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What does it mean to be healthy?

The definition here is somewhat different than definitions we have learned about during our training. In fact we really, or at least I do not recall much about the topic of “health”/”healthy” being addressed during training. The focus was on the absence of health or to state it more plainly, disease. Diseases were well defined for the most part by objective criteria. And if and when those objective criteria moved back (WNL) into the normal range and the patient was feeling much better they were said to be on the road to or have returned to “health.”

I remember a lecture in med school in which we were taught that our job as physicians was to get folks back the way they were prior to getting sick. That was our job. That is one perspective. In that relationship with the infirm other we held the power to fix the problem. And get folks back to….? To what? To health? Or to the way things were prior to getting sick? To normal.

And to me that is not the same thing. So how, then, do I define ‘health?” Health here is the ability to work, to love, to play and to think soundly. That means that someone with hypertension, diabetes, cardiovascular disease, bipolar disorder, cancer, etc. can be healthy. Whereas someone else without any known ailment and lab results WNL, probably isn’t. It’s not about the criteria we learned in medical school, however poorly defined by the absence of disease. It is about how people experience the living of their lives: their jobs, their families, their friends, their gifts, their purpose, themselves and well being. It is a definition I stole from Ashley Montagu in a book titled, GROWING YOUNG.

His premise is that we aren’t meant to grow into the kinds of adults we become. We are not meant to grow old we are meant to grow young. We are meant to stay in a developmental process throughout the life cycle, staying in touch with the wonderful behavioral characteristics of the child, which helps us stay vital, and yes, young, regardless of our age.

Because we do not stay in touch with those traits, we can slip into a box long before we are dead. So what happened? We learned, we got acculturated  on the road to becoming grownups and what we learned allows us to function now as adults in the work-a-day world. Being able to function as normal adults means when stressed we often make a bad situation worse, addictive disorders abound with workaholism rampant, that 50% of marriages end in divorce, financial wealth goes up but happiness doesn’t above $65,000/year, less than half of Americans are happy with their jobs, in families with teenagers when the youngsters have problems their parents are the court of last resort, we are better at competing than cooperating with each other, honesty is not the best policy, we repress how we really think and feel while expressing just what’s safe to say and we learned to be our own worst enemies!

That may be normal but it certainly isn’t healthy!

The irony is that sometimes it isn’t until someone gets sick that they wake up and get healthy. They may have cancer but they see the familiar in a new way and make life decisions that reflect what is actually most important to them. They begin doing what is suspiciously healthy and can even be grateful for their world stopping, status quo breaking diagnoses.

Why wait for cancer or the near death experience to see what we want to start doing that we haven’t risked doing yet? Why wait to stop doing what is unhealthy for us and our relationships as well? And finally, what do we want to keep doing, albeit differently? Open that box. It seems safe but it’s a trap. You may be caught, but look. The door opens from the inside.

Self-compassion gets tested daily

Testing one, two, testing….did you take the test, the self-compassion test yet?  There is a link to it in the last blog.  It’s true there is an actual test, 26 questions to determine if you are low, moderate or high in compassion for yourself.  The reason to know is that there are health implications.  Folks that score high are more optimistic and happier with less anxiety and depression.  And they make healthier lifestyle choices about food consumption and issues of weight loss.

This makes perfect sense to me although it may be contrary to popular pundit opinion.  Why? Self acceptance is the beginning of change.  Accepting the actual reality of our common humanity means letting go of perfectionism to appreciate the wonder of our common beauty as we are.  Sure, maybe you do need to lose some weight.  But you don’t have to beat yourself up about it to lose it.  In fact, beating yourself up may have just the opposite effect.  The belittling self talk only makes you feel bad about yourself and more likely to then use food as a medicative behavior for those bad feelings.

Dr. Kristin Neff, who came up with the test, makes the point clearly.  She said that the reason many folks aren’t scoring higher is cultural.  ”Most people have gotten it wrong because our culture says being hard on yourself is the way to be.”

I had a patient who was overweight who came in to see me and I noted that she looked great.  It was clear she had lost weight.  I asked her how and she said something that fits in this discussion.  She told me about standing naked in front of a mirror and looking for long periods at her image.  Her goal was to love and accept the person looking back at her in the mirror.  The better she got at doing that, the more she made healthier choices and the more weight she lost.

Here’s Dr. Neff, “if you care about yourself, you do what’s healthy for you rather than what’s harmful to you.”

