Wellness Wednesday: Survey Results for your Biggest Health Challenges

Don't you like getting survey results? It's like getting the punchline to a joke or solving a puzzle. Basically you get to compare your anticipation of the results with the actual results. It's even more fun when the results you get are unexpected. 

Many thanks to those who took the time to complete the survey. The number is small, but it is more than last survey I ran.

Here are the key results:

• Approximately three quarters of respondents felt that their health was only somewhat where they wanted it to be.
• The biggest health challenges were divided almost equally across nutrition, fitness, weight, and stress.
• Most everyone who took the survey took the time to write a bit about the biggest obstacle to health maintenance. Time was the most common theme expressed in a variety of different ways. Some people referred to the time demands of their job, partner, kids, house and pets. I doubt very much that these things are ever going to go away. In fact, I hope all of us always have jobs, partners, kids,  houses and pets. It sounds to me that concerted improvements in time management would be helpful across the board.
• Respondents were uncertain and vague when asked open ended questions about what would help them the most with there health. However when given a choice of specific set of health related products, they were able to clearly choose what would help them the most. This is where the surprise came. It wasn't a product at all. Far and away the most often chosen product was a "health coach." 

Fairly recently I ran into a physician friend of mine who I thought had retired. It turns out she had actually gotten certified as a health coach. She is loving it and and really feels like she's making a difference in her patients' lives. So after I saw the results of my survey I called her up to find out a little bit more. It turns out that health coaches are probably the next big thing in preventive medical care. 

It turns out that there quite a few health coaches out there and it turns out there are a lot of courses you can take in person and online by a great many certifying organizations to become one. However, only one organization is approved by the American College of Sports Medicine, the Wellcoaches School of Coaching. (wellcoachesschool.com) It is an evidence based program which uses up to date behavioral, exercise and fitness science to help people improve their life and their health. Luckily for us, my friend was certified in this manner. She works at out local fitness center. 

All well and good. But I called her later and grilled her about insurance coverage for such services. It turns out that, yes, many insurances do cover some health coaching, which struck me as a pleasant surprise. So I am going to start utilizing her and her team for my patients. I and many other doctors do a lot of office based health coaching, but in the setting of providing specialized medical care I can only give health coaching a limited focus. 

I wonder about those without insurance, those with high deductibles, and those with insurance that does not cover health coaching. I still would like to know what resources would be helpful to people who wish to, in effect, be their own health coach. What do you think ? 

Wellness Wednesday: The Benefit of Trying New Things

Nutrition, fitness and good relationships can keep us healthy. But... trying new things ? Yes, being adventurous has physical as well as psychological benefits to our health. (1) 

Adventure is a relative thing. For one person it might mean trying a new cookbook (me) while another may need to paraglide to 5000 feet above sea level (my son). But in all cases it means doing something different than your usual, and, for best results, it means getting out of your comfort zone. Comfort zones vary considerably in size.  

Does adventure have to be dangerous ? Of course not. But it should expose you to a new environment and require you to do things you have not done before. So why does it have to be all that? 

Before I explain, lets take a look at the American vacation. It is an endangered species. We are one of the few developing countries without a national policy of paid leave. Those companies who do provide paid leave do not always encourage its use, even though research shows it greatly improves employee productivity and satisfaction. When the companies do provide leave AND encourage its use, employees are reluctant to take it. Why ? Forty percent are afraid of coming back to " a mountain of work" , a third feel no one can do their work but them, a third feel they cannot afford it, and about a fifth feel guilty.  Forty-three percent of adults do not remember the last time they tried to have an adventure. Reasons for avoiding adventure range from lack of money to embarrassment. (2) Fear of one thing or another plays a role in skipping vacations. Ironically, it should be the opposite, since skipping vacations is associated with a measurable and significantly increased risk of heart disease in men and women, according to the Framingham study. (3)

And yet, we bemoan our lack of time off and we make bucket lists all of the things we don't and won't do. We execute what Tim Ferris calls the " deferred life plan". (4) Moreover, we note how every year seems to pass more quickly. 

Enter adventure. If we do get around to it, here is what happens. First, our narrow view of the world opens back up. We experience different ways of living, and see ourselves and others in a new light. Novelty and some degree of challenge have to be a part of it. This way, our confidence and competence is enhanced. A 2015 Study on newly graduated nurses found that a nontraditional outdoors adventure leadership program increased feeings of competence and confidence. When they returned to work, their transformation was felt to have impacted their entire work culture. (5) 

Adventure may even be an antidote for the accelerated passage of time. Dave Engelmann, a neuroscientist, notes that the more familiar the world becomes, the less we remember, and thus the faster times seems to pass. (3). I deduce that novelty and adventure may help us savor the time we have. 

Check out these fun resources: 

30 New Things to Try by Lifehack.com

The Beginner's Guide to Trying New Things

Staying on Top of Your Game

References: 

1. http://www.huffingtonpost.com/laurie-gerber/are-we-having-fun-yet_b_7948588.html
2. http://www.huffingtonpost.com/2014/08/19/americans-vacation-days_n_5682576.html
3. http://www.newyorker.com/magazine/2011/04/25/the-possibilian
4. http://www.bothsidesofthetable.com/2010/01/10/what-can-you-learn-from-the-4-hour-workweek/
5. http://www.ncbi.nlm.nih.gov/pubmed/25608096

Food Friday: Cooking for One

I have written a lot about the value of meals with others. But what about the single person, student or empty nester who is often cooking for one ? 

