list of 20 questions include "Do you regularly underestimate how long something will take the rush to complete it ?” This is a more in depth read and I recommend it. 

FORBES 

http://www.forbes.com/sites/deborahlee/2014/10/20/5-signs-you-might-be-a-workaholic/#430847d833d1

Forbes showcases a very worthy article about work-life balance, citing some interesting statistics including the following : "Americans put in more hours than workers in other wealthy countries and are more likely to work nights and weekends.” They alsogive an introduction to Bryan Robinson’s book “ Chained to the Desk”, which is available on Amazon. 

The follow up articles in the same series 

http://www.forbes.com/sites/deborahlee/2014/10/20/6-tips-for-better-work-life-balance/#5ae8fd25dbc9

details 6 tips for a better work like balance. The two tops which appeal to me the most are “ Letting go of perfectionism” and “ Limit time wasting activities and people”. 

SCIENCE DAILY

https://www.sciencedaily.com/terms/workaholic.htm

This site highlights some more surprising aspects of workaholism including the observation that workaholics lose track of time. They also highlight some chilling aspects of workaholism including the problem in Japan, where early death related to workaholism has its own word, karoshi. We all know that workaholism takes a huge toll on mental and physical health, but death by karoshi is hard to fathom. 

I am going to strive in the next few weeks to make my posts more brief. I will feature more outside sources. It is my hope that these posts will be easier to write and easier to read. This is one step I will be taking toward a better work like balance. 

Send me your thoughts on the matter. I would love to see what you think. 

 

 

 

 

 

 

Wellness Wednesday: Recovering from a Serious Injury

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This last weekend my son Vale had a major skiing accident. He broke his femur, had a pulmonary contusion, a broken rib, and a mild concussion.  He had to have emergency surgery. We quickly travelled to attend him, and since then we have been making arrangements for his recovery care. 

Though he will be off school for a time he will stay at college and we will return home. Therefore, I have been working with a team of friends and relatives to accomplish his care. This will, of course, consist of a series of wound checks, physical therapy appointments and post op appointments. It will also consist of a calendar of people doing shopping, making meals and doing laundry. When he returns to school in two or three weeks, it will mean getting driven to campus and wheelchairing around. It will mean seeing how it goes.

It has also meant getting correspondence passed back and forth between the doctors, physical therapists and the university faculty. To coordinate all this, I have had to send no end of contact information. I have had to create shared calendars and documents in the cloud, and distribute them to all his friends and family who have stepped forward to help.

Vale has had to deal with pain, disappointment and disruption. It is taking all of us together to shore him up during this trying time. It is taking everything from favorite foods to ice packs, but it is worth it. Even though it has been only four days, we can see distinct and major improvements every day.

 I am in awe of his caregivers. The surgeon and anesthesiologist spent significant time on the phone with me both before and after the case. It was easy to tell they were top notch, but they were also genuinely invested in my son, and empathized with me having to be so far away during the surgery.  I will be forever grateful for the time and energy they spent. I later leaned that that they spent this kind of energy during the entire weekend, since Vale's hip fracture was one of five such cases. The winds in the mountains had been high, and had swept the ski slopes to a hard shiny gloss. It took its toll.

Vale's physical therapist was a ray of hope. She came from both academic and clinical practice backgrounds, and was deeply invested in her field. She was immediately able to put us at ease and to identify all kinds of helpful strategies. Vale felt 100 percent better after one appointment, from a combination of the physical treatments, but also the encouragement of knowing his prognosis.

All this touched me as a mother and as a physician. It sheds renewed light on what I do.

Wellness Wednesday: Gratitude is at the Center of Wellness 

Most people think of gratitude as a feeling. Actually, it is a practice. Did you know that there is a science of gratitude?

Major academic centers the world are investing in gratitude. Gratitude is studied as a part of a relatively new branch of Psychology called Positive Psychology. A landmark study in the Journal of Personality and Social Psychology, 2003, volume 84 number 2, entitled “Counting Blessings versus Burdens: an experimental investigation of gratitude and subjective well-being in daily life." This research suggested that”...a conscious focus on blessings may have emotional and interpersonal benefits”.

Much more recent research since then has also underscored the physical health benefits of gratitude. Most of us understand by now that the mind and body are connected on a neurophysiologic level, and while it is fascinating, it is no surprise that a mental practice such as gratitude could go on to have concrete benefits to physical health. 

What is gratitude, the practice?

Prof. Robert Emmons, the author of”Gratitude Works !" recommends establishing a full on gratitude ritual. These can include the following:

  • Make a resolution or vow to practice gratitude. 
  • Make a plan to practice gratitude. 
  • Have a morning gratitude ritual. Examples would be glancing over your gratitude journal or meditating for a few minutes about what you are grateful for. 
  • Adopt the physical habits of gratitude such as smiling and making eye contact, saying hello,, saying please and thank you, and making a physical gesture such as handshaking if appropriate.
  • Send written expressions of gratitude such as emails and thank you notes in paper.
  • Place objects or other visual cues in your house, office, or where you can see them to remind you of something for which you are grateful.
  • Keep a gratitude journal. Make it brief but make it regular. If you keep it by your bed you can glance at it first thing in the morning.
  • Go out of your way to remember good times.

 

What will a practice of gratitude do for you?

