Pain, muscle spasm, free will and mindfulness

Some wit, was it Oscar Wilde?, observed that ‘nothing focuses the mind as knowing you are going to be shot in the morning.’ I would like to add that focused attention is exponentially increased when your lower back muscles go into painful spasm, without these neuro-vultures asking first!

It started off yesterday morning, which is the fourth such episode in my life. Moving from a sitting to standing position, on a cold morning, I felt the crunch of muscles, like a hot knife piercing and slashing my flesh over my lower spine. For a few moments I was paralyzed and immobilized. Then the pain subsided, and could shuffle off to the bedroom, and call for reinforcements. Fortunate to be married to a pharmacist, who keeps a stock of a wide range of medications: for coughs and flu, for pain and nausea, for sleeplessness and shortness of breath. So out popped the anti-inflammatories et al.

But these meds take time to kick in. So hobbled around most of the day, finding that warm muscles ease the contractions and pain. Also hot showers. However, with hindsight I became aware of what position or movement hurts, and which eases the discomfit. Nothing concentrates the mind as a sudden jolt of muscular spasm when arising from the bed or chair or car seat. The excruciating pain fills working memory, and cannot think of much else.

Then things changed: I began to decide a few seconds before standing, sitting, or walking, on the next move. Which position was the least likely to cause discomfit? And so on. Who said we have no free will? Baloney. I was in total control of every next move, as I struggled from bedroom to kitchen; from toilet to verandah. Who says one cannot be mindful? Baloney!

Intriguing that when lying or sitting in a comfortable position, there is no pain whatsoever, and my mind can rapidly refill with all kinds of combinations: imaginations, ideas, memories, hunger pangs, thirst, guilt, what I ought to do … But when shifting into ‘pain position’ all those fillers are wiped clean off the stage, and the pain takes full possession of current awareness, except, critically, that I am mindful of the pain. Mindfulness sensitivity helped me differentiate these two mind states, when to simply observe the language (prosody, timbre, intensity) of pain, and when to act and move on.

My empathy and thoughts are with those who suffer from long term unremitting pain – emotional, physical, loss, existential angst. These psychopaths are all incorrigible thieves of open minded and present happiness. But maybe we attach to tightly to their pathologic claws. Mindfulness, as Jon Kabat-Zinn implores, radically reduces the intensity of pain. It allows space for different choices.

That was my lesson for the day

Italian men, ageing and long held regrets

Often, ‘things’ happen in threes. Scene: Favorite bookshop: There I was reading and reflecting and writing and editing, when a 79 year old lady (friend) stopped to chat about life, the universe, and the funny decisions we all make. Loves her work, and has purpose and meaning.

The second wave was a 64 year old lawyer (also a long term family friend) who is reinventing her career and interests. Does a lot of pro bono legal work for the poor and indigent, travels, reads the classics, and meets interesting people that tend to engage in deep meaningful conversations.

We agreed after about a half hour of chatting that we need to move on to fulfill non-urgent and important stuff of the day. A few shelves away Stephen Covey smiled down from heaven: his famous book, The Seven Habits of Highly Effective People, seemed to dust itself off, and leant forward in agreement. Live and love a life of important and non-urgent matters. I sat down and heaved a sigh of relief that I could now search for the misplaced comma or apostrophe in one of my recent writings. So I thought.

Then the third wave gently drifted in my direction. A tall but thin octogenarian Italian man softly introduced himself as a retired tailor who manufactured bespoke suits for many Jewish men over many decades. So good so far. Then somehow I knew it was coming. “I overheard you are a doctor, a psychiatrist?”
“Yes, I am but don’t practice as one at present.” Leaving those words hanging in the air, indeed ambiguous, for at that moment, for sure I had no intention of practicing psychiatry right there.
“Do you perhaps have just five minutes to help me?”
So five minutes turns into thirty minutes. This is what tends to happen when Jews and Italians get schmoozing.

All I heard him repeat, over and over again: “I have so many regrets, so many regrets.”
“Like what for example?” I urged.
“I am Italian of origin, a survivor of the War. I should have paid a bit into a Italian pension fund and could be drawing to R15,000 a month. I am penniless now. No family. I am very depressed. What should I do?”

What could I do? Reverse the past? Impossible! Say a few magic words. Unlikely to help. This sad man, riddled with deep seated regrets needs someone to sit and listen and help him reframe. He needs to spin his focus of attention towards the future. And be grateful of what is good in his life. If he could listen in to my two previous conversations, draw my attention, be brave to expose his vulnerability to a stranger, there is hope.

I referred him to a local FAMSA clinic near where he lives. (With my email address scribbled on the serviette If there is no success.) He thanked me profusely, well beyond what I thought I helped. Gratefulness is in the eye of the beholder.

Neuroplasticity and Epigenetics! Your choice.

It is a good time for me to be alive and breathing-in the cutting edge findings of neuroscience. Seems the professional levee has been breached, the conversion of complicated laboratory insights into layperson speak. What do I mean is this? Neuroscience concerns itself with all things Brain by applying the tried and tested scientific method to describe what is going on in our thick skulls. In other words the unraveling the science of neurons, the basic infrastructure of the brain/mind, and how we tick along. One bunch of neurons at a time
Neuroplasticity is the most exciting and most applicable of all recent findings for humanity.

