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BOTH PARENTS AT HIGHEST RISK OF DEPRESSION IN THE FIRST YEAR AFTER THEIR CHILD’S BIRTH

Wednesday, September 8th, 2010

A group of investigators at the Medical Research Council, London, England, led by Shreya Dave, Ph.D., studied the incidence of parental depression in 86,957 families in the U.K. The data was taken from primary care clinic medical and pharmacy records during the period 1993-2007. Between their child’s birth and their child turning age 12 more than one-third of all mothers and about one-fifth of all fathers became depressed, with the highest rates of depression for mothers and fathers occurring within the first year of their child’s birth.

During their child’s first 12 years of life 19,286 mothers had a total of 25,176 episodes of depression and 8,012 fathers had a total of 9,683 episodes of depression. The overall rate of depression was 7.53 per 100 mothers and 2.69 per 100 fathers per year. In the first year after the child’s birth the depression rate was 13.93 per 100 mothers and 3.56 per 100 fathers.

Dr. Dave said the most likely factors for these high rates of post-partum depression shared by all parents are poor parental sleep, extra demands on parents and the negative effects of stress on spousal intimacy. Some specific factors that would apply to some but not all parents include being young parents, having an unplanned pregnancy, being low wage earners unable to afford child care, having a limited social support network, and the temporary discontinuation of mothers taking anti-depressants while pregnant and breastfeeding. Dr. Dave’s study was published in the September 6, 2010, online version of Archives of Pediatrics & Adolescent Medicine.

Lawyers should be aware of theses findings, because they may tend to attribute all feelings of depression to their work even when those feelings are coming from raising a new child. Let’s face it, raising a new child is stressful for anyone but especially so when you have to be up early for court, completely prepared for argument, well groomed, bright-eyed and alert – instead of exhausted, bleary eyed and covered in baby vomit.

Despite our high earning potential, lawyers are living in weird economic times – a stagnant recession – when jobs are scarce for new lawyers and layoffs are plentiful for older lawyers. The financial stress of unemployment or underemployment for a lawyer can add fuel to depression associated with raising a child. 

Once you realize and acknowledge that raising your child is contributing to an episode of depression for you and/or your spouse, then you are in a position to deal with it by seeing a psychologist, getting counseling, going on temporary medication and learning how to develop a stronger social support network.

It’s also a time to open your perspective to include you, your spouse and your child. Maternal or paternal depression during a child’s first years can cause permanent emotional damage to a child and raise his or her lifetime risk for depression and other psychiatric problems. Yes your career is important and yes it’s important to earn money, but your child is very important too. If you’re stuck at home due to a lousy job market, rather than spend all your time brooding and being resentful of your parental responsibilities which limit your time for job hunting, relax into parenting, enjoy it and create a beautiful bond with your child. This can ease your depression by creating meaning and pleasure during a layoff which would otherwise by somewhat tense and joyless. Yes children are burdensome (in some respects), but they are also a gift, the greatest gift I know.

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LEARN TO REGULATE YOUR CRAVINGS FOR CIGARETTES, ALCOHOL OR DRUGS

Tuesday, September 7th, 2010

Addiction to substances damages people’s health and careers. Cigarette smoking causes more than 400,000 deaths per year (more than all deaths from illicit drugs and alcohol combined). Alcohol consumption causes 75,000 deaths per year. The CDC estimates that 35,000 of these deaths come from cirrhosis of the liver, cancer and other diseases linked to excessive drinking while 40,000 come from car crashes and other mishaps. Experts on addiction agree that what drives addictions is craving not fear of painful withdrawal symptoms. Can people learn to effectively control their cravings for a substance?

The answer is yes. We all know people who have mastered their craving and permanently given up smoking, illicit drug use or alcoholic drinking. Some of them used a twelve step group. Some used meditation or other relaxation techniques. And, some of them took up running or other intense exercise. What do these people have in common? One thing they have in common is full awareness of the terrible long term consequences of giving into their cravings, and a strong conscious commitment to overcome their cravings and break free of addiction so they can lead healthier, happier, longer lives.

What else do they have in common? That’s what a group of neuroscientists led by psychology professor Kevin Ochsner, Ph.D., of Columbia University wanted to find out. Dr. Ochsner’s group did brain scans of a group of smokers who had been taught cognitive strategies to control their craving for cigarettes, especially to think about the long term consequences of smoking. Their paper was published in the August 3, 2010 online issue of the Proceedings of the National Academy of Sciences.

The smokers who had been taught to control their cravings showed increased activity in the parts of the brain associated with rational thought and cognitive control over emotions (the dorsomedial, dorsolateral and ventrolateral prefrontal cortex). They also showed decreased activity in the parts of the brain associated with craving for substances, reward-seeking and addiction (the ventral striatum, subgenual cingulate, amygdale and ventral tegmentum). Co-author Hedy Krober, assistant professor psychiatry at Yale School of Medicine, said “This shows that smokers can indeed control their cravings, they just need to be told how to do it.”

