IS IT TIME FOR YOUR CHILDREN TO LEARN MINDFULNESS STRATEGIES?

In my past posts as well as in other media there has been growing discussion about and awareness of the benefits of activities such as yoga, meditation, and deep breathing exercises. These are all strategies which help us focus on the present moment.  Most frequently, the discussion has centered around workplace issues.  There is a body of research showing that the above exercises lower stress, reduce anxiety, improve sleep and general health, and reduce depression and pain.  Meditators have been shown to have increased brain activity in areas known to induce calmning effects, such as the anterior cingulate cortex.  Calm breathing triggers the parasympathetic nervous system which reduces stress through slowing heart rate and lowering blood pressure.  But for all this work, less attention had been paid to the potential positive effects of mindfulness strategies for children.  That is changing with articles such as in Time Magazine for October 3, 2016, titled "The Mindful Classroom" by Mandy Oaklander, as well as multiple online articles such as "Why Children Need Mindfulness Just As Much as Adults Do" by Carolyn Gregoire of the Huffington Post for June 3, 2014.  

Being mindful essentially is the ability to sustain a focused awareness on the present moment. Mindfulness practice has been shown to increase our abilities to focus and attend.  It may be as effective for children as it is for adults.  Research is accumulating to demonstrate that mindfulness has positive effects for many challenges children confront.  Children increasingly face stress and this can affect their health including as adults.  In Gregoire's article, reference was made to a University of Florida study that found that "stressful events can impact a child's health and well-being almost immediately, and can contribute to the development of physical and mental health problems and learning disabilities".  Children suffer increasingly from anxiety and diagnoses for attention-deficit/hyperactivity disorder (ADHD) also are increasing each year.  

Most research on mindfulness with children has been done in school settings.  There is evidence that youngsters as young as 4 years who practice the skills have reduced test anxiety and fewer ADHD symptoms.  There also has been noted improved sleep quality and math scores.  Various authors have suggested that the positive effects can include social skills such as improved compassion and kindness. There have been benefits in studies with children with ADHD in reducing disruptive behaviors.  Mindfulness programs achieve incremental benefit when the teachers and/or parents also engage in such training.

To give an idea of ways to involve children in mindfulness, here are five of Sarah Rudell Beach's from her post titled "8 Ways to Teach Mindfulness to Kids" in the Huffington Post for September 22, 2014:

1. Listen to the bell. An easy way for children to practice mindfulness is to focus on paying attention to what they can hear. You can use a bell or a set of chimes. Tell your child that you will make the sound, and they should listen carefully until they can no longer hear the sound (which is usually 30 seconds to a minute).

2. Practice with a breathing buddy. For young children, an instruction to simply “pay attention to the breath” may be hard to follow.  One way is for each student to grab a stuffed animal, and then lie down on their back with their buddy on their belly. They focus their attention on the rise and fall of the stuffed animal as they breathe in and out.  Other ways include placing one hand on the chest and one on the belly to allow the child to follow and focus on their breathing.

3. Make your walks mindful. Go on a “noticing walk.” As you walk in the neighborhood, notice things you haven’t seen before.  A favorite of my grand daughter when she was young was to do the exercise "I spy with my eye something . . ." and then encourage her attention.  You also can designate one minute of the walk to be completely silent and simply pay attention to all the sounds you can hear.

4. Establish a gratitude practice. Gratitude is a fundamental component of mindfulness, teaching children to appreciate the abundance in their lives, as opposed to focusing on all their material possessions.   

5. Practice mindful eating. The exercise of mindfully eating a raisin or a piece of chocolate is a staple of mindfulness education, and is a great activity for kids. 

In other posts, I wrote about what I perceived to be the potential power of teaching youth how to overcome limiting thoughts.  If we can combine that with teaching mindfulness strategies, we can raise a new generation of children well able to manage their stresses, be happier, and get along better with others.  Good luck to all on the journey.

Dr. Paul Longobardi

For information on these and related posts, please see my website at www.successandmindset.com

WILL YOU EXERCISE FOR YOUR BRAIN?

I have written about the benefits of physical exercise on your brain and on your mental well being in past posts.  However, exercise is in the news again with an excellent article in Time Magazine for September 12, 2016 by Mandy Oaklander titled "The New Science of Exercise".  In that article, the author reviews how physical activity strengthens the body and brain.  

Current guidelines from the World Health Organization (WHO) and the U.S. Centers for Disease Control (CDC) recommend that most adults do 150 minutes per week of moderate intensity aerobic physical activity and twice-weekly muscle strengthening.  As pointed out in the article, many activities count such as brisk walking, gardening, walking the dog, etc.  Many people are aware of cardiovascular training but are less aware of the need for muscle strengthening as we age.  That strength training helps build muscle and bone, which protects against injury.  But you say that you don't like lifting weights.  Don't worry.  You can do other strengthening forms of exercise such as yoga, tai chi, and Pilates.  

Now here's the bad news as outlined in the article.  Only 20% of Americans get the requisite 150 minutes per week, more than half of all baby boomers (people born between 1946 and 1964) report doing no exercise at all, and over 80 million Americans over age 6 are completely inactive from an exercise perspective.  We have heard the consequences of this inactivity and they are not good.  People with very low levels of physical activity are at higher risk for a variety of diseases to include heart disease, diabetes, cancer, and Alzheimer's Disease.  Prior to development of these diseases, your inactivity can make worse arthritis symptoms, increase lower back pain, and lead to depression and anxiety.  

So what can be said about your brain and exercise?  In the Time Magazine article referenced, the author reviewed some of what is known about the effect of exercise on your brain.  There is research linking exercise to reduced depression, better memory, and increased learning. Exercise is one of the better ways to prevent or delay the onset of Alzheimer's Disease.  In other posts, I noted several promising lines of research.  For example, in CNN Health News, author Morgan Manella noted recent studies showing that higher levels of physical fitness in middle-aged adults were associated with larger brain volumes five years later, particularly in brain areas having to do with memory such as the hippocampus (Kilgore, Olsen and Weber, 2013, Scientific Reports).  In a study published this year in the online journal Neurology (Wiley et al), the authors found that older people who exercised regularly experienced a slower rate of mental decline.

Why does exercise affect brain structure and function for the better?  While scientists are not completely sure, it has been shown that exercise improves blood flow to the brain, feeding the growth of new blood vessels and even new brain cells.  This is considered due to the effect of the protein BDNF (Brain Derived Neurotrophic Factor).  BDNF stimulates the growth of new neurons and repairs and protects brain cells from degeneration.  This is exciting because for so many decades it was thought that when brain cells (neurons) die, that's the end. However, we are learning so much about how you can preserve and increase your brain functioning through exercise.  By the way, speaking of preservation, there is research showing that moderate intensity exercise may slow down the aging process of cells.  

So what are you waiting for?  Lace up those athletic shoes and get going.  Take a brisk walk, get out into the garden, get some light weights or find other strengthening strategies outlined above.  These will help preserve your brain, improve your mood, and reduce your anxiety and perceived stress.  If you haven't been active in quite some time, consult your primary care physician as to an appropriate level of exercise at which to begin.  As always, don't let mind clutter get in your way such as "I'm too old", "I have no time", or "It's too late". These are all falsehoods you tell yourself and convince yourself are true.  Challenge them and get on with improving your health and well being.  Good luck on your journey.

Dr. Paul Longobardi

For more information on these and related topics, please visit my website at www.successandmindset.com.

DOES STRESS IMPACT ADULT ATTENTION DEFICIT DISORDER?

Do you or a loved one suffer from adult Attention Deficit Disorder (ADD)?  There has been increasing recognition that this is not only a disorder of children.  While many ADD children continue to manifest symptoms in adulthood, there are individuals who have an initial onset of the disorder as an adult.  For both children and adults, the primary symptoms that define ADD include impulsivity, hyperactivity, and inattention.  The National Institute of Mental Health (NIMH) estimates the one year prevalence of adult ADD at 4.1% and a lifetime prevalence of 8.1%. These are millions of individuals suffering from this syndrome.  More men than women are diagnosed with adult ADD.  

I mentioned hyperactivity as a symptom but this is one area that does seem to present a bit differently in adulthood. For example, the overt hyperactivity may not be as prevalent for adults. Rather, the adult may experience feelings of uncomfortable restlessness.  Adults typically display some combination of the following behaviors:

Need to move; feel restless inside, fidgety
Can't sit through meetings, meals, movies
Extremely impatient
Finish people's sentences; draw rapid conclusions; interrupt others
Drive too fast, reckless
Prefer very active job
On the go; low tolerance for frustration
Talk excessively; may make inappropriate comments; interrupt others

Common symptoms of adult ADD include poor attention; excessive distractibility; problems with memory and forgetfulness; frequently losing things; trouble organizing steps in a project; chronic lateness and procrastination; trouble starting and finishing tasks; careless mistakes; and disorganization.

People with ADD cost the economy billions of dollars.  The Center for Disease Control (CDC) noted that this is so because individuals with ADD have more difficulties in school, at work, and in social relationships than those without the disorder. They have higher rates of emergency room visits and automobile accidents, are at greater risk for substance abuse, and experience higher rates of job turnover. The economic cost to American society has been estimated at between $36 billion and $52 billion annually (2005 dollars).

Individuals living with ADD have a greater risk of experiencing stress such as work stress and stressful life events (e.g. bankruptcy, divorce, etc.).  Stress actually can cause ADD symptoms to become worse. So what is stress?  As I've written about in numerous other posts, stress onset usually occurs when we anticipate or perceive danger or a threat.  When you subjectively feel stressed, it is usually because of a change that you don't feel able to handle. Clearly, different people have different senses of what is stressful to them. Some examples include: a long wait in a line, being stuck in traffic, a fast approaching deadline at work, a large bill to pay.

Physiologically, when you perceive a stressor, your sympathetic nervous system is activated. The "fight or flight" response is initiated and the stress hormones adrenaline and cortisol are released. Your pulse increases, blood pressure goes higher, and you breathe faster. You are able to respond quickly to get out of danger. Blood is diverted to the heart, brain, and large muscle groups, so you can think and act quickly.  Once the stressor is no longer present, the parasympathetic system takes over from the sympathetic nervous system and gets your body back into its normal state.

Some adults with ADD notice that they enjoy a certain level of stress as it makes them feel motivated, ennervated, and focused.  However, that activation frequently turns into feelings of being anxious and overwhelmned.  This is because we are not designed to stay alert and activated for long periods of time.  Yet, in today's world it is common for people to go from one stressful situation to another.  Unless you are able to manage your stressors, your body remains in "fight or flight" mode.  It is well established that chronic stress has numerous negative effects on physical and mental health to include increased risk for colds and flu, illnesses such as heart disease and stroke, as well as depression/anxiety and substance use and abuse.  

