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  • How does a Recovery Coach work with a Treatment Team?

    How does a Recovery Coach work with a Treatment Team?

    manhattan_bridge_post_versionRecovery coaching services are starting to be more widely used, more often within the finest treatment centers. Yet, there are still addicts in crisis, or families with loved ones in inpatient substance-abuse treatment that are unaware that such services exist. Many therapists, re-unification specialists’ psychiatrists and LCSWs specializing in addiction treatment have not worked with a recovery coach, even though the recovery coaching profession has existed for over a decade. So it is important for more clinicians, outpatient coordinators, aftercare coordinators and other treatment professionals to understand how a recovery coach can benefit the client’s recovery and how the entire treatment team can work together.

    75% Will Relapse!

    Leaving an inpatient treatment facility, a client is very vulnerable to relapse during the initial days and weeks following their discharge. In fact, within a ninety-day period after discharge, seventy-five percent will have experienced one or more relapses (Godley, Dennis, Funk, & Passetti, 2002). Hiring a recovery coach can keep a client sober, and it is important to link a client to a continuing care program as early as possible. Both of these aftercare tools can be coordinated prior to discharge so the client can extend their sober life style after discharge.

    Research has shown, that coordinating this continuing care program does not guarantee a client will see a therapist, embrace a 12-step program or attend intensive outpatient treatment after discharge. This is where a recovery coach comes in. A recovery coach is called in to meet with the client either at the treatment center and then escort them home, or meet with the client at their home to take them to their first 12-step meeting, the continuing care program, or even therapist appointments. And always, the coach begins working with the client on their recovery plan.

    Who is the Treatment Team?

    Post discharge, or during outpatient treatment the Treatment Team consists of a variety of people, dependent on the client’s case. Key participants on the team can include the recovery coach, frontline clinicians and doctors from the treatment organization; the client’s primary care physician, psychiatrist or therapist; a staff member/social worker from a recovery-based agency or a representative from a community organization such as public housing; child protective services or any religious-based recovery program. The legal system may be involved so a lawyer, a probation officer, or a social worker assigned from the courts, the state’s drunk driving agency or child protective services can also be included. Many times the family is involved as well, whether it is a spouse, or in the case of an adolescent client, the parents or caregivers will participate on the team. (In all aspects of coordinating within the treatment team, a HIPAA disclosure form must be signed by the client allowing the coach and the team to discuss the client’s case).

    In early recovery, I cannot overstate the value of a recovery coach who is a hands-on partner and support person to help a newly sober addict learn all of the life skills that addiction robs from its victims. After 30-60 days in treatment, even a 45-year-old college-educated person has forgotten how to prepare and abide by a basic family budget; how to write a resume; how to do healthy things such as yoga; how to shop in a store and avoid the liquor aisle; have the confidence to walk into a 12-step meeting; or ask the right questions of a 12-step sponsor. These skills are not found in the “manual of the newly recovered” (a manual which does not actually exist). And even when such structure does appear in aftercare plans, sending an addict with 30 or 60 days of new found recovery out into the world to go forth and execute on such a plan is a big challenge, in many cases, one doomed to failure.

    The recovery coach will primarily be responsible for the provision of general treatment and recovery maintenance support in collaboration with the treatment team. The recovery coach responsibilities will include program support, connecting clients to recovery activities in the community, transportation of participants, helping clients get their basic needs met, assistance with navigation of the substance abuse, social services and mental health service systems, facilitation of attendance at support groups, or 12-step meetings and taking toxicology screens. The recovery coach can have daily contact with the client through telephone support and often meets weekly with the client in face-to-face sessions.

    David Loveland, PhD. and Michael Boyle, MA, wrote in the 2005 Manual for Recovery Coaching and Personal Recovery Plan Development an outline specifying that a recovery coach should also provide guidance to create a personal recovery. This personal recovery plan development is the first assignment a client completes when working with a coach.

    In order to work in the same manner that a clinician or a treatment center team member would expect, a recovery coach adopts the same system of notes, documentation and paperwork a clinician uses. The coach will provide the treatment facility and/or the client with documentation on billable services. The coach will complete thorough documentation or progress notes on the client’s recovery process, written in the guidelines required by the facility or that is acceptable to the clinician, such as DAP notes (data, assessment and plan). The coach will communicate frequently with the lead clinician and in the event of a crisis, more frequently with the team.

    Working through Potential Conflicts

    The role of a recovery coach is described in the Recovery Management and the Assertive Continuing Care models. These models may be new to most service providers and front line clinicians. It is important to address potential misconceptions and resistance that can be encountered by a recovery coach and the team. Here are some examples of potential conflicts between a recovery coach and the people they work with:

    • Establishment of clear guidelines of communications.
    • Who speaks to who — The recovery coach speaks to the client and the primary clinician
    • Everything a recovery coach discloses to the primary clinician is to be discussed with the team and the client
    • In the case of a relapse communication guidelines are to be established as to who in the team receives this information
    • Conflict between the treatment goals of the addiction treatment program and recovery coach can happen. It is best if treatment goals are discussed with the coach. The coach will defer to the clinician, most generally.
    • The team will establish guidelines or a contract with the client in the event there is the possibility a client will leave treatment against medical advice/orders (AMO) or be administratively discharged.
    • Sometimes there are ideological conflicts between the professional-based primary addiction treatment model and the strengths-based model, the Assertive Continuing Care or the Recovery Management model used by recovery coaches. These conflicts should be discussed with the team.
    • Rules within treatment facilities may conflict with recovery coach services, such as signing a HIPAA agreement, leaving a therapeutic group to work with a coach, working on other issues before completing specific phases of treatment or treatment programs that discourage working with other people during treatment. The coach is encouraged to work through these differences as best they can.
    • Changes in peoples’ treatment needs as a result of receiving recovery coaching services during a waiting period (e.g., no longer needing residential treatment after achieving some success with a recovery coach and the client can move to a PHP or IOP program).

    As a recovery coach, I enjoy working with a treatment team, and doing so allows me to work with a “net” while bouncing ideas or concerns off of an actively involved person with great interest in the client’s well being. When I am introduced to a clinician and team, it is often the first time the clinicians have worked with a recovery coach. If I am able to speak to the lead clinician prior to beginning a contract, I attempt to do so. Often, I attend the therapeutic sessions, after the client has their sixty-minute session, I will enter the room and spend a half hour or so discussing things with the client and the clinician. At other times, there are separate meetings with the treatment team that do not include the client. Frequently, there are daily and sometimes hourly conversations, text messages or emails with the lead clinician. Every assignment varies.

    The availability of recovery coaches is increasing. Clients can find recovery coaches for free or can pay anywhere up to $250 per hour for a coach. Many coaches have a website and can be found by using a search engine such as Google’s. There is an organization of Recovery Support Centers (http://www.facesandvoicesofrecovery.org/who/arco ) that offer free recovery coaches to clients. Often a treatment center has a recovery coach suggestion.

    In the end, the clinician, lawyer and client will benefit from the collaboration of the recovery coach with the treatment team, and often the coaching relationship with the client continues.

     

  • How can I get more sleep?

    manhattan_bridgeSleep has a potent effect on the addicted brain

    There are many tools available to a recovery coach. Information on the importance of sleep is one of them. Sleep is a necessity for everyone, including those in recovery from addiction. In fact, successful recovery and practicing healthy sleep habits are inseparable. Sleep has a potent effect on the addicted brain, proving to be one of the most influential factors in successful recovery.

    Dr Ralph Carson, author of The Brain Fix, describes why proper sleep is crucial while recovering from addiction. He explains that for addicts in an inpatient treatment program, it’s paramount that individuals be prepared to accept new concepts, embrace a different lifestyle, and apply their creativity to this recovery challenge. The effectiveness of treatment is compromised if people aren’t getting quality sleep and thus don’t wake up feeling refreshed, responsive, positive, and committed to the hard work of recovery.

    Of special interest to those in recovery, sleep impacts the pre-frontal cortex of the brain. Sleep removes neural toxins from the brain, which provides the brain the opportunity to re-organize the information that it has learned. Addiction negatively affects the pre-frontal cortex of the brain, leading to many problems, including compulsivity, impulsivity and most of all, impaired judgment. Strengthening this part of the brain is an essential part of the recovery process and strengthening the pre-frontal cortex involves getting enough sleep to clear out the neural toxins accumulated during the day.

