Outsmart Your Pain – by Dr. Christiane Wolf
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Dr. Wolf is a physician turned mindfulness teacher. As such, and holding an MD as well as a PhD in psychosomatic medicine, she knows her stuff.
A lot of what she teaches is mindfulness-based stress reduction (MBSR), but this book is much more specific than that. It doesn’t promise you won’t continue to experience pain—in all likelihood you will—but it does change the relationship with pain, and this greatly lessens the suffering and misery that comes with it.
For many, the most distressing thing about pain is not the sensation itself, but how crippling it can be—getting in the way of life, preventing enjoyment of other things, and making every day a constant ongoing exhausting battle… And every night, a “how much rest am I actually going to be able to get, and in what condition will I wake up, and how will I get through tomorrow?” stress-fest.
Dr. Wolf helps the reader to navigate through all these challenges and more; minimize the stress, maximize the moments of respite, and keep pain’s interference with life to a minimum. Each chapter addresses different psychological aspects of chronic pain management, and each comes with specific mindfulness meditations to explore the new ideas learned.
The style is personal and profound, while coming from a place of deep professional understanding as well as compassion.
Bottom line: if you’ve been looking for a life-ring to help you reclaim your life, this one could be it; we wholeheartedly recommend it.
Click here to check out Outsmart Your Pain, and recover the beauty and joy of life!
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Homeopathy: Evidence So Tiny That It’s Not there?
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Homeopathy: Evidence So Tiny That It’s Not There?
Yesterday, we asked you your opinions on homeopathy. The sample size of responses was a little lower than we usually get, but of those who did reply, there was a clear trend:
- A lot of enthusiasm for “Homeopathy works on valid principles and is effective”
- Near equal support for “It may help some people as a complementary therapy”
- Very few people voted for “Science doesn’t know how it works, but it works”; this is probably because people who considered voting for this, voted for the more flexible “It may help some people as a complementary therapy” instead.
- Very few people considered it a dangerous scam and a pseudoscience.
So, what does the science say?
Well, let us start our investigation by checking out the position of the UK’s National Health Service, an organization with a strong focus on providing the least expensive treatments that are effective.
Since homeopathy is very inexpensive to arrange, they will surely want to put it atop their list of treatments, right?
❝Homeopathy is a “treatment” based on the use of highly diluted substances, which practitioners claim can cause the body to heal itself.
There’s been extensive investigation of the effectiveness of homeopathy. There’s no good-quality evidence that homeopathy is effective as a treatment for any health condition.❞
The NHS actually has a lot more to say about that, and you can read their full statement here.
But that’s just one institution. Here’s what Australia’s National Health and Medical Research Council had to say:
❝There was no reliable evidence from research in humans that homeopathy was effective for treating the range of health conditions considered: no good-quality, well-designed studies with enough participants for a meaningful result reported either that homeopathy caused greater health improvements than placebo, or caused health improvements equal to those of another treatment❞
You can read their full statement here.
The American FDA, meanwhile, have a stronger statement:
❝Homeopathic drug products are made from a wide range of substances, including ingredients derived from plants, healthy or diseased animal or human sources, minerals and chemicals, including known poisons. These products have the potential to cause significant and even permanent harm if they are poorly manufactured, since that could lead to contaminated products or products that have potentially toxic ingredients at higher levels than are labeled and/or safe, or if they are marketed as substitute treatments for serious or life-threatening diseases and conditions, or to vulnerable populations.❞
You can read their full statement here.
Homeopathy is a dangerous scam and a pseudoscience: True or False?
False and True, respectively, mostly.
That may be a confusing answer, so let’s elaborate:
- Is it dangerous? Mostly not; it’s mostly just water. However, two possibilities for harm exist:
- Careless preparation could result in a harmful ingredient still being present in the water—and because of the “like cures like” principle, many of the ingredients used in homeopathy are harmful, ranging from heavy metals to plant-based neurotoxins. However, the process of “ultra-dilution” usually removes these so thoroughly that they are absent or otherwise scientifically undetectable.
- Placebo treatment has its place, but could result in “real” treatment going undelivered. This can cause harm if the “real” treatment was critically needed, especially if it was needed on a short timescale.
- Is it a scam? Probably mostly not; to be a scam requires malintent. Most practitioners probably believe in what they are practising.
