How Does One Test Acupuncture Against Placebo Anyway?
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Pinpointing The Usefulness Of Acupuncture
We asked you for your opinions on acupuncture, and got the above-depicted, below-described, set of answers:
- A little under half of all respondents voted for “It’s well-backed by modern science, per neurology, cardiology, immunology, etc”
- Slightly fewer respondents voted for “We don’t understand how it works, but it works!”
- A little under a fifth of respondents voted for “It may have some limited clinical applications beyond placebo”
- One (1) respondent voted for for “It’s placebo at best”
When we did a main feature about homeopathy, a couple of subscribers wrote to say that they were confused as to what homeopathy was, so this time, we’ll start with a quick definition first.
First, what is acupuncture? For the convenience of a quick definition so that we can move on to the science, let’s borrow from Wikipedia:
❝Acupuncture is a form of alternative medicine and a component of traditional Chinese medicine in which thin needles are inserted into the body.
Acupuncture is a pseudoscience; the theories and practices of TCM are not based on scientific knowledge, and it has been characterized as quackery.❞
Now, that’s not a promising start, but we will not be deterred! We will instead examine the science itself, rather than relying on tertiary sources like Wikipedia.
It’s worth noting before we move on, however, that there is vigorous debate behind the scenes of that article. The gist of the argument is:
- On one side: “Acupuncture is not pseudoscience/quackery! This has long been disproved and there are peer-reviewed research papers on the subject.”
- On the other: “Yes, but only in disreputable quack journals created specifically for that purpose”
The latter counterclaim is a) potentially a “no true Scotsman” rhetorical ploy b) potentially true regardless
Some counterclaims exhibit specific sinophobia, per “if the source is Chinese, don’t believe it”. That’s not helpful either.
Well, the waters sure are muddy. Where to begin? Let’s start with a relatively easy one:
It may have some clinical applications beyond placebo: True or False?
True! Admittedly, “may” is doing some of the heavy lifting here, but we’ll take what we can get to get us going.
One of the least controversial uses of acupuncture is to alleviate chronic pain. Dr. Vickers et al, in a study published under the auspices of JAMA (a very respectable journal, and based in the US, not China), found:
❝Acupuncture is effective for the treatment of chronic pain and is therefore a reasonable referral option. Significant differences between true and sham acupuncture indicate that acupuncture is more than a placebo.
However, these differences are relatively modest, suggesting that factors in addition to the specific effects of needling are important contributors to the therapeutic effects of acupuncture❞
Source: Acupuncture for Chronic Pain: Individual Patient Data Meta-analysis
If you’re feeling sharp today, you may be wondering how the differences are described as “significant” and “relatively modest” in the same text. That’s because these words have different meanings in academic literature:
- Significant = p<0.05, where p is the probability of the achieved results occurring randomly
- Modest = the differences between the test group and the control group were small
In other words, “significant modest differences” means “the sample sizes were large, and the test group reliably got slightly better results than placebo”
We don’t understand how it works, but it works: True or False
Broadly False. When it works, we generally have an idea how.
Placebo is, of course, the main explanation. And even in examples such as the above, how is placebo acupuncture given?
By inserting acupuncture needles off-target rather than in accord with established meridians and points (the lines and dots that, per Traditional Chinese Medicine, indicate the flow of qi, our body’s vital energy, and welling-points of such).
So, if a patient feels that needles are being inserted randomly, they may no longer have the same confidence that they aren’t in the control group receiving placebo, which could explain the “modest” difference, without there being anything “to” acupuncture beyond placebo. After all, placebo works less well if you believe you are only receiving placebo!
Indeed, a (Korean, for the record) group of researchers wrote about this—and how this confounding factor cuts both ways:
❝Given the current research evidence that sham acupuncture can exert not only the originally expected non-specific effects but also sham acupuncture-specific effects, it would be misleading to simply regard sham acupuncture as the same as placebo.