    Psychologist Jack Edinger, Ph.D., of the VA Medical Center in Durham, North Carolina, and Professor of Psychiatry and Behavioral Sciences at Duke University, cautions that treating depression usually doesn’t resolve sleep difficulties. From his clinical experience, he has found that most patients with depression should be checked for insomnia and should be examined for specific behaviors and thoughts that may perpetuate the sleep problems. When people develop insomnia, they try to self-regulate or compensate by engaging in activities to help them get more sleep. Maybe they sleep later in the mornings or spend excessive times in bed or nap. These efforts usually appear as depression and are not helpful in resolving insomnia.

    According to sleep researchers, a night’s sleep is divided into five continually shifting stages, defined by the types of brain waves that reflect either lighter or deeper sleep. Toward morning, there is an increase in rapid eye movement, or REM sleep, when the muscles are relaxed and dreaming occurs, and recent memories may be consolidated in the brain. Experts say that hitting a snooze alarm over and over again to wake up is not the best way to feel rested. “The restorative value of rest is diminished, especially when the increments are short,” says psychologist Edward Stepanski, Ph.D. who has studied sleep fragmentation at the Rush University Medical Center in Chicago. This on-and-off-again effect of dozing and waking causes shifts in the brain-wave patterns. Sleep-deprived snooze-button addicts are likely to shorten their quota of REM sleep, impairing their mental functioning during the day.

    Cognitive behavioral therapy and sleeping

    From his clinical Cognitive Behavioral Therapy (CBT) work and research on sleep, psychologist Charles M. Morin, Ph.D., a Professor in the Psychology Department and Director of the Sleep Disorders Center at University Laval in Quebec, Canada, says that ten percent of adults suffer from chronic insomnia. In a National Sleep Foundation study released in the recent issue of the Sleep Medicine Alert, Morin outlines how CBT helps people overcome insomnia. Clinicians use sleep diaries to get an accurate picture of someone’s sleep patterns. Bedtime, waking time, time to fall asleep, number and durations of awakening, actual sleep time and quality of sleep are documented by the person suffering from insomnia.

    A person can develop poor sleep habits like using their smart phone, tablet or laptop in bed, watching Jimmy Fallon in order to go to sleep or eating too much before bedtime. Many times they may compensate by sleeping late the day after a bout of insomnia, or taking a long nap during the day to compensate for the lost sleep. Some develop a fear of not sleeping and a pattern of worrying about the consequences of not sleeping, which perpetuates the insomnia and can result in a dependence on sleep aids. Cognitive behavioral therapies are essential for patients attempting to alter the conditions that perpetuate insomnia.

    CBT attempts to change a person’s dysfunctional beliefs and attitudes about sleep such as letting go of thoughts like, “I’ve got to sleep eight hours tonight” or “I’ve got to take medication to sleep” or “I just can’t function if I don’t sleep.” These thoughts focus too much on sleep, which can be similar to performance anxiety. Sleep has a way of creeping up on you when you are not actively seeking it. Banishing negative thoughts will allow sleep to arrive at your bedroom door.

    According to a study published in the October 2004 issue of The Archives of Internal Medicine, cognitive behavior therapy is more effective and lasts longer than the sleeping pill, ary. The study involved 63 healthy people with insomnia who were randomly assigned to receive Ambien, cognitive behavior therapy, both or using a placebo. The patients in the therapy group received five 30-minute sessions over six weeks. They were given daily exercises to “recognize, challenge and change stress-inducing thoughts” and were taught techniques like delaying bedtime or getting up to read if they were unable to fall asleep after 20 minutes. The patients taking Ambien were on a full dose for a month and then were weaned off the drug. At three weeks, 44 percent of the patients receiving the therapy and those receiving the combination therapy and pills fell asleep faster compared to 29 percent of the patients taking only the sleeping pills. Two weeks after all the treatment was over, the patients receiving the therapy fell asleep in half the time it took prior to the study, and only 17 percent of the patients taking the sleeping pills fell asleep in half the time.

    What works in many cases, is to give a person more control over their sleep. A person can keep a sleep diary for a couple of weeks so a clinician can monitor the amount of time spent in bed to the actual amount of time sleeping. Then the clinician can instruct the patient to either go to bed later or get up earlier or vice versa. A person can also establish more stimulus control over his or her bedroom environment, such as going to bed only when sleepy, getting out of bed when unable to sleep, removal of electronic devices from the bedroom and not smoking or drinking before bedtimes. The same wake-up times every morning (including weekends) and avoiding daytime naps are also good regimes to adopt in thwarting insomnia.

    Finally, a person can incorporate relaxation techniques as part of his or her treatment. For example, a person can give herself or himself an extra hour before bed to relax and unwind and time to write down gratitude lists, meditate or use tapping (Emotional Freedom Techniques).

    In CBT, said Morin, breaking the thought process and anxiety over sleep is the goal. “After identifying the dysfunctional thought patterns, a clinician can offer alternative interpretations of what is getting the person anxious so a person can think about his or her insomnia in a different way.” Morin offers some techniques to restructure a person’s cognitions. “Keep realistic expectations, don’t blame insomnia for all daytime impairments, do not feel that losing a night’s sleep will bring horrible consequences, do not give too much importance to sleep and finally develop some tolerance to the effects of lost sleep.”

    How can I get more sleep?

    According to leading sleep researchers, here are some techniques to get more sleep:

    • Start a sleep diary to chart your progress
    • Keep a regular sleep/wake schedule and develop a regular bedtime (go to bed at the same time on weekends as on weeknights)
    • Try and wake up without an alarm clock—get rid of the snooze alarm
    • Attempt to go to bed earlier every night for a certain period of time; this will ensure that you’re getting enough sleep
    • Give yourself a 60-minute relaxation period before you sleep, meditate, chant, write a gratitude list, complete an eleventh step
    • Don’t drink or eat caffeine four to six hours before bed and minimize daytime use
    • Don’t smoke, especially near bedtime or if you awake in the night
    • Avoid alcohol and heavy meals before sleep, curb night eating
    • Get regular exercise
    • Minimize noise, light and excessive hot and cold temperatures where you sleep
    • Avoid daytime naps, especially after 3pm
    • Reading is okay, however make it a non-stimulating choice, romance, murder mysteries and sci-fi thrillers are very stimulating and can inhibit the relaxation portion of your pre-sleep ritual
    • Consider taking a hot shower at bedtime, instead of in the morning. Use aromatic soaps that promote sleep such as chamomile and lavender

    Dr Ralph Carson writes about the additional impacts of having a pre-frontal cortex that is “shut down” due to poor sleep. He explains: “This can cause you to overreact to negative experiences. Instead of facing your problems like a well-reasoned adult, you’ll be more apt to act moody, inpatient, or irritable.” For those in recovery, these negative mood states can be extremely triggering, increasing the likelihood of relapse.

    As previously stated, sleep deprivation inhibits the pre-frontal cortex’s ability to work efficiently, making it more difficult to focus on “what your big goals are.” Addicts who increase the duration of their sleep experience an improved ability to “resist relapse.” Increased sleep makes their brains cleaner and better fueled, helping them remember their goals to remain sober.

    If you choose to try a few of these suggestions, please first speak to a medical professional about your lack of sleep or insomnia.

    Resources using in compiling this blog:

    National Sleep Foundation
    http://www.sleepfoundation.org/

    American Academy of Sleep Medicine
    http://www.aasmnet.org/

    American Insomnia Association
    http://www.americaninsomniaassociation.org/

    Sleep Research Society
    http://www.sleepresearchsociety.org/

    NIH National Center for Sleep Disorders Research
    http://www.nhlbi.nih.gov/sleep

    The MayoClinic.com Sleep Center
    MayoClinic.com

    Ralph Carson (2012) The Brain Fix, Health Communications, Deerfield Beach, Florida, p 214
    http://ralphcarson.com/

    National Institute of Health (2013) How Sleep Clears the Brain,
    http://www.nih.gov/researchmatters/october2013/10282013clear.htm

    National Institute of Health (2013), New Brain Cleaning System Discovered:
    http://www.nih.gov/researchmatters/september2012/09172012brain.htm

    Martica Heaner (2004), Snooze Alarm Takes Its Toll on a Nation, Health Section, New York Times.com, http://www.nytimes.com/2004/10/12/health/12snoo.html

    American Psychological Association (2014 ) Why Sleep is so important and what happens when you don’t get enough, http://www.apa.org/topics/sleep/why.aspx

    John O’Neil (October 5, 2004) Treatment: Think before You Sleep, New York Times.com, Vital Signs Section, http://www.nytimes.com/2004/10/05/health/05trea.html

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  • Why I can’t make a good decision when I am fatigued?

    manhattan_bridgeFatigue takes a toll on the brain

    In the August 2004 issue of the journal Sleep, Dr. Timothy Roehrs, the Director of Research at the Sleep Disorders and Research Center at Henry Ford Hospital in Detroit, published one of the first studies to measure the effect of fatigue or sleepiness on decision-making and risk-taking. He found that indeed it does take a toll on effective decision-making.