There is an enormous body of science from a variety of sources that indicate the following effects of gratitude:

  • Stress reduction
  • Improvement of a immune function as measured in the bloodstream.
  • Better recovery from loss, i.e. Better resilience
  • Higher levels of life satisfaction.
  • For students,better grades.
  • It makes you a better friend to others.
  • Improved sleep.
  • Strengthens interpersonal relationships
  • Improves team functioning 
  • Greater alertness
  • Greater enthusiasm
  • Greater goal attainment.
  • Lower levels of depression
  • Enhanced capacity for empathy
  • Improved self esteem
  • Reduced aggression
  • Decreased loneliness
  • Greater tendency to act with generosity and compassion
  • Increased energy.
Gratitude
$11.27
By Oliver Sacks
Buy on Amazon

This is not just new age foo foo nonsense. Institutions such as Stanford, Harvard, and Penn, not to mention Google have thrown serious money, time, and entire departments into the pursuit of the evidence based effects of gratitude.

So this Thanksgiving, capitalize on this most important of national holidays. Find your gratitude, and keep it going. 


References and Additional Reading: 

Pass the Gratitude: Recipe for a happy Thanksgiving, From Huff Post Los Angeles

In praise of gratitude, from the Harvard Mental Health Letter

Seven scientifically proven benefits of gratitude that will Motivate you to Give Thanks Year-round from Forbes

Expanding the Science and Practice of Gratitude, From the Greater Good Science Center at the University of California, Berkeley

Why gratitude is Good for You, From the Stanford Social Innovation Review

Structures Sunday: the Structure of Studying

I'm a perpetual student. You may not realize it but in certain circles this was considered an insult. I now realize it is good thing. Indeed life long learning is the only way to go.

I have already blogged about the importance of reading and creativity. Those of you who know me realize I have a number of serious creative pursuits, Since we are approaching Halloween, I am deep in preparation to sew a detailed costume. For these sorts of things as well as my work, I have to study. That's right, study.

For my costume I have had to research everything from specialized sewing machine feet to the thermal properties of craft foam. For my amateur photography I have had to research telescope eyepieces and how to connect a old school serial port to a USB port.

Tonight for example I am deep into my annual board review preparation. Every year we have to review research articles and take tests, But every 10 years or so we have to take a big test and that is what I am preparing for this week.

Additionally, I am aware of many of my friends and their adjustment to the new school year. Bottom line: all parents home school, even those parents whose kids go to public or private school. That's how I felt anyway when my kids were in grade school and high school. Every day when I would come home from work I would simply change hats and I would turn from OB/GYN to homeschool teacher. I would check in with each of my kids to see what they had to do for homework and upcoming tests. I would check in on how their classes were going. I might take a some time and give them a little supplemental information on a topic if I happened to know something about it. Finally I would monitor their study habits. As much as I think they found it irksome, I think even they would admit it has served them well. 

So what are good study habits? There are numerous books written on the subject which are beyond the scope of this blog post and well worth reading. I just want to emphasize that you should stay intellectually and creatively active as a part of your overall good health. I also want to empower you to get involved in your children's academic life. So here are a few basic tips for studying that will serve you as a parent coaching children, a student, or simply as an adult keeping her intellectual and creative life healthy.

  • Get an overview of the task at hand. Even grade school children should know that school goes in semesters or quarters. They should know when the tests and quizzes are given, and when their assignments are due. Both children and adults should have a simple clear system for writing this down. It can be either digital or paper. Their should be a daily and weekly routine for referring back to this schedule. That makes for no surprises and less procrastination. 
  • Prepare. It does not matter whether you are preparing for a book report in seventh grade or a board exam when you are a doctor, preparation is key. Learn to channel your anxiety and concern into an early jump start on your project. This is imperative because it alleviates stress and gets the job done.
  • Know how to study. Here is a general method for low stress, effective preparation. 
  1. Scan the material for an overview.
  2. Read the material thoroughly.
  3. Highlight the material thoroughly.
  4. Make your own handwritten notes from your highlights.
  5. Make index cards from your handwritten notes, using a brief description on one side and more complete details on the other.
  6. Quiz yourself on your index cards. Do it out loud. When you do, put the ones you know well in one pile and the ones you need to review in another pile. Repeat your index card quiz, this time only with the pile that you need to review. Again, put the ones you fully understand in the good pile and the ones you need to review in the bad pile. Repeat the process until there is nothing in your bad pile.

It turns out that getting as many senses involved in your learning helps. The technique described above involves several senses, sight, touch, and hearing. Reading, writing with your own hand, and seeing what your own hand has written or hearing yourself read what you're own hand has written reinforces the learning of information on multiple levels, indeed in multiple areas of brain.

This is all well and good if you simply need to learn facts. However, if you need to know how to work problems, that comes next. Work on all the problems you can two or three days before they are due. That way you have a chance to go in and ask questions well before the problems need to be turned in. If you are a parent supervising children with homework like this, be sure that they do their assignments at least two days before they are due. You will ingrain this kind of habit in them for the rest of their life, and that will serve them well. And don't forget to lead by example.