Therefore, researchers should be cautious when using the term sham acupuncture in clinical investigations.❞
Source: Sham Acupuncture Is Not Just a Placebo
It’s well-backed by modern science, per neurology, cardiology, immunology, etc: True or False?
False, for the most part.
While yes, the meridians and points of acupuncture charts broadly correspond to nerves and vasculature, there is no evidence that inserting needles into those points does anything for one’s qi, itself a concept that has not made it into Western science—as a unified concept, anyway…
Note that our bodies are indeed full of energy. Electrical energy in our nerves, chemical energy in every living cell, kinetic energy in all our moving parts. Even, to stretch the point a bit, gravitational potential energy based on our mass.
All of these things could broadly be described as qi, if we so wish. Indeed, the ki in the Japanese martial art of aikido is the latter kinds; kinetic energy and gravitational potential energy based on our mass. Same goes, therefore for the ki in kiatsu, a kind of Japanese massage, while the ki in reiki, a Japanese spiritual healing practice, is rather more mystical.
The qi in Chinese qigong is mostly about oxygen, thus indirectly chemical energy, and the electrical energy of the nerves that are receiving oxygenated blood at higher or lower levels.
On the other hand, the efficacy of the use of acupuncture for various kinds of pain is well-enough evidenced. Indeed, even the UK’s famously thrifty NHS (that certainly would not spend money on something it did not find to work) offers it as a complementary therapy for some kinds of pain:
❝Western medical acupuncture (dry needling) is the use of acupuncture following a medical diagnosis. It involves stimulating sensory nerves under the skin and in the muscles.
This results in the body producing natural substances, such as pain-relieving endorphins. It’s likely that these naturally released substances are responsible for the beneficial effects experienced with acupuncture.❞
Source: NHS | Acupuncture
Meanwhile, the NIH’s National Cancer Institute recommends it… But not as a cancer treatment.
Rather, they recommend it as a complementary therapy for pain management, and also against nausea, for which there is also evidence that it can help.
Frustratingly, while they mention that there is lots of evidence for this, they don’t actually link the studies they’re citing, or give enough information to find them. Instead, they say things like “seven randomized clinical trials found that…” and provide links that look reassuring until one finds, upon clicking on them, that it’s just a link to the definition of “randomized clinical trial”:
Source: NIH | Nactional Cancer Institute | Acupuncture (PDQ®)–Patient Version
However, doing our own searches finds many studies (mostly in specialized, potentially biased, journals such as the Journal of Acupuncture and Meridian Studies) finding significant modest outperformance of [what passes for] placebo.
Sometimes, the existence of papers with promising titles, and statements of how acupuncture might work for things other than relief of pain and nausea, hides the fact that the papers themselves do not, in fact, contain any evidence to support the hypothesis. Here’s an example:
❝The underlying mechanisms behind the benefits of acupuncture may be linked with the regulation of the hypothalamic-pituitary-gonadal (adrenal) axis and activation of the Wnt/β-catenin and OPG/RANKL/RANK signaling pathways.
In summary, strong evidence may still come from prospective and well-designed clinical trials to shed light on the potential role of acupuncture in preserving bone loss❞
Source: Acupuncture for Osteoporosis: a Review of Its Clinical and Preclinical Studies
So, here they offered a very sciencey hypothesis, and to support that hypothesis, “strong evidence may still come”.
“We must keep faith” is not usually considered evidence worthy of inclusion in a paper!
PS: the above link is just to the abstract, because the “Full Text” link offered in that abstract leads to a completely unrelated article about HIV/AIDS-related cryptococcosis, in a completely different journal, nothing to do with acupuncture or osteoporosis).
Again, this is not the kind of professionalism we expect from peer-reviewed academic journals.
Bottom line:
Acupuncture reliably performs slightly better than sham acupuncture for the management of pain, and may also help against nausea.
Beyond placebo and the stimulation of endorphin release, there is no consistently reliable evidence that is has any other discernible medical effect by any mechanism known to Western science—though there are plenty of hypotheses.
That said, absence of evidence is not evidence of absence, and the logistical difficulty of testing acupuncture against placebo makes for slow research. Maybe one day we’ll know more.