What Dr. Krober is talking about here is not the same thing as the silly “just say no” campaign during the Regan years. Lawyers who are dependent on cigarettes, illicit drugs or alcohol to relieve the many stresses of law practices aren’t going to quit because someone tells them to just say no. The fact is that the stresses will continue, the temptations to indulge will continue and you will continue to be surrounded by lawyers who do indulge. However, you can enroll in a program which teaches cognitive strategies to control your cravings and gradually teach your brain to control your cravings as it strengthens the command circuit running from the prefrontal cortex to the subcortical dopamine producing and receiving areas.

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TAKE CHARGE OF TREATING YOUR OWN CHRONIC ILLNESS AND GET HEALTHY AGAIN

Saturday, September 4th, 2010

Our country is suffering an epidemic of obesity, diabetes, hypertension, and heart disease. In More Health, Less Care, Dr. Peter J. Weiss argues convincingly that traditional medicine has not provided a solution to this epidemic. Dr. Weiss was an internist and infectious disease specialist who was asked to be the Medical Director of a health care plan in Florida and ended up running the entire company as CEO. From his unique vantage point he saw that traditional medical practices were making people with chronic illnesses worse not better over the long term. He decided to write a book to reform how chronic illness is treated and to help people understand that only they can make themselves well, because it’s their modern lifestyle that has made them ill.

Under the traditional  model the doctor doesn’t see his patient as a person or undertake a comprehensive inquiry into the patient’s life to understand all the physical, emotional, social, and spiritual factors that may play a role in his illness. Rather, he spends 15 minutes with a patient, orders lab tests, identifies his “medical problem,” and then attempts to fix his problem with a drug. Pills that lower cholesterol, blood sugar or blood pressure don’t address the root cause of obesity, diabetes or hypertension. They don’t address the stress of commuting and working, reduced physical activity, lots of time spent in front of screens, consumption of comfort foods high in sugar and unhealthy fats, heavy alcohol consumption or smoking.

The traditional medical approach makes the person with the illness completely passive and precludes him from playing an active and helpful role in figuring out why he’s ill and what he can do to regain his health and wellbeing. Dr. Weiss advocates that people make a total commitment to their health and that they collaborate with their physician to develop a treatment plan which realistically addresses their unique issues. If you’re obese because you have a very stressful job and you habitually engage in emotional over-eating to self-soothe, then being told to lose weight or being given a pill to reduce the hypertension from the obesity won’t work.

Dr. Weiss stresses that all patients are different and that cookie-cutter approaches to obesity, diabetes, and hypertension will fail. Some patients are and some are not prepared to stick to a plan that involves completely cutting out smoking or TV watching, cooking healthy meals and getting vigorous exercise. To get well you need to work with your doctor to lay out all the options and choose options you know you can handle. An effective health plan could include exercising more, getting more sleep, eating healthier foods, cutting out or reducing TV watching, cutting out or reducing junk food, cutting out or reducing alcohol consumption, or adopting stress reduction techniques such as walking, listening to music or meditation.

Dr. Weiss wisely advises us that no one can succeed on their own and that we will increase our chances of success by building a support network made up of family and friends to help us with things like quitting smoking or resisting that pint of ice cream. He tells us to forgive ourselves if we slip up by having too much wine, having one cigarette or eating a pint of ice cream. After all we’re only human, and a commitment to health is a lifelong commitment on a very long journey. Better to forgive than to engage in self-hate and despair and go completely off the wagon.

Dr. Weiss finds it helpful to think of our alternatives in terms of vicious or virtuous cycle. In the vicious cycle negative thoughts and feelings interact and reinforce each other. In the virtuous cycle positive thoughts do the same. A vicious cycle can occur when a minor injury leads to less exercise, more comfort food eating, weight gain, self-recrimination and loss of self-confidence. A virtuous cycle occurs when more exercise takes off pounds and yields a more attractive, energetic body producing still greater resolve to eat healthy, exercise regularly and stay on track. We should be conscious of which cycle we’re in at any given moment. Seeking honest feedback from trusted people helps. If we are in a vicious cycle, then seeking help from our support network will help get us back into a virtuous one.

More Health, Less Care is bursting with anecdotes and tips to help motivate you and guide you to overcome your obesity, diabetes or hypertension and regain your health. I strongly recommend you buy a copy, read it cover to cover and give your copy to a friend you care about who has similar issues.

 

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Posted in Exercise, Longevity of Life, Nutrition, Stress Management | No Comments »

TIME IS ALL WE HAVE, SO LIVE YOUR BEST LIFE NOW BEFORE YOUR TIME IS UP

Friday, September 3rd, 2010

In her poem When Death Comes the great American poet Mary Oliver makes the certain prospect of our death pose the question of how we will live out our lives:

When it’s over, I want to say: all my life
I was a bride married to amazement.
I was the bridegroom, taking the world into my arms.

When it is over, I don’t want to wonder
if I have made of my life something particular, and real.
I don’t want to find myself sighing and frightened,
or full of argument.

I don’t want to end up simply having visited this world.

Will you have lived as a timid visitor, simply observing life from the outside because you were too fearful to plunge in – or will you have committed,  lived fully and left your footprints here in this world?

Yesterday at lunch I attended a fascinating talk by Bonnie O’Brien Jonsson, M.S., who teaches MBSR (mindfulness based stress reduction), Buddhist meditation and a class for dying persons on how to live their last year. Bonnie said that life is poised on the fingertips of your intention. She asked each member of the audience to face another member and tell them what made him feel most alive and what he most wanted out of the life remaining to him. She reminded us that life makes no guarantees except for constant change up until the unknowable moment we die.