If you're working with older children who will be taking tests, coach them a little bit in test preparation. Emphasize early and repeated contact with material as well as working of every problem that the teacher has handed out. Encourage students to use practice tests that have been provided to them and that are available on the Internet. Encourage them to fill in their understanding with information they find on reputable Internet sites such as Khan Academy. Have them try finishing the test preparation the day before the test is given so that they can spend that day asking the remaining questions. Tell them not to be afraid of being like Hermione Granger and having their hand in the air all the time. 

Make sure you and your children have a good night’s rest before any tests. I realize this is easier said than done but it is sound advice. In fact, make sure they are well rested before any school day. This will maximize their ability to learn. Equally important is a good protein rich breakfast, especially before tests.

It is important that if you are parents supervising children in their studying or their homework that you be supportive not harsh. Regardless of what you may think of their teachers, encourage courtesy toward the teacher. To do otherwise is a disservice to your child. 

Is very important to remember that if you are helping someone with their work, you're principally helping them to understand how to do the work themself. Under no circumstances do you do the work for them. You may work a similar problem for them to see, since that is different.

A healthy creative and intellectual life has been proven to benefit health. This is true for both adults and children. I hope these tips help make your studies easy and fun.

 

Wellness Wednesday: Workouts for your Mind and Soul

Have you ever heard of TED talks ? If I had to think of the SINGLE BEST USE of media, TED talks would be it. Now aren’t you curious ? 

TED talks are short (usually less than 18 minutes) powerful talks by people with important and timely insights. Originally they were by just the very best and the brightest, people such as Bill Gates, Steve Jobs and Steven Hawking. To this day, they are still given by those who have a deep special interest and expertise in a subject. 

The TED talks were originally conceived in California. They have close ties with the California University system, Stanford, and all major universities the world round. They are international in scope. To be invited to speak is a rare privilege. To attend in person is enormously expensive, but all talks are provided free to everyone over the internet.  TED talk conferences have branched into all major cities, and TEDx has been developed to give smaller communities the chance to participate. 

Oftentimes Ted speakers are researchers, or high level thought leaders, heads of state, or industry innovators. Commonly they are scientists or extreme athletes. Occasionally they are artists of note. They are always fascinating, and always worth watching.

And while you can listen to TED talks on iTunes radio, podcasts, and elsewhere, they are best watched. There is nothing like seeing these sorts of people give these usually intense distillations of human wisdom and brilliance. If you want to see a great example, check out the Talk by Jill Bolte Taylor. In video format, it brings it so much more down to earth. The speakers seem more accessible, as though you might run into them in the grocery store. 

I can tell you why a TED talk is so potent. This is because I was asked to to do one at the first TEDx conference in our area. I had done public speaking before, so I thought it would be straightforward. Wow did I have a lot to learn. A TED talk is not like an academic lecture. For our conference in northwestern Montana, I had several coaches, starting weeks in advance. One came all the way from Southern California to coach us. The coaches had to tear my style apart and put it back together again. I was lecturing, whereas they needed me to actually connect on a personal level over my material. I had to explain myself in clear ordinary nonmedical language.  I had to connect, which was my biggest challenge, and I had to end with a call to action. Plus I had to get it all done in 18 minutes or less.  

 

There are so many stories you and your family NEED to watch at TED.org and TEDx.org. I have been showing them to my kids, family and friends for years, and they are an endless source of inspiration. The TED.org website is great in that you can chose a talk by speaker, topic, or even rating. You can get an app on any platform or you can use a computer and a browser to go to TED.org. I cannot recommend then any more highly. 

 

Structure Sunday: The Structure of Friendship

Tonight I had dinner with a friend I have known since early high school, about 40 years ago. I love the the idea that we have been friends that long. I actually don’t like the idea of ever losing any of my friends, regardless of time or distance. And there has been a great deal of time and distance between me and most of my friends. Nonetheless, I think old friendships hold the world together. 

This friend took the initiative to keep in touch. We went to the same small high school and left there in 1977 and 1979 respectively.  Our high school was an intense, supportive and inspiring place, and as a group, we departed there meaning to do good in the world. He and I went off to separate colleges a continent away, and went about marrying, having kids, going to school, school, and more school. I became a physician and he became a researcher for the World Health Organization, among other things. 

After Facebook reunited many people, he decided it would be nice to visit. And so he did, especially since I live in eminently visit worthy place. Of course, truth is stranger than fiction, so during his visit, he naturally he fell right in love with my wonderful neighbor and returned later to stay many months with her. Eventually they parted ways as friends and he still visits to this day. 

So tonight I had my good neighbor and my old friend over for dinner since he is visiting. It was such a treat since I also invited my niece and nephew over as well so they could meet my old friend. For you see, my friend did go out and do good in the world, and I wanted to share it with these kids. 

He recently finished his residency in Anesthesia, as he decided later in life to become a doctor. At the end of his residency, the Ebola outbreak began, so he departed for Sierra Leone, one of the hardest hit areas, to help. He spent six weeks there, and at tonight’s table, he told us about all we wanted to know and more, from the percentages that lived, to the special suits he wore, to his American co-worker who contracted the disease and lived. I was so pleased that he could share all this, especially with the kids present. It not only tied us together, it tied us together with all the Ebola fighters, and even put us degrees closer to the Ebola patients themselves, and helped us understand their humanity in a near first hand way. Best of all, he told us about the preliminary announcement from about three weeks ago, that an effective Ebola vaccine is on the horizon. 