For now:
- If you find it helps you: great! Enjoy
- If you think it might help you: try it! By a licensed professional with a good reputation, please.
- If you are not inclined to having needles put in you unnecessarily: skip it! Extant science suggests that at worst, you’ll be missing out on slight relief of pain/nausea.
Take care!
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The Growing Inequality in Life Expectancy Among Americans
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The life expectancy among Native Americans in the western United States has dropped below 64 years, close to life expectancies in the Democratic Republic of the Congo and Haiti. For many Asian Americans, it’s around 84 — on par with life expectancies in Japan and Switzerland.
Americans’ health has long been unequal, but a new study shows that the disparity between the life expectancies of different populations has nearly doubled since 2000. “This is like comparing very different countries,” said Tom Bollyky, director of the global health program at the Council on Foreign Relations and an author of the study.
Called “Ten Americas,” the analysis published late last year in The Lancet found that “one’s life expectancy varies dramatically depending on where one lives, the economic conditions in that location, and one’s racial and ethnic identity.” The worsening health of specific populations is a key reason the country’s overall life expectancy — at 75 years for men and 80 for women — is the shortest among wealthy nations.
To deliver on pledges from the new Trump administration to make America healthy again, policymakers will need to fix problems undermining life expectancy across all populations.
“As long as we have these really severe disparities, we’re going to have this very low life expectancy,” said Kathleen Harris, a sociologist at the University of North Carolina. “It should not be that way for a country as rich as the U.S.”
Since 2000, the average life expectancy of many American Indians and Alaska Natives has been steadily shrinking. The same has been true since 2014 for Black people in low-income counties in the southeastern U.S.
“Some groups in the United States are facing a health crisis,” Bollyky said, “and we need to respond to that because it’s worsening.”
Heart disease, car fatalities, diabetes, covid-19, and other common causes of death are directly to blame. But research shows that the conditions of people’s lives, their behaviors, and their environments heavily influence why some populations are at higher risk than others.
Native Americans in the West — defined in the “Ten Americas” study as more than a dozen states excluding California, Washington, and Oregon — were among the poorest in the analysis, living in counties where a person’s annual income averages below about $20,000. Economists have shown that people with low incomes generally live shorter lives.
Studies have also linked the stress of poverty, trauma, and discrimination to detrimental coping behaviors like smoking and substance use disorders. And reservations often lack grocery stores and clean, piped water, which makes it hard to buy and cook healthy food.
About 1 in 5 Native Americans in the Southwest don’t have health insurance, according to a KFF report. Although the Indian Health Service provides coverage, the report says the program is weak due to chronic underfunding. This means people may delay or skip treatments for chronic illnesses. Postponed medical care contributed to the outsize toll of covid among Native Americans: About 1 of every 188 Navajo people died of the disease at the peak of the pandemic.
“The combination of limited access to health care and higher health risks has been devastating,” Bollyky said.
At the other end of the spectrum, the study’s category of Asian Americans maintained the longest life expectancies since 2000. As of 2021, it was 84 years.
Education may partly underlie the reasons certain groups live longer. “People with more education are more likely to seek out and adhere to health advice,” said Ali Mokdad, an epidemiologist at the Institute for Health Metrics and Evaluation at the University of Washington, and an author of the paper. Education also offers more opportunities for full-time jobs with health benefits. “Money allows you to take steps to take care of yourself,” Mokdad said.
The group with the highest incomes in most years of the analysis was predominantly composed of white people, followed by the mainly Asian group. The latter, however, maintained the highest rates of college graduation, by far. About half finished college, compared with fewer than a third of other populations.
The study suggests that education partly accounts for differences among white people living in low-income counties, where the individual income averaged less than $32,363. Since 2000, white people in low-income counties in southeastern states — defined as those in Appalachia and the Lower Mississippi Valley — had far lower life expectancies than those in upper midwestern states including Montana, Nebraska, and Iowa. (The authors provide details on how the groups were defined and delineated in their report.)