In doing some research for this post, I found some unexpected hilarity. One of the best posts came from one of my favorite websites called Greatist.com. They addressed headlong the temptation to have a pity party. They called out tendency to wallow in loneliness and junk food. They described " sad bowls of cereal ". I was laughing and feeling bad at the same time. 

But seriously, loneliness is bad. And if a person finds themselves feeling lonely, they should name it and change it if they wish. I am no expert in this regard since I am most often surrounded by people. But I am a physician and I would encourage any one who suspects they have the corollary of loneliness, i.e. depression,  to reach out to their physician for assistance. 

But let's say you are not depressed. You're just cooking for one. You have several options. 

1. Find someone to eat with. There is a large selection of apps and websites out there to help you find a random stranger to dine with. Seriously ! Check out the HuffPost article below which features several of them. Consider also eatwith.com, mealsharing.com, lunchmeetapp.com, and cookening.com.

2. Go out to a restaurant and at least be around people. This could work if the food was healthy and good choices were made. However one of my sources listed below indicated that, as a general rule, restaurant food is consumed in greater quantities, and contains more saturated fat and sodium compared to home cooked food. 

3. Cook a nice full meal with nice regular sized recipes and have a bunch of leftovers. This is the theme in the Bon Appetite pages cited below. They take the position that you should eat only the best. Tiny little streamlined recipes do not do it for them. 

4. Cook a balanced little meal for one with little mini recipes for one. Most of the links below propose this. 

Notice I did not say have a bowl of cereal or have a TV dinner. I am talking about healthy food here. Here are some tips for literally cooking portions for one. 

Buy food strategically. Here are some examples:

1. Choose individually frozen portions such as cut fish fillets  or chicken tenders.

2. Choose foods that doing not spoil quickly such as broccoli over red lettuce.

3. Choose foods that require very little preparation since let's face it, the time we usually want to spend cooking is directly proportional to the number of people for whom we are cooking. Fresh fruit takes little prep. Sliced tomatoes with fresh mozzarella takes little more. 

4. Accept that you are going to have to add a few different components to your meal to make it nutritionally optimal.   A banana and a glass of milk is not a meal. It is, however, a decent snack. 

5. Buy large quantities of healthy foods an repackage them for easy storage and access. 

This weekend I might, through a series of unfortunate events, be spending some time cooking for one. I'll be all about the can of salmon over the complex giant salad. But you may want to do better. Here are some great recipe collections for one. 

http://greatist.com/health/healthy-single-serving-meals

http://allrecipes.com/recipes/15050/everyday-cooking/cooking-for-one/

http://www.helpguide.org/articles/healthy-eating/cooking-for-one.htm

http://www.bonappetit.com/entertaining-style/trends-news/article/cooking-for-one

http://www.huffingtonpost.com/2013/09/18/dining-app_n_3942874.html

Wellness Wednesday: Workouts for your Mind and Soul

Have you ever heard of TED talks ? If I had to think of the SINGLE BEST USE of media, TED talks would be it. Now aren’t you curious ? 

TED talks are short (usually less than 18 minutes) powerful talks by people with important and timely insights. Originally they were by just the very best and the brightest, people such as Bill Gates, Steve Jobs and Steven Hawking. To this day, they are still given by those who have a deep special interest and expertise in a subject. 

The TED talks were originally conceived in California. They have close ties with the California University system, Stanford, and all major universities the world round. They are international in scope. To be invited to speak is a rare privilege. To attend in person is enormously expensive, but all talks are provided free to everyone over the internet.  TED talk conferences have branched into all major cities, and TEDx has been developed to give smaller communities the chance to participate. 

Oftentimes Ted speakers are researchers, or high level thought leaders, heads of state, or industry innovators. Commonly they are scientists or extreme athletes. Occasionally they are artists of note. They are always fascinating, and always worth watching.

And while you can listen to TED talks on iTunes radio, podcasts, and elsewhere, they are best watched. There is nothing like seeing these sorts of people give these usually intense distillations of human wisdom and brilliance. If you want to see a great example, check out the Talk by Jill Bolte Taylor. In video format, it brings it so much more down to earth. The speakers seem more accessible, as though you might run into them in the grocery store. 

I can tell you why a TED talk is so potent. This is because I was asked to to do one at the first TEDx conference in our area. I had done public speaking before, so I thought it would be straightforward. Wow did I have a lot to learn. A TED talk is not like an academic lecture. For our conference in northwestern Montana, I had several coaches, starting weeks in advance. One came all the way from Southern California to coach us. The coaches had to tear my style apart and put it back together again. I was lecturing, whereas they needed me to actually connect on a personal level over my material. I had to explain myself in clear ordinary nonmedical language.  I had to connect, which was my biggest challenge, and I had to end with a call to action. Plus I had to get it all done in 18 minutes or less.  

There are so many stories you and your family NEED to watch at TED.org and TEDx.org. I have been showing them to my kids, family and friends for years, and they are an endless source of inspiration. The TED.org website is great in that you can chose a talk by speaker, topic, or even rating. You can get an app on any platform or you can use a computer and a browser to go to TED.org. I cannot recommend then any more highly. 

Wellness Wednesday: Dealing with Disappointment

The other day, I inadvertently backed up into my husband's truck, for the second time in one month.  Both times it was parked in an atypical location, but both times I should've seen it. Both times I was going about 1 mile an hour. I have incurred enough damage to pay for two round-trip airfares to Europe. This was a disappointment.