    So what can you do as an adult with ADD to better manage your stressors and reduce the likelihood of being overwhelmned?  There are several steps for you to employ:

1.  Identify what causes you stress - This is usually the first step to solve most problems.  Start noticing what stress "triggers" exist for you?  To help, consider the following areas:

     a.    Physical environment.  This might include the route you travel to work, distractions on the train or bus, and how you can plan to manage these with less stress.

     b.   Relationships.  Is there tension and stress with people in your life?

     c.   Money.  Do you have financial worries?

     d.  Life events.  Have there been or are there upcoming or present major events, e.g. births, deaths, marriages, illnesses?

     e.  Lifestyle or behavioral issues.  Are you having health challenges, not taking care of yourself, living a disorganized life, having problems managing your time and meeting deadlines, abusing alcohol or drugs?

2.     Problem solve to find different ways to handle the problems you identified above.  For example, if you are having health challenges, you can make a plan to schedule exercise, see your primary care provider, get more rest, take some time for yourself, etc.    

3.     Make a stress management plan and implement it.  While some stressors may be out of your complete control, most are not.  It is important that you plan on a daily/weekly basis to get out of activation mode and reduce your stress.   Here are eight ways to better manage your stressors:

1.  Exercise.  There is research support for the assertion that if you engage in 150 minutes per week of cardiovascular and muscle strengthening exercise that your health benefits physically and mentally increase.  I will have more to say about that in an upcoming post.

2.  Get regular sleep and make it a priority.  No one handles stress well burdened by a chronic lack of sleep accompanied by fatigue.

3.  Eat healthy foods.

4.  Reduce caffeine and sugar.

5.  Avoid alcohol and cigarettes.

6.  Practice deep breathing and muscle relaxation.  In other posts I've written about the positive effects of progressive muscle relaxation (PMR) on health.  PMR combines positive imagery, proper breathing, and reduction of muscle tension.

7.  Get a massage regularly.  In another post, I've written about the positive effects of therapeutic massage on general relaxation as well as reduction of muscle tension and anxiety.

8.  Change how you speak to and about yourself.  This is a hallmark of a successful mindset approach. Much of our malaise is caused by what we say to and about ourselves rather than what actually is happening.  You can read many of my other posts for details.

So, the answer to the title questions is yes.  As challenging as it is to live with adult ADD, how you manage the inevitable stresses of life will either help you live with higher well being or suffer even more.  What are you doing currently to manage your stressors?  As I always say, how you react to stress is a choice.  Make yours a healthy one.  Best wishes on your journey.  

Dr. Paul Longobardi

For information on these and related topics, please see my website at www.successandmindset.com

HOW MUCH IS THAT DOGGIE IN THE WINDOW SEAT?

Yes, I know the title of the classic song by Patti Page in 1953 is "How much is that doggie in the window?"  However, I imagine she never foresaw the growth of animals as far more than pets. In my last post, I described the hurricane experience in my trip to Belize, Central America. Well, while waiting to board the airplane from Houston, Texas, to Belize, I met a man who was travelling with his Emotional Support Animal (ESA), a lovely Goldendoodle.  In case you're as perplexed as I was, that is a mix of a Golden Retriever and a Poodle.  He had a business in Belize and was travelling with the dog, who occupied a window seat with the man on the plane.  That got me rethinking the issue of when is your animal a pet and when is it a therapeutic aid, a topic also discussed by Rebecca Clay in an article in the Monitor on Psychology for September 2016.  In the mental health area, there are Emotional Support Animals (ESA), Service Animals (SA, including Psychiatric Service Animals), and Animals for Assisted Therapy (AAT).  The main distinction is that the ESA provides support by its presence alone while a SA has been trained specifically to perform tasks for someone with a disability, such as reminding them to take their medication or checking a room and turning on lights for a person with anxiety.  

Emotional support animals make sense, given the large literature on animals’ ability to reduce human stress and anxiety and provide other health benefits, says psychologist Aubrey H. Fine, Ed.D., a professor of education at California State Polytechnic Institute in Pomona and editor of the "Handbook on Animal-assisted Therapy: Foundations and Guidelines for Animal-assisted Interventions" (2015). Dr. Fine did suggest that some people may be abusing the ESA concept so they can have their pets with them.  Individuals can go online, answer some questions, and receive a certification and jacket for their dog.  In fact, the issue of need for the ESA is a clinical/forensic question involving determination of mental health disability of the individual as well as demonstrated clinical benefit of having the animal present.  The evaluation should be conducted by a licensed professional.

Additionally, there is not much research to support the claim that emotional support animals help people more than traditional pets.  This is according to co-authors Cassandra L. Boness,  Jeffrey N. Younggren, PhD, a psychology professor at Missouri, and Jennifer A Boisvert, PhD, a private practitioner in Beverly Hills and Long Beach, California (Professional Psychology: Research and Practice, 2016). Their review of the literature revealed little evidence that emotional support animals are effective, The co-authors indicated that "The research we did find was inconclusive".

The certification of ESAs appears to have become a growing industry. There are a number of online commercial entities that specialize in providing SA or ESA certification for dogs and other animals without ever having seen or evaluated a person or their animal. For instance, the United States Dog Registry provides three levels of certification: SA dogs, ESA dogs and therapy dogs. In their advertising, the U.S. Dog Registry states that certification will allow the animal (ESA, SA, or therapy dog) to fly in a commercial airplane for free and will allow the dog in all housing regardless of an existing pet policy.

The media has taken note of the topic of airline accommodations being made for ESAs.  In a 2014 New Yorker article titled, “Pets allowed: Why are so many animals now in places where they shouldn’t be?” author Patricia Marks reported that the National Service Animal Registry, a private commercial enterprise that sells certificates, vests, and badges for helper animals, signed up 11,000 animals online in 2013, even though the animals may not have merited certification. In a USA Today (2015) article, the editorial staff took the position that while SAs were acceptable, ESAs infringed on other’s rights and reflected an exploitation of law and regulation by animal lovers. The article was critical of how some online commercial entities provide ESA certification.  As I noted above, some commercial entities render a letter in support of needing an ESA without a licensed mental health professional seeing or evaluating an individual or their pet in person. There are commercial services specializing in online and telephone disability assessments and offering letters of certification to those thought to qualify.   

It is easy to see how an industry has developed around the certification of ESAs, allowing pet owners to have their pets travel on commercial aircraft at no cost. Nonetheless, it is clear to me that these commercial evaluative services are questionable from a professional standards perspective and inconsistent with existent psychological ethics and forensic standards. This media publicity and industry has implications for my fellow psychologists as they might be pressured by patient requests for a letter of evaluation in support of their need for an ESA or certification of their pet.  In fact, at a former clinic where I worked, it was not uncommon to have patients requesting such letters from their clinicians.  

So what are we to do about all this?  It is clear that Service Animals provide specific valuable services.  Animals used in Animal Assisted Therapy also provide clear benefit in a carefully planned clinical program.  And we all love our pets.  But what are we to do about Emotional Support Animals?  It would appear that, given the paucity of empirical evidence to support the concept, more careful evaluations are in order conducted in person by licensed professionals. These evaluations would need to meet more specific criteria such as those suggested by attorney John Ensminger and neuropsychologist Dr. J. Lawrence Thomas in Law and Human Behavior in 2013: 

1.  Confirm that the individual actually has a mental health diagnosis.

2.  Explain clearly how the animal helps lessen the severity of the mental health condition.

3.  Describe how the individual and animal interact, which assumes that the evaluator meets with both.

4.  Explain clearly the possible negative effects of the individual not having the animal with them.

5.  Note any training the animal has had from a qualified trainer, if appropriate.

This appears to be an issue gradually getting out of control.  What is needed is a mix of compassion as well as evaluations marked by more scientific rigor.  This will assist all the travelling public.

Good luck on your journey as always.

Dr. Paul Longobardi

For information on these and related topics, please see my website at www.successandmindset.com. 

HOW DO YOU COPE WITH PSYCHOLOGICAL RESPONSES TO NATURAL DISASTERS?

I've been away for three weeks and natural disasters have been in the news.  Flooding in Louisiana, wildfires in my home state of California, and an earthquake in Italy are just several such disasters.  Well, I was a participant in my own natural disaster as I was visiting Belize, Central America, when Hurricane Earl struck the night of August 3, 2016.  Howling wind, torrential rain, flooding, no electricity and water, and widespread devastation to many poorly built houses were the experiences of that night.  Over the next week, I followed the government's response and the human stories.  In Belize, thankfully there was no loss of life but significant destruction of property to include buildings as well as large portions of the citrus crop.  When television did return, I watched people homeless and in shelters as well as trying to salvage property and rebuild.  It got me rethinking about psychological responses to such disasters and coping strategies.

Natural disasters such as hurricanes, earthquakes, or wildfires are typically unexpected, sudden and overwhelming. For many people, there are no outwardly visible signs of physical injury, but there can be nonetheless an emotional effect. It is common for people who have experienced disaster to have strong emotional reactions.

We know that in the initial weeks after a natural disaster, many people experience distress, including anxiety, disturbing memories, sleep disturbance, nightmares, and restlessness. This is very common and is an understandable reaction to stress.  We also know that most mental health problems typically reduce over time as people get over the initial distress.  However, there is usually a significant minority who will have persistent problems and whose problems may actually worsen.  Often, this occurs because their coping resources have been worn down by the ongoing stressors involved in slowness of rebuilding their lives and often financial difficulties.  In fact, it is not uncommon for persistent stress reactions to come from the more ongoing long-term effects of disasters.  

What are common psychological reactions to such disasters?  The American Psychological Association has listed the following after the initial reactions subside:

1. Intense or unpredictable feelings.  You may be anxious, nervous, overwhelmned, or grief stricken.  You also may be more irritable or moody than usual.  
2. Changes to thoughts and behavior patterns. You might have repeated and vivid memories of the event. It may be difficult to concentrate or make decisions.
3. Sleep and eating patterns also can be disrupted — some people may overeat and oversleep, while others experience a loss of sleep and loss of appetite.
4. Sensitivity to environmental factors. Sirens, loud noises, burning smells or other environmental sensations may stimulate memories of the disaster creating heightened anxiety. These “triggers” may be accompanied by fears that the stressful event will be repeated.
5. Strained interpersonal relationships. Increased conflict, such as more frequent disagreements with family members and coworkers, can occur. You might also become withdrawn, isolated or disengaged from your usual social activities.
6. Stress-related physical symptoms. Headaches, nausea and chest pain may occur and could require medical attention. Preexisting medical conditions could be affected by disaster-related stress.