The past is gone and exists only in the form of a story. The future is not yet here and may never come. Bonnie reminded us that all the people who died in the 9/11 catastrophe showed up for work that morning believing they would be fine. They were in a state of complete ignorance that they were going to die that morning. Given that our death is certain but we never know when it will come, tomorrow or 30 years from now, what makes more sense – to live suffocated by the fear of dying (which causes us to withhold loving others, taking chances and being creative) or to live our unique purpose and “dance the wild dance” of those who know they won’t get out of life alive?

How do you live at work? Are you grateful for any of the time you spend at the office? Do you notice and appreciate any of what happens during the work day? Perhaps you’re like most lawyers out there. You start off by making a list of tasks which you regard as hard, tedious, unpleasant but essential. Then you rush through those tasks as fast as you can without coming up for air so you can experience the relief that comes from getting them done. You do this day in and day out. Then one day you’re old and gray and the doctor says you have heart disease or cancer. Not a pretty picture is it?

What keeps us back from making full use of our time and really living life? Is it because we are busy or are we busy because we are afraid and being busy distracts us from our fears? Bonnie, who has worked intimately with dying people for a dozen years, says it’s fear. Fear of what? Fear of dying, sickness, injury and pain. Fear of social rejection. Fear of breaking free of the story of one’s past that makes one a helpless victim and becoming responsible for oneself. Fear of trying and failing at a goal and making a fool of oneself. Fear of succeeding and then losing everything. Fear of succeeding and having to live with too many demands and expectations.

So how can we transcend fear and learn to take risks? Bonnie says it’s only by befriending our fear. Fear is an emotion. It will not kill us. It can be faced. The word courage comes from an old French term for heart. The heart is the seat of compassion. Bonnie says that having compassion for yourself is the key to facing and transcending fear.

She had everyone in the class do an exercise. First she had us close our eyes and call to mind an old fear. Next she told us to allow the fear to spread and feel all the sensations of the fear in our body, e.g. a tight abdomen. Then we were asked to trace the pattern of the fear in our body with our hands while having full compassion for ourselves. Bonnie suggested we use our hands to approach the anatomic area of our fear as if it was a puppy or a cute, helpless infant – by stroking it in a loving manner with a loving intention while silently murmuring reassuring words (may you be safe, healthy, happy, peaceful and at ease).

This exercise worked for everyone in the sense that it enabled us to face, endure, soften and reduce an old fear. If you engage in frequent practice of this exercise you may find it reduces the fears that are holding you back from risking change, living in the present moment and getting more out of life.

Yesterday evening I had the privilege of attending a talk given by Julia Butterfly Hill, the young woman who attained fame by sitting in a one thousand year old redwood tree for 2 years which forced a logging company to abandon its plan to cut down that tree and the grove in which it stood.

By coincidence (or was it synchronicity) Julia addressed the same issue. How can we commit ourselves to anything when we know we may lose, that we would feel terrible and even have our hearts broken? Julia said she learned from the tree to stay flexible and bend in life’s storms instead of being rigid and snapping. It boils down to attachment. If you are attached to the outcome of any endeavor (which means you make the value of your work and your happiness contingent on getting the result you envisioned), then you will keep on experiencing the fear of losing and you are setting yourself up for misery.

Few if any events in life happen exactly just when and how we want them. But if we learn to release our attachment to the result, then we can stay committed without the constant fear in our belly that makes us give up or never try in the first place. Julia ended her talk by saying her credo is to serve others for no reason. That is her shorthand way of saying that she serves others without attachment to the result she envisions. This enables her to stay loose instead of being tight (both figuratively and literally) as she serves.

Can she pull this off all the time? No. Julia said part of being human is slipping back into attachment. She knows she’s getting attached when she experiences rage or cynicism. Julia copes with the unconscious process of re-attachment by doing her best to stay mindful and monitor her thoughts and feelings. Then she can consciously choose to let go of her attachment and usher in freedom and inner peace. In the tree Julia could only enjoy the tree, the birds, the sky, and the clouds, in a state of non-attachment to the result of her fight with the logging company. Through practice she spends much more of her time in a state of non-attachment (serving for no reason), but her life is still a bit of a see-saw, because she sometimes get re-attached.

I hope you will take away something useful from the example and the advice of these two wise women. Don’t let fear of fear or fear of suffering hold you back from living your best life. Work on releasing your attachment to results. If the fear keeps coming up, then have compassion for yourself and use Bonnie’s exercise of patting and stroking the part of your body that is tight and clenched while breathing and wishing yourself well.

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SCIENTIFIC LINKAGE OF SOCIAL REJECTION AND PHYSICAL PAIN PUTS THE INCIVILITY CRISIS IN A NEW LIGHT

Thursday, September 2nd, 2010

When someone disturbs, annoys or otherwise ill-treats you, do you call him a “pain,” a “pain in the neck,” or a “pain in the ass?” Is there any truth to these expressions? The answer is yes according to C. Nathan DeWall, Ph.D., an Assistant Professor of Psychology at the University of Kentucky, and Gregory Webster, Ph.D., at the University of Florida. In the July 2010 issue of Psychological Science they published their research into the connection between social rejection and physical pain. Remarkably taking the equivalent of a Tylenol for 3 weeks reduced self-reported social pain from being rejected.