Opioid use and HIV rates didn’t account for the disparity between these white, low-income groups, Bollyky said. But since 2010, more than 90% of white people in the northern group were high school graduates, compared with around 80% in the southeastern U.S.
The education effect didn’t hold true for Latino groups compared with others. Latinos saw lower rates of high school graduation than white people but lived longer on average. This long-standing trend recently changed among Latinos in the Southwest because of covid. Hispanic or Latino and Black people were nearly twice as likely to die from the disease.
On average, Black people in the U.S. have long experienced worse health than other races and ethnicities in the United States, except for Native Americans. But this analysis reveals a steady improvement in Black people’s life expectancy from 2000 to about 2012. During this period, the gap between Black and white life expectancies shrank.
This is true for all three groups of Black people in the analysis: Those in low-income counties in southeastern states like Mississippi, Louisiana, and Alabama; those in highly segregated and metropolitan counties, such as Queens, New York, and Wayne, Michigan, where many neighborhoods are almost entirely Black or entirely white; and Black people everywhere else.
Better drugs to treat high blood pressure and HIV help account for the improvements for many Americans between 2000 to 2010. And Black people, in particular, saw steep rises in high school graduation and gains in college education in that period.
However, progress stagnated for Black populations by 2016. Disparities in wealth grew. By 2021, Asian and many white Americans had the highest incomes in the study, living in counties with per capita incomes around $50,000. All three groups of Black people in the analysis remained below $30,000.
A wealth gap between Black and white people has historical roots, stretching back to the days of slavery, Jim Crow laws, and policies that prevented Black people from owning property in neighborhoods that are better served by public schools and other services. For Native Americans, a historical wealth gap can be traced to a near annihilation of the population and mass displacement in the 19th and 20th centuries.
Inequality has continued to rise for several reasons, such as a widening pay gap between predominantly white corporate leaders and low-wage workers, who are disproportionately people of color. And reporting from KFF Health News shows that decisions not to expand Medicaid have jeopardized the health of hundreds of thousands of people living in poverty.
Researchers have studied the potential health benefits of reparation payments to address historical injustices that led to racial wealth gaps. One new study estimates that such payments could reduce premature death among Black Americans by 29%.
Less controversial are interventions tailored to communities. Obesity often begins in childhood, for example, so policymakers could invest in after-school programs that give children a place to socialize, be active, and eat healthy food, Harris said. Such programs would need to be free for children whose parents can’t afford them and provide transportation.
But without policy changes that boost low wages, decrease medical costs, put safe housing and strong public education within reach, and ensure access to reproductive health care including abortion, Harris said, the country’s overall life expectancy may grow worse.
“If the federal government is really interested in America’s health,” she said, “they could grade states on their health metrics and give them incentives to improve.”
KFF Health News is a national newsroom that produces in-depth journalism about health issues and is one of the core operating programs at KFF—an independent source of health policy research, polling, and journalism. Learn more about KFF.
Subscribe to KFF Health News’ free Morning Briefing.
This article first appeared on KFF Health News and is republished here under a Creative Commons license.
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Dr. Dean Ornish’s Program For Reversing Heart Disease – by Dr. Dean Ornish
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We’ve previously reviewed Dr. Ornish’s “Undo It!” which is about reversing many kinds of chronic diseases (not all, alas, but quite a few) by undercutting their common etiologies, such as inflammation, insulin resistance, and so forth.
This book is entirely consistent with that one, but the focus here is (as the title says) specifically on reversing heart disease.
Of course, it does not require you to already have heart disease—if you do, well, getting onto this is better sooner than later. If you don’t, and are “merely” in a risk zone, or even just want to be proactive about your heart health, then this book will stand you in good stead.
The book covers all the lifestyle things you’d expect it to (especially diet, but also exercise, and not just “quit smoking” but also how, things like that), and possibly some things you might not expect (chapters on more psychological factors that have a big impact on heart health).
There are recipes (157 pages of them; they are plant-based and good) and there is a 21-day meal plan to get you going.