    Cited in the October 12, New York Times Science section, Dr. Roehrs and his colleagues monetarily rewarded sleepy and fully alert subjects who completed a series of decisions and tasks. At random times, the subjects were given a choice to take their money and stop. Or they could forge ahead with the potential of either earning more money or losing it all if their work was not completed within the time remaining. A kind of “Who wants to be a Millionaire” science experiment.

    Dr. Roehrs found that the alert people were very sensitive to the amount of work and time they needed to do in order to finish the tasks and understood the risk of losing their money if they didn’t. But the sleepy subjects chose to quit the tasks prematurely or they risked losing everything by trying to finish the task for more money, even though it was likely that they would not be able to finish.

    According to the National Commission on Sleep Disorders Research (1998) and reports from the National Highway Safety Administration (NHSA, 2002), a high number of accidents can partly be attributed to people suffering from a severe lack of sleep.

    Each year, according to the NCSDR, the cost of sleep disorders, sleep deprivation and sleepiness is estimated to be $15.9 million in direct costs and $50 to $100 billion a year in indirect and related costs. And according to the NHSA, falling asleep while driving is responsible for at least 100,000 crashes, 71,000 injuries and 1,550 deaths each year in the United States. Young people, in their teens and twenties, who are particularly susceptible to the effects of chronic sleep loss, are involved in more than half of the fall-asleep crashes on the nation’s highways each year. Sleep loss also interferes with the learning of young people in our nation’s schools, with 60 percent of grade school and high school children reporting that they are tired during the daytime and 15 percent of them admitting to falling asleep in class.

    We’ve always known that sleep is good for your brain, but new research from the University of Rochester provides the first direct evidence for why your brain cells need you to sleep, and sleep the right way. The study found that when you sleep your brain removes toxic proteins from its neurons that are by-products of neural activity when you’re awake. Unfortunately, your brain can remove them only while you’re asleep. So when you don’t get enough sleep, the toxic proteins remain in your brain cells, wreaking havoc by impairing your ability to think — something no amount of caffeine can fix.

    Skipping sleep impairs your brain function across the board. It slows your ability to process information and problem-solve, kills your creativity, and raises your stress levels and emotional reactivity. Basically, it affects your decision-making ability.

    Decision Fatigue

    The mental work of making decisions time after time can wear you down. Decision fatigue is the newest discovery involving a phenomenon called ego depletion, a term coined by the social psychologist Roy F. Baumeister. This sort of fatigue can make quarterbacks prone to dubious choices late in the game, a CEO leans toward disastrous dalliances late in the evening or a recovering addict deciding to use after a long day at work. It routinely warps the judgment of everyone, executive, delivery driver, rich or poor — in fact, it can take a special toll on the poor. Yet few people are even aware of it, and researchers are only beginning to understand why it happens and how to counteract it.

    Decision fatigue helps explain why ordinarily sensible people get angry at colleagues, splurge on clothes, pick up candy at the market’s check out lane and can’t resist the dealer’s offer to rustproof their new car. No matter how rational and high-minded you try to be, you can’t make decision after decision without paying a price. It’s different from ordinary physical fatigue — you’re not consciously aware of being tired — but you’re low on mental energy. The more choices you make throughout the day, the harder each one becomes for your brain, and eventually it looks for shortcuts, usually in either of two very different ways.

    One shortcut is to become reckless: to act impulsively instead of expending the energy to first think through the consequences. (Sure, tweet that photo! What could go wrong?) The other shortcut is the ultimate energy saver: do nothing. Instead of agonizing over decisions, avoid any choice. Ducking a decision often creates bigger problems in the long run, but for the moment, it eases the mental strain. You start to resist any change, any potentially risky move — like releasing a prisoner who might commit a crime. So a fatigued judge on a parole board takes the easy way out, and the prisoner stays in prison.

    These experiments on Decision Fatigue demonstrated that there is a finite store of mental energy for exerting self-control. When people fended off the temptation to scarf down M&Ms or freshly baked chocolate-chip cookies all day at the office, they were then less able to resist other temptations, like stopping for a bottle of brandy on the drive home. When they forced themselves to remain stoic during a tearjerker movie, afterward, they gave up more quickly on tasks requiring self-discipline such as brushing their teeth, taking off their make-up or sleeping with the guy that paid for the movie. Willpower turned out to be more than a folk concept or a metaphor. It really was a form of mental energy that could be exhausted.

    In the rest of the animal kingdom, there aren’t a lot of protracted negotiations between predators and prey. A lioness doesn’t arbitrate with an antelope. To compromise is a complex human ability and therefore, it is one of the first abilities to decline when Decision Fatigue sets in. If you’re shopping, you’re liable to look at only one dimension, like price: just give me the cheapest. Or purchase only the products you have coupons for. Or purchase only the items which are covered by food stamps. Or limit yourself to only the $100. you have in your budget for groceries. And now, you have to put away the barrettes you got for your daughter, and the athletic socks for your son. Shopping can be especially tiring for the poor, who have to struggle continually with trade-offs.

    Researchers argue that this sort of Decision Fatigue is a major, and a largely ignored factor in trapping people in poverty. Because their financial situation forces them to make so many trade-offs, they have less willpower to devote to school, work and other activities that might move them up into the middle class. It’s hard to know exactly how important this factor is, but there’s no doubt that willpower is a special problem for poor people.

    Decision Fatigue is a reason that the liquor, candy and soda is displayed in the front of the store, featured prominently near the cash register, just when shoppers have depleted all their decisions in the aisles. With their willpower reduced, they’re more likely to yield to any kind of temptation, but they’re especially vulnerable to booze, candy and soda. While supermarkets figured this out a long time ago, only recently did researchers discover why.

    Despite this series of findings, brain researchers did find that glucose is a vital part of willpower. They helped solve the puzzle of how it increases the brain’s energy. Your brain does not stop working when glucose is low. It stops doing some things and starts doing others. It responds more strongly to immediate rewards and pays less attention to long-term prospects. A perfect environment for alcohol abuse.

    The discoveries about glucose help explain why dieting is a uniquely difficult test of self-control and why even those people with phenomenally strong willpower in the rest of their lives can have such a hard time losing weight. They start their day with virtuous intentions, resisting croissants at breakfast and dessert at lunch, but each act of resistance further lowers their willpower. As their willpower weakens late in the day, they need to replenish it. But to resupply that energy, they need to give the body glucose. They’re trapped in a nutritional catch-22:

    1. In order not to eat, a dieter needs willpower.
    2. In order to have willpower, a dieter needs to eat.

    Fatigue at work

    At work when we are fatigued, we are pretty good at avoiding the urge to spend money, but not so good at resisting the lure of relaxation, such as scrolling through Facebook, online shopping or viewing pornography on the web.  Today there are so many choices to make. Your body may have dutifully reported to work on time, but your mind can escape at any instant. A typical computer user looks at more than three dozen Web sites a day and gets fatigued by the continual decision-making — whether to keep working on a project, or check out YouTube, or follow a link to another interesting research topic or buy something on Amazon. Ever wonder why Cyber Monday is one of the biggest shopping days of the year?

    The cumulative effect of these temptations and decisions isn’t intuitively obvious. Virtually no one has a gut-level sense of just how tiring it is to decide. Big decisions, small decisions, they all add up. Choosing what to have for breakfast, where to go on vacation, what to do next, how much to spend from this paycheck— these all deplete willpower, and there’s no blinking indicator light on your dashboard to warn you that your willpower is low.