So how do you cope with the emotional/psychological reactions to natural disasters?  There are some steps experts recommend to help you regain your emotional well being and take back control of your life.  These include:

1. Give yourself time to adjust.  Accept that this will be a difficult time but that you will get through it.  Allow yourself to mourn the losses you have experienced and try to be patient with yourself.  
2. Ask for support from people who care about you and who will listen and empathize with your situation. Social support is a key component to all stressful situations including disaster recovery. Family and friends can be an important resource. You can find support from those who've also survived the disaster. 
3. Communicate your experience. Express what you are feeling however it is comfortable to you, whether that is talking with family/friends, keep a diary, or partake in a creative activity.  
4. Consider using a local support group led by appropriately trained and experienced professionals. Support groups are frequently available for survivors. Group discussion can help you realize that you are not alone in your reactions and emotions. 
5. Engage in healthy behaviors to enhance your ability to cope with excessive stress. Be sure to eat well-balanced meals and get plenty of rest. If you experience ongoing difficulties with sleep, you may be able to find some relief through relaxation techniques I've discussed in other posts.   Avoid alcohol and drugs because they can be a diversion that could detract from as well as delay active coping and moving forward from the disaster.
6. Establish or reestablish routines. This can include eating meals at regular times, sleeping and waking on a regular cycle, or following an exercise program. Build in some positive routines to have something to look forward to during distressing times.  Establishing or returning to a regular routine assists greatly in regaining your sense of control and purpose in your life.  
7. Avoid or delay making major life decisions. Switching careers or jobs and other important decisions tend to be highly stressful in their own right and even harder to take on when you're recovering from a disaster.

Your mindset following a natural disaster has much to do with how well and quickly you will recover from the potential negative psychological consequences of a natural disaster. As always, change your thoughts, change your results.

Dr. Paul Longobardi

For information on these and related topics, please see my website at www.successandmindset.com. 

STRESS AND WEIGHT MANAGEMENT

Not long ago, a friend had gone to a weight management class through their membership in a large Health Maintenance Organization (HMO).  The friend mentioned how much time in the class was spent on discussion of stress as a cause of overeating and stress reduction strategies as part of an overall weight management program.  This interaction reminded me how large a role stress plays in overeating and weight management.

Suppose that you are having problems at work or at home.  You feel stressed and notice that it's beginning to show in the form of a bulge in your mid-section.  Why is this happening you say?  Doesn't stress cause you to have less of an appetite?  Well, yes in the short run but more long term or chronic stress actually increases your appetite. 

Most of us overeat when we feel a lot of pressure. This happens because of our fight/flight response.  This is when our body goes into survival mode. A major reason for this response is hormonal.  When your brain detects the presence of a threat, no matter if it is a tiger or bear, a difficult relationship, or a financial challenge,  it stimulates release of chemicals that include adrenaline and cortisol.  You become more alert, ready for action and able to withstand an injury. In the short-term, adrenaline helps you feel less hungry as your blood flows away from the internal organs and to your large muscles to prepare for “fight or flight.” Once the threat is done, cortisol, sometimes referred to as the "stress hormone", lingers and signals your body to replenish your food supply as well as store fat and glucose (sugar).  Now in the days of fighting or running from saber toothed tigers, you would have used much energy and calories.

However, in modern society,  sitting at desks or on couches worrying about your stressors does not expend much energy at all. Yet, your neuroendocrine system acts as if you used up many calories and encourages you to replenish those calories, even though you don't need to do so.
Levels of cortisol rise during times when you feel tense. This can turn your overeating into a habit. Because increased levels of the hormone also help cause higher insulin levels, your blood sugar drops and you crave sugary, fatty foods.  Alas, excess cortisol also slows down your metabolism, because your body wants to maintain an adequate supply of glucose for all that hard mental and physical work dealing with the threat.  You store extra body fat because your stomach has an ample supply of blood vessels and cortisol receptors to make the whole process flow more efficiently. The downside is that excess belly fat is unhealthy and difficult to eliminate. The fat releases chemicals triggering inflammation, which increases the likelihood that you will develop heart disease or diabetes. 

So what happens when you feel anxious?  You get a surge of adrenaline and feel fidgety and active.  You may engage in "emotional eating".   Overeating or eating unhealthy foods in response to stress or as a way to calm down is a very common response. In a survey on stress by the American Psychological Association,  40% of respondents reported dealing with stress in this way, while 42% reported watching television for more than 2 hours a day to deal with stress. Anxiety can also make you eat more “mindlessly”, i.e. without paying attention to what you are eating, how it tastes, how much you've eaten, or your feelings of fullness.  And you will gain weight.  You also will crave fast foods, sometimes called comfort foods as consuming sweet foods often satisfies our brain's reward systems. Comfort foods, e.g chips and ice cream, are high in the fat and sugar which cortisol craves to help you replenish supposedly lost calories.  Also, poor sleep driven by worries and stress contribute to fatigue, lower blood sugar, and disrupted functioning of ghrelin and leptin, chemicals which control appetite.  

So what can you do to maximize proper weight management even when you are stressed? Here are some ideas:

1. Get your proper exercise.  Don't skip your workouts.  Exercise can decrease cortisol and trigger release of chemicals that relieve pain and improve mood. It can also help speed your metabolism so you burn off whatever you may have eaten.  
2. Engage in stress reduction strategies such as yoga, meditation, mindfulness, progressive muscle relaxation.  All of these strategies encourage you to focus on your own immediate reality, pay better attention to your physical self, and reduce worry and anxiety.
3. Get your proper rest and sleep.  Avoid overeating in the evening, consuming stimulating beverages such as coffee, and use stress reduction strategies as discussed above.
4. Be more aware of what you are eating.  Sometimes referred to as mindful eating, pay attention to what you are eating, slow down eating, attend to the feelings of fullness, and avoid emotional overeating.  One way to reduce emotional overeating has been to focus on the future rather than on the present when inclined to eat comfort foods.  Research has shown that when focusing on the future people make healthier choices in foods.
5. Find Rewarding Activities Unrelated to Food.  Take a walk, read a book, increase your socialization with family and friends.  These can help you relieve stress without overeating. But you say that you don't have time with all your stressors.  Making and taking the time to do so will help you relieve stress, think more clearly, feel happier, and be less likely to overeat. 
6. Check yourself for proper mindset.  As I always say, become more aware of what you say to yourself about yourself.  If you have too many thoughts like "I can't handle my stresses", "I'm overwhelmned", "I'll never get out from what is stressing me", then it's time for a mindset do-over.  Challenge the above thoughts and remind yourself how many times you in fact have handled stressors.  Remember that help is available in many forms.  Keeping negative thoughts in your mind also will result in your reaching for "comfort foods" with all the additional problems that will cause.

     Remember that your response to stress is a choice.  It is not preordained.  Overeating is not inevitable in the face of life pressures.  Take control of your life.  Good luck in your journey.

Dr. Paul Longobardi

For more information on these and related matters, please see my website at www.successandmindset.com.

 

WOULD POLICE OFFICERS BENEFIT FROM STRESS REDUCTION STRATEGIES?

In recent years, and particularly the last several weeks, a focus in our society has been on problematic and frequently violent interactions between law enforcement and the communities they serve.  There have been fatal shootings of both citizens and police officers.  Most people would agree that the work of law enforcement is stressful.  They have shifting work schedules, disturbing crime scenes, emotional and upset victims and community members, among other challenges.  Officers lose sleep and frequently suffer from depression, anxiety, and the physical manifestations of stress.  They are required to deal with difficult emotional states on a daily basis. They have one of the highest rates of suicide on the job of any profession.  Is it any wonder that the life expectancy for retired police is only 10 years on average? Yet, the more that they are stressed, the more likely they are to respond aggressively or with intimidation to volatile situations, putting themselves and others in danger.  Is there any help for this situation?

For me, the answer to the question posed in the title of this post is a resounding yes.  Stress reduction strategies such as mindfulness, progressive muscle relaxation, and yoga are being used to reduce the harmful effects of stress.  In a recent article by Jill Suttie titled "How mindfulness is changing law enforcement" dated 5/18/16 in the online publication Greater Good: The Science of a Meaningful Life, applications of mindfulness with police officers in El Cerrito, California, were described.  She noted that a team of a police officer and a facilitator from the UCLA Mindful Awareness Research Center conducted mindfulness practices, such as mindful breathing and body scanning (also components of progressive muscle relaxation training and yoga).  The presentation of scientific findings was critical to acceptance by law enforcement officers.  Mindfulness has a strong scientific basis.  There are numerous studies showing that it can decrease stress, pain, anxiety, and depression in many groups.  The application of mindfulness on the job has been shown to help employees reduce stress, improve communication, increase job safety, and improve job performance.  There have been studies in which police officers who went through mindfulness training in their first year of training experienced less depression.  Other studies with mindfulness and officers have shown reduced perceived stress, burnout, anger, sleep disturbance, and improved physical and emotional health.  

By regulating officers' reactions to stress, mindfulness assists police in increasing the consideration of options even when under a degree of threat and without responding with automatic behaviors to include intimidation or violence.  Through mindfulness, as we become more aware of our emotional responses to situations, we can consider more possible options as to how to respond.  For police officers, this can include increased listening, caring, respect, and restraint.  For many in law enforcement, this is in stark contrast to the dominant culture of restraining, dampening, or ignoring emotions.  One of my professors used to say that "there's no such thing as unexpressed resentment".  What he meant was that we can not ignore our emotional states. They will find a way to expression whether for good or to our detriment. Mindfulness training can help police officers, as well as the rest of us, to be more self-aware, lessening our human tendency to restrict choices under stress.

Such approaches are not a panacea for curing all the problems for American police officers. However, stress reduction strategies can assist in helping improve the well being of our communities as well as officers, as a result of greater openness to communication between the groups.  As I have written on many occasions, stress is a choice.  While acknowledging there are challenging situations, your ability to be more aware of your thoughts, emotions, and physical manifestations can help you make better choices while under stress.  That would be a good thing for all of us, community members and law enforcement.  Good luck on your journey.

Dr. Paul Longobardi

For more information on these and related topics, please see my website at www.successandmindset.com

POST COMMENCEMENT STRESS DISORDER

It's that time of year again.  Most high school and college students have gone through their commencement ceremonies.  The students have been excited about receiving their degrees and moving on to the next step in their lives.  Those next steps might be further education or employment.  Relief from the immediate stressors of school work, deadlines, exams, and grades will be welcomed by many graduates.  However, what comes next?   Once the traditional stressors are gone, to what new level of normality does the graduate adjust?  

It is worthwhile to remember that commencement (graduation) is an academic and social custom that symbolizes a rite of passage. Commencement imposes your own expectation to achieve and society's expectation that you will perform well in the next phase, whether work or continuing education.  Fear of failure and inherent shame are several of the consequences if the graduate does not meet the internal or external definitions of success post-commencement.  