The NY Times article, 3/1/11, says a much shorter test can get at some of what we are talking about here relative to self-compassion.  It’s just one question.  Do you treat yourself as well as you treat folks you care about, your friends and family?  If you do, great.  If not, start.  You’re worth it.  And you’ll lead a healthier life while infecting friends and family by example.

From Perfection to Acceptance

OUR BEST KEPT SECRET (Part Seven)

We are a paradox, both tiger and goat.  We have a ‘scared one’ inside us driven by the fear that at any moment we could be exposed as inadequate, our goat self.  Since our ‘scared one’ fears that at any given moment our secret may be revealed, he/she has to be constantly vigilant.  Therefore, “safety and security at all costs” is the motto for the ‘scared one.’

One way to stay safe is to do things well, or better yet, perfectly.  That demonstrates to the outside world how great we are.  In school some of us got all “A”s and as adults still seek that grade from others.  We seek the “A” for adequate, to compensate for our feelings of inadequacy.

Our perfectionistic tendencies are also affirmed and admired by others.  We can be proud, are even told that we should be proud, of our accomplishments.  The car, the house, the yard, the kids, the school, the clothes–everything we do becomes an opportunity to show the world how great we are.  How perfect we are!

But, what happens when we fall short of the mark?  What is your self talk like when you don’t meet your high expectations, when you fail?  When you screw-up, what do you say to yourself?

I asked this question once to a group of women at a conference.  Most of those present shouted out self-deprecating statements like:

“That was a dumb thing to do!”

“I can’t believe I did that!”

“What an idiot!”

And, one of my personal favorites:

“I should’ve known better.  What’s wrong with me?!”

But one woman said, “Oh.”

I said “Oh?”

“That’s right, Oh! O-H Only Human.”

I said, “That’s suspiciously healthy.  I should report you to the thought police.  Now stand in the corner and straighten yourself out!”

When I inquired as to whether she had always been so accepting of her humanness, she said,  “Oh, no.  I used to be a relentless perfectionist.  Then I had years of therapy which taught me to say O-H.”

Folks, save yourself some money!  Don’t use your failures or mistakes as an opportunity to reinforce your feelings of inadequacy.  Who benefits?  No one!  You certainly don’t.  Do others benefit when you belittle yourself?  No way!

So, give yourself a break today.  After all, don’t your highest values support you doing so?  I mean, is God waiting for the new improved you?  Or just as you are, flaws and all, are you loved and accepted by a mystery that exceeds your understanding?  If that is part of your belief system, use it to support your new learning.

Our culture is so caught up in self improvement.  When you go to the self help section of the book store you have to take a number and get in line.  And after you make some improvement, are you now perfect?  Nope.

So what is required?  More improvement.  Done.  Are you now perfect?  Nope.

And on it goes.  When do you get to perfect?  Never.

So when do you get to your good feelings?  Never!

What is much more useful from my perspective is self acceptance, not self improvement.  Don’t get me wrong.  I’m very interested in learning, in getting better at everything I do.  My bias is that everyone is an underachiever.  No matter how well we do anything, we can get better.

But I don’t want to wait to feel better until I get better at what I do.

So, what about those feelings of inadequacy and insecurity that never go away?  How are you supposed to feel better when they are always present?  Very good questions.

The answer is connected back to the paradox of our humanness.  Think of it this way.  Acceptance of myself, with all my imperfections, creates a psychological space to create something new.

Why?  Self acceptance is the beginning of change.  For instance, having overcome my denial about some character flaw, accepting the actual reality of its existence, I can pay attention and deal with that flaw.

Energy follows attention.  I only have energy for that to which I attend.  Said with poor English, what I pay attention to, I have energy for.

Creation requires energy.  In order for me to create something new, energy is required.

But, what if I’m tapped out energetically?  If you’re bereft of the energy required, go to the source of energy.  Rumi has a poem with the lines…

“Move within, but not the way fear

makes you move.

Go to the well.

Move as the earth and moon move

circling what they love.

Whatever circles comes from the center.”

What is at the core, the center of your being?  Look past the mask you’ve been conditioned to wear to your essential self.  The real you made in the image of, what?  Some say a Devine Parent.  Coming back to your belief system, are you on your own, or can you get help?  What was it?  “Ask and you shall receive.”