- Is it a pseudoscience? With the exception that placebo effect has been highly studied and is a very valid complementary therapy… Yes, aside from that it is a pseudoscience. There is no scientific evidence to support homeopathy’s “like cures like” principle, and there is no scientific evidence to support homeopathy’s “water memory” idea. On the contrary, they go against the commonly understood physics of our world.
It may help some people as a complementary therapy: True or False?
True! Not only is placebo effect very well-studied, but best of all, it can still work as a placebo even if you know that you’re taking a placebo… Provided you also believe that!
Science doesn’t know how it works, but it works: True or False?
False, simply. At best, it performs as a placebo.
Placebo is most effective when it’s a remedy against subjective symptoms, like pain.
However, psychosomatic effect (the effect that our brain has on the rest of our body, to which it is very well-connected) can mean that placebo can also help against objective symptoms, like inflammation.
After all, our body, directed primarily by the brain, can “decide” what immunological defenses to deploy or hold back, for example. This is why placebo can help with conditions as diverse as arthritis (an inflammatory condition) or diabetes (an autoimmune condition, and/or a metabolic condition, depending on type).
Here’s how homeopathy measures up, for those conditions:
(the short answer is “no better than placebo”)
Homeopathy works on valid principles and is effective: True or False?
False, except insofar as placebo is a valid principle and can be effective.
The stated principles of homeopathy—”like cures like” and “water memory”—have no scientific basis.
We’d love to show the science for this, but we cannot prove a negative.
However, the ideas were conceived in 1796, and are tantamount to alchemy. A good scientific attitude means being open-minded to new ideas and testing them. In homeopathy’s case, this has been done, extensively, and more than 200 years of testing later, homeopathy has consistently performed equal to placebo.
In summary…
- If you’re enjoying homeopathic treatment and that’s working for you, great, keep at it.
- If you’re open-minded to enjoying a placebo treatment that may benefit you, be careful, but don’t let us stop you.
- If your condition is serious, please do not delay seeking evidence-based medical treatment.
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How Are You, Really?
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How Are You, Really? The Free NHS Health Test
We took this surprisingly incisive 10-minute test from the UK’s famous National Health Service—the test is part of the “Better Health” programme, a free-to-all (yes, even those from/in other countries) initiative aimed at keeping people healthy enough to have less need of medical attention.
As one person who took the test wrote:
❝I didn’t expect that a government initiative would have me talking about how I need to keep myself going to be there for the people I love, let alone that a rapid-pace multiple-choice test would elicit these responses and give personalized replies in turn, but here we are❞
It goes beyond covering the usual bases, in that it also looks at what’s most important to you, and why, and what might keep you from doing the things you want/need to do for your health, AND how those obstacles can be overcome.
Pretty impressive for a 10-minute test!
Is Your Health Above Average Already? Take the Free 10-minute NHS test now!
How old are you, in your heart?
Poetic answers notwithstanding (this writer sometimes feels so old, and yet also much younger than she is), there’s a biological answer here, too.
Again free for the use of all*, here’s a heart age calculator.
*It is suitable for you if you are aged 30–95, and do not have a known complicating cardiovascular disease.
It will ask you your (UK) postcode; just leave that field blank if you’re not in the UK; it’ll be fine.
How Old Are You, In Your Heart? Take the Free 10-minute NHS test now!
(Neither test requires logging into anything, and they do not ask for your email address. The tests are right there on the page, and they give the answers right there on the page, immediately)
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The Brain-Skin Doctor
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Of Brains And Breakouts
This is Dr. Claudia Aguirre. She’s a molecular neuroscientist, and today she’s going to be educating us about skin.
What? Why?
When we say “neuroscience”, we generally think of the brain. And indeed, that’s a very important part of it.
We might think about eyes, which are basically an extension of the brain.
We don’t usually think about skin, which (just like our eyes) is constantly feeding us a lot of information about our surroundings, via a little under three million nerve endings. Guess where the other ends of those nerves lead!
There’s a constant two-way communication going on between our brain and our skin.
What does she want us to know?
Psychodermatology
The brain and the skin talk to each other, and maladies of one can impact the other:
- Directly, e.g. stress prompting skin breakouts (actually this is a several-step process physiologically, but for the sake of brevity we’ll call this direct)
- Indirectly, e.g. nervous disorders that result in people scratching or picking at their skin, which prompts a whole vicious cycle of one thing making the other worse
Read more: Psychodermatology: The Brain-Skin Connection
To address both kinds of problems, clearly something beyond moisturizer is needed!