Another consequence of commencement for many graduates is stress.  In fact, a new term has been coined for a constellation of symptoms describing the anxiety and stress associated with the fear of the unknown inherent in commencement.  That term is Post Commencement Stress Disorder (PCSD).  PCSD was discussed in some detail in an interesting article by Dr. Bernard Luskin, LMFT, in Psychology Today several years ago in 2012.  PCSD is a condition emerging from a diagnosis of symptoms affecting new graduates facing the task of choosing, changing or pursuing a career.  Completing a degree brings both opportunity and insecurity to many new graduates as they pursue new plans, goals, and careers.  

Symptoms of PCSD can include:

1. Feelings you are not in control of your life
2. Feeling a lack of support after commencement
3. Feelings of failure if you can not find work in your area after a reasonable search time
4. Generalized anxiety and tension
5. Sleep problems 
6. Irritability
7. Avoidance of normal activities

Graduation can be a stressful time although meant to be a happy time for graduates. However, whatever the causes of PCSD, there are several steps you can take to help facilitate the transition:

Make a plan.  Take a look at what you want the first 3-6 months post graduation to be and implement a plan.  It does not matter what you choose, from an internship to a vacation. The idea is to have a plan of action that helps you organize your time and reduce the anxiety and worry which accompany the feeling of "floating" in your life.

Keep your priorities in perspective.  When it comes to the anxiety over next steps after graduation, remember that you are not alone. There are millions of new graduates each year and the job outlook has improved over the last few years.  It is always important to keep things in perspective as you organize for the struggles of the demands of the next step in your life. Whether you have graduated from college and go on to employment or from high school and are going to college, consider the following.  Create a budget and that will help you lessen the fear of mismanaging your money and can help develop new financial targets and goals. If your ideal job doesn't occur, consider working in areas where you can accumulate reasonable experience to help make that ideal situation happen.  

Confront the future.  As mentioned earlier when discussing make a plan, take action as to what point you want to achieve over the next several months.  It is critical to take some action.  If you focus on a job or school program related to your field of study or interests, it is better than taking no action.  Taking no action will result in the symptoms noted above.  Self esteem and self worth are related to behaviors. Generate positive action and positive feelings will follow. Avoid negative self talk at all costs.  Thinking that "Things will never work out for me" or similar statements will do more to keep you stuck in PCSD than almost anything else.  

As always, stress is a choice we make by how we look at, plan for, and react to the situations in our lives.  You can avoid PCSD.  I wish you well on your journey.

Dr. Paul Longobardi

For more information on these and related topics, please see my website at www.successandmindset.com

ARE THERE EMOTIONAL PROBLEMS FOLLOWING A CONCUSSION?

Just this week I reported on the question above in a presentation at the 10th Annual National Summit on Sports Concussion in Los Angeles, California.  In my recent post, I noted that a survey done through NPR and a survey firm found that one quarter of persons reported having had a concussion.  As you may remember, a concussion, also known as a mild traumatic brain injury (TBI), is caused by a bump, blow, or jolt either to the head or the body that causes the brain to move rapidly inside the skull. Loss of consciousness is not necessary for a concussion to occur.  Not all blows or jolts to the head result in a TBI.  A concussion changes how the brain normally functions.  Concussions can have serious and long-term health effects..  A concussion is considered a brain injury. The most frequent causes of non-sport related concussions include falls, being struck by blunt objects, and automobile accidents.  

Most of the time, we hear about the physical and cognitive aspects of concussion, such as headaches, loss of memory and poor attention/concentration.  However, psychiatric complaints are common in concussion.  For example, rates of some common mental health complaints in concussion include depression (25-50%), anxiety (10-77%), sleep problems (30-70%), agitation and aggression (~30%), and suicide (~3x Incidence of people without consussion).  Depression and anxiety, the most common symptoms,  often are not recognized as consequences of a concussion.  Yet, they occur with a frequency to make it advisable to assess for and manage as needed.  

Feelings of anxiety are common in postconcussive syndrome (PCS).  They are associated with a loss of self esteem along with fears of permanent brain damage and may enhance the original symptoms including physical and cognitive symptoms.  Research reports indicate that patients with symptoms at 3 months post-injury were likely to experience high levels of stress and anxiety.

Depression can occur directly or indirectly from the neurobiological results of the brain injury. It also can occur as a psychological reaction to deficits and problems associated with the brain injury.  Finally, it can co-occur with an anxiety disorder.  There are many research studies concluding that over years of follow-up individuals with a concussion have a 3x risk for developing a diagnosable depressive disorder.  The risk becomes even more concerning when we see that the risk for suicide, based on longitudinal studies in numerous countries to include Canada, Denmark, and Sweden all conclude that there is a 3x increase in suicides in the decade following concussion, with the risk increasing if you have more than one concussion.  

There is good news.  There are many direct forms of treatment for the emotional symptoms from concussion.  These include education, support, and guidance; sleep hygiene; relaxation procedures; psychotherapy; medications.  Other treatments for concussion which may assist generally include accommodations, vestibular therapy, physical therapy, cognitive rehabilitation, and vision therapy.

Support and educate benefit patients in that the patient receives information on what symptoms to expect and how to cope with them.  Research studies have shown that the sooner such information is received the better given that concussion is associated with high levels of anxiety.  Participation in a social support group results in improved mood and reduced anger, confusion, frustration, anxiety, depression, and isolation.  

Sleep problems are common in concussion.  Therefore, getting onto a regular sleep cycle is crucial to recovery.  Recommendations include:

Only go to bed when tired
Don’t lie in bed more than 20 minutes
Relax each night before bed
Wake up at the same time every morning
Avoid taking naps
Avoid caffeine after lunch

Relaxation procedures help reduce anxiety in concussion.  I have discussed these procedures in other posts to include breathing, progressive muscle relaxation (PMR), calming visualization, and meditation.  I like to use PMR as it includes a combination of breathing, relaxing visualization, and progressive tension/reduction of various muscle groups.  Some individuals have been using mindfulness procedures to achieve calming states which reduce overactivation in some brain areas.

Cognitive behavior therapy (CBT) approaches have been shown in research to reduce depression and anxiety in concussed persons.  As I have discussed in other posts, CBT is based on the premise that much of our unpleasant feelings such as depression and anxiety are driven by our thoughts.  In concussed persons with depression, overly general thoughts can include "I'm not the same as I was; I'll never get better; My life will never be right again" among many others.  All such thoughts will contribute to depression/anxiety and a worsening of other concussion symptoms both physical and cognitive.  CBT can assist in helping the concussed person correct their cognitive biases and misattributions about the effects of the concussion, contributing to an improvement in emotional state.  

So, if you or a loved one or friend has suffered a concussion, please be mindful of the emotional outcomes which often are not recognized.  There is much help available.  As always, your mindset when you suffer such an event has much to do with how well and how soon you recover.  May all your thoughts be helpful ones.  Best wishes on your journey.

Dr. Paul Longobardi

For information on these and related topics, please see my website at www.successandmindset.com.  

ARE CONCUSSIONS JUST A PROBLEM FOR ATHLETES?

Concussions have become part of the daily news. We hear about the effects of concussion on athletes in various sports.  Many of you may have watched the movie "Concussion" starring actor Will Smith as pioneering pathologist Dr. Bennet Omalu.  It was Dr. Omalu who identified serious brain changes now known as chronic traumatic encephalopathy (CTE) in the late Pittsburgh Steelers football star Mike Webster.  According to the Centers for Disease Control (CDC), 1.6 to 3 million Americans suffer concussions yearly.  The estimated costs of such injuries including medical costs and lost productivity total over $60 billion annually. But how much have these brain injuries become part of daily life?  Why should you care?  Aren't they restricted to athletes?  The answer is no.

Just this week, I reviewed the results of a poll by National Public Radio/Truven Health Analytics of 3009 adults during the period March 1 - 15, 2016.  It turned out that nearly a quarter of people — 23 percent of those surveyed — reported that they had suffered a concussion at some point in their lives. Among those who said they'd had a concussion, more than three-quarters had sought medical treatment.  While a little under half of the concussions came from sports, the rest of the concussions did not.  Have you known anyone who suffered a concussion if not yourself?  I certainly know acquaintances who have suffered a concussion not in a sports context.  

So what is a concussion?  A concussion, also known as a mild traumatic brain injury (TBI), is caused by a bump, blow, or jolt either to the head or the body that causes the brain to move rapidly inside the skull. Loss of consciousness is not necessary for a concussion to occur.  Not all blows or jolts to the head result in a TBI.  A concussion changes how the brain normally functions.  Concussions can have serious and long-term health effects, and even a seemingly mild 'ding' or a bump on the head can be serious.  A concussion is considered a brain injury. The most frequent causes of non-sport related concussions include falls, being struck by blunt objects, and automobile accidents.  

Signs and symptoms of concussion include headache, nausea, fatigue, confusion or memory problems, concentrational problems, sleep disturbances, or mood changes.  Symptoms are typically noticed right after the injury, but some might not be recognized until days or weeks later.  Sometimes, people do not recognize or admit that they are having problems. Others may not understand their problems and how the symptoms they are experiencing are impacting their daily activities.  Having multiple concussions increases the risk of lasting physical, cognitive, behavioral, and emotional consequences.  

The signs and symptoms of a concussion can be difficult to sort out. Early on, problems may be missed by the person with the concussion, family members, or doctors. People may look fine even though they are acting or feeling differently.  Recovery usually occurs over 1-2 weeks but some research indicates that recovery can take longer.  Emotional outcomes such as depression, anxiety, and apathy can take longer to manifest.  I will discuss these in more detail another time.  

In rare cases, a dangerous blood clot may form on your brain if you have a concussion and crowd the brain against the skull. According to the CDC, contact your health care professional or emergency department right away if you have any of the following danger signs after a bump, blow, or jolt to the head or body:

Headache that gets worse and does not go away.
Weakness, numbness or decreased coordination.
Repeated vomiting or nausea.
Slurred speech.

The people checking on you should take you to an emergency department right away if you:

Look very drowsy or cannot be awakened.
Have one pupil (the black part in the middle of the eye) larger than the other.
Have convulsions or seizures.
Cannot recognize people or places.
Are getting more and more confused, restless, or agitated.
Have unusual behavior.
Lose consciousness (a brief loss of consciousness should be taken seriously and the person should be carefully monitored).

My intent is not to alarm.  Most people recover normally following a concussion.  However, as mentioned, recovery times vary and your symptomatology affects both your family and colleagues in a work setting.  Do not hesitate to seek out care for yourself or a friend or loved one should you or they suffer a concussive episode.  If you would like more information, go to our website for Sports Concussion Institute at www.concussiontreatment.com.  

As in all events of life, how you view and explain what happens influences how you feel and behave.  Make all your thoughts helpful ones.  Best of luck on your journey.

Dr. Paul Longobardi

For information on these and related topics, please see my website at www.successandmindset.com.

ARE SMART DRUGS IN YOUR FUTURE?

