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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.

Vigilance VS Joy

Last time we talked about how our scared one is constantly vigilant and is chronically stressed. Then we saw the connection between chronic stress and a compromised immune defense system.  It's a paradox.
Our psychological defenses stay up and our immune defenses go down.  The result?  We can get sick.
And this morning I get this from Inward/Outward, a daily bite of soul food I receive.  Its author is Philip Slater and it is from Wealth Addiction:
"Vigilance and joy cannot coexist…. Joy is an emotion that only occurs when we let go of all watchfulness, all concern about outcomes, and simply let experience flood in and feelings flood out. Joy is incompatible with search behavior because there is nothing missing. Joy is feeling complete, full. Wealth addiction is feeling empty."

So I figure it's a synchronous event and that I should pay attention.  And I think he makes a great point. Being constantly vigilant and being joyful are mutually exclusive.  It also makes me see that being in a chronic stress state is to be joyless.

And if that is true then the remedy for being chronically stressed is to go for what brings us joy. What is it that brings you joy?  What are the circumstances in which you can drop your guard, drop your defenses and risk being vulnerable.  Do that.  For me, true joy comes from first getting my ego in check so I can relax.  Then I can feel the joy of deeply connecting with another person that I let past my perimeter to connect with my authentic and imperfect self.  That may not seem like a lot but it's enough,"because there is nothing missing."

No longer alone on guard duty, being in the guard house with a friend is also one of the best stress management strategies ever.



Give yourself a break today

We have been talking about the scared one and how stressful it is to be constantly vigilant.  Being always on guard against looking bad or doing/saying something wrong isn’t just a psychological state.  It’s also physiological. Science has long shown us the connection between psyche and soma, mind and body.  The body is a slave to the brain and what we do between our ears drives activity at a distance in the body. For example, your adrenal glands produce stress hormones, different ones depending upon the acute or chronic nature of your stress.

Chronic stress causes them to produce corticosterioid hormones.  These steroid hormones are like predisone which is used to surpress that itchy inflammatory response when you get a bad case of poison ivy.  In other words, they surpress your immune response.  This means that you are more likely to get sick when you feel you have to always be on your toes.

You know the slogan, “you deserve a break today?”  Running around all day long living our McNormal lives, dressed for success while putting our best foot forward, don’t we deserve a break today?! I think we do.  I just don’t think it’s a Big Mac.

Maybe the break is to notice the scared one running your life.  Then punch out on the trying-to-impress-others clock and do something else with your time and attention.  After all, concern for how others are thinking of you may be misplaced.  In fact, they probably aren’t thinking of you. Their scared one is probably doing with you what you had been doing with them.  :O)



A Suspiciously Healthy Elder

Last week I got a chance to
work/play with a very wonderful man named Bill Fay. Bill lost his first wife to
Alzheimer’s 12 years ago and the experience caused him to see first hand a need
that wasn’t being met.  Those patients need help.  As a result he started
a non-profit called Alzheimer’s Helpers.

Bill is “retired” in north
Florida although retired is the wrong word.  He is very far from retired.
 He is fully engaged in life and the lives of Alzheimer’s patients at 9
nursing homes in his area.  Not only is he a perfect example of what
active aging is all about, he is a wonderful example of a suspiciously healthy

The definition of health I use is
the ability to work, love, play and think soundly.  I stole this
definition from Ashley Montagu’s book GROWING YOUNG and used it in WHY NORMAL
ISN’T HEALTHY: How to find heart, meaning, passion and humor on the road most

Bill has a passion to give those
folks afflicted with a devastating disease a loving, joyful and playful
experience on a regular basis.  He and his wife AnnaMarie together with a
small group of volunteers visit Alzheimer’s patients with an openhearted,
compassionate hand. They play with them, take them out for adventures and
create positive experiences for everyone present.

He came to a presentation I did
in his area in January.  I used my alter ego, Dr. Jerko for that talk.
 We had a great time and his initial response was to have me come back and
do something for his Alzheimer’s friends.  However, as he thought about it
he decided that it would be even better to do something to honor the Certified
Nurse Assistants.  After all, these good folks are the ones that spend the
most time and give most of the care to Alzheimer’s patients.

And that’s what we did last week.
 He had me come down to Mt Dora, Florida and do a presentation for CNAs to
honor and celebrate them. In the hierarchy of status in health care facilities
CNAs, those in the trenches with Alzheimer’s patients who clean their bodies
then their sheets before they can even be sent to the wash, don’t get much. Well,
Bill turned that around at least for a day.

He used Lake Receptions, a very
nice meeting facility and invited CNAs from the places he serves to come to
a continuing education program and be served a delicious lunch.  There
were party favors and door prices.  The entire atmosphere was festive
orchestrated by Bill and AnnaMarie. I had the honor of surprising them as the
instructor in my clown character, Dr. Jerko.   And 96 invited guests
and Dr “J” had a ball talking about the importance of healthy support.

Afterwards, one of the managers
of a facility told me that Bill was a godsend.  For example, she related a
story about a patient who needed a chair and there was no money available.
 She talked to Bill, he worked his wonders and came up with the $3600
chair.  If health is the ability to work, love, play and think soundly as
one follows a path that has heart, meaning, passion and humor then Bill is
indeed “suspiciously healthy”.  And if you want to send him a donation,
apart from the fact that he spent some bucks to bring me in, he'll spend it