Neuroplasticity, essentially, is the ability of the brain to change both structure and form throughout life depending on experience and effortful learning. FLIP365 leverages this neuroscientific principle and practice. There are at least twenty two unique ways (tools) to keep the Brain fit and flexible.

Now there is Epigenetics. “Epi” (above) is the ability to switch on and off certain genes by lifestyle choices. There appear to be two ‘layers’ of genes: a deeper form that determines outcomes beyond our control; and a more accessible structure that meditation, food, relationships, touch, sleep, exercise, cognitive reframing…. can modify the genetic expression, thus, importantly, Brain Health.
I am convinced that the Neuroplastic tools individually or combined do influence the upper influential genetic echelons. Solid science findings are beyond question. There are meters of books, journal articles and prestigious prizes that prove the effect of aerobic exercise on neuronal connections; the Mediterranean diet on mood; the debris clearing effects from daily mental slogs by regular good sleep.

So Epigenetics (read methylation processes) influence gene expression which change brain form and function which guide decision making processes which determine quality of life. The gaps are rapidly disappearing. The argument is now as strong as ever. Your choice, your responsibility to activate a flourishing lifestyle is your choice.

Just check out this video link sent to me by my son Shimpa who is, inter alia, completing a higher degree in the Life Sciences.

Freedom Day, the Exodus and national stories

Today, in sunny Autumn, South Africa, is Freedom Day, a public holiday. Soon we will have Workers Day to satisfy the laborers, a leftie consideration. Last week it was for the right, the religious holidays of Good Friday and Easter Monday. So four weeks of four working days only. Plus a few to celebrate the Jewish festival of Pesach. Lots if time to reflect.

But back to today, Freedom Day, which acknowledges, the first democratic elections in 1994. Now that is 23 years ago, and a large part of the resident population, is born in this time period. Millions have never known apartheid, but still experience its consequences. Freedom gained is a long, torturous journey.

It is difficult not to be tempted into comparing the Jewish approach to remembering its hard won freedom from Egypt, under the leadership of Moses and the local celebration of the day, the exodus from white minority rule, under the leadership of Nelson Mandela.

We, the religious Jews, informed by the Torah, both its written and oral traditions, have a slow build up to the formal eight days of the Passover. We are obsessive to clean our homes and offices of leavened bread; cutlery is stopped; and food without any trace of ‘chometz’ is purchased. It is for many a taste of slavery.

Four of those days, the first two and the last two are formal days of rest, just like the Sabbath, of every seventh day. It is serious business. The first two nights in the Diaspora are set aside for hours of relating the Seder, the story of the Exodus. There are, of course, serious interruptions for festive meals. South Africans do not have a written story to share. It is a pity for to remember the hard battles to win freedom, can be easily forgotten. This can lead to serious consequences. For in any subsequent generation, a Pharaoh can arise that did not know Joseph.

The Golden Thread of Decision-Making?

What do Daniel Kahneman, Carol Dweck, Jon Kabat-Zinn, and Elkhonon Goldberg have in common? Throw in Viktor Frankl’s name as well. Short answer: Their mental models of the mind combine to help make a continuous thread that links how we decide, and why daily incorporation of Neuroplastic tools are vital for brain health. Let me focus on the deciding bit.

Let’s kick off with Dr Viktor Frankl, a psychiatrist who survived over three years of Auschwitz horror. He said: ‘there is a space between every situation and your response, and the choice of response lies within that space.’

Daniel Kahneman’s core work, together with the late Amos Twersky, builds the case for two different systems (in that space) that filters information: system 1 and system 2. System 1 is fast, frequent, automatic, effortless, emotional and subconscious. System 2 is slow, infrequent, deliberate, calculating, conscious, logical, and requires lots of effort. In other words, System 1 is ‘blink’; and System 2 is ‘think’. Your response depends on which system information traverses.

Elkhonon Goldberg, a Russian-born neuropsychologist, argues that the essential difference between the left and right hemispheres of the brain is this: the right manages novelty, new ‘stuff’; the left is about routine, like mother tongue language. Perhaps System 1 is predominantly left brain, and System 2 is right brain?

Carol Dweck’s life time work is observing and commentating on the findings that humans have one of two core mindsets: fixed or growth. Perhaps then the left hemisphere, if very strong, tends towards a fixed mindset (loves routine, strong traditions, does not like change …) whereas a fully functioning right hemisphere enjoys novelty, loves new ideas, and thus more open to personal growth and adaptation. Both hemispheres, for mental health, communicate with each other as one needs both routine and openness to novelty (which can convert into routine). Routine without novelty is an automaton; novelty without routine is chaos. People (‘shakers and movers’) who shift paradigms need both in high doses, and maximal fluid connections between each other.