My initial reaction was that I was sad and dismayed. However I was on my way to a delivery, so I knew I had to be sharp. I knew it was nobody's fault really and that there was nothing to be done about it at that moment. The necessity to get out of my funk in short order was actually a really positive exercise. It caused me to think about the best way to deal with disappointment.

All the sources that I consulted on the subject indicated the same basic set of recommendations. Here is my personal redux on the matter. 

• Pause and breathe before reacting. Take a couple of minutes if need be.
• Acknowledge your own feelings of disappointment or anger, but do not act out.
• Accept the present state of affairs.
• Deliberately avoid blame and invoke an attitude of neutrality.
• Take responsibility for what you can.
• Remind yourself that all problems have solutions or at least strategies.
• Deal constructively with what you have to and postpone the rest until the initial shock wears off.
• After the initial shock wears off, reach out to others who you know will be helpful and supportive.
• After any big disappointment, stay in your basic routine. Observe a good sleep schedule and stick to your three meals and three snacks every day as well as your workout.
• Go out of your way to remind yourself about all the good things in your life. 

Keeping this routine will help keep your stress levels down and help you recover from disappointments. 

 

Structure Sunday: The Structure of Childhood Memories

Childhood memories are an important part of who we are. It is up to parents to engineer varied and happy memories into their children's lives. This weekend we went down memory lane by virtue of hosting a wedding reception for the son of some of our closet friends. You would not think a wedding would focus a great deal on childhood memories. And yet, this weekend, it was a veritable memory fest. Of course there was the requisite slideshow of the childhood pictures of both bride and groom. But more than that, at the reception, clusters of conversations ensued, conversations between people who had done much together as children but little recently as adults. 

My extended family is large and we ourselves have three grown children. But, and this is one major point of this post, we have so many friends who are like family. These are families we have known for 20 to 30 years, and whose children have grown up with ours. Back in the day, we gravitated toward them because they were good and interesting people. More than that, they were creative and adventurous, and despite the fact that we were college students of modest means, we had adventures: us, our kids, our friends and their kids. These people have stayed our good friends all this long while. It feels like a tribe, or the proverbial village, the village it takes to raise a child. 

These adventures we had took time, planning and some wherewithal, but it all paid off in ways which we did not then entirely anticipate. Today we have grown kids who sit around the table and marvel at all they got to do as children. We look at old pictures and tell tales of glory. They know their experiences have shaped them. These children have grown to be inventive and resilient from their experiences. These are two of the greatest gifts a child can have. And now they are taking their kids out too.

It is fewer and fewer kids who have these experiences of rafting, camping, hiking or traveling for the sake of seeing a new place. I am writing to encourage you to find good people for your village. Find them and set off on adventures. You will have to take time off work, plan, get some gear, and maybe even learn a few new things. But that's all part of it. Go make some great memories for yourself and your children. You will get more out of it than you realize. 

Food Friday: Treats

This is a health oriented blog. And yet, I hope for all my readers to experience a wide range of culinary delights. Food is for celebration and rich sweet treats are served at celebrations. How can you participate without feeling like you’ve eaten poorly ? Here are ten tips to turn nutrition buffs into connoisseurs too. 

1. Eat properly on all regular days. 
2. Get your workout done before attending your party. 
3. Fill up on healthy foods before the dessert treats arrive. Savor them as much as the treats to come. 
4. Fill up on healthy beverages like water, soda water and herb tea before dessert arrives. 
5. Skip dessert if its not really well done. 
6. Skip alcohol if you chose a rich dessert. 
7. Be discriminating. Chose only the best for yourself, e.g. choose chocolate mousse over a cheap candy bar. 
8. Take a small portion. 
9. Savor your portion; Eat slowly and mindfully. 
10. Enjoy ! 

Wellness Wednesday: Physical Methods

Not uncommonly I have patients with pain issues, mood issues or both. Now, I suppose I write as many prescriptions for these conditions as the average doctor, but such a thing is hard to know. And yet, I am an advocate of what I like to call "physical methods" to control these problems.  

Since I practice evidence based medicine, I am committed to sticking to methods that have evidence supporting them. Believe it or not, the following methods are all evidence based. 

Let’s tackle pain first.

It’s pretty simple. If you have pain when stationery, you need to move. If you have pain when moving, you need to reduce movement or get help to find a better way to move. Physical therapy can provide this. 

Use heat and cold. Heat is to increase circulation which helps tight muscles or cramps. Cold is best for anything inflammatory or injury related in the first 24 hours. 

Massage is helpful in many cases of muscle pain. 

Abdominal binders, support hose, and wrist braces can be helpful in certain circumstances like pregnancy related pain. 

For the open-minded, I advise yoga for all sorts of pain: migraines, rheumatologic conditions like lupus, and for back pain pending approval of the back doctor.

Meditation takes a little more commitment, but it too, is evidence based and has been shown to favorably impact pain. 

Of course actual exercise is well known to improve resilience and to make people more resistant to pain. 

I consider music a physical method. Post operative patients have lower pain medication requirements when exposed to music they consider pleasant. The applications go way beyond that. 

Physical Methods for Mood 

All of the above also improve and stabilize mood. But did you know that the smell of natural citrus elevates the mood ? That’s why we have atomizers for natural essential citrus oils in our office. 

Simple adequate sleep is a proven method to improve the mood and increase the pain threshold. 

And if you haven’t heard this term before, you need to: Hangry. It is the combination of angry and hungry, which pretty much makes the connection between mood and blood sugar. Yes, something as simple as three meals and three snacks rich in protein can improve the mood immensely. 

