Putting a Halt to Feeling Lost, Anxious, Stressed & Unhappy

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Starting From the Middle

Today’s video (below) dives straight into the heart of the issue, examining the victim mindset, with Dr. Gabor Maté immediately, and quite vulnerably, sharing his personal experiences conquering feelings of despair and anxiety.

As one of the comments on the video says, Dr. Maté is a “person who teaches about something because they experience it themselves”. And it shows through his approach.

With raw honesty, Dr. Maté empathizes with those grappling with inner turmoil, offering hope by emphasizing the power of healing in the present moment.

What is His Method?

Explained simply, Dr. Maté urges individuals to seek trauma-informed care and therapies that address underlying wounds; he emphasizes the pitfalls of relying solely on medication, and instead highlights the idea that triggers can be seen as opportunities for self-reflection and growth. He urges individuals to approach their triggers with compassionate curiosity rather than self-judgment.

In short, Dr Maté’s empathetic approach immediately calms the viewer, whilst providing knowledge crucial to self-improvement.

Let this video act as a reminder that we should take our mental health as seriously as our general health.

How was the video? If you’ve discovered any great videos yourself that you’d like to share with fellow 10almonds readers, then please do email them to us!

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  • AI: The Doctor That Never Tires?

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    AI: The Doctor That Never Tires?

    We asked you for your opinion on the use of Artificial Intelligence (AI) in healthcare, and got the above-depicted, below-described set of results:

    • A little over half of respondents to the poll voted for “It speeds up research, and is more methodical about diagnosis, so it’s at least a good extra tool”
    • A quarter of respondents voted for “I’m on the fence—it seems to make no more nor less mistakes than human doctors do”
    • A little under a fifth of respondents voted for “AI is less prone to fatigue/bias than human doctors, making it an essential new tech”
    • Three respondents voted for “AI is a step too far in medical technology, and we’re not ready for it”

    Writer’s note: I’m a professional writer (you’d never have guessed, right?) and, apparently, I really did write “no more nor less mistakes”, despite the correct grammar being “no more nor fewer mistakes”. Now, I know this, and in fact, people getting less/fewer wrong is a pet hate of mine. Nevertheless, I erred.

    Yet, now that I’m writing this out in my usual software, and not directly into the poll-generation software, my (AI!) grammar/style-checker is highlighting the error for me.

    Now, an AI could not do my job. ChatGPT would try, and fail miserably. But can technology help me do mine better? Absolutely!

    And still, I dismiss a lot of the AI’s suggestions, because I know my field and can make informed choices. I don’t follow it blindly, and I think that’s key.

    AI is less prone to fatigue/bias than human doctors, making it an essential new tech: True or False?

    True—with one caveat.

    First, a quick anecdote from a subscriber who selected this option in the poll:

    ❝As long as it receives the same data inputs as my doctor (ie my entire medical history), I can see it providing a much more personalised service than my human doctor who is always forgetting what I have told him. I’m also concerned that my doctor may be depressed – not an ailment that ought to affect AI! I recently asked my newly qualified doctor goddaughter whether she would prefer to be treated by a human or AI doctor. No contest, she said – she’d go with AI. Her argument was that human doctors leap to conclusions, rather than properly weighing all the evidence – meaning AI, as long as it receives the same inputs, will be much more reliable❞

    Now, an anecdote is not data, so what does the science say?

    Well… It says the same:

    ❝Of 6695 responding physicians in active practice, 6586 provided information on the areas of interest: 3574 (54.3%) reported symptoms of burnout, 2163 (32.8%) reported excessive fatigue, and 427 (6.5%) reported recent suicidal ideation, with 255 of 6563 (3.9%) reporting a poor or failing patient safety grade in their primary work area and 691 of 6586 (10.5%) reporting a major medical error in the prior 3 months. Physicians reporting errors were more likely to have symptoms of burnout (77.6% vs 51.5%; P<.001), fatigue (46.6% vs 31.2%; P<.001), and recent suicidal ideation (12.7% vs 5.8%; P<.001).❞

    See the damning report for yourself: Physician Burnout, Well-being, and Work Unit Safety Grades in Relationship to Reported Medical Errors

    AI, of course, does not suffer from burnout, fatigue, or suicidal ideation.