So as the night wore on, and the topic of Ebola played itself out, we realized that my nephew plans to travel to just the area of Italy where my old friends and my neighbor have visited: Venice. So I was the happy recipient of colorful descriptions of Venice. My nephew was given numerous recommendations about places to visit, things to do, and travel strategies to use. I got to listen to exuberant descriptions and enthralled questions about this place, which at this point, to me, is nearly mythical, yet now more real. 

So because of this long friendship, tonight, at my own table, I traveled from darkest Africa to brightest Venice. We were able to appreciate each far flung place as the real place that it is, and understand that hope blooms in both. We renewed bonds, and shared all this with the younger generation. 

Are your friendships in good shape ? They are so important to our collective well being, that I suggest having a look. 

 

 

 

 

 

Wellness Wednesday: Dealing with Disappointment

The other day, I inadvertently backed up into my husband's truck, for the second time in one month.  Both times it was parked in an atypical location, but both times I should've seen it. Both times I was going about 1 mile an hour. I have incurred enough damage to pay for two round-trip airfares to Europe. This was a disappointment.

 

My initial reaction was that I was sad and dismayed. However I was on my way to a delivery, so I knew I had to be sharp. I knew it was nobody's fault really and that there was nothing to be done about it at that moment. The necessity to get out of my funk in short order was actually a really positive exercise. It caused me to think about the best way to deal with disappointment.

All the sources that I consulted on the subject indicated the same basic set of recommendations. Here is my personal redux on the matter. 

  • Pause and breathe before reacting. Take a couple of minutes if need be.
  • Acknowledge your own feelings of disappointment or anger, but do not act out.
  • Accept the present state of affairs.
  • Deliberately avoid blame and invoke an attitude of neutrality.
  • Take responsibility for what you can.
  • Remind yourself that all problems have solutions or at least strategies.
  • Deal constructively with what you have to and postpone the rest until the initial shock wears off.
  • After the initial shock wears off, reach out to others who you know will be helpful and supportive.
  • After any big disappointment, stay in your basic routine. Observe a good sleep schedule and stick to your three meals and three snacks every day as well as your workout.
  • Go out of your way to remind yourself about all the good things in your life. 

 

Keeping this routine will help keep your stress levels down and help you recover from disappointments. 

 

 

Medical Monday: ACOG weekly news

Headlines proclaim “ Aggressive Treatment for DCIS May Not Save Lives”.This sounds rather dismal. Reading further, what they should have said is “ Aggressive Treatment for DCIS May Not Be Necessary to Save Lives”, which is good news. DCIS is very early microscopic breast cancer, and as such its concerns everyone. Such an alarming headline got my attention. But once I found out the news was actually good, I was a little dismayed.  There must be a chapter in the Journalism textbook where it says bad news gets more attention than good. I don’t know. Read carefully out there ! 

Just to refresh your memory, ACOG stands for the American College of Obstetricians and Gynecologists. They send its Fellows, myself included, news updates throughout week. These are articles of pertinence to women’s health. Each Monday, I pick a small sample and present them to you for your consideration. More such articles can be found at www.acog.org. 

There is such a thing as “ distracted snacking”. The Journal of Health Psychology reported the results of a small study which indicate that distracted snacking results in greater intake even afterwards. I speculate that it has to do with the fact that distracted snacking results in greater intake that say “ mindful snacking “ ( my term)  causing insulin levels to spike more than they would have, and more hunger to be stimulated later. So be mindful about your snacking and remember to always include some protein. 

The venerable diaphragm has gotten an upgrade. A Seattle based nonprofit has developed a new more contoured model. It’s name is Caya. Go to Caya.eu to learn more. It is not yet available. 

Finally, ACOG has released new guidelines regarding the treatment of morning sickness. First line therapy should be in the form of the class A combination of doxylamine and vitamin B6, commercially available over the counter without a prescription in the US as Diclegis. ( Class A is the safest pregnancy category for a drug. ) This is not to say that we are not still going to need Zofran for certain patients. It will still be considered after Diclegis is deemed insufficient. 

When you read medical related articles in the mainstream press, read very carefully. It is tricky to report accurately if you do not have medical background. For more on that please see our section “ Your internet learning toolbox”. 

Stay tuned for more medical news next week on Medical Monday. 

 

 

 

 

Wellness Wednesday: Healthy Communication Skills

Communication skills are intrinsic to our wellness. They are central to our relationships and our effectiveness in life. I have distilled a list of six main steps in healthy communication. I discovered I have lots of room for improvement. Hopefully you will find something helpful too. 

1. Attitude adjust.

  • Consider your purpose in the conversation. 
  • Assume the best intentions in everyone. 
  • Stay positive - honest, patient, optimistic,  sincere. 
  • Value everyone equally. 

2. Check physical factors.

  • Put away distractions like phones. 
  • Make comfortable eye contact.
  • Watch your body language.  
  • Watch your tone. 

3. Listen actively.

  • Listen first.
  • Ask open ended questions.
  • Set aside judgement while listening. 
  • Listen actively -  Don’t interrupt; read back, aka clarify and reflect. 

4. Guide your reaction. 

  • Use empathy; Try to see the other person’s point of view.
  • Practice self awareness -recognize emotions and stresses as they arise and rather than react to them, handle them appropriately. 

