Category Archives: relaxation

Joys of Accepting and Mastering Discomfort (aka. Stress Management and Mastery)

Reflect back on your life. The further back you remember, the more you can find what stands out and matters most to you. Do your best, your happiest, your most cherished memories include relationships that had ups and downs? Do they include new experiences that could not be predicted, no matter how small or mundane? Do they include memories when you worked really hard and achieved something that seemed impossible and you felt so proud? Do they include those thrilling moments when you knew you had created something incredible?

Yes. The greatest joys and personal growth often come from moments in life when you work through the discomfort and get to the other side. There are times in life when we accept or are forced to accept situations that we do not choose, that throw us into the unpredictable and uncontrollable, that make us uncomfortable. We all have to get to the other side of that. Let me share with you how you can make that journey a bit easier.

Here are the steps to mastering the discomfort. Writing this down or talking about this with a close confidant or neutral person can be helpful.

  1. Identify your discomfort and figure out what is in your control and what is not in your control. What is causing you discomfort? Why? Describe and label it.
  2. Take what is NOT in your control & “put it away.” Imagine putting it into a storage container or a mental file cabinet or write it down and put it away. You can re-visit this later -if you want.
  3. Take what IS in your control & “work it.” Think about best and worst case scenarios.
  4. Consider worst case scenarios and figure out ahead of time everything you in your control that you can do to prevent the worst case scenario and make a plan to do that. Figure out how you would manage it if the worse case still came to be. Consider how that scenario could be the Universe (whatever higher power you believe in) delivering you a gift to teach you something important you need to learn, to benefit you or another being, or to propel your personal growth forward and upwards. Recognize you are resilient and accept that you are doing the best you can with what IS in your control.
  5. Now, spend time focusing on what you DO want to have happen, the outcome you ARE aiming for. Visualize, dream, brainstorm, strategize and make plans to go for the BEST case scenario. Define it, label it, “see it.” Regularly repeat this step- the more the better.

Mastery is when you are in control of the discomfort rather than the discomfort in control of you. Remember that everything happens for a reason and we may not know the reason right away. Appreciate that the discomforts in our life are there as messages to help us refocus. Accept that there will be those times of discomfort and then make a plan to master the discomfort and keep moving forward. You’ve got this.

Healthier Together Series: Cycle 6C. Relaxation & Sleep – Focus your mind, Relax your body

camilo-jimenez-mUCnQpBZzXA-unsplashWant to learn how to immediately relax your body and focus your mind when your fight or flight response has been triggered – Naturally- without drugs or medications?

Let me introduce you to the Quieting Reflex, developed by Charles F. Strobel.

  1. Breathe in deeply so that your belly rises first when you breathe in (breathing from your diaphragm) and say to yourself, “Alert, amused mind.”
  2.  Breathe out through your mouth, saying to yourself, “Calm body, ” as you release the tension in your jaw.
  3. Let the tension flow out through your arms and smile inwardly to yourself.

If you practice this now, your mind can learn to respond automatically and become alert, while your body will relax. Then, you will be able to use this when you really need it – when you are overwhelmed, stressed or anxious and you need your mind to be sharp and focused.

Stroebel, Charles F., MD. QT – The Quieting Reflex. NY: Berkley Books, 1967, pp 110-112

Photo by camilo jimenez on Unsplash

Healthier Together Series: Cycle 5C. Relaxation & Sleep — 7 Steps to Using Traffic and Commuting for Self-Care

aditya-chinchure-ghbepAO7BCs-unsplashAfter residency, I decided I wanted to live within 10 minutes from my practice so I would not have to spend my precious time commuting to and from work. I moved within a 7 minute drive from my work, no traffic. I loved the extra time I had on either end of my work day. First, I was exercising more, cooking more dinners, and having time for grocery shopping. It was great! As time went on, I was able to fit other activities into that extra time and I could spend more time doing work-related activities. I could run a few more errands each day and I began taking on more work duties that could be accomplished in the extra time I now had.