All of these interventions and their effects are quite measurable and act via the nervous system and the circulatory system. Take the time to incorporate them into your life. They work. They’re cheap, and they’re fun. Because we all need to feel better sometime. 

To learn more see our pages: 

Meditation 

Yoga

Music and Health

Structure Sunday:The Structure of Back to School Preparation

I loved school. But I always hated those back to school signs in the stores. I still do. It always made summer seem shorter than it really was. And yet, now that I am a seasoned parent, I think there are real benefits to preparing for back to school. 

Just about now, it’s time to check in with your kids about any summer assignments they might have had. Don’t be that parent who declines to ask since they want their child to “ do it on their own”. Ask and get involved. Yes, it is nice when kids are self starters, but each kid is different, and you should at least know what is going on. 

It’s time to get together with your munchkin and deep clean their room. Give them some advance notice so that it is not a shock and so it does not interfere with their remaining summer plans. Let them know you might be willing to make some improvements if a good job gets done. Great examples would be a new bulletin or marker board, or perhaps a cool shelf.

Make sure that once their room is clean that everything truly has a place. Sometimes kid get blamed for having messy rooms when in fact there really is nowhere to put anything. Make sure there are enough hangers, shelves, baskets, boxes, or whatever it takes to fulfill the maxim “ A place for everything and everything in its place. “ And of course, most importantly, set a good example and keep your house clean, tidy and organized. People, especially kids, get used to whatever they’re in. You do your kids a big favor to model organization to them in this way. Being spatially organized does so much to lower stress in the house. 

Make sure to supply what they need for school. Make sure the basics are there, but also try to show you value education by going the extra mile for them with their school supplies. Make sure they have an excellent backpack to carry it all. Allow them to express their personal style. 

Make sure you know about the lunch and PE situation to come. Consider a well done home made packed lunch if school lunch quality is marginal. You can even teach your child to make her lunch eventually. Food is a great place to show kids values in action. Make sure your child has a chance to choose how they carry their lunch. 

Attend any orientations or registrations with your child, all the way through twelfth grade if you ask me. 

Finally, survey the back to school clothing situation. Assuming the room cleanup went well, ill fitting, damaged, or unwanted clothing has been given, donated, or recycled. Introduce the idea of starting your school shopping at a good thrift store such as Goodwill. Offer to take some of your child’s friends along. It is a truly fun treasure hunt. It is hip, green, and cheap.Then after that, check online for any swaps or sales, then get what you must new. 

You are the parent and you have a lot of influence. You can have this influence better by what you do, compared to what you say. Your day to day choices about how you interact with your kids convey your values. These back to school  tips will help you your convey your interest in their education, life habits, and health. They help you convey that you care about them. 

Food Friday: Summer Guests

Summer should be full of guests. Where there are guests there should be great food and drink. And yet, it is important that the work of food preparation not get in the way of entertaining. Here are simple, easy ideas for summer entertaining. 

1. Give at least a week of notice, so the gathering is informal but not too informal. Be open to drop ins. 

2. Be aware of any food intolerances or limitations. Have at least three dishes everyone can eat. 

3. Incorporate the out of doors somehow. 

4. Invite guests to contribute a dish but let them know to come even if they are too busy to prepare something. You may also simply ask them to bring soda water if you suspect they are busy. It is a good idea to invite guests to bring what they are good at cooking, within the constraints of your theme. 

5. Favor foods which can be prepared in advance, especially the main dish. An example would be meatballs in a slow cooker. 

6. Favor food which are presented, more than actually prepared, i.e. fruit and vegetable platters with dips. Similarly, favor foods which are assembled by the guest, i.e. a taco or fajita bar. 

7. Serve buffet style. 

8. Have a great selection of drinks, especially in hot weather. People love a big punch bowl. We make ours with 2 parts club soda with one part 100% fruit juice such as apple raspberry juice from frozen concentrate. We cool it with ice, but also frozen berry mix. We may also float some citrus slices. The variations on this punch can be endless, and it the flavors can morph as the bowl needs refilling. 

9. Don’t be afraid to decorate a little. You can be fun, festive or sophisticated at your whim. 

10. Finally, don’t forget the most important part of entertaining: Making your guests feel welcome. 

Wellness Wednesday: Healthy Communication Skills

Communication skills are intrinsic to our wellness. They are central to our relationships and our effectiveness in life. I have distilled a list of six main steps in healthy communication. I discovered I have lots of room for improvement. Hopefully you will find something helpful too. 

1. Attitude adjust.

• Consider your purpose in the conversation. 
• Assume the best intentions in everyone. 
• Stay positive - honest, patient, optimistic,  sincere. 
• Value everyone equally. 

2. Check physical factors.

• Put away distractions like phones. 
• Make comfortable eye contact.
• Watch your body language.  
• Watch your tone. 

3. Listen actively.

• Listen first.
• Ask open ended questions.
• Set aside judgement while listening. 
• Listen actively -  Don’t interrupt; read back, aka clarify and reflect. 

4. Guide your reaction. 

• Use empathy; Try to see the other person’s point of view.
• Practice self awareness -recognize emotions and stresses as they arise and rather than react to them, handle them appropriately. 

5. Say your piece. 

• Pause and ponder. Think before making a point.
• Understand how your message might be received.
• Tailor your message to your listener.
• Use empathetic assertiveness. 
• State needs, express feelings; Value your own point of view as well. 
• Be direct; Be BRIEF - Give the "b"ackround, "r"eason,"i"nformation, "e"nd, and "f"ollow-up.

