Counterclockwise – by Dr. Ellen Langer
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We’ve written previously about Dr. Langer’s famous “Counterclockwise” study that saw reversals in biological markers of aging after a one-week intervention that consisted only of a (albeit rather intensive) mental reframe with regard to their age.
This book, as you might expect from the title, refers to that experiment a lot—but it doesn’t stop there. While the Counterclockwise experiment remains Dr. Langer’s most well-known, it’s not her most recent, and she draws from a wealth of research (her own and that of her colleagues in the field) to show the extent and limit of psychosomatic effect on aging.
Note:
- psychosomatic effect does not mean: “imagining it”
- psychosomatic effect means: “your brain regulates almost everything else in your body, directly or indirectly, including your autonomic functions, which includes immune function, tissue replacement, and more”
And as for when it comes to aging? Aging, like cancer, is in large part a problem of immune dysfunction; in both cases cells (be they senescent or cancerous, respectively) are not being killed when they are supposed to be, and in both cases, better instructions will improve the matter.
Many larger-scale markers of aging, such as mobility, are a case of the body only being able to do what the tissues allow, and the tissues are being constantly rebuilt (for better or for worse) according to autonomically-implemented specifications, and cells’ ability to carry out those orders.
Beyond the cellular physiology, this book discusses (a lot) the brain-down mechanisms by which the most powerful organ in our body can tell the rest of the body how old to be.
Dr. Langer also discusses the matter of “priming”, that is to say, how external factors prime us to believe certain things about our age and, with it, our health. These things can include popular media, conversations with friends and family, and healthcare providers’ framing of certain issues.
For example, a person just under a certain age and a person just over a certain age could both go to the doctor with the same complaint—a pain in a certain joint, let’s say. The doctor may refer the slightly younger patient for an x-ray because “let’s see what’s going on here”, and prescribe the slightly older patient some painkillers because “this is perfectly normal at your age”. One resultant problem is obvious: a difference in the standard of care. But the other resultant problem is less obvious: the older patient has now been primed to believe, by a confident authority figure, “it is natural for my body to be in a state of decline now, and this is what to expect”.
Thus, Dr. Langer prescribes mindfulness, not in the mindfulness meditation sense (though sure, do that too), but rather in the sense of consciously interacting with the world and making our own decisions about our own health and, yes, our own age. Because after all, our body neither knows nor cares how many times it has flown around the sun, and merely responds to physiological stimuli—including those we can influence with psychological reframing.
The book is not, per se, a “how-to” guide, rather it is an explanatory treatise, but it contains more than enough information to put it into practice, and indeed, she does also provide some exercises to do along the way.
The style is… Vivacious, without being especially upbeat. Dr. Langer is enthused about her work, yes, but she’s also angry at how many people are having their health sabotaged on the daily, and calls for a more health-first approach (as opposed to illness-first).
Bottom line: this is the book on our brain’s power over aging, so if that topic interests you, this book absolutely belongs on your bookshelf. Well, in your hands, and then on the bookshelf, and then back in your hands from time to time.
Click here to check out Counterclockwise, and age counterclockwise as her experimental subjects did!
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What is a virtual emergency department? And when should you ‘visit’ one?
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For many Australians the emergency department (ED) is the physical and emblematic front door to accessing urgent health-care services.
But health-care services are evolving rapidly to meet the population’s changing needs. In recent years, we’ve seen growing use of telephone, video, and online health services, including the national healthdirect helpline, 13YARN (a crisis support service for First Nations people), state-funded lines like 13 HEALTH, and bulk-billed telehealth services, which have helped millions of Australians to access health care on demand and from home.
The ED is similarly expanding into new telehealth models to improve access to emergency medical care. Virtual EDs allow people to access the expertise of a hospital ED through their phone, computer or tablet.
All Australian states and the Northern Territory have some form of virtual ED at least in development, although not all of these services are available to the general public at this stage.
So what is a virtual ED, and when is it appropriate to consider using one?