Smart drugs are in the news lately.  They are prescription drugs used for the treatment of medical/psychiatric conditions to include cognitive enhancement purposes.  Common drugs include Adderall and Modafinil.  Adderall is prescribed in the treatment of attention deficit hyperactivity disorder (ADHD) and narcolepsy. It also is used as an athletic performance and cognitive enhancer, and recreationally as an aphrodisiac and euphoriant. Adderall increases the activity of the neurotransmitters norepinephrine and dopamine in the brain. Other medications in this class include Ritalin, Concerta, and Focalin.  Modafinil is a wakefulness-promoting agent used for treatment of narcolepsy, shift work sleep disorder, and excessive daytime sleepiness associated with obstructive sleep apnea.  The mechanism of action is one whereby the drug acts as a selective, relatively weak, atypical dopamine reuptake inhibitor.  

Such drugs have been discussed in television news pieces, in the Huffington Post, and most recently in an article by Carl Celestrom in the online Harvard Business Review (for May 20, 2016 titled "Like it or not, 'Smart Drugs' are coming to the office").  The use of the medications has been common in American universities for many years as students seek to improve concentration and stamina, particular when time for exam cramming.  In his article, Celestrom noted that up to 20% of Ivy League college students already have tried such drugs.  While not known at this time, it is likely that use is increasing in the professional and business world as the many pressures on employees demand increased concentration, stamina, and performance. Celestrom reported that the Financial Times has claimed that smart drugs are “becoming popular among city lawyers, bankers, and other professionals keen to gain a competitive advantage over colleagues.” In 2008, the magazine Nature asked its readers whether they use cognitive-enhancing drugs; of the 1,400 respondents, one in five responded yes.

Do the smart drugs work?  There has been research from Harvard Medical School consistent with the conclusion that Modafinil has significant cognitive benefits for those who do not suffer from sleep deprivation. The drug improves patients' planning and decision making ability and has a positive effect on learning and creativity. Other research has shown that Modafinil helped sleep-deprived surgeons become better at planning, redirecting their attention, and being less impulsive when making decisions. The U.S. military has already started experimenting with Modafinil, including with controlled use for air force pilots.

When acquired prescriptively, the drugs are safe when used as monitored by a physician. However, when acquired through the internet, on the street, or through friends/acquaintances, there certainly can be risks.  Using drugs like Adderall without a legitimate need for the medication or adequate medical monitoring can cause sudden changes in blood pressure, over exhausting the heart, and even death.  So, at this time, nonprescriptive use can neither be encouraged nor endorsed.  

However, as noted in the media, the drugs are not difficult to obtain.  Modafinil has an annual global share of $700 million, with high estimated off-label use.  ADHD medication sales (Ritalin, Adderrall, Concerta, Focalin) are growing rapidly, with annual revenues of $12.9 billion in 2015. Putting aside the use of the drugs prescriptively through clinics, hospitals, medical offices, etc., the HBR article raised several issues.  Should such drugs be allowed in the universities and/or work places?  Does it give an unfair advantage to some who can gain access to the drugs versus those who can not?  Does the use in the work place increase the stress levels of an already stressed and frequently overworked work force?  Perhaps the use of the smart drugs will help employees be more productive and efficient thereby facilitating their enhanced well being when out of work.  As was mentioned in the HBR article, if you were the manager at a hospital, would you want your surgeon to be under the influence of these drugs, provided there was clear evidence that they improved his/her work performance?  Or, if you were the CEO of an airline, would you prefer to have a pilot on drugs if it decreased the probability of accidents?

I am clear about one thing.  No matter what benefits the smart drugs bring to cognitive enhancement, by themselves they will not improve low self esteem and/or a lifetime of negative beliefs.  It is critical that individuals are able to attribute whatever success they have to their efforts and not outside forces such as medications and drugs.  I have seen too many patients work hard in therapy only to attribute their improvement to their medications. Then when they do not have the medications they believe themselves incapable of functioning despite their therapy progress.  However, in the business world, management will have to consider the ramifications and issues associated with such smart drug use in the work place.

For now, may all your thoughts be smart ones.  Good luck on your journey.

Dr. Paul Longobardi

For information on these and related topics, please see my website at www.successandmindset.com.

HOW THE "THREE Ps" CAN HELP YOU BE MORE RESILIENT IN LIFE AND BUSINESS

Many times the question is asked: "How it is that some people handle similar life challenges with less distress than others?".  The answer lies within the core of cognitive therapy and actually goes back as far as Epictetus and the Roman stoics in the first century AD. Specifically, how you view challenging events in terms of your thoughts and attributions leads to your degree of emotional distress more than the challenging event itself.  

I was reminded of this process in reading of Sheryl Sandberg's commencement speech to UC Berkeley's Class of 2016 in an LA Times article of May 15, 2016 by Jessica Roy.  Ms. Sandberg is the CEO of Facebook and recent author of "Lean In: Women, Work, and the Will to Lead."  Just over one year ago, her husband died suddenly from a cardiac arrhythmia while they were on vacation.  In discussing her resilience in recovering from that loss, she mentioned the "Three Ps" identified by psychologist Dr. Martin Seligman.  The "Three Ps" are: Personalization, Pervasiveness, and Permanence.  Let's look at each in turn:

1.  Personalization.  This is the belief that a challenging event happened because of something you did not do.  What is critical to recognize is that not everything bad happens because of some lapse on our part.  Ms. Sandberg blamed herself for not somehow having recognized a sign or symptom in her husband that might have prevented the outcome.  I have worked with numerous patients and clients who personalize most distressing events.  These events range from more minor ones such as inconveniences of everyday life to major ones such as the death of loved ones.  I am working now with a client who believes that there must be something she could have done to prevent the death of her ex-husband of fifteen years in a car accident in a different city where she was not present.  Frequently, the people who personalize often have overly strongly held beliefs around taking responsibility and being in control in most areas of their life.  While taking responsibility and trying to arrange events are generally good qualities, beating yourself up about not having total personal control does not help your situation.  Yet, I have seen managers, spouses, and many others who blame themselves incessantly.  One of my favorite books is by don Miguel Ruiz titled "The Four Agreements: A Practical Guide to Personal Freedom".  The second of the four agreements is: Don't take anything personally. Once you can begin to ask yourself, "How could I really personally have prevented this upsetting event?", you begin to rid yourself of the Personalization problem.  

2.  Pervasiveness.  This is the belief that because something bad happened in one area of your life, it will occur in and affect all areas of your life.  If you make a bad financial decision, does that mean that you will make bad decisions in all areas of your life such as in your work, as a parent, etc.?  The answer is no unless you believe so and then you will act accordingly to your detriment.  You will feel more defeated and overwhelmned, often sinking into depression.  In the case of Ms. Sandberg, she noted that she came to realize that, despite the enormity of her loss, there were some other areas of her life that were not terrible.  My own client is coming to realize that she is good at her profession and is a good friend to others. This is why counselors often recommend that individuals who have lost a loved one attempt to return to some normality of routine in their lives as soon as possible, though that varies by individuals.  When you can contain your distress to the particular event (loss, frustration, challenge), you will limit its hold on other areas of your life.

3.  Permanence.  This is the belief that your upset will last forever.  As my current grieving patient says for now, "I don't know if I'll ever feel good again".  This is very close to what Ms. Sandberg said about her loss and the belief that her grief always would be there.  However, with encouragement, she was able to recognize that her feelings would not last forever. Sometimes, when I work with individuals dealing with upset, I encourage them to imagine themselves perhaps six months or one year out into the future and what they will be doing and how their life will be.  If nothing else, this technique assists them in beginning to question the permanence of their current distressful emotions.  

The "Three Ps" are similar to the acronym "SUE" I have used in other posts to remember helpful strategies to facilitate your dealing with upsetting events both small and large in life and business.  SUE stands for Specific (opposite of Pervasiveness), Unstable (opposite of Permanence), and External (opposite of Personalization).  Please read my post on "SUE Your Way to Success" for even more information in this area. 

You can use the "Three Ps" or SUE strategies to help yourself deal with the emotional reactions of many of life's challenges, whether in your personal lives or in business.  The key is recognizing that you are clinging to less helpful beliefs.  You'll know by how you feel.  The more distressed you feel, the more likely that a contributor remains your extreme beliefs in your personal responsibility, the pervasiveness of the challenging event on your total life, and the likely permanence of your condition as you see it.  

The optimistic view is that you are more resilient in dealing with life's challenges than you might think.  You learned to think the way you do and see the world as you do.  You can change those beliefs so that you can enjoy your life more as well as handle future challenges large and small with less upset.  Good luck on your journey.

Dr. Paul Longobardi

For information on these and related topics, please see my website at www.successandmindset.com

WHAT QUALITIES CAN HELP NURSES IMPROVE AS LEADERS?

Well, it's International Nurses Week again. This is the week to honor all those nurses who serve by caring for us and our loved ones when we are ill.  Thanks to all the dedicated nurses for the services they provide us.  Now, anyone who has worked with nursing staff in a health care facility knows who really runs the unit and it is the nurses, particularly the Registered Nurse (RN) staff and Managers.  I certainly have worked in such areas and know how important it is for RNs to recognize and embrace the managerial and leadership roles for their units and clinics to function as a cohesive and effective organization.  This is no different from the leadership/management discussions pertaining to non-health care organizations.  The principles remain the same.  

Having said that, no matter what type of organization, effective leaders inspire others to do and be their best. They successfully create group consensus because others trust them, commit to their vision, and follow their lead. When conflicts arise, they deal with them directly. 

If you are currently working as a registered staff nurse or manager, you will be looked upon as a leader – by newer RNs, LPNs, CNAs and by patients and their families. Whether you are the charge nurse of the day, a unit manager, or higher, you will make a stronger contribution to the profession by developing effective leadership skills.

If you’re interested in developing your leadership potential, you might start by focusing on the following four emotional skills.  As I discussed in another post, Emotional Intelligence refers to the extent to which we identify and manage our emotions as well as respond to others.   

1.  Self-Awareness

To be an effective nurse leader, you must begin by taking a good look at yourself. Self-awareness means knowing how to read your own emotions and understand how those emotions can affect others. For example, when a family member expresses concern that their loved one patient may be missing a regular treatment or medication, you may feel emotions such as anger or disappointment. In such a situation, it would be helpful to take time to recognize those emotions and think about how expressing them would affect the situation.

As part of increasing your self-awareness, you might want to meditate or exercise to practice focusing on yourself, your feelings and emotions. Spending time walking, running or working out at a gym can be great for your body and your mind. It relieves stress and allows you time to think about your actions and reactions to various work situations.

2.  Social Awareness

Social awareness is caring about what others outside of you are experiencing, to include their needs, and responding to them. To become a nurse leader means excelling in this area. Fortunately, nurses are encouraged to display compassion to patients and their families. Today’s nursing leaders know that it’s critical to develop good social awareness skills, such as active listening, identifying emotions, and recognizing what feelings are behind a person’s words.