The style is a little dated (written in the 90s), but the content doesn’t suffer for it, having been updated over the years in any case.
Bottom line: if you want a holistic approach to taking care of your heart that’s not extreme and/but is very effective, then well, you’ve found it.
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What’s The Difference Between Minoxidil For Men vs For Women?
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It’s Q&A Day at 10almonds!
Have a question or a request? We love to hear from you!
In cases where we’ve already covered something, we might link to what we wrote before, but will always be happy to revisit any of our topics again in the future too—there’s always more to say!
As ever: if the question/request can be answered briefly, we’ll do it here in our Q&A Thursday edition. If not, we’ll make a main feature of it shortly afterwards!
So, no question/request too big or small 😎
❝I’m confused, does minoxidil work the same for women and for men? The label on the minoxidil I was looking at says it is only for men❞
Great question!
Simple answer: yes, it works (or not, as the case may be for some people, more on that later) exactly the same for men and women.
You may be wondering: what, then, is the difference between minoxidil for men and minoxidil for women?
And the answer is: the packaging/marketing. That’s literally it.
It’s like with razors, there are razors marketed to men and razors marketed to women, and both come with advertising/marketing promising to be enhance your masculine/feminine appearance (as applicable), but at the end of the day, in both cases it’s just sharp steel blades that cut through hairs as closely as possible to the skin. The sharp steel neither knows nor cares about your gender.
When it comes to minoxidil, in both cases the active ingredient is indeed minoxidil, usually at 2% or 5% strength (though other options exist, and all these get marketed to men and women), and in both cases it works in the same ways, by:
- dilating the blood vessels that feed the hair follicles and thus allowing them to perform better
- kicking the follicles into anagen (growth phase) and keeping them there for longer
Note: this is why we mentioned that it won’t work for all people, and it’s because (regardless of sex/gender), it cannot do those things for your hair follicles if you do not have hair follicles to treat. In the case of someone who has had hair loss for a long time, sometimes there will not be enough living follicles remaining to do anything useful with. As a general rule of thumb, provided you have some hairs there (even if they are little downy baby hairs), they can usually be coaxed back to full life.
In both cases, it’s for treating “pattern hair loss”, the pattern being “male pattern” or “female pattern”, respectively, but in both cases it’s androgenetic alopecia, and in both cases it’s caused by the corresponding genetic factors and hormone-mediated gene expression (the physical pattern therefore is usually a little different for men and women; that’s because of the “hormone-mediated gene expression”, or to put it into lay terms “the hormones tell the body which genes to turn on and off”.
Fun fact: it’s the same resultant phenotype as for PCOS, though usually occurring at different stages in life; PCOS earlier and AGA later—sometimes people (including people with both ovaries and hair) can get one without the other, though, as there may be other considerations going on besides the genetic and hormonal.
Limitation: if the hair loss is for reasons other than androgenetic alopecia, it’s unlikely to work. In fact, it is usually flat-out stated that it won’t work, but since one of the common listed side effects of minoxidil is “hair growth in other places”, it seems fair to say that the scalp is not really the only place it can cause hair to grow.
Want to know more?
You can read about the science of various pharmaceutical options (including minoxidil) here:
Hair-Loss Remedies, By Science ← this also goes more into the pros and cons of minoxidil than we have today, so if you’re considering minoxidil, you might want to read this first, to make the most informed decision.
And if you want to be a bit less pharmaceutical about it:
Take care!
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CBD Oil’s Many Benefits
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CBD Oil: What Does The Science Say?
First, a quick legal (and practical) note:
CBD and THC are both derived from the hemp or cannabis plant, but only the latter has euphoriant psychoactive effects, i.e., will get you high. We’re writing here about CBD derived from hemp and not containing THC (thus, will not get you high).
Laws and regulations differ far too much from place to place for us to try to advise here, so please check your own local laws and regulations. And also, while you’re at it, with your doctor and/or pharmacist.
As ever, this newsletter is for purposes of education and enjoyment, and does not constitute any kind of legal (or medical) advice.