    When the brain’s regulatory powers weaken, frustrations seem more irritating than usual. Impulses to eat, drink, spend and say stupid things have no filter and alcohol causes self-control to decline further. The Decision Fatigue effect was even demonstrated with dogs in two studies by Holly Miller and Nathan DeWall at the University of Kentucky. After obeying sit and stay commands for 10 minutes, the dogs performed worse on self-control tests and were also more likely to challenge another dog’s turf. Fatigued humans are also more likely to get into needless fights over turf. In making decisions, they take illogical shortcuts and tend to favor short-term gains (like ending the meeting and going home) and delay reviewing costs (yes even adding numbers up on a calculator is a decision).

    “Good decision making is not a trait of the person, in the sense that it’s always there,” Baumeister says. “It’s a state that fluctuates.” His studies show that people with the best self-control are the ones who don’t schedule endless back-to-back meetings, they avoid temptations like all-you-can-eat buffets, and they establish good sleeping habits. Instead of deciding every morning whether or not to exercise, they work out with a friend. Instead of counting on willpower to remain robust all day, they conserve it so that it’s available for important decisions.

    “Even the wisest people won’t make good choices when they’re not rested and their glucose is low,” Baumeister points out. That’s why the truly wise choose not to restructure the company at 4 p.m. Board meetings are not held at night. Major commitments are not made over cocktails. And if a decision must be made late in the day, they make sure they have eaten something like an apple or an orange to recharge their glucose levels. “The best decision makers,” Baumeister says, “are the ones who know when not to trust themselves.” 

    Next week’s post will feature tips and tools on how to achieve a good night’s sleep.

    Resources for this article came from:

    Baumeister, R.F., & Heatherton, T.F. (1996). Self-regulation failure: An overview. Psychological Inquiry, 7, 1-15.

    Kathleen D. Vohs and Roy F. Baumeister, Running Head: Self-Regulation and Choice-Decision Fatigue Exhausts Self-Regulatory Resources-But So Does Accommodating to Unchosen Alternatives http://www.chicagobooth.edu/research/workshops/marketing/archive/ WorkshopPapers/vohs.pdf

    Baumeister, R. F.; Sparks, E. A.; Stillman, T. F.; Vohs, K. D. (2008). “Free will in consumer behavior: Self-control, ego depletion, and choice”. Journal of Consumer Psychology 18: 4–13. doi:10.1016/j.jcps.2007.10.002.

    Baumeister, R. F.; Vohs, K. D. (2007). “Self-regulation, ego depletion, and motivation”. Social and Personality Psychology Compass 1: 115–128. doi:10.1111/j.1751-9004.2007.00001.x.

    Dr. Timothy Roehrs, (August 2004), The Journal Sleep, http://www.journalsleep.org/PDF/AbstractBook2004.pdf

    Drowsy Driving and Automobile Crashes, NCSDR/NHTSA expert panel on driver fatigue and sleepiness,
    http://www.nhtsa.gov/people/injury/drowsy_driving1/drowsy.html

    Dr. Travis Bradberry (December, 2014), Sleep Deprivation Is Killing You and Your Career , Forbes Magazine,
    http://www.forbes.com/sites/travisbradberry/2014/12/01/skipping-sleep-is-career-suicide/

    John Tierney, (2011) Do you suffer from Decision Fatigue? New York Times Magazine,
    http://www.nytimes.com/2011/08/21/magazine/do-you-suffer-from-decision-fatigue.html?_r=0&pagewanted=print

    Holly Miller (2014) Self-control without a “self?”: common self-control processes in humans and dogs Department of Psychology, University of Kentucky, Lexington, KY 40506-0044, USA.

    Psychological Science (Impact Factor: 4.43). 04/2010; 21(4):534-8. DOI: 10.1177/0956797610364968, Source: PubMed

     

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  • I can’t go to sleep!

    manhattan_bridgeCan I function on less than 8 hours of sleep?

    Sleep is essential for a person’s health and well-being, according to the National Sleep Foundation (NSF). A recent poll taken by the NSF found that many people can’t sleep more than six hours a night, and 75% of us experience sleep difficulties a few times a week. Although a short-lived bout of insomnia is generally nothing to worry about, most sleep problems go undiagnosed and untreated. In addition, more than 40% of adults experience daytime tiredness, severe enough to interfere with their daily activities, at least a few days each month. The bigger concern is chronic sleep loss, which can contribute to health problems such as weight gain, high blood pressure, and a decrease in the immune system’s power, reports the Harvard Women’s Health Watch.

    Everyone’s individual needs are different. Most healthy adults need an average of eight hours of sleep a night. However, some individuals are able to function with as little as six hours. Others can’t perform at their peak unless they’ve slept ten hours. And, contrary to common myth, the need for healthy slumber doesn’t decline with age but the ability to get eight hours a night does.

    Psychologists and other scientists who study the causes of sleep disorders have shown that these problems can directly or indirectly be tied to abnormalities in the following systems:

    1. Brain functions, learning and memory: Sleep helps the brain commit new information to memory through a process called memory consolidation. In studies, people who’d slept after learning a task did better on tests, later.
    2. Metabolic functions and weight: Chronic sleep deprivation may cause weight gain by affecting the way our bodies process and store carbohydrates, and by altering levels of hormones that affect our appetite, and can lead to diabetes.
    3. Mood: Sleep loss may result in irritability, impatience, inability to concentrate, and moodiness. Too little can also leave you too tired to do the things you like to do.
    4. Cardiovascular health: Serious sleep disorders have been linked to hypertension, increased stress hormone levels, chances of stroke and irregular heartbeat.
    5. Immune system, and disease: Sleep deprivation alters immune function, including the activity of the body’s killer cells. Keeping up with sleep may also help fight cancer.

    Furthermore, unhealthy conditions, disorders and diseases can also cause sleep problems. They include:

    1. Pathological drowsiness, insomnia and accidents: Lack of sleep contributes to a tendency to fall asleep during the daytime. These lapses may cause falls and mistakes such as medical errors, air traffic mishaps, and road accidents.
    2. Emotional disorders: Depression, bipolar disorders can be aggravated by insomnia
    3. Alcohol and drug abuse: People often use alcohol or drugs in order to sleep.
    4. Decreased decision-making capacity: More on how sleep is essential to the brain’s decision making capacity in next week’s blog

    What disrupts your sleep?

    Stress is the number one cause of short-term sleeping difficulties. According to experts, common stress triggers for these difficulties include school or job related pressures, a family or marriage problems and a serious illness or death in the family. Usually the sleep problem disappears when the stressful situation passes. However, if short-term sleep problems such as insomnia aren’t managed properly from the beginning, they can persist long after the original stress has passed.

    Drinking alcohol or beverages containing caffeine in the afternoon or evening, exercising close to bedtime, following an irregular morning and nighttime schedule, and working or doing other mentally intense activities right before or after getting into bed can disrupt restful slumber.

    If you are a shift worker, as are 20% of employees in the United States, sleep may be particularly elusive. Shift work forces you to try to sleep when activities around you — and your own biological rhythms — signal you to be awake. One study shows that shift workers are two to five times more likely than employees with daytime hours to fall asleep on the job. Traveling is also disruptive, especially jet lag and traveling across several time zones. This can upset your biological or circadian rhythms.

    Environmental factors such as when a room is too hot or cold, too noisy or too brightly lit, can be a barrier to sound night’s rest. Parents often complain of sleeping problems as interruptions from children or other family members will disrupt sleep. Other influences requiring attention are the comfort and size of your bed and the habits of your sleep partner. If you have to lie beside someone who has different sleep preferences, snores, tosses and turns, can’t fall or stay asleep, or has other sleep difficulties, it often becomes your problem, too. Pets sleeping in the bed are another factor in sleep disruption.

    Having a 24/7 lifestyle or the demands of working in a global marketplace can also interrupt regular sleep patterns; the global economy that includes round-the-clock industries working to beat the competition; widespread use of nonstop automated systems to communicate and an increase in shift work makes for sleeping at regular times difficult.

    Groups that are at particular risk for sleep deprivation include night shift workers, physicians whose average is 6.5 hours a day; residents whose average sleep is 5 hours a day, truck drivers, parents, caregivers and teenagers.

