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:
- Exploring and understanding the issue at hand
- Guiding and deciding importance and goals
- 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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Women Rowing North – by Dr. Mary Pipher
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Ageism is rife, as is misogyny. And those can be internalized too, and compounded as they intersect.
Clinical psychologist Dr. Mary Pipher, herself 75, writes for us a guidebook of, as the subtitle goes, “navigating life’s currents and flourishing as we age”.
The book does assume, by the way, that the reader is…
- a woman, and
- getting old (if not already old)
However, the lessons the book imparts are vital for women of any age, and valuable as a matter of insight and perspective for any reader.
Dr. Pipher takes us on a tour of aging as a woman, and what parts of it we can make our own, do things our way, and take what joy we can from it.
Nor is the book given to “toxic positivity” though—it also deals with themes of hardship, frustration, and loss.
When it comes to those elements, the book is… honest, human, and raw. But also, an exhortation to hope, beauty, and a carpe diem attitude.
Bottom line: this book is highly recommendable to anyone of any age; life is precious and can be short. And be we blessed with many long years, this book serves as a guide to making each one of them count.
Click here to check out Women Rowing North—it really is worth it
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Seven and a Half Lessons About the Brain – by Dr. Lisa Feldman Barrett
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We’ve reviewed books about neurology before, and we always try to review books that bring something new/different. So, what makes this one stand out?
Dr. Lisa Feldman Barrett, one of the world’s foremost neuroscientists, starts with an overview of how our unusual brain (definitely our species’ defining characteristic) came to be, and then devotes the rest of the book to mostly practical information.
She explains, in clear terms and without undue jargon, how the brain goes about such things as making constant predictions and useful assumptions about our environment, and reports these things to us as facts—which process is usually useful, and sometimes counterproductive.
We learn about how the apparently mystical trait of empathy works, in real flesh-and-blood terms, and why some kinds of empathy are more metabolically costly than others, and what that means for us all.
Unlike many such books, this one also looks at what is going on in the case of “different minds” that operate very dissimilarly to our own, and how this neurodiversity is important for our species.
Critically, she also looks at what else makes our brains stand out, the symphony of “5 Cs” that aren’t often found to the same extent all in the same species: creativity, communication, copying, cooperation, and compression. This latter being less obvious, but perhaps the most important; Dr. Feldman Barrett explains how we use this ability to layer summaries of our memories, perceptions, and assumptions, to allow us to think in abstractions—something that powers much of what we do that separates us from other animals.
Bottom line: if you’d like to learn more about that big wet organ between your ears, what it does for you, and how it goes about doing it, then this book gives a very practical foundation from which to build.
Click here to check out Seven and a Half Lessons about the Brain, and learn more about yours!
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What are the most common symptoms of menopause? And which can hormone therapy treat?
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Despite decades of research, navigating menopause seems to have become harder – with conflicting information on the internet, in the media, and from health care providers and researchers.
Adding to the uncertainty, a recent series in the Lancet medical journal challenged some beliefs about the symptoms of menopause and which ones menopausal hormone therapy (also known as hormone replacement therapy) can realistically alleviate.
So what symptoms reliably indicate the start of perimenopause or menopause? And which symptoms can menopause hormone therapy help with? Here’s what the evidence says.
Remind me, what exactly is menopause?
Menopause, simply put, is complete loss of female fertility.
Menopause is traditionally defined as the final menstrual period of a woman (or person female at birth) who previously menstruated. Menopause is diagnosed after 12 months of no further bleeding (unless you’ve had your ovaries removed, which is surgically induced menopause).
Perimenopause starts when menstrual cycles first vary in length by seven or more days, and ends when there has been no bleeding for 12 months.
Both perimenopause and menopause are hard to identify if a person has had a hysterectomy but their ovaries remain, or if natural menstruation is suppressed by a treatment (such as hormonal contraception) or a health condition (such as an eating disorder).
What are the most common symptoms of menopause?
Our study of the highest quality menopause-care guidelines found the internationally recognised symptoms of the perimenopause and menopause are:
- hot flushes and night sweats (known as vasomotor symptoms)
- disturbed sleep
- musculoskeletal pain
- decreased sexual function or desire
- vaginal dryness and irritation
- mood disturbance (low mood, mood changes or depressive symptoms) but not clinical depression.