Nurses are trained to tend to patients’ physical and emotional needs. As a leader, they recognize emotional needs of their peers and subordinates.  As a nurse, when you empathize with patients or staff, you will gain trust, increase cohesion on your unit or in your clinic, and thus become a more effective leader.  

3.  Relationship Management

Nurse leaders use relationship management skills to inspire others, influence them, and develop their potential.  This is done at the same time you are managing projects, emergencies and conflicts. Managing relationships can be more complicated than managing projects.  I've spoken with many line staff who tell me they don't want to become supervisors or managers simply because they don't want to deal with managing relationship conflicts.  

Nurse leaders use their social awareness skills to assess the needs and desires of others. Be aware of what people are feeling and what led to the feelings originally.  Then you can decide how you will react to achieve an outcome that best meets your needs, those of the person, and those of the organization.  

4.  Patient Self-Care Advocacy and Empowerment 

Nurse leaders see the bigger picture in health care.  They know that it's not enough to treat illness solely in the clinic.  They advocate for patients to take charge of their own health.  They treat patients as partners in their health care.  They encourage patients to take steps to improve their care whether it be by eating better, taking up exercise, or relieving stress.  Nurse leaders know that health care professionals must be proactive and go where the patients live to reach them.  This may be through health fairs or community clinics at the churches patients attend. These initial or ongoing contacts help to build trust, demonstrate empathy, provide knowledge and encouragement, and demonstrate awareness of what their patients are experiencing.  

Nurses are the backbone of the health care system and always will be.  It is a given that they will need to embrace management and leadership roles in addition to their clinical roles.  While this is a very big challenge, it is my hope that the above principles will cause thought about what is needed from nurse leaders in the areas of self awareness, social awareness, relationship management, as well as patient self-care advocacy and empowerment.  There is a lot more to this topic but we all have to start somewhere.  

Again, to all nurses, Happy International Nurses Week and thanks for all you do. 

Dr. Paul Longobardi

For information on these and related topics, please see my website at www.successandmindset.com

IS MOTHERING INSTINCTIVE OR LEARNED?

As we approach Mother's Day this week, it is fitting to wish all mothers, grandmothers, mothers-in-law, and mother figures (aunts and other non relative kin who care for us) a most Happy Mother's Day.  Where would we be without them?  Having said that I turn to the question in the title.  Is mothering instinctive or learned?  I think we all have had contact with mothers who seemed so naturally nurturing, caring, and loving that we were left to wonder how or why they were that way?  Alas, this sometimes was in contrast to some other mothers who were far less caring.  What accounts for this?  Usually the question is posed as nature versus nurture.  I have dealt with this dichotomous approach for over 40 years in psychology, including in reference to intelligence and various personality characteristics.  So how about mothering?

There are many examples in natural wildlife consistent with the thought that much mothering is "hard-wired".  For example, a bird, the North American killdeer, lures predators away from the nest by pretending it has a broken wing — and sometimes loses its life. To protect their young, giraffe mothers have given their lives to lions.  In Africa, elephants, sensing a threat to their babies, have attacked jeeps. Mother octopi won't leave their eggs untended, thus going without food. Within a month, the mothers are dead, having made the ultimate sacrifice. What makes these females so motherly? Is it instinct — or learned?  

Some favor biological or genetic explanations for mothering behavior.  Biologically, female rodents without a proper dose of the hormone oxytocin in their brains fail to care for their young.  When the proper dose is added to the fluids of their brains, they start caring for their young.  Interestingly, this also occurs for female rodents who never have given birth.  They can be transformed into nurturers given the right dose of oxytocin.  The same result has been found for rhesus monkeys as well.

However, almost 20 years ago, a group of Harvard research scientists led by Jennifer Brown and Michael Greenberg, conducted a study with mice suggesting that a specific gene might be among the causes for a mother to become, or fail to become, an instinctive nurturer.  They did not intend to study nurturing but instead were curious about fosB, because it is one of many early genes thought to be integral in learning, memory and other types of behavioral change. The thinking was that such genes react quickly to a wide variety of changes in the environment. As such, they may bring about lasting adaptations in the circuitry of the brain.

As an unintended consequence, when the mice reproduced, the female mice without the fosB gene displayed minimal to no interest in their offspring, ignored them and left them to fend for themselves. Whole litters were wiped out just a day or two after birth. This was odd as the babies were healthy and so were the mothers. But the research team observed that soon after the pups were born, they'd be scattered everywhere around the cage, shivering and starving, while the mothers went about their business. Normal mother mice round up their brood and feed and lick them. But the mothers without the fosB gene did not do so.  At least for mice, the research team surmised that the first time a mother sniffs her newborns, the smell triggers a nerve signal that activates fosB in a brain region called the hypothalamus, which other scientists have already shown to be involved in nurturing. FosB may then turn on other genes, which, in turn, heighten the sensitivity of the brain to maternal hormones that enhance nurturing behavior. For the animals without fosB, the mothers never nurtured their young, no matter how many litters they bear. Even if they shared a cage with a maternalistic mother that doted on her pups, they never learned to imitate her behavior. 

This study triggered interest in whether there might be a "Mommy gene"!   Several years later researchers found that genes called Peg 1/Mest and Peg3 also have an effect on the motherliness of mice. When scientists disabled these genes the result was similar to the FosB experiment. All of these genes influence how oxytocin, the hormone behind caressing and nursing and other mothering behavior, is processed in the brain. 

Popular media thought that "More Mommy genes!" had been discovered.  Since mice and humans share many of the same genes, there was an argument that these genes might influence women's nurturing instincts.   Maybe genetic engineering could make super mothers. This is rather extreme as the scientists doing the work referenced never claimed to find such a gene.  Humans are obviously far more complex than mice, and our behavior is more nuanced -- that is, dependent on context and personal experience.

So, is mothering all a result of hormones and genes?  Well, if so, why are there shelves of books in stores and libraries on mothering?  Or is it that a complex set of cultural, societal, and familial factors modulate the expression of genes in human mothers?  Most psychologists are familiar with the findings about identical twins reared in different social environments.  Those twins, largely identical genetically, displayed intellectual, personality, and social behavior more consistent with the environments in which they were raised.  To say a gene makes a woman a good mother does a disservice to all those forces as well as all the efforts the mother makes to do her best under her circumstances, with all the challenges of modern society and the changing social roles for women.  

It may well be true that genes influence how proteins are transcribed, neurons fire, signals are dispatched, and hormones are received and processed. Each component supports our nurturing behavior.  But there is so much more to being a mother which involves experiencing, modeling, learning, changing, and adapting to the many challenges of modern day motherhood.  It's unlikely that any one gene explains such a complex phenomenon, interesting as it is.  

So, I again come to the conclusion to which I've come so many times over the decades when the nature versus nurture question is raised.  Neither is defining but I'd place more emphasis on the capacity of mothers to learn, adapt, and seek out help.  I have seen so many patients make significant positive changes in their "mothering behavior" despite challenging earlier circumstances which might have predicted bad outcomes.  As always, it starts with your dominant thoughts and beliefs which will help or limit you.

Thanks to all the mothers in our lives.  My hat is off to you.  Good luck on your continuing journey.  As always, change your thoughts, change your results.

Dr. Paul Longobardi

For information on these and related topics, please see my website at www.successandmindset.com

AM I GRIEVING OR SUFFERING FROM DEPRESSION?

Recently, I have been working clinically with several clients who experienced the death of loved ones.  The times elapsed since the death event has ranged from one month to one year.  In all cases, the individuals have asked me a question I've heard repeatedly: "How long should grief last before I return to my normal self?"  In each case, I have explained that there is no established time line for when you should be "over" grieving.  Usually, the follow-up question is: "Am I experiencing more than grieving, am I depressed?"  Now that is a question which is not always easy for mental health professionals to answer, namely, the distinction among grief, complicated grief, and depression.  

So just what is grief?  Grief is a natural response to loss. It’s the emotional suffering you feel when something or someone you love is taken away. The more significant the loss, the more intense the grief will be.  Most people associate grief with the death of a loved one.  This is often the most frequent cause of grief.  However, there are other losses which can cause grief, such as: divorce; loss of health for self or loved one; loss of job; loss of financial stability; retirement; miscarriage, among others.  The more significant the loss, the more intense or severe the grief. Though everyone grieves differently, grieving is a normal process.  Yet, it can worsen your quality of life and sometimes involves more serious symptoms when it lasts for a long time.  This often is referred to as Complicated Grief.  Estimates are that 10-20% of people who suffer from grief go on to suffer from Complicated Grief, a more long lasting and severe form of grief.  Studies of complicated grief even have indicated brain changes in several areas (nucleus accumbens and amygdala) having to do with reward and avoidance centers in the brain.

Symptoms of grief can include: an intense pain when you think of your lost loved one; a heightened focus on reminders of your lost loved one; an overall feeling of numbness; a feeling of bitterness when you think about your loss; a loss of purpose or motivation; a loss of trust in friends, family, and acquaintances; an inability to enjoy life.  People experiencing grief frequently suffer sleep and appetite disturbances as well as feelings of regret, guilt, or lessened worth depending on the circumstances.  

The above symptoms and the profound sadness associated with grief can look a lot like the sadness clinical depression brings. The similarity can create a dilemma for mental health professionals: When should someone experiencing the loss of a loved one be diagnosed as depressed?  In our old diagnostic manuals, no one was diagnosed with major depression, a major clinical mood disorder, within two months of the death of a loved one.  That has changed with the latest edition of the manual making it easier to diagnose and treat a grieving person with depression.   

So I go back to the original title question.  Are you suffering from grief or depression?  In both forms of sadness, you can experience a loss of interest or pleasure in activities you normally enjoy, as well as changes in sleeping patterns, difficulty concentrating, fatigue and other symptoms. However, there are distinctions. Someone who is grieving typically focuses his or her thoughts on the person who has passed away and experiences intermittent waves of pain rather than the constant pain typical of depression. Research also indicates that in most cases the depression-mimicking symptoms associated with grief tend to lessen over time with the help of family and friends.  The support and assistance of family/friends as well as the individual's responsiveness to the support often are contrasted with the isolation and withdrawal of individuals suffering from clinical depression.