    Next week’s post will focus on why we can’t make good decisions when we are tired. 

    Resources for this article came from:

    National Sleep Foundation
    http://www.sleepfoundation.org/

    American Academy of Sleep Medicine
    http://www.aasmnet.org/

    American Insomnia Association
    http://www.americaninsomniaassociation.org/

    Sleep Research Society
    http://www.sleepresearchsociety.org/

    NIH National Center for Sleep Disorders Research
    http://www.nhlbi.nih.gov/sleep

    The MayoClinic.com Sleep Center

    American Psychological Association
    http://www.apa.org/topics/sleep/why.aspx

    Blake, et al, Psychological Reports, 1998; National Heart, Lung and Blood Institute Working Group on Insomn

    David F. Dinges, PhD, Professor of Psychology in Psychiatry, Chief, Division of Sleep and Chronobiology, University of Pennsylvania School of Medicine

    Van Dongen HPA, Dinges DF (2005). Sleep, circadian rhythms, and psychomotor vigilance performance. Clinics in Sports Medicine 24: 237-249.

    Van Dongen & Dinges, Principles & Practice of Sleep Medicine, 2000

    American Academy of Sleep Medicine and National Heart, Lung, and Blood Institute Working Group on Problem Sleepiness, 1997

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    Thank you for your response. ✨

  • I am Lonely, Part Three

    manhattan_bridgeWhat Can I Do?
    John Cacioppo author and researcher on loneliness, offers a few tips on how to overcome being lonely:

    Recognize that loneliness is a sign that something needs to change. Notice your self-deflating thoughts. We often create self-centered stories to explain our feelings when we are young, it is not unusual for children to assume that there is something wrong with them if they are not happy. If they are lonely and sad, children may assume other people don’t like them. You are not five any more, you can address loneliness as an adult.

    Realize that loneliness is a feeling, not a fact. Habitual assumptions about negative social status continue into adulthood and if you are looking for evidence that the world sucks, you can always find it.When you are feeling lonely, it is because something has triggered a memory of that feeling, not because you are in fact, isolated and alone. The brain is designed to pay attention to pain and danger, and that includes triggering painful scary feelings. Many times these triggering scary memories create lonely feelings.

    But then the brain tries to make sense of the feeling. Why am I feeling this way? Is it because nobody loves me? Because I am a loser? Because everyone else is mean? Theories about why you are feeling lonely can become confused with facts. Then it becomes a bigger problem, so just realize that you are having this feeling as temporary and not to overreact.

    Make a plan. If you realize you are dealing with an emotional habit, you can make a plan to deal with loneliness. Since healthy interaction with friends is good, make some effort to reach out to others, to initiate conversation and face time even when your loneliness and depression are telling you not to. Yes, it is work, but it is worthwhile, just like exercising is good. Reach out because loneliness is painful and can confuse you into thinking that you are a loser, an outcast or less than. You might react by withdrawing into yourself, your thoughts, and your lonely feelings, and this is not helpful. At its best, anticipation of loneliness might motivate us to reach out and cultivate friendships, which is the healthiest thing to do if you are sad and alone. When you are a child, and your sadness causes you to cry, you may evoke a comforting response from others. If you’re an adult, crying about your isolating life style rarely receives a positive response.

    Understand the effects that loneliness has on your life, both physically and mentally. Morbidity among lonely people is increased by 45%. Loneliness is associated with depression and anxiety. Loneliness effects your heart, your immune system and increases the likelihood of Alzheimer’s disease. What to do? Embrace a healthy lifestyle, eat right, exercise every day, develop an awareness of wellness, visit your dentist, get that mammogram, start taking care of yourself and at the same time you will be combating loneliness.

    Consider doing community service or another activity that you enjoy. Volunteer for a good cause. You don’t have to worry about interacting with people, you all have something in common, because you are all doing something good.You have the power to offer loving kindness and generosity of spirit to all with whom you come into contact. These situations present great opportunities to meet people and cultivate new friendships and social interactions.Focus on the needs and feelings of others, and less attention on your own lonely thoughts and feelings. You can walk down the street thinking about your loneliness and the hopelessness of it all, staring at the sidewalk or your cell phone. Or you can walk down that same street grateful for the diversity of people you get to share the sidewalk with, silently wishing them good health and good fortune, and smiling at each person you pass. The latter is more fun. Be persistent even if a particular group  seems to be not a good fit for you. Just try another group! AA, NA and Al Anon recommend that you try six different meetings to find one that suits you best. If you are persistent, challenging the not good enough assumptions, quelling the feelings that tell you to give up and shutting off the old tapes that tell you to resign yourself to a life of a troll, you can emerge from isolation by just showing up! By being curious, adventurous and kind to others in groups, you can squash your loneliness.

    Focus on developing quality relationships with people who share similar attitudes, interests and values with you. Find others like you. Nowadays there are more tools than ever before for finding out where the knitters, hikers or computer code writers are congregating through meet-up sites advertised on the Internet. This makes it much easier to identify groups with ideas similar to yours. At the activities, you don’t have to tell jokes like a stand up comic or run for president of the knitter’s society at your first meeting. But you do have to show up. Remember, always show up when meeting with others. No shows make people doubt your reliability, and then they do not invite you to participate again because of your past record of not showing up. Therefore as a result of having no invitations to go places,  you feel more isolated. This is the vicious circle of loneliness. So, show up!

    Be curious, but don’t expect perfection or applause. Each time you show up, it is an experiment, a micro adventure in social bonding. If you are curious about and interested in others, they will be attracted to you because you are giving them attention. So you will get attention in return. Curiosity about others also takes your focus away from those painful feelings that tend to make you hide and sulk. Kindness and curiosity goes a long way.

    Develop one good intimate friend. And once you have a friend or two, nourish those friendships with time and attention. Don’t be too analytical about whether you are giving more than you are getting. If you make more friends and some of them are takers, you can choose to spend more time with the other friends who give and reward your friendship.

    And finally,

    Expect the best. Lonely people often expect rejection, so instead, focus on positive thoughts and attitudes in your social relationships.

    Research gathered for this post came from:

    Daniel Askt, (2008, Sept. 21). A talk with John Cacioppo: A Chicago scientist suggests that loneliness is a threat to your health. The Boston Globe Found online at http://www.boston.com/bostonglobe/ideas/articles/2008/09/21/a_talk_with_john_cacioppo/

    Cacioppo, J. T., Fowler, J. H., & Christakis, N. A. (in press). Alone in the crowd: The structure and spread of loneliness in a large social network. Journal of Personality and Social Psychology.

    Cacioppo, J. (2008, Nov. 3). John Cacioppo on How to Cope with Loneliness. Big Think. Found online at http://bigthink.com/johncacioppo/john-cacioppo-on-how-to-cope-with-loneliness

    Cacioppo, et al. (2009). What Are the Brain Mechanisms on Which Psychological Processes Are Based? Perspectives on Psychological Science, 4 (1): 10 DOI: 10.1111/j.1745-6924.2009.01094.x

    Loneliness affects how the brain operates. (2009, Feb. 19). Science Daily Found online at http://www.sciencedaily.com/releases/2009/02/090215151800.htm

    Shute, N. (2008, Nov. 12). Why loneliness is bad for your health. U.S. News and World Report. Found online at http://health.usnews.com/articles/health/2008/11/12/why-loneliness-is-bad-for-your-health.html

    You Tube TED talk with John Cacioppo, accessed at: https://www.youtube.com/watch?v=_0hxl03JoA0.

  • I am Lonely, Part Two

    manhattan_bridgeThe Research on Loneliness

    Have you ever been all alone at a party? Are you perfectly content sitting home reading a book or watching Hulu? Even though you secretly hate sitting at home watching Hulu? Do you have a need to fill the hole in your heart with anybody, or any substance and to take away the feeling created by that empty place? Even if that body or substance is not good for you? Lonely adults consume more alcohol and get less exercise than those who are not lonely. Are you one of them?

    Loneliness is a complex mental phenomenon that has at its base a powerful emotion, the building of which begins in childhood, and is a survival mechanism linked to Bowlby’s attachment theory. Research completed by Robert S. Weiss (1973) defines loneliness as a social, as well as, an emotional phenomenon. All of us have experienced some degree of it, if only for a short time, and remember the painful feeling that goes along with it.

