Start Small

22 Feb

I’m going to focus here on the idea of starting small. Most of the thoughts that seem to get in our way are problematic because they frame the avoided task as something big, complex, and difficult. To get around this barrier, it helps to break the task down into very small steps that seem manageable. If I’m writing a book, for example, the kiss of death would be to put “write book” on my to do list. I think my brain sees the words “write book,” and alarm bell start to go off: “This is too much! You don’t have time for this! There’s no way you can do it!” Instead, I might write down, “Spend 20 minutes writing Chapter 1. No alarm bells go off when I see that I only have to work on my book for 20 minutes. Take a large task, break it down into small pieces, and mindfully tackle one piece at a time. With the exercise equipment, my plan for today is to simply move it to the place where I want it, and to open the box. Perhaps, tomorrow, I will inspect the parts to ensure that they are all there, and look for appropriate tools. Who knows what I might do the next day? I plan to avoid worrying about whether I’m going to put the whole thing together or when it will be done and ready for use. Consider taking this approach to tasks that you might be inclined to avoid or procrastinate about. Get your thoughts out of your way by presenting your brain with something that seems manageable. ~ Alexander L. Chapman, Ph.D., R.Psych.

Progress Can Be Slow and Frustrating

15 Feb

I was just talking to a group of students about self-care strategies. If you’re trying to enhance your self-care, I think that one of the biggest mistakes you can make is to try to do too much at once. Let’s say you have the goal of being fit and healthy. So, you decide that you’re going to get up at 4am every day, spend 2 hours at the gym before breakfast, eat only non-processed foods, avoid all refined sugar, caffeine, alcohol, and so forth. How long will this plan last? Probably not too long. These drastic changes are hard to sustain. Even worse, I think that the idea that becoming fit and health requires drastic changes dissuades people from even starting. As a result, I often advise people to avoid making a self-care change that they can’t keep up for over a year. You can’t get fit and healthy in a day, a week, or even a month. Fitness and physical health are long-term goals. You can make tremendous progress over time, but your progress on any given day or week is a lot like the effect of water flowing over rocks. You don’t see the change right away, but over time, those rocks become worn down to smooth pebbles. Start small. For example, about 15 years ago, my wife and I were living in a non-walking friendly neighbourhood in North Carolina. We discovered it wasn’t walking-friendly when we went on a walk, and people started to come out onto their porches to watch us go by. We had a gym in our apartment complex, but I didn’t really enjoy going there, and I was a busy intern at Duke University Medical Centre with little time for extra stuff. That said, fitness was very important to me, and I wanted to get back into a healthy routine. I decided to do pushups every morning. I started with 15 or 20, and every couple of weeks, I added more. Eventually, I added more stuff to my daily routine, and even though I’m 15 years older, I regularly do many times the pushups I started with, and I’m keeping up quite well with my teenaged classmates in my martial arts class. The changes that occurred day in and day out were small, but cumulatively, they made a big difference. If you take this approach, one pitfall is that you could get demoralized when you don’t notice big changes. You might find the slow rate of progress to be incredibly frustrating. Indeed, in other areas (such as progress working on mental health problems), slow, episodic, and unpredictable progress can be frustrating and demoralizing. When you become demoralized (and you will from time to time), remember that your goal is to be like water over rocks, not like a jackhammer. A jackhammer will break up the rocks into uneven, jagged fragments. Water will break them down and smooth them into small pebbles or grains. Another thing to remember is that you really can’t subtract progress. If you’ve made progress, and then you slide backward, that doesn’t mean you’re really back where you started. While you were making progress, important changes occurred in your brain that can be revived when you get back on track. Barring brain surgery or a major head injury, the stuff you learned that helped you move forward can’t be erased. In fact, even people who have had major head injuries, surgery to remove tumors, catastrophic strokes, and so forth, have sometimes made startling recoveries. Our brains are amazing learning machines. Keep this in mind. Practice accepting slow progress, and plan for times when it gets frustrating. ~ Alexander L. Chapman, Ph.D., R.Psych.