You see, if we place our psychological development within a spiritual space in the psyche, we feel safe and secure.  And our developmental process will be infused with the energy required for change.

The ‘scared one’ doesn’t believe any of this because he/she feels unworthy of help.  But, our ‘sacred self’ understands the secret.  At the center, the ‘sacred one’ watches with an inward-turned eye.  Turning within, “but not the way fear makes you move,” the ‘sacred one’ opens to the loving embrace of the Mystery of God.

Rumi says and the ‘scared one’ agrees:

“I am so small.  I can barely be seen.

How can this Great Love be inside me?”

Then he answers from the mouth of his own ‘sacred one’:

“The eye is small

yet it holds enormous things.”

The paradox of the ‘scared one’ / ‘sacred one’ is only known by the latter.  My ego doesn’t know my soul.  But my essential self, my soul center understands the ego as a loving parent understands a child.  It’s energetic source is the Ecstatic Love of its Creative Parent.

The dual nature of our ‘isness’ requires two sets of parents.  One set provides 23 chromosomes each, to build a body and then the environment to nourish development.

The other set made the ‘sacred one’ and implanted this essential self into the body to live through it into Realization.  The Realization of its true nature, it’s true Tiger nature.  And although the ‘scared one’ and our egocentric concerns don’t permanently dissolve as long as we’re breathing, they don’t have to drive the engine of the psyche.

We can disengage from those small obsessions of the ego by changing what we attend to.  Energy follows attention.  Change what you pay attention to and you change the energetic equation.

It isn’t by adding to what you have inside, that gives you value.  It isn’t a matter of improvement.

It is by recognizing what is already present, as a Present, a Gift, from a Divine Source.  Reconnecting with this gift happens when we remember.  And remembering often happens when life forces us to change that to which we attend.

Newly awakened, we see the familiar with Tiger eyes. Those eyes that pierce the blackest night of the soul and see clearly that which supports us, feeds us, energizes us.

Rumi says,

“Ecstatic Love is the ocean

on which the Milky Way floats,

like a flake of foam on the sea.”

Tiger food is the abundant love that flows from that source whose center is everywhere and whose circumference is no where.

“Whatever circles

comes from the center.”

 

 

 

 

The Gift

It's the beginning of a new year.  e. e. cummings has a poem about new beginnings which I cannot find at present.  It's about partings and new beginnings and with each beginning, new meaning.  We can look at the new year as a new beginning, a fresh start.

We cannot change anything that has happened up to this moment.  But we do have this moment and the unfolding adventure of the rest of our lives.  "New meaning" may be something we discover as we spend more time doing what is most important to us.  Most folks don't spend their energy and attention doing what is most important to them.  Most live their lives on automatic pilot acting out the role they were given to play on life's stage.  

It was the role that was programmed in by their family, local culture and environment.  The status quo of that life has it own inertia and momentum.  Changing that is difficult.  It can be broken but it's not easy.  Unless you have a world stopping event that breaks that status quo for you: like cancer, the illness of a child or the loss of a close loved one.  Then everything changes rapidly.  Want to change your life?  How about a near death experience or a devastating diagnosis.

See the three minute TED talk "The Gift" by Stacey Kramer for example.  It may not be such a big change but one that you cannot ignore.  And that change provides an opening for you to see clearly what is most important to you as well as appreciate the blessings you do have.  Discovering what is most important to us and giving our lives to doing that, whatever that is, gives new meaning to our life adventure.

Without the "gift" of a world stopping event it may be more difficult to discover what is most important to you.  So just pretend.  Pick out something like finding out you have been given that devastating diagnosis.  What would you stop doing?   What would you keep doing ? And what would you change?  In the process of answering those three questions you might discover what is most important to you.  If not, you may still get a clue and the discovery may happen later.  

Happy New Year !

TGIF

Today’s Friday, TGIF !

It’s interesting with the economy in the tank those folks with jobs feel differently about them.  Sure everything about their job may not be perfect.  The hours aren’t what they’d prefer.  Their boss is controlling and needs to micromanage.  Their coworkers may not be the folks with whom they would have chosen to spend day after day.  The money is only OK.  The work itself doesn’t fully engage their talents. The insurance is only fair.  No dental.  Yadayadayada…..
But, and it’s a big but, they have a job.  And how they feel about that fact is now markedly different.
Where before the job was a source of discomfort, frustration mixed with anger.  Now, to have work, to have a job when so many other folks don’t or soon won’t, is a source of comfort. Same job.  Same person. Yet everything’s different.
They can live with the hours.  Their boss may not be perfect but who is?  Their coworkers aren’t so bad either when you give them half a chance.  The money’s not bad.  The work itself now engages the mind in a new way and one’s talents also.  Sure no dental but at least they have health insurance.  That’s a plus.  And, hey, it’s Friday.  Things aren’t half bad.  I’m pretty lucky.