The researchers conducted two experiments. In the first one volunteers took either a 1,000 mg. acetaminophen pill or a placebo pill every day and kept a diary in which they reported their social pain. The subjects who took the acetaminophen reported substantially less social pain.

In the second experiment volunteers took either a 2,000 mg. acetaminophen pill or a placebo pill everyday for 3 weeks. At the end of the 3 week period all participants played a computer game designed to elicit feelings of social rejection while a functional MRI scanner monitored their brain activity. The MRI showed that acetaminophen reduced neural responses to social rejection in brain regions associated with distress from social pain (the anterior cingulate cortex) and from physical pain (the insula). 

This simple yet remarkable experiment showed that a drug designed to reduce physical pain managed to reduce the pain of social rejection. Dr. DeWall says the study shows that social and physical pain centers may overlap in the brain and rely on some of the same behavioral and neural mechanisms. Dr. Webster said the experiment showed that the physical and social or emotional pain systems are inherently linked and it makes sense, because if someone is hurting you, you want to know about it and get away.

What does this mean for us? Clearly the old saying “sticks and stones may break my bones but names will never hurt me” isn’t true. When lawyers exchange rude, insulting language which conveys contempt they aren’t just “pissing each other off” (to use another bodily expression) they are causing each other social, and perhaps also, physical pain. Do you live with headaches, neck aches, stomach aches or other aches which have no apparent cause? These could be coming from your law practice.

In life we get back what we give. It’s called karma. When you’re unreasonable and downright hostile to other lawyers, they will treat you the same way. If you’re reasonable and civil to other lawyers, they will act the same towards you. One way guarantees social stress, muscle tension, and very possibly physical ailments, while the other invites peace and calm even in the midst of strong disagreements over legal issues. You get to choose the way.

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GRUDGE-BASED LEGAL PRACTICE IS BAD FOR YOUR HEALTH

Tuesday, August 31st, 2010

Have you noticed that some lawyers become easily incensed and keep lashing out over some perceived incident that you regarded as innocent?How many times have you encountered another lawyer who howls with outrage over something that you or your client said or did and openly vows to exact revenge during litigation in whatever ways he can pull it off without violating the law? Lawyers who operate on grudges seem to draw power from them as if a squirt of grudge worked like jet fuel. Are you ever guilty of this?

Holding grudges and burning with anger has a physiologic cost and damages your health. Holding a grudge elevates heart rate, blood pressure and muscle tension. It increases pain for people already in pain. Holding a grudge is known to cause insomnia, anxiety and depression. It may appear to produce a short term gain, because you feel powerful when you indulge outrage against opposing counsel, but it produces a long term loss of health. While jet engines can be cleaned or even replaced it’s not so easy with your cardiovascular system.

Living in a state of anger against other people increases the risk of cardiovascular disease and lowers life expectancy. A recent study at Johns Hopkins Medical School which tracked 1,337 male medical students for 36 years following medical school, found that students who became angry quickly under stress were 3 times more likely to develop premature heart disease and 5 times more likely to have an early heart attack. The American Heart Association says that women also suffer increased heart attacks from anger.

Forgiveness is a decision to let go of bitterness, resentment and thoughts of revenge. It is based on understanding the negative effects of grudge holding on your own health and wellbeing. To forgive you don’t have to condone, excuse, justify or accept the act done to you. But you do have to forgive the person who did it. You have to stop hating that person for hurting you. Forgiveness sometimes leads to feelings of understanding, empathy and compassion for the one who hurt you. Whether it does or doesn’t help you see the other in a softer light, forgiveness effectively lessens the grip of anger on you and helps you focus on the positive parts of your life. It melts away preoccupation with hurt and revenge. Forgiveness brings peace and it’s the state of peace that enables you to go on with your life and to enjoy your life. Forgiveness reverses the adverse physiologic effects of grudge holding, increases your health and wellbeing and makes you more optimistic.

To avoid practicing law in a grudge-based way that is bad for your cardiovascular system make an effort to be more patient, gentle and accommodating with other people. This doesn’t mean you have to agree with their objectives, arguments or tactics or let them walk all over you. What it does mean is finding a way to relate to others in a more relaxed way instead of the seethe and snap way.

Try always to remember that your opponent is under pressures and has worries just like you and that these can lead him to say or do things which can irritate or offend you. Law school has no courses in diplomacy. It rewards highly competitive people. Too many law firms and clients think the most aggressive lawyer is the best lawyer instead of prizing tact, intelligence and persuasion.

Try to remember that under the aggressive persona there lays a human being who is trying to support his family and who has fears about losing the case, losing face and maybe losing his job. Try to remember that a person with these fears can become agitated, anxious and unpleasant without meaning to be. Can you find anything about your opponent that you like or share in common? Is it possible to tone down the rancor and lighten things up with some humor?