Mindful Eating

2 Feb

I am a slow eater. I have always known this, but it came to the forefront during a recent trip to an annual Zen mindfulness retreat. During this retreat, we have a very specific protocol for meals. Everyone comes in, gets their food, and then stands by their table until everyone else has gotten their food. At that point, everyone is allowed to begin to eat. At the end of the meal, we all have to wait until everyone is finished before we can leave the kitchen to begin our break. Believe me, everyone wants to get out of there as quickly as possible, as meditating from 6 AM until 9 PM every day is hard work, and breaks are precious. There’s a certain amount of unspoken social pressure to get done as quickly as possible. I’ve been attending this retreat for the past 15 years, and for many years, I was the one holding people up, preventing them from leaving for their break, due to my slow eating. My new strategy over the past few years has been to simply take less food. This generally seems to work out: I’m not usually the last person to finish. But, why is it that people who take twice as much food are still finished eating before I am? I know the easy answer is that they are eating faster, but how and why are they eating faster? I made some discrete observations this year (sorry to those of you who were sitting with me!), and I think I at least have an answer to the question of how (maybe we’ll tackle “why” in another blog). When I eat, I put a portion of food in my mouth chew it until I’m done, swallow, and then put another portion in my mouth. I thought this was how everyone ate, but apparently it is not. I noticed that the quick eaters put food in their mouth, and as they are chewing, they put more food in their mouth. It’s almost like a conveyor belt of food that keeps going until everything on the plate has vanished. They must have some kind of system of chewing and swallowing and getting that food down their esophagi as quickly as possible. When I have tried that particular technique, I feel uncomfortable, almost like I’m force-feeding myself. Now, I’m not judging quick eaters. I think they have an unusual talent that we slow eaters seem to lack. That said, there has been an increased emphasis in cognitive behavioural treatments for eating disorders on mindful eating. Mindful eating is a component of many such treatments. Researchers don’t know yet whether it is an extremely important or critical component, but many clients struggling with binge eating often report eating on automatic pilot with little awareness of how much they are consuming. Mindful eating involves slowing the process down, paying mindful attention to the sight, smell and taste of the food, and taking time to really experience eating. Even if you are not using mindful eating to combat an eating disorder, eating mindfully can still be worth a try. My personal belief is that eating is one of the great pleasures in life. Slowing down and mindfully experiencing every minute of it can enrich the experience. Since we all have to eat several times a day, why not make eating the best experience possible? As I have observed, one way to do this is to slow down the conveyor belt. Take a portion of food, experience it fully, chew it, swallow it, and then move onto the next portion. This simple strategy can be an excellent first step in mindful eating. Try it out. Time for lunch. ~ Alexander L. Chapman, Ph.D., R.Psych.

Re-thinking Criticism

25 Jan

I recently have been learning some new weapon techniques in my martial arts class: double-nunchucks. Spinning those metal tubes quickly, often doing different things with the right and left side can be challenging! Indeed, I have perpetual bruises on my inner elbows. If you have ever hit your inner elbow by accident, you know how much it smarts. I’m trying to use a cognitive therapy strategy, called reappraisal, to learn from this experience. Reappraisal involves construing events in a different way. Instead of thinking, “Oh, for crying out loud, not again!” whenever I hit my elbow with the nunchucks, I try to think, “What can I learn from this? What am I doing, and how can I do it better?” The elbows are still sore, but I’m hitting them a lot less often, and I’m surprised that I’m actually catching on to the whole thing.

