Building Psychological Resilience (Without Undue Hardship)
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What’s The Worst That Could Happen?
When we talk about the five lifestyle factors that make the biggest difference to health, stress management would be a worthy addition as number six. We haven’t focused explicitly on that for a while, so let’s get ready to start the New Year on a good footing…
You’re not going to have a stress-free 2024
What a tender world that would be! Hopefully your stressors will be small and manageable, but rest assured, things will stress you.
And that’s key: “rest assured”. Know it now, prepare for it, and build resilience.
Sounds grim, doesn’t it? It doesn’t have to be, though.
When the forecast weather is cold and wet, you’re not afraid of it when you have a warm dry house. When the heating bill comes for that warm dry house, you’re not afraid of it when you have money to pay it. If you didn’t have the money and the warm dry house, the cold wet weather could be devastating to you.
The lesson here is: we can generally handle what we’re prepared for.
Negative visualization and the PNS
This is the opposite of what a lot of “think and grow rich”-style gurus would advise. And indeed, it’s not helpful to slide into anxious worrying.
If you do find yourself spiralling, here’s a tool for getting out of that spiral:
RAIN: an intervention for dealing with difficult emotions
For now, however, we’re going to practice Radical Acceptance.
First, some biology: you may be aware that your Central Nervous System (CNS) branches into the Sympathetic Nervous System (SNS) and the Parasympathetic Nervous System (PNS).
The PNS is the part that cues our body to relax, and suppresses our fight/flight response. We’re going to activate it.
Activating the PNS is easy for most people in comfortable circumstances (e.g., you are not currently exposed to stressful stimuli). It may well be activated already, and if it’s not, a few deep breaths is usually all it takes.
If you’d like a quick and easy Mindfulness-Based Stress Reduction (MBSR) technique, here you go:
No-Frills, Evidence-Based Mindfulness
Activating the PNS is hard for most people in difficult circumstances (e.g., you either are currently exposed to stressful stimuli, or you are in one of the emotional spirals we discussed earlier).
However, we can trick our bodies and brains by—when we are safe and unstressed—practicing imagining those stressful stimuli. Taking a moment to not just imagine it experientially, but immersively. This, in CBT and DBT, is the modern equivalent to the old samurai who simply accepted, before battle, that they were already dead—and thus went into battle with zero fear of death.
A less drastic example is the zen master who had a favorite teacup, and feared it would get broken. So he would tell himself “the cup is already broken”. One day, it actually broke, and he simply smiled ruefully and said “Of course”.
How this ties together: practice the mindfulness-based stress reduction we linked above, while imagining the things that do/would stress you the most.
Since it’s just imagination, this is a little easier than when the thing is actually happening. Practicing this way means that when and if the thing actually happens (an unfortunate diagnosis, a financial reversal, whatever it may be), our CNS is already well-trained to respond to stress with a dose of PNS-induced calm.
You can also leverage hormesis, a beneficial aspect of (in this case, optional and chosen by you) acute stress:
Dr. Elissa Epel | The Stress Prescription
Psychological resilience training
This (learned!) ability to respond to stress in an adaptive fashion (without maladaptive coping strategies such as unhelpful behavioral reactivity and/or substance use) is a key part of what in psychology is called resilience:
And yes, the CBT/DBT/MBSR methods we’ve been giving you are the evidence-based gold standard.
Only the best for 10almonds subscribers! 😎
❝That was helpful, but not cheery; can we finish the year on a cheerier note?❞
We can indeed:
How To Get Your Brain On A More Positive Track (Without Toxic Positivity)
Take care!
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Adult Children of Emotionally Immature Parents – by Dr. Lindsay Gibson
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Not everyone had the best of parents, and the harm done can last well beyond childhood. This book looks at healing that.
Dr. Gibson talks about four main kinds of “difficult” parents, though of course they can overlap:
- The emotional parent, with their unpredictable outbursts
- The driven parent, with their projected perfectionism
- The passive parent, with their disinterest and unreliability
- The rejecting parent, with their unavailability and insults
For all of them, it’s common that nothing we could do was ever good enough, and that leaves a deep scar. To add to it, the unfavorable dynamic often persists in adult life, assuming everyone involved is still alive and in contact.
So, what to do about it? Dr. Gibson advocates for first getting a good understanding of what wasn’t right/normal/healthy, because it’s easy for a lot of us to normalize the only thing we’ve ever known. Then, beyond merely noting that no child deserved that lack of compassion, moving on to pick up the broken pieces one by one, and address each in turn.