As a result of my increased number of activities, the exercise routine became more sporadic. Instead of working out before work, I could “get more stuff done” and then plan to workout in the evenings. Of course, EVEN IF my clinic didn’t run late with last minute add-on patients and phone calls or EVEN IF I wasn’t too fatigued or hungry after a full clinic day missing lunch, my family members needed my focused attention and my workouts would be further “postponed.” I now didn’t have time to workout. Basically, the “saved” time started out as more time for self-care, but ultimately was squeezed out with with more time spent on activities and obligations that I didn’t need to do BEFORE I eliminated my commute and less self-care. Poor planning…Lots of reflection and learning…

Fast forward to my current job that I love but that is far from home. (We can discuss in the future about how to grow into the job you love.) When considering this job, I had to accept that I would have a total daily commute of potentially up to 2.5-3 hours with the common severe traffic. I considered taking the train in. The hospital even offers a free shuttle to drive people to and from the train station. However, I do not live close to the train station, so it would still take me about 2-2.5 hours door to door to take the train, and without the flexibility of coming and going as I wanted. It was clear. With this new job, I would have a long commute to and from work, 5 days a week.

I began investigating how to optimize my commute time. After trial and error and rapid “quality improvement,” my commute is part of my self-care time. If you have a long commute, here are my 7 steps to achieving a Self Care Commute:

  1. Figure out when you HAVE to be in your office.
    • Can you work from home on some days?
    • Does it matter the exact time you get to work or leave work?
    • Can you adjust your work day start and end times? If no, move to #4.
  2. Figure out your transportation options that agree with your work hours.
    • Do you need personal space and time without other people during your commute? Do you have a car? If yes, move to #3.
    • Are there ride share or public transportation options for you to get to and from your work that you would consider? For example: Uber, Lyft, Train, Subway, Bus, Carpool with neighbor. List them.
    • How long does it take to get from your front door, to your office door for each of those options? Add to your list next to each option.
    • Is your schedule predictable enough that your schedule can match a ride share, bus or train schedule? If no, move to #3.
    • Will you need to travel from one site to another during the day? If so, will it be easier if you have your own car? If yes, move to #3. If no, list your options for travel during your workday. Include the door-to-door travel times and costs associated with each option.
  3. If commuting by car or truck, review the various driving routes to work and traffic patterns. 
    • Waze, ETA and other apps offer anticipated travel times to destinations at various hours of the day. Make a list.
    • Can you find the range of travel times for the times you could drive to and from work for the hours you need to be there. Circle those travel times.
  4. Make a list of the categories of activities you can do during your various commuting options that you would like more time for. For example, Train: knitting, reading, listening to music, audiobooks, podcasts, writing, closing eyes and visualizing. Car: listening to music, audiobooks, podcasts, sitting in silence, connecting and talking to family/friends hands-free, driving through scenic route.
  5. Figure out the options for your activities on the way TO work which may be different than the way FROM work to home. For example, I am focused and my brain is eager to learn early in the morning, so I listen to non-fiction educational audiobooks on the way TO work. At the end of my day, my brain needs to relax. I may process my day by listening to music or thinking in silence or I may connect with others by calling my family or friends or I may want to be entertained and eagerly listen to the next chapter in the current detective series.
  6. Organize your commute times to optimize your commute and productivity. For example, my commute is cut in half if I drive in extra early before my scheduled meetings or clinic. This works great for me since that is when my brain is most productive so I can use that early quiet time in the office to achieve more. On my ride home, my commute is not optimized and is longer (by choice). I love that the longer drive home allows me more protected time to “squeeze” in a chapter or two of a fiction audiobook (which I wouldn’t read otherwise), process my day and connect with family and friends.
  7. Try it out and adjust your daily routines to optimize your commute times. After adapting my schedule and travel times, my commute time is not as long as I anticipated. I am more productive, my time is spent more efficiently and I have protected self care time daily. Despite the long commute, I have better integration of my work life and personal life.
    • Maybe you will have more time to connect with more of your family and friends with hands free phone calls.
    • Maybe you will find a new podcast or book series that make that unexpected traffic delay enjoyable.
    • Maybe you will learn new skills with personal development audiobooks or a recorded lecture series.
    • Maybe you will use the time to process your day, think about your family, consider your future.
    • Maybe you will learn a new language and take that trip abroad or meet new people.
    • Maybe you will work out at the gym near work in the evening before you drive home so that your commute time will be shorter and you will achieve your daily workout goals.