In my clinical experience, mindset or beliefs about the loss event have much to do with differentiating between what will remain a grief process and what will turn into a chronic depression.  I find that most people are in a crisis at the time of the loss.  How they give meaning to it for and about themselves and their lives is crucial.  People with more absolutistic thoughts/beliefs about the situation and their lives are at higher risk for clinical depression. For example, I have worked with numerous clients who have suffered the loss of a loved one and said: "I'm sad, I think about them, I miss them".  That is grief.  Other clients state: "I can't go on with my life without my loved one, I can't trust any more, I can't enjoy my life anymore".  These are the clients headed for or maybe already in clinical depression.  I remember a particularly sad case some years back.  A family had brought in their 70 year old grandmother following the murder of her 25 year old grandson approximately six months earlier.  She reportedly was sad, withdrawn, not sleeping or eating well.  In speaking with her, she told me that she no longer could get close to anyone, particularly the grandchildren, nieces, and nephews, for fear she would lose them too. I only had this one meeting as the family did not return with her despite my recommendations.  I learned about six months later that she had died in her sleep. While I can not say with any certainty, the old phrase "died of a broken heart" came to mind complicated by her beliefs about this very sad event for her.  My point here is that the beliefs we adopt in resolving our feelings about the losses leading to grief influence whether the reaction remains grief or turns into clinical depression.

In any event, there is help available.  Use the support of family and friends.  Take care of yourself.  Allow yourself gradually over time to re-engage life under the changed circumstances at your pace.  If your sadness persists and interferes with your participation in life, consider obtaining professional help.  You may need assistance with a clinical depressive disorder for which therapy and/or medications can help.  As always, your mindset and beliefs will be critical.  

Good luck on your journey.  May all your thoughts be helpful ones.  

Dr. Paul Longobardi

For information on related topics, please see my website at www.successandmindset.com.

MINDSET CHANGES CAN OCCUR ANYWHERE

Recently, I was thinking.  What kind of view of yourself and your world might you develop if you had to drop out of school at age 11 years and go to work selling snacks and homemade trinkets to local tourists?  And to make matters worse, if you did not make enough money, your parents would shout at you and berate you.  I was intrigued by a recent article in the Los Angeles Times of April 4, 2016 by Shashank Bengali titled "Surf girls fight cultural tide".  In the article,  that scenario is exactly the world of many young girls in the conservative southern section of Bangladesh.  In the article, we learn of the world of young Bangladeshi girls who all too often see little future for themselves.  However, in the article, we learn of how several girls become acquainted with a young surfer and gradually expand their world to learn how to surf. This occurs despite the protests of parents and negative judgments of others in their village.

As their instructor said, "The girls' parents want them to work.  We have to convince them that they can have a future outside the house".  One 14 year old young girl profiled in the story said, "My life before was making jewelry at home, work, sleep, making jewelry, work, sleep.  When I started surfing, I began thinking about my dreams.  Now I think there are lots of things I want to do".  For one of the girls profiled, she became proficient enough at surfing to enter and place third in a competition, winning $40, the equivalent of two months' salary as a housekeeper.  

I spend much time clinically and in consultation working with clients who doubt the possibility that they can know and be more than they are currently.  In a land of so much opportunity, they doubt themselves incessantly and limit trying new things even when there are no obstacles other than in their minds and beliefs.  How much more difficult is it for these young girls to overcome societal, parental, and economic challenges to dream of and accomplish something more for themselves?  

Now I do not mean to criticize anyone as I know the suffering and inner turmoil caused by limiting thoughts and beliefs.  Rather, it is to be encouraging so that if you observe what the young Bangladeshi girls did with so many obstacles on so many levels, you may be more confident to make changes in your own life.

However, to do so, there is a four step process to be followed for mindset change:

1.  Notice what you are thinking and saying to yourself.  Particularly notice what you say when something goes wrong in your life or work.  This really is the first and biggest challenge because we think so often of our thoughts as "automatic".  In fact, the godfather of cognitive therapy, Dr. Aaron Beck, referred to the thoughts behind what we say as "automatic thoughts" and noticed these in his patients though the patients never verbalized them.  The Bangladeshi girls noticed that they were telling themselves that they could have no dreams or hope for anything better in their lives.

2.  Once you've noticed what you are saying to yourself, ask yourself the following three questions.  Is this thought helping me feel better about myself?  Is this thought helping me get along better with others?  Is this thought helping me get along better in my world?  If the answer to any one or more of these questions is no, then it's time to move on to step three. The Bangladeshi girls likely recognized that their world was limited by their views, particularly when they came into contact with something (surfing) at odds with their view that they could accomplish nothing.

3.  Challenge the validity of your thought.  Could you prove it in court to a judge and jury? Are you really a "screw up all the time"?  Is "nothing good ever happens for me" really true?  Are you really a "failure" at all you try?  Most often it's a matter of overgeneralizing from one event to all.  No one is "always" anything, least of all the negative outcome of your thoughts.  At some point, the Bangladeshi girls had to decide that their limiting thought might not be as true as they thought or they would not have started surfing.

4.  Develop a plan to keep track of the alternative to your biggest problematic or limiting thought.  For example, if you are inclined to say that "Nothing good ever happens for me", then keep track of some of the good (perhaps small) things so as to counterract your negative or limiting thought.  The Bangladeshi girls developed a plan to do some surfing in the morning while still doing their selling chores the rest of the day.  Their world view had been enlarged.

As we have seen, mindset change is possible anywhere and anytime.  Of course, sometimes the limitations have been longer lasting and more problematic in life for you.  In such cases, know that help is available from mental health professionals.  Yet, change your thoughts and change your results is never bad advice.  Good luck on your journey.

Dr. Paul Longobardi

For information on these and related topics, please see my website at www.successandmindset.com.

DID YOU EXERCISE TODAY?

Did you exercise today?  If so, how much time?  When did you last exercise?  How about in the last month? We hear a lot about the positive effects of exercise on our physical health such as increased stamina and general physical and emotional well being.  All this is true.  However, physical fitness is evolving as a significant factor related to cognitive health in middle to older age. Most of us have had the experience of difficulty in recalling names or remembering where we left things as we get older. This in part is because your brain shrinks as you age, and the atrophy is related to cognitive decline and increased risk for dementia.  Exercise appears to reduce that deterioration and cognitive decline.

In CNN Health News, author Morgan Manella noted recent studies showing that higher levels of physical fitness in middle-aged adults were associated with larger brain volumes five years later, particularly in brain areas having to do with memory such as the hippocampus (Kilgore, Olsen and Weber, 2013, Scientific Reports).  In a study published this year in the online journal Neurology (Wiley et al), the authors found that older people who exercised regularly experienced a slower rate of mental decline.

In the Scientific Reports study, more than 1,500 people at an average age of 40 and without dementia or heart disease took a treadmill test. Twenty years later, they took another test, along with MRI brain scans. The study found that those who didn't perform as well on the treadmill test -- a sign of poor fitness -- had smaller brains 20 years later.  

In the Neurology study, older adults averaging 71 years with low activity patterns (light exercise, such as walking and gardening) or high activity patterns (moderate to high-intensity exercise such as running and aerobics) were followed for up to 12 years.  On neuroimaging and a battery of tests examining memory and cognitive skills, people with no signs of cognitive impairment at the start of the research who reported low activity levels showed a greater decline in processing speed and episodic memory over five years than the high activity group. Their brains aged about 10 years more than the group that exercised.

These studies suggest that promotion of physical fitness during middle age is an important step toward ensuring healthy brain aging.  Researchers also have found that people with higher blood pressure and heart rate during exercise were more likely to have smaller brain sizes 20 years later. People with poor physical fitness usually have higher blood pressure and heart rate responses to low levels of exercise compared to people who exercise more.  Given so many older adults have hypertension and reduced blood flow secondary to elevated levels of cholesterol, the potential effects on brain aging and decline are serious.  However, exercise training programs that improve fitness may increase blood flow and oxygen to the brain over the short term.  Over time, improved blood flow may have an impact on brain aging and lessen cognitive decline in older age.

Exercise is also a great stress reliever, which can protect the brain from damage caused by stress.  Stress also serves to impair memory and slow down your thinking.  What these studies show is that you need to keep active even into older age if you want to keep your brains intact as well as reduce stress and its negative effects on your brain.  

So how much exercise should you do to receive cognitive benefits?  Clearly this differs for each person and you should consult your primary care physician if you have not been doing a regular exercise program. However, in the Kilgore Scientific Reports study of middle aged adults, the average number of sessions per week was three and the average number of minutes per week was 189 (about 3 hours).  This level of activity was associated with an increase in gray matter volume in the hippocampus, a region associated with memory.

So let's get active to maintain our cognitive health.  The choices you make now, whatever your age, influence your fitness in all areas to include cognitive.  It's never too late to take action.  Good luck and best wishes on your journey.

Dr. Paul Longobardi

For information on these and related topics, please see my website at www.successandmindset.com. 

 

HOW CAN YOU IMPROVE YOUR EMOTIONAL INTELLIGENCE?

In my last post I discussed the concept of Emotional Intelligence (EI).  EI refers to our ability to identify and manage our emotions as well as respond to others.  For individuals like Dr. Daniel Goleman, a psychologist who popularized the concept in his 1995 book "Emotional Intelligence: Why it can matter more than IQ", what we think of as general intelligence may not convey as much potential for success as our EI.  I described the five main elements as noted by Dr. Goleman.  In this post, I want to discuss some ideas as to how you can improve your own EI.

Let me go through the five elements in turn:

1. Self-awareness.  If you're self-aware, you always know how you feel, and you know how your emotions and your actions can affect the people around you. So, what are some things you can do to improve your self-awareness?

Keep a journal – Journals help you improve your self-awareness. If you take just several minutes per day to write down what you thinking or feeling, you can become more self aware.  In working with numerous clients in cognitive behavioral therapy, I find that many are out of touch both with what they think and feel.  I often start by asking them to write down only what they feel, and then proceed to identifying their thoughts.  
Slow down – When you experience anger or other strong emotions, slow down to examine why. No matter what the situation, you can choose how you react to it. However, to do so, you have to identify what you are thinking.  Anger usually is the lead emotion behind which are the driving emotions like frustration, disappointment, rejection, hurt, etc., among others.  

2. Self-regulation.  People who regulate themselves effectively rarely verbally attack others, make hurried or emotional decisions, stereotype people, or compromise their values. Self-regulation is all about staying in control.  So how can you improve your self-regulation?

Know your values – Do you know what values are most important to you?  This refers to areas such as work, family, spirituality, leisure, etc.  When you do not follow your own ordering of values, you do not live in harmony.  To prioritize family time over work but spend all your time at work and neglect your family leads to internal conflict (probably family too!).  Spend some time examining your values. If you know what's most important to you, then you probably won't have to think twice when you face a moral or ethical decision – you'll make the right choice.
Hold yourself accountable – If you tend to blame others when something goes wrong, stop. Make a commitment to admit to take responsibility for your thoughts and actions.  
Practice being calm – The next time you're in a challenging situation, be very aware of how you act. Do you relieve your stress by shouting at someone else? As I mentioned in the last post, practice breathing or using yoga, meditation, or progressive muscle relaxation.  Also, try to write down all of the negative things you want to say, and then rip it up and throw it away. This prevents expressing them to others and allows you to identify what thinking is behind these negative emotions.  