5. Say your piece. 

  • Pause and ponder. Think before making a point.
  • Understand how your message might be received.
  • Tailor your message to your listener.
  • Use empathetic assertiveness. 
  • State needs, express feelings; Value your own point of view as well. 
  • Be direct; Be BRIEF - Give the "b"ackround, "r"eason,"i"nformation, "e"nd, and "f"ollow-up.

6. Connect and conclude. 

  • Connect personally.
  • Encourage the other.
  • Focus on the result.
  • Ask for input and feedback. 
  • Follow up with a plan. Close the loop. 
  • Show appreciation for the person and the conversation.  

 

Awesome references that expand on these tips: 

http://lifehacker.com/top-10-ways-to-improve-your-communication-skills-1590488550

http://www.lifehack.org/articles/communication/9-tips-to-improve-communication-skills.html

http://www.wikihow.com/Develop-Good-Communication-Skills

http://www.skillsyouneed.com/ips/improving-communication.html

http://www.skillsyouneed.com/general/emotional-intelligence.html

http://www.skillsyouneed.com/ips/improving-communication.html

http://www.inc.com/kevin-daum/8-ways-to-improve-your-communication-right-now.html

http://www.citehr.com/11334-6-good-tips-increase-your-communication-skills.html

http://advancedlifeskills.com/blog/14-very-effective-communication-skills/

http://www.wfm.noaa.gov/workplace/Comp_Conf_Handout_1.pdf

http://www.helpguide.org/articles/relationships/effective-communication.htm

Wellness Wednesday: Curing Procrastination

Is procrastination an illness ? No. But it can affect your health. Let’s take a look at what it is, why it happens, and how to cure it. 

What is procrastination? 

Procrastination is putting off things that need to be done. How big is the problem ? About 20 % of people are chronic procrastinators and these percentages increase significantly during college. People who are chronic procrastinators perform more poorly in their family, in high school, in college, in jobs, and in relationships. This sounds like an unfortunate nuisance, but it is actually a health problem. According to many sources, procrastination creates stress which interferes with sleep, weakens the immune system and makes heart disease more likely. It is also very hard on mental health. 

To understand why procrastination happens, we have to look deeply into issues like self control, self image, inner honesty, fear of failure and distress tolerance. 

1. Procrastination may start as a form of silent rebellion against parents. This becomes a vicious cycle as adolescents avoid parents in favor of friends, who do not hold them accountable as parents would. 

2. Certain necessary tasks or even the idea of the tasks make people uncomfortable (distressed) , either because they dislike doing them or they are perceived as difficult or overwhelming. Those who cope with their feeling of dread or discomfort (distress) by avoidance may procrastinate, only making matters worse. Those who have poor coping skills or distress tolerance are likely to do other dysfunctional things to cope with life’s daily challenges and discomforts, such as abuse substances. 

3. When people do not want to risk failure, they will subconsciously "arrange" to have insufficient time for a task, thereby providing themselves with a ready excuse for their suboptimal performance.

4. Procrastination is self sabotage. People procrastinate to fail in order to show others they have been mistreated, to “get back at them” or to acquire victim status. ( This is, by the way, passive aggressive behavior.) 

5. Some people who procrastinate simply want others to pull up the slack in whatever it is that needs doing. 

6. Some people who really want to succeed procrastinate. They deceive themselves about several things: 

  •      They will be more motivated tomorrow.
  •      They have plenty of time left. 
  •      Their task will not be that challenging nor take that much time. 
  •      They will do better when they are feeing more motivated or inspired. 
  •      They think they do better under pressure. 
  •      They are talented enough to pull it off. 

     These are white lies we tell ourselves. 

 

What can be done about procrastination ? 

 

1. Procrastination is hard to overcome but it requires honesty with oneself and usually firm persistent guidance from others. 

2. Strong feelings of interpersonal conflict should be evaluated by a qualified counselor. 

3. Problems with procrastination in the setting of substance abuse should also be evaluated by a qualified counselor. 

4. Simple methods to beat procrastination are as follows: 

  •      Fortify your will power and your distress tolerance with adequate sleep, healthy meals, snacks and regular exercise.      
  •      Become a list maker. Get a system which is either digital, paper or both and include reminders such as sticky notes or alarms. 
  •      Use SMART goals criteria for your list items. See more about SMART goals HERE. Nutshell version: SMART goals are specific,measurable,attainable, relevant and time-bound.
  •      Overestimate the time it will take you to get something done. 
  •      Ditch perfection as a goal. It gets in the way of progress and accomplishment. 
  •      Divide large tasks into a series of small manageable tasks. 
  •      Practice mental “ time travel” to see how you will really feel tomorrow. 

5. All of this requires self regulation. Practicing self regulation with small tasks has been proven to improve self regulation with big tasks. 

  •      Realize that self regulation is critical to healthy relationships and success in life. That should be plenty of motivation. 
  •      Pick several easy small tasks, and stick to them. Larger tasks WILL get easier as a result. 
  •       Yoga or meditation is especially good training for the nervous system where self regulation is concerned. 
  •      Be easy on yourself for lapses. 
  •      Pat yourself on the back for all successes. 