However, none of these symptoms are menopause-specific, meaning they could have other causes.
In our study of Australian women, 38% of pre-menopausal women, 67% of perimenopausal women and 74% of post-menopausal women aged under 55 experienced hot flushes and/or night sweats.
But the severity of these symptoms varies greatly. Only 2.8% of pre-menopausal women reported moderate to severely bothersome hot flushes and night sweats symptoms, compared with 17.1% of perimenopausal women and 28.5% of post-menopausal women aged under 55.
So bothersome hot flushes and night sweats appear a reliable indicator of perimenopause and menopause – but they’re not the only symptoms. Nor are hot flushes and night sweats a western society phenomenon, as has been suggested. Women in Asian countries are similarly affected.
You don’t need to have night sweats or hot flushes to be menopausal.
Maridav/ShutterstockDepressive symptoms and anxiety are also often linked to menopause but they’re less menopause-specific than hot flushes and night sweats, as they’re common across the entire adult life span.
The most robust guidelines do not stipulate women must have hot flushes or night sweats to be considered as having perimenopausal or post-menopausal symptoms. They acknowledge that new mood disturbances may be a primary manifestation of menopausal hormonal changes.
The extent to which menopausal hormone changes impact memory, concentration and problem solving (frequently talked about as “brain fog”) is uncertain. Some studies suggest perimenopause may impair verbal memory and resolve as women transition through menopause. But strategic thinking and planning (executive brain function) have not been shown to change.
Who might benefit from hormone therapy?
The Lancet papers suggest menopause hormone therapy alleviates hot flushes and night sweats, but the likelihood of it improving sleep, mood or “brain fog” is limited to those bothered by vasomotor symptoms (hot flushes and night sweats).
In contrast, the highest quality clinical guidelines consistently identify both vasomotor symptoms and mood disturbances associated with menopause as reasons for menopause hormone therapy. In other words, you don’t need to have hot flushes or night sweats to be prescribed menopause hormone therapy.
Often, menopause hormone therapy is prescribed alongside a topical vaginal oestrogen to treat vaginal symptoms (dryness, irritation or urinary frequency).
You don’t need to experience hot flushes and night sweats to take hormone therapy.
Monkey Business Images/ShutterstockHowever, none of these guidelines recommend menopause hormone therapy for cognitive symptoms often talked about as “brain fog”.
Despite musculoskeletal pain being the most common menopausal symptom in some populations, the effectiveness of menopause hormone therapy for this specific symptoms still needs to be studied.
Some guidelines, such as an Australian endorsed guideline, support menopause hormone therapy for the prevention of osteoporosis and fracture, but not for the prevention of any other disease.
What are the risks?
The greatest concerns about menopause hormone therapy have been about breast cancer and an increased risk of a deep vein clot which might cause a lung clot.
Oestrogen-only menopause hormone therapy is consistently considered to cause little or no change in breast cancer risk.
Oestrogen taken with a progestogen, which is required for women who have not had a hysterectomy, has been associated with a small increase in the risk of breast cancer, although any risk appears to vary according to the type of therapy used, the dose and duration of use.
Oestrogen taken orally has also been associated with an increased risk of a deep vein clot, although the risk varies according to the formulation used. This risk is avoided by using estrogen patches or gels prescribed at standard doses
What if I don’t want hormone therapy?
If you can’t or don’t want to take menopause hormone therapy, there are also effective non-hormonal prescription therapies available for troublesome hot flushes and night sweats.
In Australia, most of these options are “off-label”, although the new medication fezolinetant has just been approved in Australia for postmenopausal hot flushes and night sweats, and is expected to be available by mid-year. Fezolinetant, taken as a tablet, acts in the brain to stop the chemical neurokinin 3 triggering an inappropriate body heat response (flush and/or sweat).
Unfortunately, most over-the-counter treatments promoted for menopause are either ineffective or unproven. However, cognitive behaviour therapy and hypnosis may provide symptom relief.
The Australasian Menopause Society has useful menopause fact sheets and a find-a-doctor page. The Practitioner Toolkit for Managing Menopause is also freely available.
Susan Davis, Chair of Women’s Health, Monash University
This article is republished from The Conversation under a Creative Commons license. Read the original article.
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Hummus vs Guacamole – Which is Healthier?