With that in mind, onwards to today’s research review…
CBD for Pain Relief
CBD has been popularly touted as a pain relief panacea, and there are a lot of pop-science articles out there “debunking” this, but…
The science seems to back it up. We couldn’t find studies refuting the claim (of CBD as a viable pain relief option). We did, however, find research showing it was good against:
Note that that latter (itself a research review, not a single study, hence covering a lot of bases) describes it matter-of-factly, with no caveats or weasel-words, as:
“CBD, a non-euphoriant, anti-inflammatory analgesic with CB1 receptor antagonist and endocannabinoid modulating effects”
As a quick note: all of the above is about the topical use of CBD oil, not any kind of ingestion
CBD for Anxiety/Depression
There’s a well-cited study with what honestly we think was a bit of a small sample size, but compelling results within that:
A study published in the Brazilian Journal of Psychiatry tested the anxiety levels of 57 men in a simulated public speaking test.
Compared to placebo…
- Those who received 300mg of CBD experienced significantly reduced anxiety during the test.
- Those who received either 150mg or 600mg of CBD experienced more anxiety during the test than the 300mg group
- This means there’s a sweet spot to the dosage
There was also a clinical study that found CBD to have anti-depressant effects.
The methodology was a lot more robust, but the subjects were mice. We can’t have everything in one study, apparently! There is probably a paucity of human volunteers to have their brain slices looked at after tests, though.
Anyway, what makes this study interesting is that it measured quite an assortment of biological markers in the brain, and found that the CBD had a similar physiological effect to the antidepressant imipramine.
CBD for Treating Opioid Addiction
There are a lot of studies for this, both animal and human, but we’d like to put the spotlight on a human study (with the participation of heroin users) that found:
❝Within one week, CBD significantly reduced cravings, anxiety, resting heart rate, and salivary cortisol levels. No serious adverse effects were found.❞
This is groundbreaking because the very thing about heroin is that it’s so addictive and the body rapidly needs more and more of it. You might think “duh”, but most people don’t realize this part:
Heroin is attractive because it offers (and delivers) an immediate guaranteed “downer”, instant relaxation… with none of the bad side effects of, for example, alcohol. No nausea, no hangover, nothing.
The problem is that the body gets tolerant to heroin very quickly, meaning your doses need to get bigger and more frequent to have the same effect.
Before you know it, what seemed like an affordable “self-medication for a stressful life” is very much out of control! Many doctors have personally found this out the hard way.
So, it’s ruinous:
- first to your financial health, as the costs rapidly spiral
- then to your physical health, as you either suffer from withdrawal or eventually overdose
Consequently, heroin is an incredibly easy drug to get hooked onto, and incredibly difficult to get back off.
So CBD offering relief is really a game-changer.
And more…
CBD has been well-studied and found to be effective for a lot of things, more than we could hope to cover in a single edition here.
Some further reading that may interest you includes:
- CBD against Diabetes in mice / in vitro / in humans
- CBD against neurological diseases (in general, in humans)
- CBD against arthritis in mice / in humans
- CBD specifically against the pain of rheumatoid arthritis / of osteoarthritis
Let us know if there’s any of these (or other) conditions you’d like us to look more into the CBD-related research for, because there’s a lot! You can always hit reply to any of our emails, or use the feedback widget at the bottom
Read (and shop, if you want and it’s permitted where you are):
10 Best CBD Oils of 2023, According to the Forbes Health Advisory Board
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The Metabolism Reset Diet – by Alan Christianson
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The liver is an incredible organ that does a very important job, but what’s not generally talked about is how we can help it… Beyond the obvious “try to not poison it too much with alcohol, tobacco, etc”. But what can we do that’s actually positive for it?
That’s what Alan Christianson offers in this book.