Mindfulness (meditation and beyond)
Mindfulness is a well-evidenced healthful practice for many reasons, and Dr. Aguirra argues the case for it being good for our skin too.
As she points out,
❝Cultural stress and anxiety can trigger or aggravate many skin conditions—from acne to eczema to herpes, psoriasis, and rosacea.
Conversely, a disfiguring skin condition can trigger stress, anxiety, depression, and even suicide.
Chronic, generalized anxiety can create chronic inflammation and exacerbate inflammatory skin conditions, such as those I mentioned previously.
Chronic stress can result in chronic anxiety, hypervigilance, poor sleep, and a whole cascade of effects resulting in a constant breakdown of tissues and organs, including the skin.❞
So, she recommends mindfulness-based stress reduction (MBSR), for the above reasons, along with others!
Read more: Mind Matters
How to do it: No-Frills, Evidence-Based Mindfulness
And as for “and beyond?”
Do you remember in the beginning of the pandemic, when people were briefly much more consciously trying to avoid touching their faces so much? That, too, is mindfulness. It may have been a stressed and anxious mindfulness for many*, but mindfulness nonetheless.
*which is why “mindfulness-based stress reduction” is not a redundant tautology repeated more than once unnecessarily, one time after another 😉
So: do try to keep aware of what you are doing to your skin, and so far as is reasonably practicable, only do the things that are good for it!
The skin as an endocrine organ
Nerves are not the only messengers in the body; hormones do a lot of our body’s internal communication too. And not just the ones everyone remembers are hormones (e.g. estrogen, testosterone, although yes, they do both have a big impact on skin too), but also many more, including some made in the skin itself!
Dr. Aguirra gives us a rundown of common conditions, the hormones behind them, and what we can do if we don’t want them:
Read more: Rethinking The Skin As An Endocrine Organ
Take-away advice:
For healthy skin, we need to do more than just hydrate, get good sleep, have good nutrition, and get a little sun (but not too much).
- We should also practice mindfulness-based stress reduction, and seek help for more serious mental health issues.
- We should also remember the part our hormones play in our skin, and not just the obvious ones.
Did you know that vitamin D is also a hormone, by the way? It’s not the only hormone at play in your skin by a long way, but it is an important one:
Society for Endocrinology | Vitamin D
Want to know more?
You might like this interview with Dr. Aguirre:
The Brain in Our Skin: An Interview with Dr. Claudia Aguirre
Take care!
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Synergistic Brain-Training
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Let The Games Begin (But It Matters What Kind)
Exercise is good for brain health; we’ve written about this before, for example:
How To Reduce Your Alzheimer’s Risk ← there are many advices here, but exercise, especially cardiovascular exercise in this case, is an important item on the list!
Today it’s Psychology Sunday though, and we’re going to talk about looking after brain health by means of brain-training, via games.
“Brain-training” gets a lot of hype and flak:
- Hype: do sudoku every day and soon you will have an IQ of 200 and still have a sharp wit at the age of 120
- Flak: brain-training is usually training only one kind of cognitive function, with limited transferability to the rest of life
The reality is somewhere between the two. Brain training really does improve not just outwardly measurable cognitive function, but also internally measurable improvements visible on brain scans, for example:
- Cognitive training modified age-related brain changes in older adults with subjective memory decline
- Functional brain changes associated with cognitive training in healthy older adults: A preliminary ALE meta-analysis
But what about the transferability?
Let us play
This is where game-based brain-training comes in. And, the more complex the game, the better the benefits, because there is more chance of applicability to life, e.g:
- Sudoku: very limited applicability
- Crosswords: language faculties
- Chess: spatial reasoning, critical path analysis, planning, memory, focus (also unlike the previous two, chess tends to be social for most people, and also involve a lot of reading, if one is keen)
- Computer games: wildly varied depending on the game. While an arcade-style “shoot-em-up” may do little for the brain, there is a lot of potential for a lot of much more relevant brain-training in other kinds of games: it could be planning, problem-solving, social dynamics, economics, things that mirror the day-to-day challenges of running a household, even, or a business.
- It’s not that the skills are useful, by the way. Playing “Stardew Valley” will not qualify you to run a real farm, nor will playing “Civilization” qualify you to run a country. But the brain functions used and trained? Those are important.