   

References: 

 

Cal Poly’s Procrastination PDF - WOW amazing document ! http://sas.calpoly.edu/asc/ssl/procrastination.html

Psychology Today: 

https://www.psychologytoday.com/blog/dont-delay/200903/self-regulation-failure-part-4-8-tips-strengthen-willpower

https://www.psychologytoday.com/articles/200308/procrastination-ten-things-know

https://www.psychologytoday.com/articles/200909/ending-procrastination-right-now

https://www.psychologytoday.com/articles/201109/procrastination-oops-where-did-the-day-go

https://www.psychologytoday.com/articles/200308/procrastination-ten-things-know

 

Mindtools: 

http://www.mindtools.com/pages/article/newHTE_96.htm

 

The Procrastination DOOM LOOP 

http://www.theatlantic.com/business/archive/2014/08/the-procrastination-loop-and-how-to-break-it/379142/

 

Procrastination and the great Stanford Marshmallow experiment 

http://youarenotsosmart.com/2010/10/27/procrastination/

 

University of Cambridge 

http://www.counselling.cam.ac.uk/selfhelp/leaflets/procrastination

 

Princeton

http://www.princeton.edu/mcgraw/library/for-students/avoiding-procrastination/procrastination.pdf

 

Procrastination and Your Heart

http://nymag.com/scienceofus/2015/03/procrastination-is-not-great-for-your-heart.html

 

 

 

 

Structure Sunday: The Structure of Your Home Office

Today's women have to do it all. Homemakers and professionals alike need a home office to do all that they need to do. Here are my tips for what goes into a home office, and what should take place there. 

I have also included some great resources about home offices. 

 

Three setups tailored to your budget:

The Essentials:

  • A place to write and store your life management things. 
  • Day runner with addresses, calendar, and notes or smartphone with same features. 
  • Backup for your smartphone if you have one. ( ? cloud) 
  • Writing implements, pens, pencils, highlighters, markers 
  • Spiral notebook to centralize and keep notes ( instead of sticky notes everywhere)
  • A few sticky notes even so 
  • Filing box and files 

Nice to have: 

  • Laptop with internet access 
  • Software 
  • Spreadsheet like Excel for Windows or Numbers for Apple  
  • Word processor like Word for Window
  • Photo storage and processing software. 
  • Bulletin or marker board for ideas, art and planning 
  • Bookshelves 
  • File cabinet 
  • A decent camera

Deluxe: 

  • Printer/fax/scanner
  • Nice speakers
  • Nice headphones 
  • IOS device like ipad 
  • an extra monitor 
  • A good camera

 

Ideas for your home office schedule

 

At the beginning of your day...

  • Leave your home office alone. Get your health related things done first, like working out, bathing, and eating a healthy breakfast. 

 

 In your home office work time… 

  • Check your email twice per day. Don’t do it reflexively. 
  • Leave social media closed until tasks are finished. 
  • Add every new contact into your address book AS THEY COME IN.
  • Keep a spread sheet of your budget. 
  • Use accounting software like Mint, which is free, ibank, which is cheap, or Quicken, to keep your bank, loan and credit card accounts in order. 
  • Set up bills to pay automatically or put reminder notices in your calendar program. 
  • Store your photos digitally, and backup those and your other documents two ways, the cloud, and a cheap external hard drive. 
  • Work on your projects in sessions about 45-90 minutes long. Then get up and stretch and drink some fluids. 
  • Develop a system of file keeping. You may like Evernote which is free. You can organize anything into albums. In side the albums are notes where you can put text, documents, picture, sound, movies, links, or anything. 

 

At the end of the day

  • Review your calendar and plans for the next day. 
  • Chart any nutrition or fitness data that you are working with on a daily basis. Make sure the method is simple and fast. 

At the end of the week

  • Review your calendar and plans for the next week. 

 

Home offices can be a lot of fun. They are ground zero for domestic creativity. Think recipes, projects with kids, projects for the house, tracking that workout and budgeting for that vacation. Knowledge is power and organization will put it to work. 

Tools4Wisdom Planner - Life. Simplified.
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Wellness Wednesday: Beyond Relaxation to Renewal 

Most of us are familiar with the recommendation to relax on a regular basis. We are all familiar with the ravages of stress and the problems associated with insufficient sleep. We generally think of relaxation as the antidote. To most people this means to physically rest or sleep , and to be quiet and still. There is no doubt that some of this kind of time is good on a daily basis, especially if it is done in a mindful fashion such as in meditation.

But sometimes we need more than relaxation. We need renewal. Renewal goes beyond relaxation. It is similar to relaxation in that it is a break from the usual work routine. However, after that, the similarities end. Renewal is more planned. It may involve physical activity, such as exercise, or an outdoor adventure. It may even involve a challenge. It often involves other people, especially people who are new to you. It involves unfamiliarity, learning and even getting outside of one’s comfort zone. 

Productivity experts are extolling such “ strategic renewal” as the newest productivity tool in the success toolbox. This concept can be utilized on different time schedules: daily, weekly , monthly, quarterly. 