I think that this is a lot like dealing with feedback – critical, negative, constructive, and so on – from other people. If we think of negative feedback as awful, unwanted, undesirable, unhelpful, and so on, we’re unlikely to learn from it. This would be a lot like ignoring or denying the fact that I keep hitting my elbows and continuing to do the same thing over and over again. If I were to do that, I’d never improve, and eventually, I wouldn’t be able to move my arms. When someone says that we have done something wrong, expresses dissatisfaction with something we’ve done or said, or asks us to change our behaviour, it can be easy to become defensive and dismissive. It’s harder to look for the wisdom or truth in what the other person is saying and learn from the experience. I think that reappraising critical feedback as a learning experience can help us make the most of it and avoid the pitfalls of defensiveness or denial. In DBT, there’s a new skill in the interpersonal effectiveness section (Linehan, 2015) that can help with this: Recovering from invalidation. In short, this skill involves figuring out whether invalidation or critical feedback is valid and possibly useful versus invalid and less useful. If it’s valid, or even if there’s a grain of truth in there somewhere, the idea is to learn from it and make changes if needed. If there’s not much validity to it, then you might go down a different path: accept that you have received the feedback or have been invalidated, remember that invalidation is rarely a catastrophe, and then figure out what to do next. Even when negative feedback smarts, it can still be a helpful opportunity to learn, grow, and act skillfully. ~ Alexander L. Chapman, Ph.D., R.Psych.

Focusing on One Thing at a Time

19 Jan

When I teach people mindfulness skills, I often emphasize the importance of doing one thing in the moment. This is, indeed, one of the DBT mindfulness skills (“one-mindfully”; Linehan, 1993b; 2015). Doing one thing in the moment is kind of the opposite of multi-tasking. Instead of dividing your attention among many tasks at once, doing one thing in the moment involves focusing your full attention on the one task at hand. This task might be driving, eating, walking, talking with someone, working on something, getting dressed and ready for something, or any of the many things we all do each day. Some of these tasks involve many different components, such as driving, where you need to pay attention to lots of different things, shift gears, brake, weave in and out of traffic, and so on. One-mindfully driving, therefore, involves keeping your mind focused on the many tasks involved in driving. I often cook meals for my family, and cooking is surely another example of a multi-component task – one that might seem hard to do one-mindfully. When I’m cooking, I try my best to focus on whatever step I’m working on. This could be preparing spices, chopping vegetables, getting the slow cooker going, gathering things from the fridge, and so forth. Cooking requires a lot of preparation and coordination, especially if your meal has many parts to it, or if you’re making slightly different meals for different people (i.e., picky family members!). It might seem like a good idea, therefore, to try to do more than one thing at a time, such as frying onions while cooking rice or preparing meat. I find that getting a lot done while cooking doesn’t really require multi-tasking; it requires organization. If I organize things ahead of time, I can get a lot accomplished at the same time without actually doing more than one thing at a time. For example, while I’m chopping chicken for butter chicken, the slow cooker might be making the rice, I’ve put the garlic on, so it’s starting to sauté, and I’ve got the oven preheating and the cookies ready to go in the oven when we start eating (so they’re done by dessert time). A lot is happening at once, but I try to focus on whatever I’m doing in the moment, even if it’s only for a brief moment. A common misconception about doing one thing in the moment is that you can only apply this strategy to simple tasks. On the contrary, if you really focus one-mindfully on each activity throughout the day, you might find that each activity becomes a simple task. ~ Alexander L. Chapman, Ph.D., R.Psych.

Daylight

17 Dec

I’m currently looking out my home office window as the sun rises on a cold, crisp, sunny December morning. There is a good foot or more of snow on the ground, and the sky is unusually bright for this time of year in the Metro Vancouver area. This brings to mind an interesting talk I recently attended, given by an expert in sleep research: Dr. Jerome Siegel, from the University of California at Los Angeles. This professor has conducted some fascinating research on the sleep patterns of hunter gatherer societies.

There were a few interesting take-home points from his talk. First, hunter gatherers, on average, sleep slightly less than people living in more modern societies. This seems to go against the common myth that we modern folk are all horribly sleep deprived, and that if we could only return to a more primitive lifestyle, we would sleep a lot more. Second, the sleep of hunter gatherers is not 100% tied to the presence or absence of daylight. One would think that, with no artificial light and increased potential for danger in the dark, such individuals would generally hunker down and go to sleep around sunset. On the contrary, they seem to go to sleep an average of a few hours after sunset. Third, there seems to be little or no insomnia, obesity, or cardiovascular disease. In the research reviewed by Dr. Siegel, this difference in health profiles between hunter gatherers and people in modern societies did not seem to be related to differences in activity level or calories burned throughout the day through physical activity. Fourth, some of the findings seemed to suggest that sleep is strongly related to circadian fluctuations in ambient and body temperature. Sleep generally occurred during a period of falling outside, ambient temperature, corresponding to a period of falling core body temperature. Therefore, how cool your room is at night may not be as important as whether the temperature is falling.