It becomes easily explicable, then, why these two research reviews with very similar titles got very different results:
- A Game a Day Keeps Cognitive Decline Away? A Systematic Review and Meta-Analysis of Commercially-Available Brain Training Programs in Healthy and Cognitively Impaired Older Adults
- Game-based brain training for improving cognitive function in community-dwelling older adults: A systematic review and meta-regression
The first review found that game-based brain-training had negligible actual use. The “games” they looked at? BrainGymmer, BrainHQ, CogMed, CogniFit, Dakim, Lumosity, and MyBrainTrainer. In other words, made-for-purpose brain-trainers, not actual computer games per se.
The second reviewfound that game-based training was very beneficial. The games they looked at? They didn’t name them, but based on the descriptions, they were actual multiplayer online turn-based computer games, not made-for-purpose brain-trainers.
To summarize the above in few words: multiplayer online turn-based computer games outperform made-for-purpose brain-trainers for cognitive improvement.
Bringing synergy
However, before you order that expensive gaming-chair for marathon gaming sessions (research suggests a tail-off in usefulness after about an hour of continuous gaming per session, by the way), be aware that cognitive training and (physical) exercise training combined, performed close in time to each other or simultaneously, perform better than the sum of either alone:
See also:
❝Simultaneous training was the most efficacious approach for cognition, followed by sequential combinations and cognitive training alone, and significantly better than physical exercise.
Our findings suggest that simultaneously and sequentially combined interventions are efficacious for promoting cognitive alongside physical health in older adults, and therefore should be preferred over implementation of single-domain training❞
~ Dr. Hanna Malmberg Gavelin et al.
Take care!
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Ayurveda’s Contributions To Science
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Ayurveda’s Contributions To Science (Without Being Itself Rooted in Scientific Method)
Yesterday, we asked you for your opinions on ayurveda, and got the above-depicted, below-described, set of responses. Of those who responded…
- A little over 41% said “I don’t know what ayurveda is without looking it up”
- A little over 37% said “It is a fine branch of health science with millennia of evidence”
- A little over 16% said “It gets some things right, but not by actual science”
- A little over 4% said “It is a potentially dangerous pseudoscience”
So, what does the science say?
Ayurveda is scientific: True or False?
False, simply. Let’s just rip the band-aid off in this case. That doesn’t mean it’s necessarily without merit, though!
Let’s put it this way:
- If you drink coffee to feel more awake because scientific method has discerned that caffeine has vasoconstrictive and adenosine-blocking effects while also promoting dopaminergic activity, then your consumption of coffee is evidence-based and scientific. Great!
- If you drink coffee to feel more awake because somebody told you that that somebody told them that it energizes you by balancing the elements fire (the heat of the coffee), air (the little bubbles on top), earth (the coffee grinds), water (the water), and ether (steam), then that isneither evidence-based nor scientific, but it will still work exactly the same.
Ayurveda is a little like that. It’s an ancient traditional Indian medicine, based on a combination of anecdotal evidence and supposition.
- The anecdotal evidence from ayurveda has often resulted in herbal remedies that, in modern scientific trials, have been found to have merit.
- Ayurvedic meditative practices also have a large overlap with modern mindfulness practices, and have also been found to have merit
- Ayurveda also promotes the practice of yoga, which is indeed a very healthful activity
- The supposition from ayurveda is based largely in those five elements we mentioned above, as well as a “balancing of humors” comparable to medieval European medicine, and from a scientific perspective, is simply a hypothesis with no evidence to support it.
Note: while ayurveda is commonly described as a science by its practitioners in the modern age, it did not originally claim to be scientific, but rather, wisdom handed down directly by the god Dhanvantari.
Ayurveda gets some things right: True or False?
True! Indeed, we covered some before in 10almonds; you may remember:
Bacopa Monnieri: A Well-Evidenced Cognitive Enhancer
(Bacopa monnieri is also known by its name in ayurveda, brahmi)
There are many other herbs that have made their way from ayurveda into modern science, but the above is a stand-out example. Others include:
- Ashwagandha: The Root of All Even-Mindedness?
- Boswellia serrata (Frankincense) Against Pain and Depression/Anxiety
Yoga and meditation are also great, and not only that, but great by science, for example:
- NCCIH | Yoga for Health: Clinical Guidelines, Scientific Literature, Info for Patients
- The Neuroscience of Mindfulness: How Mindfulness Alters the Brain and Facilitates Emotion Regulation
Ayurveda is a potentially dangerous pseudoscience: True or False?
Also True! We covered why it’s a pseudoscience above, but that doesn’t make it potentially dangerous, per se (you’ll remember our coffee example).