Once you recognize your commute time can be protected time to fit in the enjoyable activities you currently don’t make time for, you will find it is a luxurious time. While sitting in traffic on my ride home, I am forced to slow down. There is no checking emails or texts or getting online. I am in control of and I choose which activity I engage in. I appreciate the extra time I have for those fun activities that I otherwise would not make time for. The traffic ensures that I dedicate more time to self-care.  It’s now my Self-Care Commute.

Photo by Aditya Chinchure on Unsplash

Healthier Together Series: Cycle 5A. Nutrition – How To Manage Your Hunger – 10 Things to Know

melissa-walker-horn-lo_udD1o_lk-unsplashHunger can be a natural physiologic signal from the body requesting more fluids or nutrients or it can be cravings (learned habitual behaviors) and pathologic symptoms of a mismanaged metabolism. We sometimes forget to check in and determine why we might be hungry.

NATURAL & HEALTHY HUNGER SIGNS:
1. Dehydration. In most cases, this can be managed by drinking water.

2. Need to replenish nutrient supply.  For most people, eating a variety of colors of vegetables and supplementing with protein, will meet all the body’s nutritional needs. Make a list of easy naturally nutrient rich snacks that you can have readily available – then you can make healthy choices when you are hungry and need to replenish.

HUNGER SIGNS TO BEWARE OF:
3. Insulin resistance. If your waist line has grown since after highschool and you are not pregnant, you are developing or have developed insulin resistance. As we age, we also naturally become more insulin resistant. This means that our body over-reacts to sugars and carbohydrates in the diet which leads to a roller coaster ride of high and low blood sugar levels which lead to fatigue, mental fog & “the munchies.” Solution: Drink water, Eat protein or leafy vegetables when hungry and avoid sweetened or carbohydrate heavy foods.

4. Poor food choices earlier (ie. starting your day with sugar or processed carbs). Eating sugar will cause you to crave more sugar later in the day. Sugar can trigger the same area in the brain as heroin. It IS addictive. Solution: Avoiding it is the best way to manage being losing control. Make smart food choices. Start your day with protein instead of sugars or starchy processed carbohydrates. Choose whole foods.

5. Some medication and illicit substances (ie. marijuana). Some medications and illicit substances make people hungry and eat more, usually poor quality foods like most fast food. Solution: If your meds are making you want more broccoli, that’s great, but if it makes you get “the munchies” or you notice weight gain, have that important discussion with your doctor to see if you can find a way to manage it. Also, when you get “the munchies” or are hungry, drink water, eat veggies, nuts, or a cheese stick or have a light soup.

6. Boredom. Solution: Find something to do that is NOT related to food. Do something physical – take a walk, stretch, dance, move. Connect with family or a friend. Journal, garden, read, play solitaire, play a musical instrument, work on a hobby or create something artistic, etc.

7. Emotional unrest. Solution: If you are an emotional eater, it will be important to find new ways to soothe yourself. Consider finding a counsellor to help you process and learn better ways to cope. Find other healthy outlets – take a walk, spend time in nature, contact a friend or family member who nourishes you, spend time with you pet, listen to soothing music, learn meditation, go to a religious/spiritual place.

8. Habit (ie. before bedtime or while watching TV/movie). If you link certain activities or times of the day with eating/drinking, this is a habit and can be challenging. Solution: The best way to change that habit, it to create a NEW (more desirable) habit to replace the old, undesirable habit. For example, instead of having hot cocoa after being out in the cold or at bedtime, have some hot rooibos tea which is caffeine free and deliciously different. Instead of buttered popcorn with a movie at home, try berries or baby carrots. Keep healthy snack options easily available for “break time” at work- have salty, crunchy and “creamy” options available.

9. Seeing or thinking about food/drink you like. Having a variety of options to eat actually has been shown to increase the amount of food we eat. The larger the plate, the more options of different foods at any time, we eat more and sample more. Solution: Use a smaller plate. If you are sampling, think of the size of your stomach when not-too-full (the size of your fist), and look at the total volume of food you have on your (smaller) plate. STOP adding to your plate when it exceeds the size of your stomach. If you have more foods to sample, take less of each item so that you are not OVER-stuffing your stomach as it would not feel good anyways. Really, if you look at your plate and wonder how that would fit in your body, it’s too much. It’s ok to leave food on your plate. Note: Raw leafy greens shrink dramatically when chewed up, so you can be liberal with raw leafy greens!