    Whenever we are reminded of this feeling or anticipate it, we get a twinge of distress that can be linked with a feeling of abandonment we perhaps experienced in our youth. This is what we experience as loneliness, but it is so much more. This feeling can occur at a party, in the classroom or even after making love. It can be pretty confusing and can pull you into a downward spiral, if you don’t know what’s going on.

    Research on loneliness is relatively new. John Bowlby did a lot of loneliness research when working on his attachment theory in the 1970s. Robert S. Weiss distinguished between social loneliness, (people who are considered introverts could be socially lonely) and emotional loneliness (people who are emotionally lonely may not have had a firm and reliable care-giving figure early in their childhood development).

    People who are socially lonely have certain personality traits that inhibit the formation of social relationships. These traits might take the form of an individual more self-focused or unable to pay a lot of attention to their partner. For women, these traits present as lonely ladies who do not disclose their intimate feelings to their female friends, and for men, these traits present as less participation in group activities like softball or even playing chess with a friend. Personality research has shown that depression, shyness, and low self-esteem are linked to loneliness.

    Another approach to loneliness is the perception that loneliness is not good. Being lonely is less satisfying than other feelings, like joy. It is perceived as never ending or a permanent state of being. You should not be lonely, no matter what. It is also perceived that there is an ideal social relationship and a not so ideal social interaction. The not so ideal social interactions create loneliness.

    There is research that suggests loneliness is hereditary. According to research by John Cacioppo, a University of Chicago psychologist and a top loneliness expert, loneliness is strongly connected to genetics.

    Nonetheless, whether social, emotional or perceived, loneliness can be measured. The most frequently used assessment is the 1996 UCLA Loneliness Scale created by Daniel W. Russell. Research based on those individuals taking this assessment is quite interesting.

    Lonely feelings are more prevalent in adolescents and young adults (16-25) and very old individuals (80 plus years of age). As a parent, I look back on my son’s constant retort, “I’m bored.” After reading this research, I wonder if he could possibly have been unable to articulate that he was lonely. Of course, numerous 80-year-old respondents were in retirement or assisted-living communities when participating in this research. And many of these oldest adults didn’t have the level of social interaction they had when they were young. Doesn’t it make you want to go bring Grandma home for Thanksgiving dinner?

    Overall, women report slightly greater feelings of loneliness than men. I wasn’t surprised by that finding. As researchers drill down into the demographics, they discovered non-married men are lonelier than non-married women. Marriage is well known as protection against loneliness, which is greater in those that are divorced or never married.  African Americans of both genders tend to be lonelier than Caucasians. Yet, African American women are less lonely than Latina or Caucasian women. Based on a university study, it was found that college-aged Asian students were more lonely than their peers. Following along the lines of educational success, it was determined that the attainment of a high school diploma protects the population against loneliness, possibly indicating the enhancing benefit of the higher social status and self-esteem associated with this accomplishment. Employment is another factor illuminating loneliness. Retirement and unemployment represent a loss of social contact, so both groups experience feelings of loneliness greater than those that are still employed. Participation in a religious organization has also been identified as yet another protection against loneliness.

    Let’s get back to Grandma in the nursing home. Negative health factors increase with a higher level of loneliness. Sensory impairment, such as hearing loss, significantly contributes as well, because it impairs an individual’s ability to participate in conversations. Impaired mobility (walking) is also a contributor to loneliness, limiting the access and the desire to venture out to seek social interaction. Once loneliness takes a foothold in the individual, it makes a mountain out of a molehill. Those who are lonely react more intensely to negative situations, and they experience fewer uplifting feelings from positive events. Even if there is success by a loved one or a friend in delivering nurturing support, a lonely 85-year-old woman may perceive any exchange as less fulfilling. Using fMRI scans of a lonely person’s brain show they derive less pleasure from pleasing social interactions. Not only do the lonely contribute to their own negativity, others view them as negative and begin to pull away as a way to avoid negative situations. All of this confirms to the lonely that their interpretation of a negative social interaction is true, that social interactions will be consistently threatening and that changing those interactions is beyond their control.

    Loneliness is an added stress to the individual’s life. Perceiving stress as a growth and motivational opportunity is a start. Responding to going out and engaging with business colleagues can be looked at optimistically instead of with pessimism and avoidance. Thinking that anything is better than watching Hulu again tonight is an optimistic view of having an interaction with colleagues. The lonelier someone is, the less successful they are in dealing with stressors. Oftentimes the lonely withdraw and often they quit trying altogether. Not a good reaction to completing a work deadline or when trying to advance in your career.

    The lonely have higher systolic blood pressure and a higher body mass index than non-lonely people, which affects their heart health. Older lonely people have more differences in the hormonal production of the hypothalamus, the pituitary and the adrenal glands than people their own age who are not lonely. This can negatively affect their autoimmune system. Research has shown that people with loneliness experience non-restorative sleep (sleep that is non-refreshing despite an 8-hour normal sleep time). The risk of Alzheimer’s disease is twice more likely to appear in a lonely person than in non-lonely individuals. Living with loneliness can increase the likeliness of an early death by 45%.

    So, what can a lonely person do, not to mention a friend or family member of a lonely person? More will be revealed in my next post.

    Research gathered for this blog post came from:

    Loneliness, a paper written by John T. Cacioppo and Louise C. Hawkley, from the Chicago Center of Cognitive and Social Neuroscience, at the University of Chicago. This research was supported by the National Institute on Aging and the Templeton Foundation.

    John Cacioppo is also the co-author of the book Loneliness: Human Nature and the Need for Social Connection.

    Further reference material was drawn from Robert S Weiss’s book Loneliness: The experience of emotional and social isolation, published in 1973 at MIT Press, in Cambridge MA, and the 1996 UCLA Loneliness Scale created by Daniel W Russell.

    The You Tube TED talk with John Cacioppo, is accessed at: https://www.youtube.com/watch?v=_0hxl03JoA0.

  • I am lonely

    manhattan_bridgeWhat Is Loneliness?

    Webster’s Dictionary defines loneliness as a state of solitude or being alone. But I believe loneliness to actually be a state of mind. It causes people to feel empty, alone and unwanted. People who are lonely crave human interaction, but their state of mind makes it difficult to socialize or make connections with others.

    Loneliness is not about being physically alone. Instead, loneliness is the perception of being alone. A new employee might feel lonely despite being surrounded by colleagues and bosses. A soldier might experience loneliness upon returning home after being deployed abroad. Or a new college student may perceive being alone, despite being in the keg line at a frat party.

    The state of loneliness is an emotional one, in which a person experiences a powerful feeling of emptiness and isolation. It is more than the feeling of needing company or wanting to do something with another person. Loneliness is a feeling of being cut off, disconnected and alienated from other people. The lonely person may find it difficult, or even impossible, to have any form of meaningful human contact. People who are lonely often experience a subjective sense of inner emptiness or hollowness, accompanied by those feelings of separation or isolation from the world.

    How did I get so lonely?

    People can experience loneliness for many reasons, and many life events are associated with it. The lack of friendships during childhood and adolescence, or the physical absence of meaningful people are causes for loneliness or the seeking of extreme degrees of isolation. At the same time, loneliness may be a symptom of another social or psychological problem, for example, chronic depression, for which professional help should be sought.

    Many individuals experience loneliness for the first time when they are left alone as an infant. It is also a very common consequence of divorce or the breakup of any important long-term relationship. In these cases, it may stem both from the loss of a specific person and the withdrawal from social circles caused by the event, as well as the associated sadness. Loneliness can also be attributed to low self-esteem. People who lack confidence in themselves often believe that they are unworthy of positive attention. This can lead to the aforementioned states of isolation and chronic loneliness.

    Grief also can lead to loneliness. Leaving home and going to college is an example of an event that will trigger a grief response, homesickness, both possibly resulting in loneliness. It may also occur after the birth of a child, when a spouse devotes all of his/her attention to the new baby while the other spouse grieves the loss of their adult companion. Loneliness can occur within marriages or close relationships where there is anger, resentment, or where love cannot be given or received. Other contributing factors include situational variables, such as actual physical isolation, say, after moving to a new location, and/or a divorce.

    According to the results of a study of 5,000 people, loneliness is contagious. It can spread much like the flu. Loneliness can spread through groups of people via negative social interactions. More will be discussed on this topic in my future posts.