Daily Renewals 

  • exercise 
  • meditation 
  • reading 
  • connect with close family and friends 

Weekend Renewals: 

  • connect with farther flung family and friends, socialize and entertain
  • patronizing the arts 
  • sports 
  • spiritual observance
  • volunteer
  • outdoors 
  • reading 
  • exercise 
  • creative pursuits outside of work 

Monthly or Quarterly renewal: 

  • adventures 
  • conferences 
  • different kinds of work projects 
  • travel

See to the basics first: adequate sleep, regular exercise, and good nutrition. Ensure some relaxation on a daily basis. But go beyond all this and try to start thinking about renewal as well. 

To learn more :

See our sections on Sleep Yoga and Meditation 

LIfehacker

Huffington Post 

New York Times 

Stanford University Cafe Science

What Most Successful People Do On the Weekend, by Lauren Vanderkam 


Structure Sunday: The Structure of Your Media Consumption

IMG_0083.jpg

Omigosh I must be so easily amused. I have flown planes, climbed mountains, and swam with sea lions, but today, I got the biggest rush from organizing cookbooks in their new shelves. I just adore their beautiful pages full of recipes like magic spells waiting to be cast. A beautiful recipe transforms you as you make it, and your family as they see what has been prepared for them. 

I am reading a riveting book right now. It is called Seveneves. I found myself reading it at a stop light. Not good. I chose it based on the genre, sci fi, but also because of the reviews on Amazon, and finally because of what I was able to learn about the author, for instance that he double majored in Physics and Geography. I learned all this on the internet.

Seveneves: A Novel
$21.00
By Neal Stephenson
Buy on Amazon

 

 I did all that research because I wasn't going to devote several hours of my life to something less than totally worthwhile. You see, I get absorbed in my books, fiction and non-fiction alike. They transport me. I don't hear things around me when I am reading. If something is going to affect me like this, it better be quality and it better have redeeming value. I want to finish the book a better person. 

I feel the same way about film, but there are far fewer good films than there are good books. Still, the depths of Netflix and Apple TV are unplumbed, and I look forward to it whenever I have time to dive deep. I don't know if my approach is correct; I save film like candy or ice cream, and cannot watch it until I eat all my vegetables, i.e. work, housekeeping, bills, and exercise. 

Music, however, is like water to me. I have to have it all the time. Patients know it plays all day long in all our clinic rooms, and we try to make it wonderful. We try to make people enjoy their time with us. I want to turn more people on to fine music.

I believe music puts you in touch with yourself. If a song makes you melancholy and wistful, it is touching something within. You may gain from this awareness, and perhaps be able to give the issue more attention. Likewise, if you hear something that makes you feel like dancing, it's because that dance is already in you; the song merely helps release it. 

When I was growing up, all this was so expensive. Books were bought in bookstores, and records required expensive equipment to play well. Regarding films, well, you had to make arrangements to go to a theater, providing you were old enough. But nowadays, the widespread availability of all this media is astonishing. I believe it is world changing. 

I have a great personal interest in the lives of those with low income and high aspirations. I respect these people. I want to understand how they can realize their dreams. I think one big piece of this puzzle is widespread high quality media: books, film, and music. These are not just      niceties in life. They nurture the soul and enlighten the mind. 

Media like music, film and books are not about living vicariously or being passive. They are about learning and getting inspired to go out and live life to the fullest. That is why I think everyone should have access to all the good stuff all of the time. 

So I wondered how much it would cost to have unlimited access to all this media all the time. Here is a rough calculation: 

 

  • Amazon Prime costs $99 per year. You get access to 41,000 movies and TV episodes, and 350,000 Kindle books. Of course the Kindle app is free for any platform. Just be aware these are like Netflix titles, not necessarily the hot new releases, but still very good. 
  • Netflix has a somewhat different set of movies, all for $7.99 per month,  all released several months after they hit theaters. 
  • Apple Music, is $9.99 per person  or $14.99 per family per month. For this you may stream the entire Apple music catalog. Or, you could get Pandora with ads, for free, or without ads, for $4.99 per month. 
  • Let's say you actually want to buy a few physical books because, like me, you think cookbooks should be physical, or because you want to have a paper book to pass around, then you must budget a few dollars for that. Let's say you, like me, buy used books on Amazon, and you decide your budget is one book per month, at $5 per book used, plus $3.99 per book shipping.

If you have a smartphone and internet already, then we can ignore those costs. If we say, for purposes of argument that you "want it all" , the tally is as follows: 

Amazon Prime = $99/yr

Netflix annually = $95.88/yr

Apple Music for one = $119.88/yr

Paper books one year, as detailed above = $107.88

Total = $422.64 per year or $35.22 per month. Aren't numbers interesting ? 

Let's say you are really on a tight budget. You pick only Amazon Prime for Kindle books and streaming video, together with free Pandora for music. Your cost is only $99/year or $8.32 per month. Honestly, that is two lattes. What an amazing time we live in. 

 

Medical Monday: Participatory Medicine

Are you an empowered patient? Do you participate in Medicine 2.0 and Health 2.0? Learn more about these terms and the interesting and beneficial changes that they describe.

Click HERE to learn more. 

P.S.  We would be very pleased if you would consider subscribing. I have placed a Subscribe and Comment page in the navigation menu for your convenience. When you subscribe, you will receive a White Paper (see definition HERE) entitled "How to Become an Empowered Patient " with our compliments. 