10. Worry that later you won’t have time/opportunity to eat (ie. busy schedule). How many of you are “go-go-go” all day long and time for eating is a luxury? As a physician who may be running behind because of an earlier unexpected patient emergency, I hear you. Solution: Keep that stash of quick, healthy food/drink readily available, ALWAYS. Nuts, cheese stick, baby carrots and hummus, celery sticks and almond butter, whatever. Remember, IF you are unable to eat, as long as you are drinking, you are going to be fine for several hours. In fact, if you do not eat, but you maintain proper hydration, worse case, you will have to eat later than desired. However, your body starts to draw energy from your personal fat stores. Unless you are medically underweight, you should be ok to be burning extra fat on your body until you can eat later in the day.

Do you have other times you “hunger” triggers? How do you manage your hunger? What are some of your snacks you keep on hand?

Photo by Tim Mossholder on Unsplash

Healthier Together Series: Cycle 4D. Putting It All Together – Winter Well-Being

aaron-burden-cGW1w-qLix8-unsplashWinter in the Midwest – ice cold this year, but we don’t have the 7+ feet of snow as in Boston. The cold and darkness of winter are often used as excuses as to why someone is not exercising or eating as healthy. It’s used to explain “loss of motivation” to continue to make healthy choices. This “motivation” and “effort” may resume for a short time after the NEW year, but often dwindles away again until the days get much longer and warmer.

Here’s another option. Have “seasonal” wellness plans! Figure out what you need to include to maintain a healthy lifestyle: nutrition, physical activity and relaxation & sleep. There are many ways to incorporate those into each season. They don’t all have to be the same. In fact, the body will be optimized if you change it up periodically, so why not with the seasons? So change up your healthy lifestyle routines for the different seasons.

Here are some suggestions to get your creative juices flowing…Find what works for you.

If you workout in the mornings in the spring and summer, maybe in the winters, you meditate in the morning for a shorter duration than what your workout would have been? Maybe your workout is on the drive home from work or school or running errands- when you already are out of the house. Just DON’T go home first without the workout (as it can be hard to motivate to go out into the cold). Or maybe your workout is at home instead of at the gym. Maybe you use home workout DVD’s or smartphone exercise apps? The workout routine might be different – you may work more on strength or core training or take a different exercise class this season. If you have snow, you may choose to incorporate winter sports into you life – ice skating, skiing, snowboarding, snow shoeing, etc. A good friend introduced me to snow shoe-ing last year, and it’s wonderful! What a treat to be out in nature and having the brightness of the snow recharge me!

You may choose to rely on the crockpot more (especially if you are going to be working out after work and have less time to cook in the evening). You may get more of your veggies in a soup or stew. These also make great lunches the next day! You may cook more winter root vegetables- they last longer after purchase (less frequent grocery shopping trips).

The winter seems to have more quiet times of the day when it might be easy to stop and meditate, even if only for a brief time. There are many smartphone apps that help facilitate and time meditation sessions. You may even find incorporating meditative activities with physical activity is the answer for winter – Tai Chi and Yoga are popular ways to get both the relaxation and physical activity in one.

Sleep changes with the seasons and with stressors. Allow yourself to have a day once a week, when you can sleep in as much as you need. It will help you bring it all together and help keep your mind young and keep you upbeat throughout winter.

Please share what works for you!

 

Photo by Aaron Burden on Unsplash

Healthier Together Series: Cycle 4C. Relaxation & Sleep — Meditation

filip-mroz-zK049OFP4uI-unsplashThe act of quieting the mind…Meditation.

Meditation comes in various forms and is easily misunderstood. It does not require one to empty the mind. How many times have I heard, “I can’t think of nothing!”?  In fact, you can let the thoughts pass by in your mind and observe them.