    John Cacioppo, respected loneliness researcher, suggests that loneliness is becoming rampant in the United States. When polled as part of a 1984 questionnaire, respondents frequently reported having three close confidants. When the question was asked again in 2004, the most common response was zero confidants. Experts believe that it is not the quantity of social interaction that combats loneliness, but that it is the quality of such interactions. Having just three or four close friends is enough to ward off loneliness and reduce the negative health consequences associated with this state of mind, with the emphasis on close friends. This trend is unfortunate.

    Are we lonelier as an outcome of our computer-generated, social-networking circles, or video game dependence, with their resulting sacrifices of good friends for just peripheral acquaintances or online social relationships? I will expand on this in my next post.

    _________________________________________________________________

    Research gathered for this post came from:

    A blog hosted at About.com, featured in the education section entitled: Loneliness: Causes, Effects and Treatments for Loneliness by Kendra Cherry, accessible at http://psychology.about.com/od/psychotherapy/a/loneliness.htm.

    More information was received from the John Cacioppo, J.H. Fowler & N.A. Christakis book: Alone in the crowd: The structure and spread of loneliness in a large social network

    Journal of Personality and Social Psychology. As well as the Boston Globe interview with John Cacioppo by Daniel Askt, (2008, Sept. 21).

    A talk with John Cacioppo: A Chicago scientist suggests that loneliness is a threat to your health. The Boston Globe is found online at www.boston.com/bostonglobe/talk with John Cacioppo.

    And the You Tube video of a TED talk with John Cacioppo, accessed at: https://www.youtube.com/watch?v=_0hxl03JoA0.

  • I am hungry — Why I can’t make good decisions when I am hungry

    melissa-new-post
    Melissa Killeen

    Hungry people are often difficult to deal with. Ask any waiter how pleasant a patron can be when they have been waiting over thirty minutes for a table. A good meal can affect more than our mood; it can also influence our willingness to take risks. Research proves that the willingness of many animals to take risks increases or declines depending on whether the animal is hungry or full. For example, a predator only hunts more dangerous prey when it is close to starvation.

    Three studies have been released, recently, that look into the behavior of hungry people. Well, the first study deals with fruit flies, but eventually researchers will get to conduct this study using real people. A team of scientists led by Dr Grunwald-Kadow at the Max Planck Institute of Neurobiology, in Martinsried, Germany, studied the behavior of hungry fruit flies. It was found that fruit flies have an instinctive fear of carbon dioxide, which they normally associate with danger even at low levels, because it kills them (a very healthy fear, don’t you think?). We all know that the fruit flies’ favorite food is rotting fruit. However, rotting fruit releases large amounts of carbon dioxide gas. So why do the flies want to eat rotting fruit? This fact lead researchers to explore the conflict between the regions of the fruit flies‘ nervous system, which was instructing the flies to get away from the fruit and the region of the flies’ brain which was telling them to sit down and eat, essentially to ignore the dangers of the CO2! These fruit flies are obviously risking death in order to eat. Being hungry shifts decision-making to a different part of the brain, bypassing the natural fight-or-flight reflex, which suggests there is an inherited instinct in other areas of the brain that was controlling the flies’ decision-making.

    “The hungry flies continued to eat despite the presence of carbon dioxide, confirming that the brain was happy to trade off risk instinctively with the advantage of getting a square meal,” Dr Grunwald-Kadow explained. Now how does this effect a 180-pound human? Well, hunger is not always just sitting down and having a triple cheeseburger, fries and a chocolate shake at Wendy’s. Although making a decision to have a triple cheese burger when it could affect your risk of high cholesterol or heart disease is similar to a fruit fly eating rotten fruit. The chances are the fly will die sooner than you will. So, let’s look at another hunger. The hunger of addiction.

    Yale researchers were focusing their attention on the brain’s reward circuits located in the midbrain to develop treatments for metabolic disorders such as obesity and diabetes. Funny, they were in working on diabetes and obesity research, and they came up with an interesting angle of interest in ‘novelty’ or risky behavior and stimulating behavior, also known as drug use. Yale School of Medicine researcher Marcelo O. Dietrich has found that increased appetite for food can actually be associated with a decreased interest in drugs. On the other hand, less interest in food can predict increased interest in cocaine. How many times have I thought: “I am hungry, but I don’t want to eat, because I want to lose weight, so I’ll smoke a cigarette?” The same reward circuits are working here. Can you see this thought working for you: “Boy, I have to work late to get this report done; I don’t have time to go out to grab dinner, let me do a line to pick me up until I am finished”? An interesting look at risk versus reward. Risk is completely ignored when the reward is food or drugs.

    Finally, let’s think about how angry we get when we are hungry. Ohio State Researcher, Brad Bushman, presented his research at the Proceedings of the National Academy of Sciences (PNAS) in 2013. His Hangry Study (or the hungry-people-are-cranky-people study) provided couples with blood glucose monitors and voodoo dolls, and then instructed each partner to take their blood sugar in the morning and evening. Each person was then told to take their voodoo doll every night and stick pins in it, representing how angry they were with their partner on a scale of 0 – 51. Zero pins meant no anger at all, while 51 pins was, well, a bit more than just angry!

    The researchers found that even when controlling a number of variables like overall relationship satisfaction, the people with lower blood sugar stuck their voodoo dolls with more pins. So Dr. Bushman fed them. And like magic, their blood sugar was elevated and they mellowed out.

    Bushman speculated that this study could prove blood sugar is a possible factor in domestic violence – although I think that is a stretch. But have you ever yelled at a waiter? Yes. Thrown a plate at them? No, unless alcohol is involved. So research proves that if you are having a discussion with your boss about a conflict situation, make sure it is not just before lunch or after 3:00pm, and that you are well fed.

    These studies all overlap with one result: Don’t make any decisions when you’re hungry.

    Isn’t it wonderful knowing that HALT (hungry, angry, lonely and tired) has some real scientific underpinnings?

    This blog was based on the following research:

    Dr. Grunwald-Kadow and Dr. Stefanie Merker, June 25, 2013, Hunger affects decision making and perception of risk,Max Planck Institute of Neurobiology Web site, Martinsried, Germany. To read more go to: http://www.mpg.de/7422218/hunger-behaviour.

    Emma Innes, June, 26, 2013. Why skipping lunch could make you a liability: Hunger affects the fight-or-flight reflex and triggers ’risky behavior’. Published by Associated Newspapers Ltd, part of the Daily Mail, The Mail on Sunday & Metro Media Group. To read more go to: http://www.dailymail.co.uk/health/article-2348930/Why-skipping-lunch-make-liability-Hunger-affects-fight-flight-reflex-triggers-risky-behaviour.html#ixzz3H6AYqTYb.

    Drug Addiction and Hunger May Be Linked, June 25, 2012. Sott.net is owned and distributed by Quantum Future Group, Inc., San Francisco, CA. Quantum Future Group, Inc. is a registered 501 (c) (3) nonprofit U.S. corporation, and Sott.net (Signs of the Times) is a research and news project of QFG. To read more go to: http://www.sott.net/article/247134-Drug-Addiction-and-Hunger-May-Be-Linked

    Charlotte H Anderson,Do You Get “H-Angry”? Science Says Hungry-Angry is Legit [Plus: 11 More Funny Food-Emotions] April 15, 2014. The Great Fitness Experiment.com, the personal blog of Charlotte H Anderson. To read more go to:
    http://www.thegreatfitnessexperiment.com/2014/04/do-you-get-hangry-science-says-hungry-angry-is-legit-plus-10-more-funny-food-emotions.html.

    Jeff Grabmeier, April 14, 14, Lashing Out at Your Spouse? Check Your Blood Sugar- Study finds that ‘hangry’ husbands and wives get more aggressive.The Ohio State University Research and Innovation Communications Web site, Office of Media and Public Relations, Columbus, OH. To read more go to: http://researchnews.osu.edu/archive/hangryspouse.htm.

  • I am hungry — Why?

    melissa-new-post
    Melissa Killeen

    Hunger can be a physical or emotional need. Understanding the need to eat is fairly straightforward. Meeting nutritional needs allows our bodies to operate to the highest potential, and will keep us feeling better. So to ease your hunger, it is advised not to turn to destructive habits, substances or negative people. This will not fill the physical or emotional emptiness that you’re feeling. Instead, find something wholesome to eat or talk to a good friend or loved one.