Now, usually when someone speaks of a “four week cleanse” as this book advertises on its front cover, it’s a lot of bunk. The liver cleanses itself, and the liver and kidneys between them (along with some other organs and processes) detoxify your body for you. No amount of celery juice will do that. However, this book does better than that:
What it’s about, is not really about trying to do a “detox” at all, so much as supporting your liver function by:
- Giving your liver what it needs to regenerate (mostly: protein)
- Not over-taxing your liver while it does so
The liver is a self-regenerating organ (the mythological story of Prometheus aside, here in real life it can regenerate up to 80% of itself, given the opportunity), so whatever the current state of your liver, it’s probably not too late to fix it.
Maybe you’ve been drinking a little too much, or maybe you’ve been taking some meds that have hobbled it a bit (some medications strain the liver rather), or maybe your diet hasn’t been great. Christianson invites you to draw a line under that, and move forwards:
The book gives an overview of the science involved, and explains about the liver’s role in metabolism (hence the promised weight loss benefits) and our dietary habits’ impact on liver function. This is about what we eat, and also about when we eat it, and how and when our body metabolizes that.
Christianson also provides meal ideas and recipes. If we’re honest (and we always are), the science/principles part of the book are worth a lot more than the meal-plan part of the book, though.
In short: a great book for understanding how the liver works and how we can help it do its job effectively.
Click here to check out “The Metabolism Reset Diet” on Amazon today!
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Easing Election Stress & Anxiety
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At the time of writing, the US is about to have a presidential election. Most of our readers are Americans, and in any case, what the US does tends to affect most of the world, so certainly many readers in other countries will be experiencing stress and anxiety about it too.
We’re a health science publication, not a political outlet, so we’ll refrain from commenting on any candidates or campaign policies, and we’d also like to be clear we are not urging you to any particular action politically—our focus today is simply about mental health.
First, CBT what can be CBT’d
Cognitive Behavioral Therapy (CBT) is far from a panacea, but it’s often a very good starting point. And when it seems the stakes are high, it’s easy to fall into such cognitive distortions as “crystal ball” and “catastrophization”, that is to say, predicting the future and feeling the impact of that (probably undesired version of the) future, and also feeling like it will be the end of the world.
Recognizing these processes and how they work, is the first step to managing our feelings about them.
Learn more: The Art of Being Unflappable (Tricks For Daily Life)
Next, DBT what can be DBT’d
A lot of CBT hinges on the assumption that our assumptions are incorrect. For example, that our friend does not secretly despise us, that our spouse is not about to leave us, that the symptoms we are experiencing are not cancer, and in this case, that the election outcome will not go badly, and if it does, the consequences will be less severe than imagined.
But… What if our concerns are, in fact, fully justified? Here’s where Dialectic Behavior Therapy (DBT) comes in, and with it, what therapists call “radical acceptance”.
In other words, we accept up front the idea that maybe it’s going to be terrible and that will truly suck, and then either:
- there’s nothing we can reasonably do about it now (so worrying just means you’ll suffer twice), or
- there is something we can reasonably do about it now (so we can go do that thing)
After doing the thing (if appropriate), defer processing the outcome of the election until after the election. There is no point in wasting energy to worry before then. In a broadly two-party system where things are usually close between those two largest parties, there’s something close to a 50% chance of an outcome that’s, at least, not the worst you feared.
Learn more: CBT, DBT, & Radical Acceptance
Lastly, empower yourself with Behavioral Activation (BA)
Whatever the outcome of any given election, the world will keep turning, and the individual battles about any given law or policy or such will continue to go on. That’s not to say an election won’t change things—it will—but there will always still be stuff to do on a grassroots level to make the world a better place, no matter what politician has been elected.
Being involved in doing things on a community level will not only help banish any feelings of despair (and if you got the election outcome you wanted, it’ll help you feel involved), but also, it can give you a sense of control, and can even form a part of the “ikigai” that is often talked about as one of the pillars of healthy longevity.
Learn more: What’s Your Ikigai?
And if you like videos, then enjoy this one (narrated by the ever soothing-voiced Alain de Botton):
Watch now: How To Escape From A Despairing Mood (4:46) ← it also has a text version if you prefer that
Take care!
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