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Our Verdict
When comparing hummus to guacamole, we picked the guacamole.
Why?
First up, let’s assume that the standards are comparable, for example that both have been made with simple whole foods. The hummus is mostly chickpeas with tahini and a little olive oil and some seasoning; the guacamole is mostly avocado with a little lime juice and some seasoning.
In terms of macronutrients, hummus has slightly more protein and fiber, 2x the carbohydrates (but they are healthy carbs), and usually slightly less fat (but the fats are healthy in both cases).
In terms of micronutrients, the hummus is rich in iron and B vitamins, and the guacamole is rich in potassium, magnesium, vitamins C, E, and K.
So far, it’s pretty much tied. What else is there to consider?
We picked the guacamole because some of its nutrients (especially the potassium, magnesium, and vitamin K) are more common deficiencies in most people’s diets than iron and B vitamins. So, on average, it’s probably the one with the nutrients that you need more of at any given time.
So, it was very very close, and it came down to the above as the deciding factor.
However!
- If you like one and not the other? Eat that one; it’s good.
- If you like both but feel like eating one of them in particular? Eat that one; your body is probably needing those nutrients more right now.
- If you are catering for a group of people? Serve both!
- If you are catering for just yourself and would enjoy both? Serve both! There’s nobody to stop you!
Want to read more?
You might like: Avocado Oil vs Olive Oil – Which is Healthier?
Enjoy!
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Feel-Good Productivity – by Dr. Ali Abdaal
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“Rise and grind” is not a sustainable way to live. Yet for most of us, there are things we do have to do every day that we don’t necessarily do for fun. So, how to be productive with those things, and not feel like we are constantly compromising and sacrificing our time on this earth for some intrinsically trivial but extrinsically required activity that’ll be forgotten tomorrow?
And most of us do also have dreams and ambitions (and if you don’t, then what were they before life snatched them away from you?), things to work towards. So there is “carrot” for us as well as “stick”. But how to break the cycle and get more carrot and less stick, while being more productive than before?
Dr. Abdaal frames this principally in terms of neurology first, psychology next.
That when we are bored, we simply do not have the neurochemicals required to work well anyway, so addressing that first needs to be a priority. He lays out many ways of doing this, gives lots of practical tips, and brings attention to the ways it’s easy to go wrong (and how to fix those too).
The writing style isdeceptively relaxed and casual, leading the reader smoothly into understanding of each topic before moving on.
Bottom line: if you want to get more done while feeling better about it (not a tired wreck), then this is the book for you!
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7 Invisible Eating Disorders
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It’s easy to assume that anyone with an eating disorder can be easily recognized by the resultantly atypical body composition, but it’s often not so.
Beyond the obvious
We’ll not keep them a mystery; the 7 invisible eating disorders discussed by therapist Kati Morton in this video are:
- OSFED (Other Specified Feeding or Eating Disorder): a catch-all diagnosis for those who don’t meet the criteria for more specific eating disorders but still have significant eating disorder behaviors.
- Atypical Anorexia: characterized by all the symptoms of anorexia nervosa (especially: intense fear of gaining weight, and body image distortion) except that the individual’s weight remains in a normal range.
- Atypical Bulimia: similar to bulimia nervosa, but the frequency or duration of binge-purge behaviors does not meet the usual diagnostic criteria and thus can fly under the radar.
- Atypical Binge-Eating Disorder: has episodes of consuming large amounts of food without compensatory behaviors (e.g. purging), but the episodes are less frequent and/or intense than typical binge-eating disorder.
- Purging Disorder: purging behaviors such as self-induced vomiting or laxative abuse without having binge-eating episodes (thus, this not being binging, and nothing obvious is happening outside of the bathroom).
- Night Eating Syndrome: consuming excessive amounts of food during the night while being fully aware of the nature of the eating episodes, which disrupts sleep and leads to guilt.
- Rumination Disorder: repeatedly regurgitating food, which may be rechewed, reswallowed, or spat out, without nausea or involuntary retching, often as a self-soothing mechanism.
For more on each of these, along with a case study-style example of each, enjoy:
Click Here If The Embedded Video Doesn’t Load Automatically!
Want to learn more?
You might also like to read:
Eating Disorders: More Varied (And Prevalent) Than People Think
Take care!
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