    So, what was the caveat?

    The caveat is about bias. Humans are biased, and that goes for medical practitioners just the same. AI’s machine learning is based on source data, and the source data comes from humans, who are biased.

    See: Bias and Discrimination in AI: A Cross-Disciplinary Perspective

    So, AI can perpetuate human biases and doesn’t have a special extra strength in this regard.

    The lack of burnout, fatigue, and suicidal ideation, however, make a big difference.

    AI speeds up research, and is more methodical about diagnosis: True or False?

    True! AI is getting more and more efficient at this, and as has been pointed out, doesn’t make errors due to fatigue, and often comes to accurate conclusions near-instantaneously. To give just one example:

    ❝Deep learning algorithms achieved better diagnostic performance than a panel of 11 pathologists participating in a simulation exercise designed to mimic routine pathology workflow; algorithm performance was comparable with an expert pathologist interpreting whole-slide images without time constraints. The area under the curve was 0.994 (best algorithm) vs 0.884 (best pathologist).❞

    Read: Diagnostic Assessment of Deep Learning Algorithms for Detection of Lymph Node Metastases in Women With Breast Cancer

    About that “getting more and more efficient at this”; it’s in the nature of machine learning that every new piece of data improves the neural net being used. So long as it is getting fed new data, which it can process at rate far exceeding humans’ abilities, it will always be constantly improving.

    AI makes no more nor less fewer mistakes than humans do: True or False?

    False! AI makes fewer, now. This study is from 2021, and it’s only improved since then:

    ❝Professionals only came to the same conclusions [as each other] approximately 75 per cent of the time. More importantly, machine learning produced fewer decision-making errors than did all the professionals❞

    See: AI can make better clinical decisions than humans: study

    All that said, we’re not quite at Star Trek levels of “AI can do a human’s job entirely” just yet:

    BMJ | Artificial intelligence versus clinicians: pros and cons

    To summarize: medical AI is a powerful tool that:

    • Makes healthcare more accessible
    • Speeds up diagnosis
    • Reduces human error

    …and yet, for now at least, still requires human oversights, checks and balances.

    Essentially: it’s not really about humans vs machines at all. It’s about humans and machines giving each other information, and catching any mistakes made by the other. That way, humans can make more informed decisions, and still keep a “hand on the wheel”.

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  • When You Know What You “Should” Do (But Knowing Isn’t The Problem)

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    When knowing what to do isn’t the problem

    Often, we know what we need to do. Sometimes, knowing isn’t the problem!

    The topic today is going to be a technique used by therapeutic service providers to help people to enact positive changes in their lives.

    While this is a necessarily dialectic practice (i.e., it involves a back-and-forth dialogue), it’s still perfectly possible to do it alone, and that’s what we’ll be focussing on in this main feature.

    What is Motivational Interviewing?

    ❝Motivational interviewing (MI) is a technique that has been specifically developed to help motivate ambivalent patients to change their behavior.❞

    Read in full: Motivational Interviewing: An Evidence-Based Approach for Use in Medical Practice

    It’s mostly used for such things as helping people reduce or eliminate substance abuse, or manage their weight, or exercise more, things like that.

    However, it can be employed for any endeavour that requires motivation and sustained willpower to carry it through.

    Three Phases

    Motivational Interviewing traditionally has three phases:

    1. Exploring and understanding the issue at hand
    2. Guiding and deciding importance and goals
    3. Choosing and setting an action plan

    In self-practice, maybe you can already know and understand what it is that you want/need to change.

    If not, consider asking yourself such questions as:

    • What does a good day look like? What does a bad day look like?
    • If things are not good now, when were they good? What changed?
    • If everything were perfect now, what would that look like? How would you know?

    Once you have a clear idea of where you want to be, the next thing to know is: how much do you want it? And how confident are you in attaining it?