    Maybe if we look into to why we are hungry, it can help us tease out these feelings. Feelings are, for a recovering person, very difficult to identify and challenging to discern. When we use the recovery tool known as HALT (hungry, angry, lonely, and tired) to assess our situation, we may see that being hungry is more physical and less emotional. Maybe being hungry is bringing up your emotional need for something else? Or maybe hunger comes from the physical triggers that we will explore more in this blog.

    Some reasons that you are hungry

    So, it’s 3:00, past lunch yet many hours before dinner, and you are hungry. All you can think about is the next time you get to eat and what you are going to eat.  It’s all you can do not to scarf down whatever is in the nearest vending machine. But what gives? You ate a good lunch, why are you ravenous now? Turns out, our brains and bodies are frequently conspiring to trick us into thinking it’s time to eat when it really isn’t.

    I bet you didn’t sleep enough last night. Ever notice your grumbling stomach is a bit louder on the days after a fitful night’s sleep? That’s because too little sleep has been linked to higher levels of the hormone ghrelin, which is responsible for triggering hunger. This recent study from Northwestern University showed that people who regularly stay up late are also more likely to eat unhealthier food, weigh more and eat more during the evening, compared with people who go to bed early. And to make matters worse, when you’re sleep deprived, you’ll usually crave carbohydrates, and calorie-laden foods, as your body searches for alternate sources of energy. Researchers at the University of Chicago think this could be a clue as to why people who regularly get too little sleep are at a greater risk of obesity.

    You had dinner at your Mother’s last night and ate too much. Science doesn’t have a completely fool-proof explanation for this sensation yet, (of eating too much, not the sensation of eating at Mom’s) but there’s no denying that you are hungrier in the morning after going to bed stuffed to the gills. Contrary to common belief, it’s not that your stomach is stretched out, but more likely a result of the type of foods you overindulged in. If you overdid it on starches, you could have triggered dramatic changes in your blood sugar that trick the brain into thinking you’re still not full. I believe that this phenomenon is the reason why we will eat cold pizza for breakfast after a night a watching the World Series and downing four other pizzas, chips and soda.

    You’re pre-menstrual. Guys, you are off the hook here. But many women intuitively know this, and now there is proof to back up those thoughts that PMS is really the reason you ate the whole container of Ben and Jerry’s. During the pre-menstrual phase, progesterone production increases. This increased hormone production boosts your appetite but also increases your general malaise about your body in general, as if you weren’t already emotional enough.

    You could have had granola instead of Pop Tarts. The most important meal of the day is breakfast. It is also the one that is most under pressure to be eaten dashing out the door, while driving in the car or standing at the bus stop. Eating the wrong thing for breakfast can throw off an entire day. A 2013 study suggested that one of the most important breakfast component is protein. A serving in the range of 300-400 calories of fruit, plain yogurt, eggs and yes, even a turkey sausage or bacon is an ideal breakfast. In this study, people who ate high-protein breakfasts were less likely to reach for fatty, sugary foods later in the day. You might also be getting too little fiber or fat, both of which help keep you full. As many as 31 million people in the U.S. skip breakfast each day, with men ages 18 to 34 leading the pack. So that is why so many people join you in the break room at 3pm.

    Some medication’s side effects include weight gain. In the last 20 years, the number of meds with weight gain side effects has increased from one in 10 to one in four.  The drugs you should be concerned about are drugs for chronic diseases, like diabetes and psychiatric problems, because you may have to be using these drugs for a long time. Even innocuous meds like over-the-counter sleep aids can cause weight gain by slowing your metabolism, or by altering the hormones in your body that control your appetite. If you use a drug for chronic conditions that require life-long treatment, experts suggest discussing your medication with your doctor. There could be a similar drug without the weight gain side effect.

    You are hooked on diet soda. A zero-calorie sweet drink sends a message to the brain that calories are on their way. Then, no calories are actually delivered, this triggers the brain to send out hunger pangs to compensate for that bait-and-switch. More research is being completed on this, so in the meantime, it’s probably a good idea to cut out or at least cut back on artificially-sweetened pop.

    Open a bottle of water, you’re actually just thirsty.A little mild dehydration can give you a sluggish, fatigued feeling and, just like when you’re sleep deprived, the body often turns to calories for fuel. That means, when you experience what you think is hunger, it’s really thirst. Weight-loss experts often suggest drinking a glass of water and then waiting a few minutes before giving in to the craving for something to eat.

    You are on a tele-conference call and you’re bored. Dopamine is a chemical messenger in the brain linked with motivation, stimulation and reward. Dopamine makes us feel good about eating, so we don’t forget to do it, which is not exactly a problem for most of us! So, in the absence of more stimulating fare, like drugs, alcohol, sex, or internet gaming, the handy dopamine neuron-stimulating electrode in our brain triggers a lever whenever we fancy a thrill, like during a telephone conference call, and the food starts calling to us.

    You’re emotionally impaired, angry or stressed. Yes, there’s a biological reason for emotional eating, too. Think fight or flight. Our natural stress response is technically an evolutionary tactic to help us avoid becoming someone else’s dinner. In the face of stress, hearts race, muscles fire – all to give us the ability to run away or be eaten. Once we are safe, our body relaxes and our brain sends messages to refuel and replenish for the next harrowing experience. So stress activates a couple of brain systems to increase appetite. It seems to trigger cravings for sugary or fatty foods, and a flight to the corporate cafeteria before they close.

    So what can a person do to avoid the constant and dreaded desire to eat when they are not really hungry?

    Of course, the most obvious advice is to avoid it in the first place: drink water, avoid stress, chose foods that will keep you full longer, avoid carbs, and eat foods that are high in volume and low in calories, like leafy greens, which are also full of protein and fiber. Beyond that, all you can do is some damage control: eat a sensible, filling breakfast (oatmeal, granola egg-veggie scrambles!), walk around the office, straighten the copy area, talk to your colleagues, and know that the hunger will pass.

    Next week’s blog will focus on making decisions when you are hungry and what the research says.

    This blog was based on the following research:

    Sleep Deprivation Could Increase Hunger, What a Study Suggests. (7/10/12 ) Huffington Post. See more at: http://www.huffingtonpost.com/2012/07/10/sleep-hunger-deprivation-_n_1659954.html

    Night Owls at Risk for Weight Gain, People who go to bed late and sleep late eat more fast food and weigh more, (5. 4. 2011) Marla Paul, Northwestern University web site – See more at: http://www.northwestern.edu/newscenter/stories/2011/05/night-owls-weight-gain.html

    Why Am I Hungry After A Big Meal? (7.18.2012) Meredith Melnick, Huffington Post. See more at: http://www.huffingtonpost.com/2012/07/16/why-am-i-hungry_n_1677364.html

    Differential associations between ovarian hormones and disordered eating symptoms across the menstrual cycle in women, (6. 07. 2011), Sarah E. Racine MA, Kristen M. Culbert MA, Pamela K. Keel PhD, Cheryl L. Sisk PhD, S. Alexandra Burt PhD and Kelly L. Klump PhD. Article first published online: 7 JUN 2011, International Journal of Eating Disorders. Volume 45, Issue 3, pages 333–344, April 2012, Wiley Online Library. See more at: http://onlinelibrary.wiley.com/doi/10.1002/eat.20941/full 

    31 Million Americans Skip Breakfast Each Day (10.11.10). Huffington Post. See more at: http://www.huffingtonpost.com/2011/10/11/31-million-americans-skip_n_1005076.html

    Why We’re Saying ‘No Thanks’ To Diet Soda, (7.24.2013), Amanda L. Chan, Huffington Post. See more at: http://www.huffingtonpost.com/2013/07/24/diet-soda-health-risks_n_3606906.html

    The Mayo Clinic Web Site, De Hydration definition, 2014, Mayo Foundation for Medical Education and Research, see more at: http://www.mayoclinic.org/diseases-conditions/dehydration/basics/symptoms/con-20030056

     Do You Eat Out of Boredom? The biology of boredom eating…and how to beat it.(12.4. 2011), Psychology Today. See more at: http://www.psychologytoday.com/blog/bad-appetite/201112/do-you-eat-out-boredom