At the end of the day the only person burdened by a grudge is the grudge holder. The person who hurt the grudge holder is typically not even aware of the grudge and he certainly isn’t harmed by it in any way. Grudge isn’t voodoo. You can’t hurt another person by holding one. You only hurt yourself and the people who have to practice law with you and live with you. If you are going to practice law in a non-grudge based way it can’t be by a mere surface pretense. You have to be sincere. Meditation is a great way to get into and stay in this mode of relating. 

          Two sources of information on how to release a grudge and forgive are the Mayo Clinic website (which has a series of articles on this) and Dr. Fred Luskin’s website www.learningtoforgive.com

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ENJOY PEOPLE MORE AND REDUCE STRESS BY RELEASING JUDGMENT

Monday, August 30th, 2010

In our professional lives as lawyers and in our personal lives as regular people we tend to see others through the lens of judgment, dividing them into human kinds, some worthy of spending time with and getting to know and others not. Why is that we are so ready to find some strangers promising candidates for inclusion in our social world yet equally ready to disdain, reject and distance ourselves from other strangers?

This weekend I got to observe and experience this process while on a trip with my 9 year old son Elliott, my friend Bruce and Bruce’s 10 year old son Diego. The four of us live in the Bay Area. On Friday night we drove to a cabin on Alpine Lake in the Sierra Mountains. Saturday we spent the day trout fishing with lures, power bait and worms. The scenery (a mountain lake at 8,000 feet elevation) was beautiful, but the trout weren’t biting because it was quite cold and windy for a late August day. Instead of eating pan fried trout in our cabin as we had hoped, we settled for some tasty pizza at the nearby Bear Valley ski lodge which was open for mountain bikers and hikers.

On Sunday we spent our day in and near the little town of Murphys named after the town’s founder John Murphy who made 1.5 million in the Gold Rush, married a survivor of the bad luck Donner Party and left to become mayor of San Jose. The town and its immediate surroundings are a mix of  old settler culture; small business people who are staunchly Republican; organic farmers; wine makers; olive oil makers; gourmet chefs; motorcycle clubs whose members ride Harleys and sport Harley Davidson clothes; and good ole boys who rekindle memories of the Dukes of Hazard.

Just before hitting town we stopped at Quayle Pottery. This is farm/winery which makes its own clay, glaze and pottery on the premises and sells modeling clay to local schools. The owner’s daughter Dolores invited us in and showed us around their clay making operation, pottery studio and vineyard. We got to hang out with the farm’s pet geese, a small flock of Chinese geese with black beaks and large, black horn-like protuberance sticking up out their foreheads. These geese were not only tame but downright friendly. They helped the farmer out by eating the weeds in his garden. One of the geese was named Gaggle. Dolores held him in her arms like a small dog, petted him and stroked his long s-shaped throat. She invited us to pet him and we did. It was great fun. Elliott got to see that country folks could be surprisingly kind and interesting and that just because a town has a lot of McCain-Palin bumper stickers on the cars doesn’t make it a cold or hostile place.  

In the afternoon we went zip lining on the grounds of Moaning Caverns. The young men who helped us on and off the zip line were tall, lanky college age guys sporting long hair, unkempt beards and tattoos. They were nice, friendly guys with good senses of humor who cracked us up with their jokes. We asked what else we could do for fun before we went home and we were told about Natural Bridges, a place a few miles away where a creek had cut a grotto out of the limestone. We drove over and had a blast. Once you get in the creek you can swim into, through and out the back of a cave with a tall roof. The depth of the water in the middle of the cave is over six feet. The cave was covered in stalactites and stalagmites displayed in many shapes, sizes and colors. The stalactites were dripping water into the creek below. The water felt freezing and must have been in the 50s.

The people sitting around the creek or enjoying the swim through the grotto were a mix of families and bikers with big arms and lots of tattoos. There were some picnic tables near the grotto. One of them was occupied by a very loud, boisterous group of bikers. They were drinking beer from cans, smoking, joking and laughing uproariously. My son and I overhead one of them say, “There’s nothing in the whole world I like more than to have a beer, smoke and shoot something.” Elliott turned and looked at Bruce and I. He said, “I just can’t imagine anyone thinking that way.”

From Elliott’s perspective this guy had just landed from outer space and expressed a form of logic which did not compute here on Earth. The problem was that Elliott was surrounded by other people who felt the same way as the speaker. Not only that but all of them were human beings just like Elliott who were just as entitled as he was to enjoy the sunshine, the air, the creek, the Grotto and the picnic tables. This started a discussion about tolerance, and the need for us to see commonalities in people rather than stop at the obvious differences which seem to divide us.

Bruce and I are both love to take long bicycle trips, but never ride motorcycles. The people we ride bikes with under our own leg power wear Spandex with names like CSC and Credit Agricole. They like wine and cheese and love to ride bikes in groups in the countryside. They fantasize about riding in France or Italy. The bikers wear black leather with names like Iron Spartans and the Forgotten Ones. They like chips and beer. They like to ride everywhere including multi-lane highways where they can go faster than cars. We asked Elliott if bicyclists and bikers are really that different.