    This is a critical process:

    • Give your answers numerically on a scale from 0 to 10
    • Whatever your score, ask yourself why it’s not lower. For example, if you scored your motivation 4 and your confidence 2, what factors made your motivation not a lower number? What factors made your confidence not a lower number?
    • In the unlikely event that you gave yourself a 0, ask whether you can really afford to scrap the goal. If you can’t, find something, anything, to bring it to at least a 1.
    • After you’ve done that, then you can ask yourself the more obvious question of why your numbers aren’t higher. This will help you identify barriers to overcome.

    Now you’re ready to choose what to focus on and how to do it. Don’t bite off more than you can chew; it’s fine to start low and work up. You should revisit this regularly, just like you would if you had a counsellor helping you.

    Some things to ask yourself at this stage of the motivational self-interviewing:

    • What’s a good SMART goal to get you started?
    • What could stop you from achieving your goal?
      • How could you overcome that challenge?
      • What is your backup plan, if you have to scale back your goal for some reason?

    A conceptual example: if your goal is to stick to a whole foods Mediterranean diet, but you are attending a wedding next week, then now is the time to decide in advance 1) what personal lines-in-the-sand you will or will not draw 2) what secondary, backup plan you will make to not go too far off track.

    The same example in practice: wedding menus often offer meat/fish/vegetarian options, so you might choose the fish or vegetarian, and as for sugar and alcohol, you might limit yourself to “a small slice of wedding cake only; coffee/cheese option instead of dessert”, and “alcohol only for toasts”.

    Giving yourself the permission well in advance for small (clearly defined and boundaried!) diversions from the plan, will stop you from falling into the trap of “well, since today’s a cheat-day now…”

    Secret fourth stage

    The secret here is to keep going back and reassessing at regular intervals. Set your own calendar; you might want to start out weekly and then move to monthly when you’re more strongly on-track.

    For this reason, it’s good to keep a journal with your notes from your self-interview sessions, the scores you gave yourself, the goals and plans you set, etc.

    When conducting your regular review, be sure to examine what worked for you, and what didn’t (and why). That way, you can practice trial-and-improvement as you go.

    Want to learn more?

    We only have so much room here, but there are lots of resources out there.

    Here’s a high-quality page that:

    • explains motivational interviewing in more depth than we have room for here
    • offers a lot of free downloadable resource packs and the like

    Check it out: Motivational Interviewing Theory & Resources

    Enjoy!

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  • What Are The “Bright Lines” Of Bright Line Eating?

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    This is Dr. Susan Thompson. She’s a cognitive neuroscientist who has turned her hand to helping people to lose weight and maintain it at a lower level, using psychology to combat overeating. She is the founder of “Bright Line Eating”.

    We’ll say up front: it’s not without some controversy, and we’ll address that as we go, but we do believe the ideas are worth examining, and then we can apply them or not as befits our personal lives.

    What does she want us to know?

    Bright Line Eating’s general goal

    Dr. Thompson’s mission statement is to help people be “happy, thin, and free”.

    You will note that this presupposes thinness as desirable, and presumes it to be healthy, which frankly, it’s not for everyone. Indeed, for people over a certain age, having a BMI that’s slightly into the “overweight” category is a protective factor against mortality (which is partly a flaw of the BMI system, but is an interesting observation nonetheless):

    When BMI Doesn’t Quite Measure Up

    Nevertheless, Dr. Thompson makes the case for the three items (happy, thin, free) coming together, which means that any miserable or unhealthy thinness is not what the approach is valuing, since it is important for “thin” to be bookended by “happy” and “free”.

    What are these “bright lines”?

    Bright Line Eating comes with 4 rules:

    1. No flour (no, not even wholegrain flour; enjoy whole grains themselves yes, but flour, no)
    2. No sugar (and as a tag-along to this, no alcohol) (sugars naturally found in whole foods, e.g. the sugar in an apple if eating an apple, is ok, but other kinds are not, e.g. foods with apple juice concentrate as a sweetener; no “natural raw cane sugar” etc is not allowed either; despite the name, it certainly doesn’t grow on the plant like that)
    3. No snacking, just three meals per day(not even eating the ingredients while cooking—which also means no taste-testing while cooking)
    4. Weigh all your food (have fun in restaurants—but more seriously, the idea here is to plan each day’s 3 meals to deliver a healthy macronutrient balance and a capped calorie total).