Structure Sunday: The Structure of a Website and ….YOU

Just last week Google lowered the boom and decreed that sites that are not mobile friendly will suffer in search rankings. At first I felt a little threatened, but after a little research, I have discovered that it is all about….YOU! Yes you. As they say in TRON, “I fight for the users.”. 

I love nothing better than to come into a patient’s room and see her on a smartphone. Do you realize any garden variety smart phone of the present day is literally powerful enough to have run the entire Apollo space program that landed a man on the moon? A smartphone is a very powerful computer and almost every girl and woman I know has one, even the ones of modest means. It is fantastic. Not only do I remember the Apollo missions, but I remember the days when women did not touch technology, not even stereo components. 

Technology is empowering. Information is empowering and the whole world of information is at your fingertips. Patients read about diagnoses, medications, and communicate with others who share their experience. So it is with great satisfaction as I watch my patients as they not only use technology, but make it. I have in my practice graphic designers, filmmakers, website designers, software engineers and IT administrators. I do believe it is technology combined with the goodwill of people, that will solve many of the world’s problems and inequities. As a force in neutralizing gender inequalities, technology is formidable. 

In blogging, and in making this website, I have wanted to provide easy access to what I would like my patients to know. My education has made me  familiar with the best sources of medical knowledge, i.e. institutions like the National Institute of Health (NIH), and the Center for Disease Control (CDC). It has enabled me to tell the legitimate from the bogus. So I feel obliged and enthusiastic to give you all key to all the doors that lead to the best paths to all this valuable information. I want to make it easy, and I want to make it fun. Additionally, I want to make it beautiful. Perhaps this last goal is a universal desire for website designers of all genders, but I think a beautiful website is more welcoming to women. 

And that user experience, in short, is what Google’s directives have been all about. I see from my website analytics that over 50% of you view the site on mobile devices. Had I looked to author my site looked on mobile? Not enough! The main page was cluttered, the font was too small, links were too small to push and you had to scroll way too much. All this gave me a very bad mobile rating on Google. Plus, page loading times were a bit long, and I admit, that is because of the higher definition photos that I chose to upload. This was all a very unpleasant but useful revelation. I felt bad but grateful for all of you devoted readers on mobile who slogged through all of that. 

I read a great deal in Google’s website design and mobile responsive design guidelines. At their heart, the recommendations are meant to enable you, the user, to see the site clearly, and to get the information you want as conveniently as possible. It is all about enhancing the user experience. I spent this weekend changing things around, using fewer main pages, and tucking more within them, so now you will do more clicking and less scrolling. And I promise, if you have a little wait for a photo, it will be a good one. More mobile friendly changes are coming next week. I fight for the users! Those of you who really want to get your geek on can learn the origin of the phrase in this clip from the movie TRON Legacy. 

Medical Monday: Evaluating Medical Reports in the Media

Everyone is interested in medical news. It is inherently sensational. But, it is challenging to report, and even journalists with the best of intentions have a hard time getting it right. 

When an intelligent patient comes to the office and spends 15 minutes with her doctor, and the doctor goes through a detailed explanation, under the best of circumstances, only part of that will be correctly remembered. Here are some links if you are interested in reading more about that : 

How Much Can Patients Learn in a 15-Minute Doctor Visit?

New Prescriptions: How Well Do Patients Remember Important Information?

Long term clinical trials: how much information do participants retain from the informed consent process?

The difficulties are on both sides. Doctors have crammed schedules. They aren't always the best of communicators. Sometimes the doctor and the patient have differing agendas for the visit. And the patients are often distressed about what they hear, which impairs understanding and memory. 

Consider classroom learning. I need to hear things and be thinking about them, take notes, see diagrams about the topic, get handouts, look it over,  and repeat it all before it is really ingrained. This type of thing is also what patients need to understand a topic. They know this and so they head for the internet. That's where it gets exciting. 

Since I am in the process of building a website for patients, I have been researching other doctors' websites. They range from the sublime to the ridiculous. Most of the sites have some useful information. However too many of them contain unfounded claims and conflicts of interest by way of selling unproven remedies. In many cases the remedies involve foods or supplements which in limited lower quality studies, showed promise, but were never followed up or proven. 

I will highlight perhaps the most prominent of these internet doctors, Dr. Mehmet Oz. With the most impeccable of academic credentials, and a media empire to boot, he is under serious fire for making unsubstantiated claims and hawking unproven products. The best documentation of this to date is through Vox Media, what I would call the thinking person's news network. Until I read the series of articles at Vox, I had no idea, since I do not have a TV. Check out this entertaining and informative debate here

Meanwhile, if you would like to read more about how to safely navigate the internet, check a  series of pages on my site, starting HERE.  There are lots of internal links so be prepared to click. I really put my heart into these pages since I believe strongly in freedom of information and the patient empowerment movement. I hope they are beneficial for you. 

 

Structure Sunday: Understanding the structure of my blog !

This evening 's blog is participatory. I will direct you to a survey link here. I has to do with the type, number and timing of my blog posts for you. Personally I think surveys are fun, especially when I can see the final results. I like to see how my preferences compare with others. 

There are so many important and fascinating topics on which I might write, that our blog would lose all structure. So since I am interested in what interests you, I am putting this out there to make it easy for you to give feedback and suggestions. 

https://www.surveymonkey.com/s/XNRRQXQ