Don’t both of them love riding in the countryside with friends in the sunshine? Don’t both of them love a certain style of clothes bearing names that have a certain sound? Don’t both have their own lingo, their own heroes and their favorite snacks? Bicyclists love to fly down hills after a tough grind uphill. What if bicyclists got a chance to ride a motorcycle? Wouldn’t they likely enjoy the speed and the steering in turns? What if bikers got a chance to ride a fine road bike and experience the challenge and camaraderie that goes with a tough group ride ending in a communal feast? Wouldn’t they enjoy it? It became pretty easy to imagine that we could all exchange places and it might be fun to do so. Suddenly the other side didn’t seem so alien or so objectionable.

Before driving home to the Bay Area we ate in town at a local cantina because the boys wanted burritos. The friend tortilla chips and salsa were incredible. The food was tasty, filling and cheap. The young waitresses, all high school girls, were super friendly and gave us good suggestions for menu selections. Bruce and I began to philosophize about the difference between seeing a place as tourist and spending time in a place in an open-minded, open-hearted way that connects you with its people.

You don’t have to leave your country, your state or your region within a state to be a tourist. It’s very possible to see strangers in your own city, your own neighborhood and even your own block from the eyes of a tourist.  A tourist sees strangers as colorful alien beings with a different way of life whose customs and mannerisms range from the quaint/pleasant to the disturbing/grotesque. When you choose to see strangers as other people, then the surface differences that come from where people live and how they earn their money begin to dissolve and you are able to accept and appreciate them. At that moment their differences become interesting and intriguing and a source of celebration rather than a reason for dismissing them as weird. The critical factor is releasing judgment. When you can release judgment you will enhance your relationships and reduce your stress at the office and at home.

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PARTNER UP WITH A WORK BUDDY TO MAKE MORE ACCURATE, LESS STRESSFUL DECISIONS

Friday, August 27th, 2010

Lawyers have to make a steady stream of decisions every day. These range from the small (whether to interrupt an activity to take a call) to the hugely consequential (whether to reject a final offer of settlement and go to trial). When it comes to making big decisions do you trust yourself above all others and make them alone or do you consult a colleague? If you make them alone you pay a price. What price? You may be sacrificing accuracy without the objectivity a colleague can provide, and you are certainly incurring more stress. When you make decisions alone you are completely responsible for them even though you may be missing something that a colleague might have seen.

The old saying that “two heads are better than one,” turns out to be largely true. In a study published in the August 2010 issue of the journal Science neuroscientists Bahador Bahrami from UCL (University College London) and Chris Frith from Aarhus University, Denmark, explored the relative accuracy of collective vs. solo decision making on a low level perceptual task. The task involved detecting a very weak signal on a computer screen, one that was so weak there could be legitimate disagreement as to whether the signal had occurred or not.

What the researchers found was that for two observers of nearly equal visual sensitivity, two heads were definitely better than one, provided they were given the opportunity to communicate freely about their perceptions. Their accuracy did not depend on getting feedback from the researchers. Simply being told by the researchers which one of them was right did not increase accuracy. But when one observer with good visual sensitivity was paired with another observer with poor visual sensitivity, two heads performed worse than one because the person with poor visual sensitivity influenced the person with better sensitivity to make the wrong decision. The researchers concluded that the optimal conditions for making a perceptual decision (did I actually see something or not?) are having a partner of comparable visual sensitivity and being able to freely discuss your perceptions with each other.

It’s logical to assume that making a complex legal decision would follow the same model. If so, then two heads are better than one provided you select a partner of comparable intellectual capability who is given access to the same information you have, and you communicate freely with each other regarding your perceptions of the data. Following this model of decision making can increase your accuracy and lower your stress at work.

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HIGH SENSITIVITY TO SOCIAL REJECTION TRIGGERS INFLAMMATORY DISEASE – LEARN TO MODIFY YOUR RESPONSE TO SOCIAL STRESS

Monday, August 23rd, 2010

Some people love to speak in public, while others fear it worse than death. Some people are energized by the prospect of a job interview and march in with confidence, while others fear the worst and blow it because they are self-conscious and ill-at-ease. Some people are able to take a “no” in stride and enjoy the dating process, while others make excuses to avoid asking people out and crumble when they reach out and receive a no. 

People in some occupations get ignored or hear “no” more than others. Lawyers are right up there with telemarketers and people selling life insurance or financial investment products. Our legal system is set up to be adversarial. It exists to process disputes between two sides that want different outcomes, hold to different positions and make opposed arguments. Whether it’s a motion, a trial or a negotiation, lawyers constantly hear no. It gets frustrating, irritating and discouraging to keep hearing no from opposing counsel. It can be downright depressing to hear no from a judge or jury. Some lawyers are said to have a “tough hide,” and they are able to shake off rejection and defeat. But not all lawyers are emotionally bullet proof. Some of them are quick to perceive rejection and hate the feeling.

What goes on in the bodies of people who are extra sensitive to social rejection? That’s what psychologist Shelly E. Taylor, Ph.D. and psychoneuroimmunologist George Slavich, Ph.D., at UCLA wanted to find out. They recruited 124 people (54 men and 70 women) and put them throw two stressful social situations. In the first they had to prepare and deliver an impromptu speech and perform difficult mental arithmetic in front of a socially rejecting panel of raters wearing white lab coats. Mouth swabs were taken before and after the test to determine if changes had occurred in two biomarkers for immune system response marked by increased inflammation – greater release of tumor necrosis factor-a and interleukin-6 (IL-6).