    You may be thinking: “that sounds dismal, and not at all bright and cheerful, and certainly not happy and free”

    The name comes from the idea that these rules are lines that one does not cross. They are “bright” lines because they should be observed with a bright and cheery demeanour, for they are the rules that, Dr. Thompson says, will make you “happy, thin, and free”.

    You will note that this is completely in opposition to the expert opinion we hosted last week:

    What Flexible Dieting Really Means

    Dr. Thompson’s position on “freedom” is that Bright Line Eating is “very structured and takes a liberating stand against moderation”

    Which may sound a bit of an oxymoron—is she really saying that we are going to be made free from freedom?

    But there is some logic to it, and it’s about the freedom from having to make many food-related decisions at times when we’re likely to make bad ones:

    Where does the psychology come in?

    Dr. Thompson’s position is that willpower is a finite, expendable resource, and therefore we should use it judiciously.

    So, much like Steve Jobs famously wore the same clothes every day because he had enough decisions to make later in the day that he didn’t want unnecessary extra decisions to make… Bright Line Eating proposes that we make certain clear decisions up front about our eating, so then we don’t have to make so many decisions (and potentially the wrong decisions) later when hungry.

    You may be wondering: ”doesn’t sticking to what we decided still require willpower?”

    And… Potentially. But the key here is shutting down self-negotiation.

    Without clear lines drawn in advance, one must decide, “shall I have this cake or not?”, perhaps reflecting on the pros and cons, the context of the situation, the kind of day we’re having, how hungry we are, what else there is available to eat, what else we have eaten already, etc etc.

    In short, there are lots of opportunities to rationalize the decision to eat the cake.

    With clear lines drawn in advance, one must decide, “shall I have this cake or not?” and the answer is “no”.

    So while sticking to that pre-decided “no” still may require some willpower, it no longer comes with a slew of tempting opportunities to rationalize a “yes”.

    Which means a much greater success rate, both in adherence and outcomes. Here’s an 8-week interventional study and 2-year follow-up:

    Bright Line Eating | Research Publications

    Counterpoint: pick your own “bright lines”

    Dr. Thompson is very keen on her 4 rules that have worked for her and many people, but she recognizes that they may not be a perfect fit for everyone.

    So, it is possible to pick and choose our own “bright lines”; it is after all a dietary approach, not a religion. Here’s her response to someone who adopted the first 3 rules, but not the 4th:

    Bright Lines as Guidelines for Weight Loss

    The most important thing for Bright Line Eating, therefore, is perhaps the action of making clear decisions in advance and sticking to them, rather than seat-of-the-pantsing our diet, and with it, our health.

    Want to know more from Dr. Thompson?

    You might like her book, which we reviewed a while ago:

    Bright Line Eating – by Dr. Susan Peirce Thompson

    Enjoy!

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  • From Cucumbers To Kindles

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    You’ve Got Questions? We’ve Got Answers!

    Q: Where do I get cucumber extract?

    A: You can buy it from BulkSupplements.com (who, despite their name, start at 100g packs)

    Alternatively: you want it as a topical ointment (for skin health) rather than as a dietary supplement (for bone and joint health), you can extract it yourself! No, it’s not “just juice cucumbers”, but it’s also not too tricky.

    Click Here For A Quick How-To Guide!

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  • What I Wish People Knew About Dementia – by Dr. Wendy Mitchell

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    We hear a lot from doctors who work with dementia patients; sometimes we hear from carers too. In this case, the author spent 20 years working for the NHS, before being diagnosed with young-onset dementia, at the age of 58. Like many health industry workers who got a life-changing diagnosis, she quickly found it wasn’t fun being on the other side of things, and vowed to spend her time researching, and raising awareness about, dementia.

    Many people assume that once a person has dementia, they’re basically “gone before they’re gone”, which can rapidly become a self-fulfilling prophecy as that person finds themself isolated and—though this word isn’t usually used—objectified. Talked over, viewed (and treated) more as a problem than a person. Cared for hopefully, but again, often more as a patient than a person. If doctors struggle to find the time for the human side of things with most patients most of the time, this is only accentuated when someone needs more time and patience than average.