What does, however, make it potentially dangerous (dose-dependent) is its use of heavy metals such as lead, mercury, and arsenic:
Heavy Metal Content of Ayurvedic Herbal Medicine Products
Some final thoughts…
Want to learn more about the sometimes beneficial, sometimes uneasy relationship between ayurveda and modern science?
A lot of scholarly articles trying to bridge (or further separate) the two were very biased one way or the other.
Instead, here’s one that’s reasonably optimistic with regard to ayurveda’s potential for good, while being realistic about how it currently stands:
Development of Ayurveda—Tradition to trend
Take care!
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Are You Flourishing? (There’s a Scale)
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What does it mean, to flourish? And how can you do it more?
In 2009, psychologists Diener et al developed the “Flourishing Scale”, or as it was more prosaically called originally, “Subjective Wellness Scale”. The name was changed later, as it was noted that it went beyond what was typically considered mere “wellness”.
This scale was so useful, that colleagues scrambled to see if they could improve on it, such as with PERMA (2012), which looked at:
- Positive emotion
- Engagement
- positive Relationships
- Meaning
- Accomplishment/Achievement
While popular (despite the tenuous acronym, it is a very good list of things to foster in your life), this was studied and measured scientifically and found to not be an improvement on the Flourishing Scale / SWS, so we’re going to stick to the original version for now.
We couldn’t find an interactive online quiz for the scale though (apart from this NY Times one, which is paywalled for NYT subscribers, so enjoy if you’re a NYT subscriber!), so here’s the source material, still hosted on the website of the (now deceased, as of a couple of years ago) author:
Flourishing Scale (FS) ← it’s an eight-question, ranked choice scale
How did you score? And…
What are the keys to flourishing more?
According to Jeffrey Davis M.A., of Tracking Wonder, there are five key attributes that we must develop and/or maintain:
The ability to direct and re-direct your attention
This isn’t just a task-related thing.This is about your mind itself. For example, the ability to recognize what your emotions are telling you, thank them for the message, and then set them aside. Or the ability to cut through negative thought spirals! How often have you worried about future events that didn’t transpire, or twisted yourself in knots over a past event that you can’t change?
Action: check out our previous article “The Off-Button For Your Brain” ← this is a technique for switching off racing thoughts, and it’s really good
Want more? We also did this:
The tendency to shape your time with intention and for impact
Time is an incredibly precious asset. How you use it is a very personal choice. You don’t have to maximize productivity (though you can if you want), but for example there’s a difference between:
- Deciding to spend an hour watching a TV show you really enjoy
- Wondering what’s on TV, browsing aimlessly, watching listlessly, just a distraction
In the former case, you are enjoying your time. Literally: you are experiencing joy during your time.
In the latter case, to borrow from Jim Steinman, “you were only killing time and it’ll kill you right back”!
Action: do a time audit for a week, and see where your time really goes, rather than where you expect or hope for it to go. Use this information to plan your next week more intentionally. Repeat as and when it seems like it might be useful!
The practice of constant improvement
Fun fact: you are good enough already. And you can also improve. You don’t have to, but improving in the areas that are meaningful to you can really add up over time. This could be becoming excellent at something for which already have a passion… It could also be brushing up something that you feel might be holding you back.
Action: do a quick SWOT* self-assessment. Then plan your next step from there!
*Strengths, Weaknesses, Opportunities, Threats. What are yours?
The ability to communicate and listen to others
A lot of this is about feedback. Giving and receiving feedback are often amongst the hardest things we do in the category of communication… Especially if the feedback is negative. How to decide what to disregard as baseless criticism, and what to take on board (and try not to take it personally), or the other way around, how to present negative feedback in a way that won’t trigger defensiveness.
Action: check out our previous article “Save Time With Better Communication” for some tips that really make relationships (of any kind) so much easier.
The commitment to positive experiences
Many things in life are not fun. Often, we know in advance that they will not be fun. The key here is the ability to make the most of a bad situation, and seek out better situations by your actions. Not like a lost person in a desert seeks water, but like a chess player who employs a general strategy to make tactical advantages more likely to appear.
Action: think about something you have to do but don’t want to. How could it be made more fun? Or failing that, how could it be made at least more comfortable?
See also: Working Smarter < Working Brighter!
Want to read more?
Check out: What Is Flourishing in Positive Psychology? (+8 Tips & PDF)
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