In the second test 31 of the participants underwent an MRI brain scan while playing a computerized game of catch with what they believed were two other real people. For the first half of the test the game was between three people, but midway through the game the other two players excluded the participant and played on their own causing the participant to feel rejected.

On MRI some of the subjects showed greatly increased activation of two areas of the brain known to respond to social stress, the dorsal anterior cingulate cortex (ACC) and anterior insula. Those very same subjects showed greater increases in tumor necrosis factor-a and IL-6 as a result of their lab test facing the stern, frowning panel of raters in white lab coats.

Dr. Slavich said this study confirms the very close relationship between mind and body and helps elucidate some of the neurocognitive pathways involved in inflammatory response to social stress. According to Dr. Slavich this is important because frequent or chronic episodes of inflammation in response to the mere perception of social stress can increase the risk for asthma, rheumatoid arthritis, cardiovascular disease and even depression.

Why would the human brain trigger the release of inflammatory proteins via the immune system when it perceives social threat or rejection? Dr. Slavich said that social ostracism in the cave man days meant death because you would have to hunt and defend yourself alone in a world full of dangerous predators and hostile bands of competitors. Thus social ostracism goes hand in hand with anticipation of physical injury and the activation of the immune system before the injury occurred could have some survival value.

What can people do to control their response to situations in which they anticipate or perceive social rejection? Dr. Slavich suggested that you question your belief that people are rejecting you. If there’s no solid evidence it’s true, then you can dismiss the belief and relax your tense mind.  For example if someone doesn’t return your call it’s not necessarily because they don’t like you. It may be that they are away from the office, incredibly busy that week, just plain disorganized or overwhelmed by all the emails and calls they get.  

There are many ways to reduce the negativity and intensity of your response to social stress. Sometimes the answer is skills training. If your greatest fear is public speaking then enrolling in your local Toastmasters club will really help, because Toastmasters has helped tens of thousands of people from all walks of life (including new immigrants with little English) to overcome their fear of public speaking and become confident, effective public speakers. The typical charge to belong is just $100 per year.

In most situations it boils down to your perspective. If your self-esteem is always on the line and it rises or falls with the result of every encounter you have with another person, you’re in deep trouble because none of us can control how other people respond to us and when we attempt to do this we’re perceived as manipulative. If you’re over-focused on something you regard as a defect you won’t be able to connect with others with a feeling of comfort and ease. Do you see yourself as too short, too bald, too fat, too ugly or too something? Do you hate your nose or your accent? Are you terribly self-conscious about the no-name law school you attended or the fact that you have a family member who is much more successful than you?

Are you constantly worried that you might not make partner? Do you evaluate every decision and every interaction with others in terms of how they affect your potential for partnership? Do you live in fear that others may discover something you’re ashamed over? Do you actively try to hide it? Whatever it is (be it a current problem with binge drinking or the imposition of professional reprimand twenty years ago) the fear of discovery is going to make you jittery around others and make you curious as to whether they know your dark secret.

There are two methods for dealing with such anxieties which can free you to interact with others less stressfully. One is to learn self-acceptance. There are many fine books and CDs which teach self-acceptance. I have written a number of blog articles on this topic using such concepts as self-compassion and self-forgiveness. The other method, which I want to talk about here, is self-forgetting – the process of realizing the self is a fiction and letting it go.

Eckhart Tolle (author of The Power of Now) is a leading exponent of self-forgetting in the popular media. While I have certainly enjoyed and gained a lot from reading his books and listening to his lectures on CD, much of my understanding of self-forgetting comes from Tarthang Tulku the Buddhist Lama who founded the Nyingma Institute in Berkeley, CA.

Tarthang Tulku says that the mind clothes itself and renders itself tangible to itself in a purely mind-created projection it calls the self. The self is like a magnet which attracts stories – stories which the mind has spun to make sense of its experiences in the world and stories which others have proffered to mind. Whether you define yourself your own way or you have allowed others to define you (such as your parents, teachers, professors, spouse or boss), either way you are placing narrow, artificial limits on your being and you are shaping the way you perceive and interpret events and situations. Depression is the difference between what you believe you should have accomplished and what you have accomplished.

If your self is a victim in your story than you’re likely to be on guard against rejection, disappointment and victimization. When you meet someone you analyze his every word and scrutinize all his facial micro-expressions for approval/disapproval. If your self is a conquering hero it’s all great until you suffer a long series of small defeats or one big humiliating disaster. As of August 2010 Tiger Woods (arguably the greatest golfer who ever lived) can’t make a golf shot, because the self he constructed with the help of PGA Tour, the press, and his fans has been shattered. Whether you’re a goat or a hero in your own story you’re loading yourself with stress because you’re always waiting for mistreatment and abuse or because you’re always working hard to stay on top.

If you confuse being (the state of existing in the present moment as a being) with having a self, then your focus is not on living in this moment but on how the self is faring (well or ill) and you are lost in tension-riddled comparisons between your self, your past and future selves and other selves. 