There are many ways to meditate, but the focus is on practicing to quiet your mind. You might learn to quiet your reactions to thoughts and events in the past and future. You may work on focusing on the present and practice bringing your mind to the present and experiencing the present (Mindfulness Meditation). You may train your mind to be quiet by distracting it, such as with a mantra (Transcendental Meditation) or deep breathing exercises or by incorporating specific physical activity (Tai Chi or Yoga).

It does not require too much time. In fact, you can choose and you can meditate for various amounts of time based on time you have available or stress level in your life. Also, as you practice, like any sport or activity, it gets easier and you are more effective and efficient with the time. There has been evidence that as little as 12 minutes a day can make so much of a difference that it structurally changes your brain (for the better) and improves your overall function. It reduces stress, improves depression, anxiety, reduces pain, improves chronic disease management, improves quality of life, trains our minds to be more adaptable and flexible and it works for children too!

Meditation can be done anywhere, but it is easiest in a quiet place. There are apps on the phone/computer/tablet and there are books, classes, meetings and audio files. It can be learned on your own or with a guide or teacher. It’s pretty cool because it’s about you and it’s good for you and you can notice positive changes in other areas of your life pretty quickly. Your neurons in your brain start to work together and coordinate. Your body has a chance to check in with itself and reconnect.

Find a way to incorporate some practice of meditation on most days of the week. Work to find a time when you can disconnect from the electronics and focus on you, in the present moment. Give yourself a time out and allow yourself to be You. Just right. Right now. Exactly as you are.

Photo by Filip Mroz on Unsplash

Healthier Together Series: Cycle 3C. Relaxation & Sleep — Missing Nature

behzad-ghaffarian-LBjA0WPtUhQ-unsplashAre you wired 24 x 7? Do you ever unplug? Maybe it’s all about missing nature.

We are busy. There’s so much to do & often, not enough time. When we are staring at a screen for much of our day (smartphone or tablet or TV or computer or movie or presentation), we are missing an opportunity to view nature, other beings in 3-D, in real life. We may be focused on driving to our destination or doing a task (often with electronics involved), we may miss the subtle beauty and appreciation of the world around us. We lose the ability to process and recover from our daily events and it becomes easier to close ourselves off to the joy and vibrant world around us and we may gravitate towards UNhealth: increased stress, poor sleep quality, more frustrations, poor nutritional choices, less time spent making healthy choices, increased blood pressure, more chronic disease issues, less enjoyment,  more depressed or anxious moods, diminished sense of humor, fewer interpersonal relationships, decreased sex drive and burn out.

In addition to meditation, journal-ing, listening to beautiful music, singing, dancing, physical activity, connecting with others (people/animals), one of the simplest ways to recharge is by spending some time in nature. Just being in nature. It has been shown that even having a picture of nature in plain site, improves overall well-being in those who see it, so imagine how powerful it is if you can see it in real life. All it takes is a few potted plants outside where you can sit or stand. Or a small path you can walk along with plants or pond or water along the way. A place where you can feel the wind on your skin and hear the birds or the waves or the movement of water or leaves.

This small but powerful exposure to nature doesn’t have to be exotic or take a long time or require time off from work. In fact, put some plants in your office or home. Put a cut flower in a vase. Step outside into the sun (or rain or snow) for a midday break. Take a walk in the woods or arboretum or park or neighborhood. Allow yourself to pause and notice the nature around you. Seeing and appreciating the natural world around you will nourish you. Think about whatever you want. Spend as much time as you plan – whether it is based on need, ability or desire. Nature accepts you as you are and you are part of nature. Remind yourself that you are human and it’s OK to take a small break and recharge.

Over time, if you allow yourself regular exposure to nature, no matter how brief, you will notice a small change inside of yourself. That internal flame, your life source can glow and grow. Then there’s the ripple effect. Things will start to improve. You will start to feel better. You can gain perspective, remember the beauty and awesomeness of nature and learn to love and accept yourself and others as nature intended. There is always change around us, and we can’t control it all and that is how life is supposed to be. We can more easily accept and adapt to those changes, improve our sleep, enjoy more relaxation and our continue to improve our overall well-being by allowing nature to recharge us. We are natural beings. Give nature a chance. You may just be missing nature.

Photo by Behzad Ghaffarian on Unsplash