Shutterstock/Nils Versemann How does a virtual ED work?
A virtual ED is set up to mirror the way you would enter the physical ED front door. First you provide some basic information to administration staff, then you are triaged by a nurse (this means they categorise the level of urgency of your case), then you see the ED doctor. Generally, this all takes place in a single video call.
In some instances, virtual ED clinicians may consult with other specialists such as neurologists, cardiologists or trauma experts to make clinical decisions.
A virtual ED is not suitable for managing medical emergencies which would require immediate resuscitation, or potentially serious chest pains, difficulty breathing or severe injuries.
A virtual ED is best suited to conditions that require immediate attention but are not life-threatening. These could include wounds, sprains, respiratory illnesses, allergic reactions, rashes, bites, pain, infections, minor burns, children with fevers, gastroenteritis, vertigo, high blood pressure, and many more.
People with these sorts of conditions and concerns may not be able to get in to see a GP straight away and may feel they need emergency advice, care or treatment.
When attending the ED, they can be subject to long wait times and delayed specialist attention because more serious cases are naturally prioritised. Attending a virtual ED may mean they’re seen by a doctor more quickly, and can begin any relevant treatment sooner.
From the perspective of the health-care system, virtual EDs are about redirecting unnecessary presentations away from physical EDs, helping them be ready to respond to emergencies. The virtual ED will not hesitate in directing callers to come into the physical ED if staff believe it is an emergency.
The doctor in the virtual ED may also direct the patient to a GP or other health professional, for example if their condition can’t be assessed visually, or if they need physical treatment.
The results so far
Virtual EDs have developed significantly over the past three years, predominantly driven by the COVID pandemic. We are now starting to slowly see assessments of these services.
A recent evaluation my colleagues and I did of Queensland’s Metro North Virtual ED found roughly 30% of calls were directed to the physical ED. This suggests 70% of the time, cases could be managed effectively by the virtual ED.
Preliminary data from a Victorian virtual ED indicates it curbed a similar rate of avoidable ED presentations – 72% of patients were successfully managed by the virtual ED alone. A study on the cost-effectiveness of another Victorian virtual ED suggested it has the potential to generate savings in health-care costs if it prevents physical ED visits.
Only 1.2% of people assessed in Queensland’s Metro North Virtual ED required unexpected hospital admission within 48 hours of being “discharged” from the virtual ED. None of these cases were life-threatening. This indicates the virtual ED is very safe.
The service experienced an average growth rate of 65% each month over a two-year evaluation period, highlighting increasing demand and confidence in the service. Surveys suggested clinicians also view the virtual ED positively.
The right advice could tell you whether you need to visit hospital in person or not. 1st footage/Shutterstock What now?
We need further research into patient outcomes and satisfaction, as well as the demographics of those using virtual EDs, and how these measures compare to the physical ED across different triage categories.
There are also challenges associated with virtual EDs, including around technology (connection and skills among patients and health professionals), training (for health professionals) and the importance of maintaining security and privacy.
Nonetheless, these services have the potential to reduce congestion in physical EDs, and offer greater convenience for patients.
Eligibility differs between different programs, so if you want to use a virtual ED, you may need to check you are eligible in your jurisdiction. Most virtual EDs can be accessed online, and some have direct phone numbers.
Jaimon Kelly, Senior Research Fellow in Telehealth delivered health services, The University of Queensland
This article is republished from The Conversation under a Creative Commons license. Read the original article.
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The Mental Health Dangers Of Oversharing
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Oversharers can be fun and amiable; the life of the party. In and of itself, this something that can be considered “pro-social” and thus healthy.
But the problem for one’s mental health in the long-run lies in the “over” part of oversharing. Sometimes, if not checking in with the other person’s comfort, oversharing can be “trauma-dumping”, and push people away. Alternatively, if the oversharing exposes an unmet need, it can make the other person feel obliged to try to help in some fashion, which in the long run may also cause awkwardness and withdrawal.