6. Connect and conclude. 

• Connect personally.
• Encourage the other.
• Focus on the result.
• Ask for input and feedback. 
• Follow up with a plan. Close the loop. 
• Show appreciation for the person and the conversation.  

Awesome references that expand on these tips: 

http://lifehacker.com/top-10-ways-to-improve-your-communication-skills-1590488550

http://www.lifehack.org/articles/communication/9-tips-to-improve-communication-skills.html

http://www.wikihow.com/Develop-Good-Communication-Skills

http://www.skillsyouneed.com/ips/improving-communication.html

http://www.skillsyouneed.com/general/emotional-intelligence.html

http://www.skillsyouneed.com/ips/improving-communication.html

http://www.inc.com/kevin-daum/8-ways-to-improve-your-communication-right-now.html

http://www.citehr.com/11334-6-good-tips-increase-your-communication-skills.html

http://advancedlifeskills.com/blog/14-very-effective-communication-skills/

http://www.wfm.noaa.gov/workplace/Comp_Conf_Handout_1.pdf

http://www.helpguide.org/articles/relationships/effective-communication.htm

Structure Sunday: What I do to stay healthy

I am 53 and I have lupus. But I am pretty darn healthy, thank goodness. People often ask me what I do to stay healthy. It's really no mystery. So today's structure Sunday is about the structure of my week. 

Sunday- the beginning of my week

• Breakfast with family
• Team clean - ( Housecleaning) especially laundry
• Clean desk, pay bills ( which I have recently mostly automated yay ! ) a big stress reducer
• Grocery shopping 
• small scale recreation 
• longer workout 
• family dinner 
• Prep for the workday per usual routine- down to packing lunch and snacks, and picking morning outfit ! ( a stress reducer and time saver ) 

Monday -workday

• The usual routine of am protein drink, midmorning snack, second breakfast, lunch and midafternoon snack. Daytime intake must include one large glass of water, one large bowl of ground green tea, and one small cup of kefir, a probiotic.
• pm- break from workout 
• family dinner per usual routine 

Tuesday- workday 

• usual routine 
• longer workout 

Wednesday - surgery and chores

• grocery shopping 
• shorter workout 
• entertain if possible 

Thursday workday 

• longer workout 

Friday - workday 

• shorter workout 
• special family dinner
• evening outing 

Saturday - 

• family breakfast 
• longer workout 
• larger scale recreation 
• entertain 

Everyone thrives on routine, from adults to children.  It gives your system signals of peace and plenty. With a reasonable routine, stress hormones decrease and everything from thinking to healing improves. 

You can also use routine help with taking medications and supplements, and to regulate your sleep schedule. If you are having a tough time meeting your health goals, just build a routine. Routine can make hard things easy. 

People say they do not have the willpower to eat well and exercise regularly. Here's the newsflash: It's not so much a matter of willpower as it is engineering. You simply schedule your healthy habits and stick to the schedule, no questions asked. 

Wellness Wednesday: Curing Procrastination

Is procrastination an illness ? No. But it can affect your health. Let’s take a look at what it is, why it happens, and how to cure it. 

What is procrastination? 

Procrastination is putting off things that need to be done. How big is the problem ? About 20 % of people are chronic procrastinators and these percentages increase significantly during college. People who are chronic procrastinators perform more poorly in their family, in high school, in college, in jobs, and in relationships. This sounds like an unfortunate nuisance, but it is actually a health problem. According to many sources, procrastination creates stress which interferes with sleep, weakens the immune system and makes heart disease more likely. It is also very hard on mental health. 

To understand why procrastination happens, we have to look deeply into issues like self control, self image, inner honesty, fear of failure and distress tolerance. 

1. Procrastination may start as a form of silent rebellion against parents. This becomes a vicious cycle as adolescents avoid parents in favor of friends, who do not hold them accountable as parents would. 

2. Certain necessary tasks or even the idea of the tasks make people uncomfortable (distressed) , either because they dislike doing them or they are perceived as difficult or overwhelming. Those who cope with their feeling of dread or discomfort (distress) by avoidance may procrastinate, only making matters worse. Those who have poor coping skills or distress tolerance are likely to do other dysfunctional things to cope with life’s daily challenges and discomforts, such as abuse substances. 

3. When people do not want to risk failure, they will subconsciously "arrange" to have insufficient time for a task, thereby providing themselves with a ready excuse for their suboptimal performance.

4. Procrastination is self sabotage. People procrastinate to fail in order to show others they have been mistreated, to “get back at them” or to acquire victim status. ( This is, by the way, passive aggressive behavior.) 

5. Some people who procrastinate simply want others to pull up the slack in whatever it is that needs doing. 

6. Some people who really want to succeed procrastinate. They deceive themselves about several things: 

•      They will be more motivated tomorrow.
•      They have plenty of time left. 
•      Their task will not be that challenging nor take that much time. 
•      They will do better when they are feeing more motivated or inspired. 
•      They think they do better under pressure. 
•      They are talented enough to pull it off. 

     These are white lies we tell ourselves. 

What can be done about procrastination ? 

1. Procrastination is hard to overcome but it requires honesty with oneself and usually firm persistent guidance from others. 