Three cups of tea, three bullets for me

My wife is reading Three Cups of Tea.  The author, Greg Mortenson, is speaking in Kansas City tonight sponsored by Rainy Day Books.
Change has been on my mind lately.  It was a theme during the election.  There was so much excitment around the world when Obama won because the very fact that he is a Black man embodies change.  My buddy, Greg Tamblyn, sent a request out through cyber space for folks from around the world to send him newspapers the day after our election.  He received 60 papers reflecting the global excitment about our big change.  And he created a wonderful poster you can get from his web site: www.gregtamblyn.com which has front pages from about 20 of them.
I heard Mortenson interviewed on the radio yesterday, thought about Obama and about change  For those of you that don’t know Mortenson’s book is a great story about change.  He went to Pakistan to climb K2, the second tallest and argueably the most difficult mountain to summit on the planet.  He failed, was rescued by a local man and vowed to return to build a school in his little village.  The book is about his adventure and what he learned in the process of fullfilling that vow.
BTW, he has now been involved in building 77 more schools in Pakistan and Afghanistan.
What does this have to do with Obama?  Mortenson has invested his time, effort, energy and attention in remote areas of conflict where our troops and those of other natioins struggle to win the hearts and minds of the people.  At the same time they fight the Taliban.  And things aren’t going well.  The Taliban has re-emerged stronger than ever and Obama’s response is to double the number of US troops deployed to Afghanistan.  While our military forces struggle in their efforts on both fronts, Mortenson’s experience is different.  He not only has captured the hearts and minds of the people, he has Taliban converts teaching in the schools.
Perhaps I should restate that.   He has been captured by the friendship of villagers, just like the one that rescued him and had a conversion experience himself.  It wasn’t a religious conversion.  It was a psychological conversion and is still ongoing.  He thought he knew what was best for the people he wanted to help.  He had to learn that they in fact knew what was best.  It wasn’t a school that they needed first.  They needed a bridge.
What a wonderful metaphor.  Now Mortenson is a bridge.  He has gone over and come back with the boon from his quest.  What he learned can help us individually and collectively.  So much so that he now consults with the department of defense.  It seems that wives of military leaders have read his book and encouraged their husbands to do so.  Some, including General Petraeus, have.  In fact he sent Mortenson a note with three bullets:
1 Build Relationships
2 Respect
3 Listen
Imagine that.  I think he got it.  I hope he tells the Commander in Chief.  Maybe more military forces aren’t the answer.  However, another volunteer force might better serve our foreign policy aims there and elsewhere.  A real Peace Corps.

The more things change…..

The more things change the more they stay the same.  I imagine you’ve read or heard that said a time or two.  And we can see how that may be the case when we note the referenced item.  However, the reverse can also be true.  The more things change the more we can see how different they are.  Both can be true.  It’s a paradox.

And it’s certainly true of people.

Some would say that people don’t really change.  They may change some superficial things but underneath that façade, they’re just the same old self.  And sometimes that may be true.  However, with or without some obvious difference that others can see, real substantive change in people is possible and does happen.  I’ve seen it happen with patients.  It’s inspiring.

The truth is the decision to make fundamental change within didn’t happen until the status quo of their old life was broken.  Facing some life stopping trauma, say cancer or some other life threatening disease, they take a new look at the familiar of their lives.  What was important and time consumptive is seen anew.  An evaluation is made and old decisions reexamined in the light of an awareness about what is now really most important.

Maybe it’s also true of not only individuals but countries.  Maybe having this world stopping economic trauma break the globalized status quo we can summon the wherewithal collectively to fundamentally change.  A band aid won’t do.  The contagion has spread.  Metastasis everywhere.  Perhaps things have gotten so bad that the world, lead by the United States has reached a firm bottom.

Having lead the world here what are we willing to change to lead the world not just back to what was before rather forward into a new, sustainable, mutually beneficial, just, peaceful, playful community of nations?  And remember, that “we” also means you and I?