The style of the book is anecdote-heavy (case studies, either anonymized or synthesized per common patterns) in a way that will probably be all-too-relatable to a lot of readers (assuming that if you buy this book, it’s for a reason), science-moderate (references peppered into the text; three pages of bibliography), and practicality-dense—that is to say, there are lots of clear usable examples, there are self-assessment questionnaires, there are worksheets for now making progress forward, and so forth.
Bottom line: if one or more of the parent types above strikes a chord with you, there’s a good chance you could benefit from this book.
Click here to check out Adult Children of Emotionally Immature Parents, and rebuild yourself!
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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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No Time to Panic – by Matt Gutman
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Matt Gutman is not a doctor or a psychologist. He’s a journalist, accustomed to asking questions and then asking more probing questions, unrelenting until he gets the answers he’s looking for.
This book is the result of what happened when he needed to overcome his own anxiety and panic attacks, and went on an incisive investigative journey.
The style is as clear and accessible as you’d expect of a journalist, and presents a very human exploration, nonetheless organized in a way that will be useful to the reader.
It’s said that “experience is a great teacher, but she sends hefty bills”. In this case as in many, it’s good to learn from someone else’s experience!
By the end of the book, you’ll have a good grounding in most approaches to dealing with anxiety and panic attacks, and an idea of efficacy/applicability, and what to expect.
Bottom line: without claiming any magic bullet, this book presents six key strategies that Gutman found to work, along with his experiences of what didn’t. Valuable reading if you want to curb your own anxiety, or want to be able to help/support someone else with theirs.
Click here to check out No Time To Panic, and find the peace you deserve!
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The Insider’s Guide To Making Hospital As Comfortable As Possible
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Nobody Likes Surgery, But Here’s How To Make It Much Less Bad
This is Dr. Chris Bonney. He’s an anesthesiologist. If you have a surgery, he wants you to go in feeling calm, and make a quick recovery afterwards, with minimal suffering in between.
Being a patient in a hospital is a bit like being a passenger in an airplane:
- Almost nobody enjoys the thing itself, but we very much want to get to the other side of the experience.
- We have limited freedoms and comforts, and small things can make a big difference between misery and tolerability.
- There are professionals present to look after us, but they are busy and have a lot of other people to tend to too.
So why is it that there are so many resources available full of “tips for travelers” and so few “tips for hospital patients”?
Especially given the relative risks of each, and likelihood, or even near-certainty of coming to at least some harm… One would think “tips for patients” would be more in demand!
Tips for surgery patients, from an insider expert
First, he advises us: empower yourself.
Empowering yourself in this context means:
- Relax—doctors really want you to feel better, quickly. They’re on your side.
- Research—knowledge is power, so research the procedure (and its risks!). Dr. Bonney, himself an anesthesiologist, particularly recommends you learn what specific anesthetic will be used (there are many, and they’re all a bit different!), and what effects (and/or after-effects) that may have.
- Reframe—you’re not just a patient; you’re a customer/client. Many people suffer from MDeity syndrome, and view doctors as authority figures, rather than what they are: service providers.
- Request—if something would make you feel better, ask for it. If it’s information, they will be not only obliged, but also enthusiastic, to give it. If it’s something else, they’ll oblige if they can, and the worst case scenario is something won’t be possible, but you won’t know if you don’t ask.
Next up, help them to help you
There are various ways you can be a useful member of your own care team:
- Go into surgery as healthy as you can. If there’s ever a time to get a little fitter, eat a little healthier, prioritize good quality sleep more, the time approaching your surgery is the time to do this.
- This will help to minimize complications and maximize recovery.
- Take with you any meds you’re taking, or at least have an up-to-date list of what you’re taking. Dr. Bonney has very many times had patients tell him such things as “Well, let me see. I have two little pink ones and a little white one…” and when asked what they’re for they tell him “I have no idea, you’d need to ask my doctor”.
- Help them to help you; have your meds with you, or at least a comprehensive list (including: medication name, dosage, frequency, any special instructions)
- Don’t stop taking your meds unless told to do so. Many people have heard that one should stop taking meds before a surgery, and sometimes that’s true, but often it isn’t. Keep taking them, unless told otherwise.
- If unsure, ask your surgical team in advance (not your own doctor, who will not be as familiar with what will or won’t interfere with a surgery).
Do any preparatory organization well in advance
Consider the following:
- What do you need to take with you? Medications, clothes, toiletries, phone charger, entertainment, headphones, paperwork, cash for the vending machine?
- Will the surgeons need to shave anywhere, and if so, might you prefer doing some other form of depilation (e.g. waxing etc) yourself in advance?
- Is your list of medications ready?
- Who will take you to the hospital and who will bring you back?
- Who will stay with you for the first 24 hours after you’re sent home?
- Is someone available to look after your kids/pets/plants etc?