2. Strong feelings of interpersonal conflict should be evaluated by a qualified counselor. 

3. Problems with procrastination in the setting of substance abuse should also be evaluated by a qualified counselor. 

4. Simple methods to beat procrastination are as follows: 

•      Fortify your will power and your distress tolerance with adequate sleep, healthy meals, snacks and regular exercise.      
•      Become a list maker. Get a system which is either digital, paper or both and include reminders such as sticky notes or alarms. 
•      Use SMART goals criteria for your list items. See more about SMART goals HERE. Nutshell version: SMART goals are specific,measurable,attainable, relevant and time-bound.
•      Overestimate the time it will take you to get something done. 
•      Ditch perfection as a goal. It gets in the way of progress and accomplishment. 
•      Divide large tasks into a series of small manageable tasks. 
•      Practice mental “ time travel” to see how you will really feel tomorrow. 

5. All of this requires self regulation. Practicing self regulation with small tasks has been proven to improve self regulation with big tasks. 

•      Realize that self regulation is critical to healthy relationships and success in life. That should be plenty of motivation. 
•      Pick several easy small tasks, and stick to them. Larger tasks WILL get easier as a result. 
•       Yoga or meditation is especially good training for the nervous system where self regulation is concerned. 
•      Be easy on yourself for lapses. 
•      Pat yourself on the back for all successes. 

References: 

Cal Poly’s Procrastination PDF - WOW amazing document ! http://sas.calpoly.edu/asc/ssl/procrastination.html

Psychology Today: 

https://www.psychologytoday.com/blog/dont-delay/200903/self-regulation-failure-part-4-8-tips-strengthen-willpower

https://www.psychologytoday.com/articles/200308/procrastination-ten-things-know

https://www.psychologytoday.com/articles/200909/ending-procrastination-right-now

https://www.psychologytoday.com/articles/201109/procrastination-oops-where-did-the-day-go

https://www.psychologytoday.com/articles/200308/procrastination-ten-things-know

Mindtools: 

http://www.mindtools.com/pages/article/newHTE_96.htm

The Procrastination DOOM LOOP 

http://www.theatlantic.com/business/archive/2014/08/the-procrastination-loop-and-how-to-break-it/379142/

Procrastination and the great Stanford Marshmallow experiment 

http://youarenotsosmart.com/2010/10/27/procrastination/

University of Cambridge 

http://www.counselling.cam.ac.uk/selfhelp/leaflets/procrastination

Princeton

http://www.princeton.edu/mcgraw/library/for-students/avoiding-procrastination/procrastination.pdf

Procrastination and Your Heart

http://nymag.com/scienceofus/2015/03/procrastination-is-not-great-for-your-heart.html

Eat That Frog!: 21 Great Ways to Stop Procrastinating and Get More Done in Less Time

$8.74

By Brian Tracy

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Procrastination: Why You Do It, What to Do About It Now

$13.47

By Jane B. Burka, Lenora M. Yuen

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Structure Sunday: The Structure of a Hobby

Who could have imagined that the love of horses could lead to so many good things. 

When I was a child, I was enamored of horses. I always asked my parents to let me have a pony ride at the fair. When my family moved into the beautiful Palos Verdes Peninsula in Southern California, horses became a major part of my world. You see, all the homes were situated around a network of riding trails and riding rings that were maintained by the city. Every house had a stable, and every family a rider or two. I got some riding lessons locally and really liked it. My parents and I decided this would be my sport and that we would pursue it as a family. 

I was accepted by an established trainer and he obtained a proper quarter horse. We trained until we were ready to show. It required about an hour and half drive out of town each way, and we did it at least four days per week. I did my homework in the car. When I arrived, I would train for several hours each time. It was dusty, intense and stressful, but I liked it nonetheless. Eventually I showed with my stable, all up and down the Pacific Coast in what was then called the Pacific Coast Hunter Jumper Stock Horse Association circuit.  It required a lot of time away from school which was hard. 

Riding has a way of building you up, no matter how hard it is. You learn tolerance: tolerance for your trainer, tolerance for your parents, and tolerance for your horse. You learn tolerance for the invariably bad weather, like intractable rain making muddy arenas, or broiling dusty heat in the Indio sun. You learn to control your fear and steel yourself as you wait to enter the competitors ring. Nowadays we call this distress tolerance. 

You learn to win, and you learn to lose. You are being trained, but at the same time you are training yourself. You have a chance to meet a great goal by meeting lesser ones along the way and you learn right away the winning takes a long long time and more work than you imagined.

I truly believe everybody should have a chance to pursue something seriously. I think all children especially should be raised knowing that they will be taught many things, and that when they find one that is special to them that they will be encouraged and even expected to learn it well. When young children attend classes for hobbies like ballet, music, riding or marital arts, or when they play sports like soccer or football, they learn that success requires practice over time. 

These traits of distress tolerance, perseverance, courage, and ability to work on a goal are key for success in life. I believe hobbies right from childhood foster these priceless traits. 

When I attended the horse show at Rebecca Farm today, I thought a lot about my horse show days. I was full of pride for all the riders and all they had accomplished. I hope you will go out and attend such sporting and arts events in your community. More than that, I hope parents will introduce their children to something inspiring they can pursue. 

For more information, see rebeccafarm.org. 

Wellness Wednesday: Exercise Statistics

Most people who come into my office for an annual exam report that they live an active lifestyle. Of course this means different things to everyone, but it is an interesting starting point of discussion. 

Our impressions of our exercise patterns are rarely accurate unless we take the time to chart them. I am going to devote this post to a reality check for us collectively. Number lovers are in for a treat. 