Tarthang Tulku recommends daily meditation to release the self and come back into the state of pure being unconditioned by stories about who we are, why we are, what we must do and so forth. He says that meditating in this way leads to compassion for all beings and unity with all beings – a condition of existence in which fear of others (social stress) cannot exist. I have been meditating in this way and making progress along this path.  I commend it you.

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INTEGRATIVE BODY MIND TRAINING REDUCES STRESS, ANGER AND DEPRESSION WHILE INCREASING RESTFUL ALERTNESS AND LEARNING CAPACITY

Saturday, August 21st, 2010

Integrative body mind training (IBMT) is a specific mind relaxation technique which incorporates aspects of traditional meditation practice, but can be learned in a matter of days rather than years. It helps users achieve a high degree of mind-body awareness within a state of restful alertness. A coach guides trainees in posture and balanced breathing while providing mental imagery and soothing music conducive to mind-body harmony in the Taoist tradition. Trainees are helped to keep their minds focused on the present moment instead of allowing their minds to switch rapidly back and forth between past and future.

IBMT was developed during the 1990s by Dr. Yi-Yuan Tang of the Dalian University of Technology in China. Dr. Tang is a distinguished researcher and professor in China where he works to link traditional meditation with modern neuroscience. He designed IBMT to serve as an easy, effective way to improve  self-regulation in cognition, emotion and social behavior.

Dr. Tang became a Visiting Professor at the University of Oregon in Eugene to work on IMBT with psychologist Michael Posner, Ph.D. In 2007 they did a pilot study on Chinese students. After 20 minutes of IMBT training over 5 days these students had lower blood cortisol levels than a control group while taking a mental math test. They also showed lower levels of tension, anger and depression.

In 2009 they did a second study involving 86 students at Dalian University of Technology. The study showed that students trained in IMBT for 20 minutes a day over 5 days showed physiologic changes consistent with reduced tension. Their brain waves went from a state of high arousal (beta) to a state of restful alertness (alpha). Heart rate and skin conductance were lowered. Breathing shifted from rapid, shallow chest breathing to slower, deeper belly breathing.

In the 2009 study Dr. Tang and Dr. Posner used SPECT scanning (which measures blood flow patterns in the brain). SPECT scans of the  participants who used IBMT displayed extra blood flow to the right anterior cingulate cortex (ACC). The ACC is an important area of the frontal lobes which helps regulate cognition by controlling where we place our attention and by resolving conflicts between new and old information. It also plays a role in emotional self-control and is capable of inhibiting fear messages from subcortical parts of the brain like the amygdale which can lower our stress level. Extra blood and oxygen helps the ACC function more efficiently and effectively.

Dr. Posner is no lightweight. He is an expert on the brain networks which underlie attention who is currently a Professor Emeritus at the Institute of Neuroscience at the university. Dr. Posner often uses brain imaging in his research. He has published book chapters and articles on the role of genetics, environment and training on the development of the neural networks of attention. He has frequently teamed up with the world’s best known cognitive neuroscientist Michael S. Gazzaniga, Ph.D., who currently heads the SAGE Center for the Study of Mind at U.C. Santa Barbara. He just won a National Science Medal.

On August 21, 2010, Dr. Posner was interviewed about IBMT on Science Friday produced by National Public Radio. During the broadcast he discussed his latest study on IBMT at the University of Oregon. For this study he recruited 45 USO students (28 males and 17 females). Twenty-two participants received IBMT while 23 were in a control group which received the same amount of general instruction in relaxation. The participants underwent a relatively new form of brain MRI called Diffusion Tensor Imaging (DTI) at the Robert and Beverly Lewis Center for Neuroimaging.

 The processing areas of the brain in the gray matter and subcortical areas are clusters of neurons of like type. They communicate with each other through tracts of white matter composed of myelinated axons. A brain criss-crossed with dense, healthy thickets of myelinated axons functions very efficiently and is said to have high connectivity. A brain with low connectivity has fewer myelinated axons to hook up its processing areas. 

DTI helps neuroscientists look at the connectivity of a person’s brain in specific regions. DTI measures the time it takes water molecules to diffuse across myelinated bundles of axons in the brain (its white matter tracts). The less white matter in a given area the quicker the water molecules travel. The more white matter in a given area the slower the water molecules travel.

Using DTI Dr. Posner discovered that changes in the brain connectivity of the IBMT group began after 6 hours of training and became clear by 11 hours. He believes the changes represent a reorganization of white matter tracts or an increase in the myelin coating around them. Deficits in activation of the ACC have been associated with attention deficit disorder, dementia, depression, schizophrenia and many other disorders. Increased activation of the ACC through IMBT would appear to be highly desirable. During his interview Dr. Posner was asked if any of the students doing IMBT had suffered harm and he said no – they either displayed no change or positive change, and he emphasized that gains in ACC connectivity should help people learn more efficiently.  

During the interview Dr. Posner said he and Dr. Tang plan to continue to study IMBT and that right now it is not commercially available in the U.S. However, I did find Dr. Tang’s website at http:www.yi-yuan.net and when I clicked the services button it said that persons interested in finding an IMBT trainer in China or the U.S. should email yiyuanbalance@hotmail.com Lawyers who are struggling with stress, anxiety or depression may wish to try this email.  

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