Finally, Mindfulness practice (developed in the West by Kabat-Zinn) is deliberate choice to observe what is happening in the inner world, in the present moment, without judgement. That is the gradual strengthening of the tips of prefrontal cortex to improve the attention capacity of system 2; improving awareness of the contents of the right hemisphere; and the ability to generate options, foresee consequences, draw on the story of the past, decide well, grow and change, which resides in the prefrontal lobes.

This five part synergistic grid (space between situation and response, two thinking (systems), hemisphere differentiation, mindset setting, and mindfulness) is the golden thread that pulls together effective decision-making, the central conductor of a (thriving) life.

(Ps. Neuroplasticity is the life-long ability of the brain to adapt and change its function/structure as a response to information and experience.)

Mindfulness techniques to deal with stress

Dear Mindful Readers,

Rushing around, juggling tasks—that’s a typical Monday. But when everyday stress is punctuated by moments of fear and panic, it can feel paralyzing, leading to more stress and anxiety. Mindfulness invites us to pay attention to the moments that send our brains and bodies into panic mode. Here are a few ways you can create some space between yourself and your panic:

1) First, you may not be able to change your situation, but you can mindfully change your response to it. Try this mindful breathing practice.

2) Then, if you find yourself overwhelmed by emotions, here’s one crucial approach that mindfulness teachers recommend.

3) Finally, face your panic. Try this mindful practice for turning toward your panic, acknowledging it, and letting it be.

Here’s hoping you all find moments to enjoy being mindful this week.

The Mindful Editors

How to have a courageous conversation

I believe the role of a leader is to create a high performance environment where success is inevitable. We achieve this by awakening possibility in people to deliver extraordinary results.

From time to time we need to have those courageous conversations! Times when we need to give challenging feedback, build awareness for the need for change, educate or have that tricky conversation.

Meaningful activities/volunteering

12 hours ago – Death can bring your career back to life. A disrupter of habit, it stops the living in their tracks.
Lucy Kellaway left the highest echelons of journalism to teach maths at a tough London school.
In November I wrote an article inciting people of a certain age to jack in their fancy jobs and join me in training to be a teacher at a tough London school. It was a tall order, but I hoped to rustle up enough interest for a small pilot project. A few dozen applications would have been decent. So far, Now Teach, the organisation I co-founded, has received nearly 800.

Sample the FT’s top stories for a week
You select the topic, we deliver the news.
While sifting through them I have been looking for patterns, many of which are much as I expected — notably that the charms of the corporate world dwindle with time, while the desire to do something more useful gets stronger.

But there is one thing that has surprised me: the part played by death.

Last week, a prospective teacher told me that what did it for him was the funeral of someone he had been at business school with. This man had become a distinguished doctor who had done so much good in his life. His former classmate looked at his own achievements in marketing and in property and resolved to do better.

Mostly, the death in question is that of a parent, and often the last remaining one. Becoming an orphan in your fifties seems to encourage all sorts of people to stop doing something comfortable (like being a partner in an accountancy firm) and apply to do something exhausting and possibly very uncomfortable indeed (like being a physics teacher).

I ought not to be surprised by this, given it is precisely what happened to me. In May, my father died. He was 90 and had had a good innings. A couple of days after his death I dragged myself into work, knowing that Dad would have disapproved of my malingering at home.

I remember listening to colleagues arguing over a headline and gawping at them with incredulity. Seriously? I thought. I could not imagine how intelligent, grown-up people could care so much about which of two almost identical sets of words was better.

At the end of that miserable first week, I told close friends I needed to do something different with my life, to which they all said the same thing: don’t. They pointed out that it would be mad to do anything rash when you are bereaved. This disconnected feeling, they warned, would not last.

I knew they were right about the last bit. When my mother died 10 years earlier, I had entertained a brief teacher fantasy but it did not last and, within a couple of months, journalism seemed as charming as it had before.

But when Dad died, I knew that waiting would be fatal. Within six weeks I had found a partner to help me set up Now Teach and a couple of weeks after that I had told the Financial Times about my plans.

Read more by Lucy Kellaway
Now that I discover my story is commonplace, I have been wondering what it is about death that is quite so galvanising. Most obviously, it forces you to ask yourself if you are doing what you really want to do. There is a cheesy trick practised by career coaches, in which they make you imagine your own eulogy. This has always struck me as too morbid and artificial to work, but the real death of someone you love makes you take stock, whether you want to or not.

Second, death tears into routine. Part of the reason people trundle along in the same jobs is because it is easier to keep doing them than to stop. The brutality of death is a disrupter of habit — it stops the living in their tracks.

Becoming an orphan in late middle age can be liberating. It has made me more willing to take risks, with no parents to try to please or to care for in their declining years. With my children grown, I have fewer ties. So if I want to do something risky, there is no one to stop me.

The final point is about mortality. Everyone says the death of both parents forces you to think: it is my turn soon. But for me the reverse has been true. Given my father lived to 90, I will probably live longer still. I have just typed my details into an online life expectancy tool, which assures me that I will live until I am 94. “Thirty-seven years left!” it declared.

Instead of time being frighteningly short, it may be even more frighteningly long. What the death of my father has taught me is that in late middle age there is plenty of time to start all over again.