Some potential problems are purely internal, such the feelings of shame or anxiety that can come afterwards; “I should not have been so vulnerable”, “What if my friends think badly of me now?”, etc.
And of course, sometimes those fears are then validated by reality, if “friends” indeed take advantage of that, or withdraw their friendship. That’s a minority occurrence, but it doesn’t make it any less of a crushing thing if it happens.
Sometimes people overshare because of being a bad judge of what’s a socially-approved appropriate amount of sharing; sometimes people overshare out of a need for closeness, and perhaps the hope of hearing what one needed to hear previously.
The dangers of oversharing don’t mean that we should never speak about our experiences and feelings; in fact sometimes, it is the most healthy thing to do—be it because it’s something that needs communicating to a specific person, or because it’s something we just need to “get off our chest”.
In short, it can be good to share! It can also be good to do so judiciously, by conscious decision and not in response to a spur-of-the-moment impulse, and remember to prioritize our own safety.
Below, Alain de Botton explains more of the psychodynamics of this:
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10almonds tip, not included in the video: unsure whether your urge to share is too impulsive or not? Write a letter/email, and wait until the next day to decide whether or not to send it.
Want to read more?
Check out:
Breathe; Don’t Vent (At Least In The Moment)
Take care!
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100 Hikes of a Lifetime – by Kate Siber
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This is published by National Geographic, so you can imagine the quality of the photos throughout.
Inside, and after a general introduction and guide to gear and packing appropriately, it’s divided into continents, with a diverse array of “trips of a lifetime” for anyone who enjoys hiking.
It’s not a narrative book, rather, it is a guide, a little in the style of “Lonely Planet”, with many “know before you go” tips, information about the best time to go, difficult level, alternative routes if you want to get most of the enjoyment while having an easier time of it (or, conversely, if you want to see some extra sights along the way), and what to expect at all points.
Where the book really excels is in balancing inspiration with information. There are some books that make you imagine being in a place, but you’ll never actually go there. There are other books that are technical manuals but not very encouraging. This one does both; it provides the motivation and the “yes, you really can, here’s how” information that, between them, can actually get you packing and on your way.
Bottom line: if you yearn for breathtaking views and time in the great outdoors, but aren’t sure where to start, this will give you an incredible menu to choose from, and give you the tools to go about doing it.
Click here to check out 100 Hikes Of A Lifetime, and live it!
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Languishing – by Prof. Corey Keyes
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We’ve written before about depression and “flourishing” but what about when one isn’t exactly flourishing, but is not necessarily in the depths of depression either? That’s what this book is about.
Prof. Keyes offers, from his extensive research, hope for those who do not check enough of the boxes to be considered depressed, but who are also definitely more in the lane of “surviving” than “thriving”.
Specifically, he outlines five key ways to make the step from languishing to flourishing, based not on motivational rhetoric, but actual data-based science:
- Learn (creating your personal story of self-growth)
- Connect (building relationships, on the individual level and especially on the community level)
- Transcend (developing psychological resilience to the unexpected)
- Help (others! This is about finding your purpose, and then actively living it)
- Play (this is a necessary “recharge” element that many people miss, especially as we get older)
With regard to finding one’s purpose being given the one-word summary of “help”, this is a callback to our tribal origins, and how we thrive and flourish best and feel happiest when we have a role to fulfil and provide value to those around us)
Bottom line: if you’re not at the point of struggling to get out of bed each day, but you’re also not exactly leaping out of bed with a smile, this book can help get you from one place to the other.
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Small Changes For A Healthier Life
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It’s Q&A Day at 10almonds!
Have a question or a request? You can always hit “reply” to any of our emails, or use the feedback widget at the bottom!
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 am interested in what I can substitute for ham in bean soup?
Well, that depends on what the ham was like! You can certainly buy ready-made vegan lardons (i.e. small bacon/ham bits, often in tiny cubes or similar) in any reasonably-sized supermarket. Being processed, they’re not amazing for the health, but are still an improvement on pork.