3. Motivation.  Self-motivated people work consistently toward their goals, and they have extremely high standards for the quality of their life and work.  How can you improve your motivation?

Know where you stand – Determine how motivated you are to do your major tasks.  There had to be a reason you wanted to do something in the first place, e.g. read the book, learn the new skill.
Be hopeful and find something good – Motivated people are usually optimistic no matter what problems they face. Every time you face a challenge, or even a failure, try to find at least one good thing about the situation. In working with many clients and consultees, I usually ask them to identify something good in every situation even if overall it did not work out well.  In listening to Reverend Joel Osteen, he was asked if he ever gets up not feeling good or motivated.  He acknowledged yes and indicated that he finds something about which to be grateful and/or does something for someone else.  Try it. 

4. Empathy.  Having empathy is critical to managing your relationships with others whether at work or at home.  People with empathy have the ability to put themselves in someone else's situation. They help develop others, give constructive feedback, and listen to those who need it.  How can you improve your empathy?

Put yourself in someone else's position – Take the time to look at situations from other people's perspectives. 
Pay attention to body language – Perhaps when you listen to someone, you cross your arms, move your feet back and forth, or bite your lip. Learning to read body language can be a real asset, because you'll be better able to determine how someone truly feels. 
Respond to feelings – Listen for the feeling states in others' voices.  They may say yes to your request but convey disappointment in their voices.  Respond by addressing their feelings.  Tell them you appreciate their fulfilling your request and understand their frustration.  See if there is some accommodation to be made.  

5. Social skills.  People who do well in the social skills element of EI are effective communicators. They're good at managing change and resolving conflicts diplomatically. So, how can you build social skills?  While this is whole topic on its own, here are several tips:

Learn conflict resolution – It is important to know how to resolve conflicts between friends, family, or work members.  Learning conflict resolution skills is vital if you want to succeed.
Improve your communication skills – How well do you communicate? Do you really hear what others are saying?  Often paraphrasing back what you think you've heard will identify any unclarity and lead to further refinements in communication.  When listening to someone upset, I often reply with "What I hear you saying is . . . ".  It can be humbling to find out that I didn't really hear what was said but at least communication goes on.  
Learn how to praise others – You can inspire the loyalty of others at home and work simply by giving praise.  Learning how to praise others is a fine art, but well worth the effort. I've worked in and around too many systems where the only feedback you hear is negative, i.e. what you did not do or did wrong.  Consider noticing behaviors worthwhile for some praise.  

You may be saying that this EI business is a big job.  Don't be overwhelmned.  Just taking one or two recommendations and looking to implement them for several weeks will begin to solidify them for you.  You'll be amazed how you feel and how positively others relate to you. As always, change your thoughts, change your results.  Good luck on your journey.

Dr. Paul Longobardi

For information on these and related topics, please see my website at www.successandmindset.com

HOW EMOTIONALLY INTELLIGENT ARE YOU?

Have you ever wondered why some people are more successful and happy than others?  Have you ever met or known friends or other people who were very smart but did not succeed as well as the friend or person with a clearly lower IQ (intelligence quotient)?  I certainly have known numerous persons much smarter than I who were far less successful than I would have thought.  Well, you say, maybe they had fewer good breaks than others.  While there may be some truth to that, the reality is that much personal and business success and happiness has to do with how we manage our emotions and relate emotionally to others.

I used to be fond of saying to consultees and supervisees that most people don't get fired from their jobs because of their technical incompetence but rather because they can't get along interpersonally with other people in the organization. Then yesterday I watched a lengthy interview with Dr. Daniel Goleman.  If you don't know who he is, he is a psychologist generally credited with popularizing the term Emotional Intelligence in his 1995 book titled "Emotional Intelligence: Why it can matter more than IQ".  During the interview he noted that he was giving a speech to a room full of hundreds of CEOs of major companies.  He asked how many had been valedictorians or salutatorians and only three CEOs stood up.  His point was that what we think of as general intelligence may not convey as much potential for success as how we identify and manage our emotions as well as respond to others.  Basically, that is the definition of Emotional Intelligence (EI).  

The concept of EI comes out of the idea of "multiple intelligences" which was originated in the 1980s by Dr. Howard Gardner, who asserted that cognitive intelligence did not explain all of our functioning.  While there are academic differences about the extent to which EI indeed is a specific form of intelligence, the idea has helped make us aware of the importance of emotions in positive self and other relationships.  There is available research showing that EI affects your work performance, physical health, mental health, and relationships.  At work, some companies are using assessment of EI in the employee selection process and have found that individuals in sales positions with high EI have higher productivity than those low in EI.  I have written often about stress management. Improving EI involves learning how to relieve stress before you suffer serious health problems including hypertension, immune disorders, heart attack, stroke, and acceleration of the aging process.  Uncontrolled stress can also impact your mental health, making you vulnerable to anxiety and depression. If you are unable to understand and manage your emotions, you’ll also be open to mood swings, while an inability to form strong relationships can leave you feeling lonely and isolated.  Finally, in terms of relationships, when you understand your emotions and learn how to control them, you can express how you feel more clearly and understand how others feel.  Your communications overall will improve.  

There are five main elements of emotional intelligence:

1. Self-awareness.  If you're self-aware, you always know how you feel, and you know how your emotions and your actions can affect the people around you.

2. Self-regulation.  This refers to your ability to inhibit emotional impulses and responses and decisions.  It is about staying in control.  In another post, I will discuss some ways to improve your EI.  However, in this area, keeping calm is critical to self regulation.  Proper breathing and mindfulness are useful and activate areas of your anterior frontal cortex where decision making is centralized.  See other posts on progressive muscle relaxation for more in this area. 

3. Motivation.  You work consistently toward your goals and get into the "flow", as Dr. Goleman refers to it.  You become absorbed in your actions.  

4. Empathy.  When you have empathy, or compassion, you are able to put yourselves in someone else's situation. You can listen when someone needs you to do so.  .

5. Social skills.  You are able to listen to others whether they are calm or upset, help others consider options and feel heard while giving support.  I realize these are tall orders for some but we all can do better in this area.

There really are three key ideas as outlined by Dr. Goleman in his interview.  One is to tune into your emotions.  Simply becoming more aware of what you feel is a great first step.  Second is to manage the negative emotions.  Once you identify a negative emotion, you can begin to examine from where this comes and what kind of thoughts (cognitions/beliefs) are driving the negative feelings/emotions?  All too often these are overgeneralized, catastrophic, and invalid thoughts. However, you need to identify the emotion first.  Third is to strengthen the positive emotions. Follow a similar strategy.  From where is the positive emotion coming, focus on it and the accompanying thought.  Your job is to increase the amount of time you spend on positive emotions.  As you are more able to do this, you will recognize the process and be able to listen, understand, and help yourself and others.

We will discuss more on this in an upcoming post.  For now, tune in to emotions, manage the negative ones, strengthen the positive ones.  Good luck on your journey. 

Dr. Paul Longobardi

For more information on these and related matters, please visit my website at www.successandmindset.com

WHAT ARE YOUR RISKS FOR DEPRESSION AND DIABETES?

About 23.5 million Americans nationwide  have diabetes, and about 14.8 million Americans have major depressive disorder in a given year, according to research statistics.  However, matters soon may be getting worse.  In a new analysis from UCLA reported on in the LA Times on March 10, 2016, estimates are that 55% of adults in California have either diabetes or pre-diabetes.  That's up to 13 million adults in the state (2.5 million with diabetes, the rest pre-diabetic).

It has been known that a comorbidity, or co-occurrence, occurs between depression and diabetes.  Some estimates have been that up to 30% of individuals with Type 2 diabetes have a diagnosable depressive disorder (Katon, Maj, & Santorius, 2010).  In a study in the Annals of Internal Medicine in 2010, Dr. Frank Hu observed that depression increased the risk for diabetes, and diabetes increased the risk for depression. Women who were depressed were 17% more likely to develop diabetes even after the researchers adjusted for other risk factors such as weight and lack of regular exercise.  Women who were taking antidepressants were 25% more likely to develop diabetes than their counterparts who were not depressed.

In the same study, women with diabetes were 29% more likely to develop depression after taking into account other depression risk factors.  Women who took insulin for their diabetes were 53% more likely to develop depression during the 10-year study.

Certain factors such as physical activity and body mass index may partially explain the link between depression and diabetes.  However, they do not completely explain the connection.

I agree with the research conclusions that the common denominator may be stress.  I have written frequently about the role of stress in the initiation or exacerbation of multiple medical conditions to include diabetes.  People who are depressed have elevated levels of stress hormones such as cortisol.  Elevated levels of cortisol  can lead to problems with glucose or blood sugar metabolism, increased insulin resistance, and the accumulation of belly fat.  These all have been noted as diabetes risk factors.  Now if you develop Type 2 diabetes and have not been identified as depressed, you still are faced with the stressors associated with diabetes management such as blood sugar control and treatment for complications.  This can lead to decreased quality of life and increased probability of depression. Research studies have shown that depression leads to poorer physical and mental functioning, so a person is less likely to follow a required diet or medication plan. Over time, thoughts may become more depressive such as "I'll never be healthy again"; "Why did this happen to me?";  "I'll never be happy again". These thoughts can lead you into a spiral of depression and worsen diabetic management. Treating depression with psychotherapy, medication, or a combination of these treatments can improve a patient’s ability to manage diabetes.

But what about the issue of pre-diabetics raised in the first paragraph?  Do you know your status and that of your loved ones?  Perhaps you indeed are pre-diabetic yourself.  Symptoms of diabetes include: 1. Being very thirsty; 2. Urinating frequently; 3. Blurry vision; 4. Being irritable; 5. Tingling or numbness in your hands or feet; 6. Feeling worn out; 7. Wounds that don't heal; 8. Yeast infections that keep coming back. 

Have you had a depression screening or think you may be depressed? Symptoms include: 
1. No longer finding pleasure in activities that you once enjoyed; 2. Insomnia or sleeping too much; 3. Loss of appetite or binge eating; 4. Inability to concentrate; 5. Feeling lethargic; 6. Feeling anxious or nervous all the time; 7. Feeling isolated and alone; 8. Feeling sadness in the morning; 9. Feeling that you "never do anything right"; 10. Having suicidal thoughts.  If you experience four or more of these symptoms for up to two weeks, please consult your primary care provider or a  mental health professional.  If you have suicidal thoughts, please see a professional immediately.  

There is excellent care available but you have to take the first steps.  As noted, evaluate your stressors in life, be aware of your mindset and the possibly depressing thoughts and limiting beliefs you tell yourself, and consult information and experts on diabetes management.  

Again, your good physical and mental health are the results of choices you make.  Choose wisely.  Good luck on your health journey.

Dr. Paul Longobardi

For information on these and related topics please see my website at www.successandmindset.com