Children: 

• Only 1 in 3 children is physically active every day. 
• Only 6 of the 50 states require PE in each grade. 
• The CDC recommends children be physically active for one hour each day. 
• One third of high school students plays video games for more than 3 hours per day. 
• In 2013 only 27 % of all high school students had 1 hour of physical activity in each of the preceding 7 days. Fully 15% of high school students reported NO physical activity in any of the prior 7 days. 

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Adults: 

• Less than 5 % of adults get 30 minutes of physical activity each day. 
• Only 1 in 3 adults gets the recommended amount of physical activity in a week. 
• The 4 states where adults have the highest incidence of exercising 3 or more times per week are: Vermont, Montana, Alaska and Hawaii. In these states about 60 % of adults meet this criteria. 

Appropriate physical exercise comprising both cardio and weight bearing exercise has numerous mental and physical benefits for children, adults, and seniors. Exercise these days has become more evidence based. We know more than ever about how to tailor it to a patient's specific health needs. Exercise certainly does not need to be onerous or miserable. Without exception, people who exercise regularly derive great satisfaction from it.

Check with your local health club or YWCA. Get some exercise DVDs for home use. Find my DVD recommendations in the RETAIL THERAPY section. Learn more in our section on FITNESS. 

Reach out and explore your exercise options today. 

References: 

http://www.fitness.gov/resource-center/facts-and-statistics/

http://www.cdc.gov/healthyyouth/physicalactivity/facts.htm

Structure Sunday: The Structure of Your Home Office

Today's women have to do it all. Homemakers and professionals alike need a home office to do all that they need to do. Here are my tips for what goes into a home office, and what should take place there. 

I have also included some great resources about home offices. 

. 

Organizing from the Inside Out, Second Edition: The Foolproof System For Organizing Your Home, Your Office and Your Life

$9.94

By Julie Morgenstern

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The Home Office Handbook: Rules of Thumb for Organizing Your Time, Information, and Workspace

$16.16

By Lorie Marrero

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Domino: The Book of Decorating: A Room-by-Room Guide to Creating a Home That Makes You Happy

$18.08

Simon & Schuster

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The Life-Changing Magic of Tidying Up: The Japanese Art of Decluttering and Organizing

$10.19

By Marie Kondo

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Day Runner Undated Terramo Refillable Planner, 8.5 x 5.5 Inches (401-0214)

$27.48

Day Runner

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Three setups tailored to your budget:

The Essentials:

• A place to write and store your life management things. 
• Day runner with addresses, calendar, and notes or smartphone with same features. 
• Backup for your smartphone if you have one. ( ? cloud) 
• Writing implements, pens, pencils, highlighters, markers 
• Spiral notebook to centralize and keep notes ( instead of sticky notes everywhere)
• A few sticky notes even so 
• Filing box and files 

Nice to have: 

• Laptop with internet access 
• Software 
• Spreadsheet like Excel for Windows or Numbers for Apple  
• Word processor like Word for Window
• Photo storage and processing software. 
• Bulletin or marker board for ideas, art and planning 
• Bookshelves 
• File cabinet 
• A decent camera

Deluxe: 

• Printer/fax/scanner
• Nice speakers
• Nice headphones 
• IOS device like ipad 
• an extra monitor 
• A good camera

Ideas for your home office schedule

 

At the beginning of your day...

• Leave your home office alone. Get your health related things done first, like working out, bathing, and eating a healthy breakfast. 

 In your home office work time… 

• Check your email twice per day. Don’t do it reflexively. 
• Leave social media closed until tasks are finished. 
• Add every new contact into your address book AS THEY COME IN.
• Keep a spread sheet of your budget. 
• Use accounting software like Mint, which is free, ibank, which is cheap, or Quicken, to keep your bank, loan and credit card accounts in order. 
• Set up bills to pay automatically or put reminder notices in your calendar program. 
• Store your photos digitally, and backup those and your other documents two ways, the cloud, and a cheap external hard drive. 
• Work on your projects in sessions about 45-90 minutes long. Then get up and stretch and drink some fluids. 
• Develop a system of file keeping. You may like Evernote which is free. You can organize anything into albums. In side the albums are notes where you can put text, documents, picture, sound, movies, links, or anything. 

At the end of the day

• Review your calendar and plans for the next day. 
• Chart any nutrition or fitness data that you are working with on a daily basis. Make sure the method is simple and fast. 

At the end of the week

• Review your calendar and plans for the next week. 

Home offices can be a lot of fun. They are ground zero for domestic creativity. Think recipes, projects with kids, projects for the house, tracking that workout and budgeting for that vacation. Knowledge is power and organization will put it to work. 

Tools4Wisdom Planner - Life. Simplified.

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Planners by Tools4Wisdom

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Mom's Ultimate Family Organizer: A One-Stop Planner for Busy Moms

By Amy Keroes

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Wellness Wednesday: Beyond Relaxation to Renewal

Most of us are familiar with the recommendation to relax on a regular basis. We are all familiar with the ravages of stress and the problems associated with insufficient sleep. We generally think of relaxation as the antidote. To most people this means to physically rest or sleep , and to be quiet and still. There is no doubt that some of this kind of time is good on a daily basis, especially if it is done in a mindful fashion such as in meditation.

But sometimes we need more than relaxation. We need renewal. Renewal goes beyond relaxation. It is similar to relaxation in that it is a break from the usual work routine. However, after that, the similarities end. Renewal is more planned. It may involve physical activity, such as exercise, or an outdoor adventure. It may even involve a challenge. It often involves other people, especially people who are new to you. It involves unfamiliarity, learning and even getting outside of one’s comfort zone. 