    Instead, Dr. Mitchell—an honorary doctorate, by the way, awarded for her research—writes about what it’s actually like to be a human with dementia. Everything from her senses, how she eats, the experience of eating in care homes, the process of boiling an egg… To relationships, how care changes them, to the challenges of living alone. And communication, confusion, criticism, the language used by professionals, or how things are misrepresented in popular media. She also talks about the shifting sense of self, and brings it all together with gritty optimism.

    The style is deeply personal, yet lucid and clear. While dementia is most strongly associated with memory loss and communication problems, this hasn’t affected her ability to write well (7 years into her diagnosis, in case you were wondering).

    Bottom line: if you’d like to read a first-person view of dementia, then this is an excellent opportunity to understand it from the view of, as the subtitle goes, someone who knows.

    Click here to check out What I Wish People Knew About Dementia, and then know those things!

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  • The Bitter Truth About Coffee (or is it?)

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    The Bitter Truth About Coffee (or is it?)

    Yesterday, we asked you for your (health-related) views on coffee. The results were clear: if we assume the responses to be representative, we’re a large group of coffee-enthusiasts!

    One subscriber who voted for “Coffee is a healthy stimulant, hydrating, and full of antioxidants” wrote:

    ❝Not so sure about how hydrating it is! Like most food and drink, moderation is key. More than 2 or 3 cups make me buzz! Just too much.❞

    And that fine point brings us to our first potential myth:

    Coffee is dehydrating: True or False?

    False. With caveats…

    Coffee, in whatever form we drink it, is wet. This may not come as a startling revelation, but it’s an important starting point. It’s mostly water. Water itself is not dehydrating.

    Caffeine, however, is a diuretic—meaning you will tend to pee more. It achieves its diuretic effect by increasing blood flow to your kidneys, which prompts them to release more water through urination.

    See: Effect of caffeine on bladder function in patients with overactive bladder symptoms

    How much caffeine is required to have a diuretic effect? About 4.5 mg/kg.

    What this means in practical terms: if you weigh 70kg (a little over 150lbs), 4.5×70 gives us 315.

    315mg is about how much caffeine might be in six shots of espresso. We say “might” because while dosage calculations are an exact science, the actual amount in your shot of espresso can vary depending on many factors, including:

    • The kind of coffee bean
    • How and when it was roasted
    • How and when it was ground
    • The water used to make the espresso
    • The pressure and temperature of the water

    …and that’s all without looking at the most obvious factor: “is the coffee decaffeinated?”

    If it doesn’t contain caffeine, it’s not diuretic. Decaffeinated coffee does usually contain tiny amounts of caffeine still, but with nearer 3mg than 300mg, it’s orders of magnitude away from having a diuretic effect.

    If it does contain caffeine, then the next question becomes: “and how much water?”

    For example, an Americano (espresso, with hot water added to make it a long drink) will be more hydrating than a ristretto (espresso, stopped halfway through pushing, meaning it is shorter and stronger than a normal espresso).

    A subscriber who voted for “Coffee messes with sleep, creates dependency, is bad for the heart and gut, and is dehydrating too” wrote:

    ❝Coffee causes tachycardia for me so staying away is best. People with colon cancer are urged to stay away from coffee completely.❞

    These are great points! It brings us to our next potential myth:

    Coffee is bad for the heart: True or False?

    False… For most people.

    Some people, like our subscriber above, have an adverse reaction to caffeine, such as tachycardia. An important reason (beyond basic decency) for anyone providing coffee to honor requests for decaff.

    For most people, caffeine is “heart neutral”. It doesn’t provide direct benefits or cause direct harm, provided it is enjoyed in moderation.

    See also: Can you overdose on caffeine?

    Some quick extra notes…

    That’s all we have time for in myth-busting, but it’s worth noting before we close that coffee has a lot of health benefits; we didn’t cover them today because they’re not contentious, but they are interesting nevertheless:

    Enjoy!

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