Finally, another interesting finding that relates more to the title of this blog was that hunter gatherers seem to get the most sunlight exposure in the relatively early morning. This seems to be because, near the equator, it is so hot during midday that people concentrate their activities in the morning and generally seek shade in the early to mid afternoon. We don’t know for a fact whether these individuals have better sleep than we do, but the absence of insomnia and the low prevalence of napping seem to suggest that hunter gatherers have slightly shorter but perhaps more compact, quality sleep. This could be due to many factors, but perhaps morning daylight exposure is among one of the important ingredients of a good night’s sleep. I’m aware of some evidence, although it is not based on the strongest research, that morning daylight exposure may enhance sleep. There has been some other research suggesting that exposure to light in the morning may be particularly important in alleviating depression. The proponents of light therapy, for example, often suggest that light machines be used for approximately 90 minutes, primarily in the morning. I have also noticed, anecdotally, that my mood, energy level, and sleep all tend to be better on days when I have had significant activity outside in the morning. Yesterday, I went for a lovely morning hike in the snow, and it seemed to give me an extra lift that persisted throughout the day. Further, I had a great sleep and woke up before my alarm went off this morning. This could certainly be a coincidence or related to other factors, but I’m definitely getting on board with the idea that being outside, actively exposed to daylight in the morning, is probably a good idea. For those of you who live in the Metro Vancouver area, take advantage of what little sunlight we seem to get in the winter. It is looking sunny for most of the week. Get out, get active, enjoy it while you can, and sleep well! ~ Alexander L. Chapman, Ph.D., R.Psych.

Snow at Last

12 Dec

After a series of warm, relatively snowless winters, the Lower Mainland is now largely buried in snow. I remember growing up in Vancouver and trudging down the street with the snow up to my knees, sometimes even up to my waist. This seemed to happen about once a year, maybe even twice. Over the past few years, however, we have been lucky to have enough snow to ski on the local mountains. Indeed, the dry, early spring wreaked havoc for the 2010 Olympics. In contrast, 2008, I recall pulling my kids out of the cul de sac on sleds, Christmas presents in tow, so we could be picked up by our parents (who had an SUV) and taken home for Christmas dinner. That year, the very last of the snow piles in the parking lot up at SFU melted around the end of April or early May.

Now that the snow is here, at least for a few days, it can’t help but influence our everyday lives. Getting from place to place is more challenging, and yet, opportunities open up for sledding, snowball fights, and simply gazing out the window at the wintry wonderland. The snow also comes with responsibilities, such as shoveling.

To be honest, I’ve always been somewhat resistant to the idea of shoveling snow. The way I saw it, it wasn’t clear why I should shovel if it’s still snowing, and all my work will have amounted to nothing within 15 or 20 minutes. Well, today, I decided to give shoveling a try anyway. I was out there for about an hour and a half, and I must say that I got a lot done. I hacked away at the ice, clearing the driveway and the sidewalk in front of our home. I even shoveled the snow that had piled up where the driveway ends and the street begins. Of course, while I was shoveling, an additional two or 3 inches of snow arrived. Rather than give up and come back inside, I persisted. Looking out the window at my work, I feel a sense of accomplishment. The thing is, even though additional snow piles up, clearing the driveway and the sidewalk helps to prevent compact ice from forming.

I think that shoveling snow is, in some ways, like trying to improve our lives more broadly or trying to recover from mental health problems. Looking out at the cold, it is hard to want to go out there and work when you know that you will sometimes take two steps forward and two steps back. Just working on your life and learning new ways to cope, however, is like preventing the compact ice from forming. Even though, at times, it might seem like you haven’t gotten anywhere, every effort you make lays the groundwork, changes your brain in important ways, and will ultimately help you sustain your movement toward the life that you would like to live. ~ Alexander L. Chapman, Ph.D., R.Psych.