Productivity experts are extolling such “ strategic renewal” as the newest productivity tool in the success toolbox. This concept can be utilized on different time schedules: daily, weekly , monthly, quarterly. 

Daily Renewals 

• exercise 
• meditation 
• reading 
• connect with close family and friends 

Weekend Renewals: 

• connect with farther flung family and friends, socialize and entertain
• patronizing the arts 
• sports 
• spiritual observance
• volunteer
• outdoors 
• reading 
• exercise 
• creative pursuits outside of work 

Monthly or Quarterly renewal: 

• adventures 
• conferences 
• different kinds of work projects 
• travel

See to the basics first: adequate sleep, regular exercise, and good nutrition. Ensure some relaxation on a daily basis. But go beyond all this and try to start thinking about renewal as well. 

What the Most Successful People Do on the Weekend: A Short Guide to Making the Most of Your Days Off (A Penguin Special from Portfo lio)

By Laura Vanderkam

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To learn more :

See our sections on Sleep Yoga and Meditation 

LIfehacker

Huffington Post 

New York Times 

Stanford University Cafe Science

What Most Successful People Do On the Weekend, by Lauren Vanderkam 

Structure Sunday: The Structure of Your Media Consumption

Omigosh I must be so easily amused. I have flown planes, climbed mountains, and swam with sea lions, but today, I got the biggest rush from organizing cookbooks in their new shelves. I just adore their beautiful pages full of recipes like magic spells waiting to be cast. A beautiful recipe transforms you as you make it, and your family as they see what has been prepared for them. 

I am reading a riveting book right now. It is called Seveneves. I found myself reading it at a stop light. Not good. I chose it based on the genre, sci fi, but also because of the reviews on Amazon, and finally because of what I was able to learn about the author, for instance that he double majored in Physics and Geography. I learned all this on the internet.

Seveneves: A Novel

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By Neal Stephenson

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 I did all that research because I wasn't going to devote several hours of my life to something less than totally worthwhile. You see, I get absorbed in my books, fiction and non-fiction alike. They transport me. I don't hear things around me when I am reading. If something is going to affect me like this, it better be quality and it better have redeeming value. I want to finish the book a better person. 

I feel the same way about film, but there are far fewer good films than there are good books. Still, the depths of Netflix and Apple TV are unplumbed, and I look forward to it whenever I have time to dive deep. I don't know if my approach is correct; I save film like candy or ice cream, and cannot watch it until I eat all my vegetables, i.e. work, housekeeping, bills, and exercise. 

Music, however, is like water to me. I have to have it all the time. Patients know it plays all day long in all our clinic rooms, and we try to make it wonderful. We try to make people enjoy their time with us. I want to turn more people on to fine music.

I believe music puts you in touch with yourself. If a song makes you melancholy and wistful, it is touching something within. You may gain from this awareness, and perhaps be able to give the issue more attention. Likewise, if you hear something that makes you feel like dancing, it's because that dance is already in you; the song merely helps release it. 

When I was growing up, all this was so expensive. Books were bought in bookstores, and records required expensive equipment to play well. Regarding films, well, you had to make arrangements to go to a theater, providing you were old enough. But nowadays, the widespread availability of all this media is astonishing. I believe it is world changing. 

I have a great personal interest in the lives of those with low income and high aspirations. I respect these people. I want to understand how they can realize their dreams. I think one big piece of this puzzle is widespread high quality media: books, film, and music. These are not just      niceties in life. They nurture the soul and enlighten the mind. 

Media like music, film and books are not about living vicariously or being passive. They are about learning and getting inspired to go out and live life to the fullest. That is why I think everyone should have access to all the good stuff all of the time. 

So I wondered how much it would cost to have unlimited access to all this media all the time. Here is a rough calculation: 

• Amazon Prime costs $99 per year. You get access to 41,000 movies and TV episodes, and 350,000 Kindle books. Of course the Kindle app is free for any platform. Just be aware these are like Netflix titles, not necessarily the hot new releases, but still very good. 
• Netflix has a somewhat different set of movies, all for $7.99 per month,  all released several months after they hit theaters. 
• Apple Music, is $9.99 per person  or $14.99 per family per month. For this you may stream the entire Apple music catalog. Or, you could get Pandora with ads, for free, or without ads, for $4.99 per month. 
• Let's say you actually want to buy a few physical books because, like me, you think cookbooks should be physical, or because you want to have a paper book to pass around, then you must budget a few dollars for that. Let's say you, like me, buy used books on Amazon, and you decide your budget is one book per month, at $5 per book used, plus $3.99 per book shipping.

If you have a smartphone and internet already, then we can ignore those costs. If we say, for purposes of argument that you "want it all" , the tally is as follows: 

Amazon Prime = $99/yr

Netflix annually = $95.88/yr

Apple Music for one = $119.88/yr

Paper books one year, as detailed above = $107.88

Total = $422.64 per year or $35.22 per month. Aren't numbers interesting ? 

Let's say you are really on a tight budget. You pick only Amazon Prime for Kindle books and streaming video, together with free Pandora for music. Your cost is only $99/year or $8.32 per month. Honestly, that is two lattes. What an amazing time we live in. 

The Smitten Kitchen Cookbook

$21.78

By Deb Perelman

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What Katie Ate: Recipes and Other Bits and Pieces

$28.44

By Katie Quinn Davies

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