Alternatively, you can make your own seitan! Again, seitan is really not a health food, but again, it’s still relatively less bad than pork (unless you are allergic to gluten, in which case, definitely skip this one).
Alternatively alternatively, in a soup that already contains beans (so the protein element is already covered), you could just skip the ham as an added ingredient, and instead bring the extra flavor by means of a little salt, a little yeast extract (if you don’t like yeast extract, don’t worry, it won’t taste like it if you just use a teaspoon in a big pot, or half a teaspoon in a smaller pot), and a little smoked paprika. If you want to go healthier, you can swap out the salt for MSG, which enhances flavor in a similar fashion while containing less sodium.
Wondering about the health aspects of MSG? Check out our main feature on this, from last month:
I thoroughly enjoy your daily delivery. I’d love to see one for teens too!
That’s great to hear! The average age of our subscribers is generally rather older, but it’s good to know there’s an interest in topics for younger people. We’ll bear that in mind, and see what we can do to cater to that without alienating our older readers!
That said: it’s never too soon to be learning about stuff that affects us when we’re older—there are lifestyle factors at 20 that affect Alzheimer’s risk at 60, for example (e.g. drinking—excessive drinking at 20* is correlated to higher Alzheimer’s risk at 60).
*This one may be less of an issue for our US readers, since the US doesn’t have nearly as much of a culture of drinking under 21 as some places. Compare for example with general European practices of drinking moderately from the mid-teens, or the (happily, diminishing—but historically notable) British practice of drinking heavily from the mid-teens.
How much turmeric should I take each day?
Dr. Michael Greger’s research (of “Dr. Greger’s Daily Dozen” and “How Not To Die” fame) recommends getting at least ¼ tsp turmeric per day
Remember to take it with black pepper though, for a 2000% absorption bonus!
A great way to get it, if you don’t want to take capsules and don’t want to eat spicy food every day, is to throw a teaspoon of turmeric in when making a pot of (we recommend wholegrain!) rice. Turmeric is very water-soluble, so it’ll be transferred into the rice easily during cooking. It’ll make the rice a nice golden yellow color, and/but won’t noticeably change the taste.
Again remember to throw in some black pepper, and if you really want to boost the nutritional content,some chia seeds are a great addition too (they’ll get cooked with the rice and so it won’t be like eating seeds later, but the nutrients will be there in the rice dish).
You can do the same with par-boiled potatoes or other root vegetables, but because cooking those has water to be thrown away at the end (unlike rice), you’ll lose some turmeric in the water.
Request: more people need to be aware of suicidal tendencies and what they can do to ward them off
That’s certainly a very important topic! We’ll cover that properly in one of our Psychology Sunday editions. In the meantime, we’ll mention a previous special that we did, that was mostly about handling depression (in oneself or a loved one), and obviously there’s a degree of crossover:
The Mental Health First-Aid That You’ll Hopefully Never Need
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How Your Brain Chooses What To Remember
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During the day, your brain is simply too busy to encode memories without interfering with normal processing. At night, however…
The filing system
The brain decides which memories to keep based on significance, using sharp brain wave ripples as an internal bookmarking system. Everyday memories fade, while important events are tagged in this manner for consolidation during sleep.
How does it do this? It starts in the hippocampus, which records experiences during wakefulness and replays them repeatedly at high speed during sleep, preparing them for transfer to the neocortex.
How do we know? Uniform Manifold Approximation & Projection (UMAP) for dimension reduction is a tool that condenses 400-dimensional neural activity data into 3D for visualization. Mice navigating a maze showed hippocampal activity encoding location and learning progression; it also showed neural patterns reflecting maze layout and task mastery.
What this means in practical terms: you need to get good sleep if you don’t want to lose your memories!
For more on all of this, enjoy:
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Want to learn more?
You might also like to read:
How To Boost Your Memory Immediately (Without Supplements)
Take care!
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