Be aware of how you do (and don’t) need to fast before surgery
The American Society of Anesthesiologists gives the following fasting guidelines:
- Non-food liquids: fast for at least 2 hours before surgery
- Food liquids or light snacks: fast for at least 6 hours before surgery
- Fried foods, fatty foods, meat: fast for at least 8 hours before surgery
(see the above link for more details)
Dr. Bonney notes that many times he’s had patients who’ve had the worst thirst, or caffeine headache, because of abstaining unnecessarily for the day of the surgery.
Unless told otherwise by your surgical team, you can have black coffee/tea up until two hours before your surgery, and you can and should have water up until two hours before surgery.
Hydration is good for you and you will feel the difference!
Want to know more?
Dr. Bonney has his own website and blog, where he offers lots of advice, including for specific conditions and specific surgeries, with advice for before/during/after your hospital stay.
He also has a book with many more tips like those we shared today:
Calm For Surgery: Supertips For A Smooth Recovery
Take good care of yourself!
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Are You A Calorie-Burning Machine?
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Burn, Calorie, Burn
In Tuesday’s newsletter, we asked you whether you count calories, and got the above-depicted, below-described set of answers:
- About 56% said “I am somewhat mindful of calories but keep only a rough tally”
- About 32% said “I do not count calories / I don’t think it’s important for my health”
- About 13% said “I rigorously check and record the calories of everything I consume”
So what does the science say, about the merits of all these positions?
A food’s calorie count is a good measure of how much energy we will, upon consuming the food, have to use or store: True or False?
False, broadly. It can be, at best, a rough guideline. Do you know what a calorie actually is, by the way? Most people don’t.
One thing to know before we get to that: there’s “cal” vs “kcal”. The latter is generally used when it comes to foodstuffs, and it’s what we’ll be meaning whenever we say “calorie” here. 1cal is 1/1000th of a kcal, that’s all.
Now, for what a calorie actually is:
A calorie is the amount of energy needed to raise the temperature of 1 liter of water by 1℃
Question: so, how to we measure how much food is needed to do that?
Answer: by using a bomb calorimeter! Which is the exciting name for the apparatus used to literally burn food and capture the heat produced to indeed raise the temperature of 1 liter of water by 1℃.
If you’re having trouble imagining such equipment, here it is:
Bomb Calorimeter: Definition, Construction, & Operation (with diagram and FAQs)
The unfortunate implication of the above information
A kilogram of sawdust contains about a 1000 kcal, give or take what wood was used and various other conditions.
However, that does not mean you can usefully eat the sawdust. In other words:
Calorie count tells us only how good something is at raising the temperature of water if physically burned.
Now do you see why oils and sugars have such comparably high calorie counts?
And while we may talk about “burning calories” as a metaphor, we do not, in fact, have a little wood stove inside us burning the food we eat.
A calorie is a calorie: True or False?
Definitely False! Building on from the above… We will get very little energy from sawdust; it’s not just that we can’t use it; we can’t store it either; it’ll mostly pass through as fiber.
(however, please do not use sawdust to get your daily dose of fiber either, as it is not safe for human consumption and may give you diseases, depending on what is lurking in it)
But let’s look at oil and sugar, two very high-calorie categories of food, because they’re really easy to physically burn and they give off a good flame.
A bomb calorimeter may treat them quite equally, but to our body, they are metabolically very different indeed.
For a start, most sugars will get absorbed and processed much more quickly than most oils, and that can overwhelm the liver (responsible for glycogen management), and lead to non-alcoholic fatty liver disease, diabetes, and more. Metabolic syndrome in general, and if you keep it up too much and you may find it’s now a lottery between dying of NAFLD, diabetes, or heart disease (it’ll usually be the heart disease that kills).
See also:
- Which Sugars Are Healthier, And Which Are Just The Same?
- 10 Ways To Balance Blood Sugars
- How To Unfatty A Fatty Liver
Meanwhile, we know all about the different kinds of nutritional profiles that oils can have, and some can promote having high energy without putting on fat, while others can strain the heart. Not even “a fat is a fat”, so “a calorie is a calorie” doesn’t get much mileage outside of a bomb calorimeter!
See also:
A calorie-controlled / calorie-restricted diet is an effective weight loss strategy: True or False?
True, usually! Surprise!
- On the one hand: calories are a wildly imprecise way to reckon the value of food, and using them as a guide to health can be dangerously misleading
- On the other hand: the very activity of calorie-counting itself promotes mindful eating, which is very good for the health
There is a strong difference between the mind of somebody who is carefully logging their pre-bedtime piece of chocolate and reflecting on its nutritional value, vs someone who isn’t sure whether this is their second or third glass of wine, nor how much the glass contained.
So if you want to get most of the benefits of a calorie-controlled diet without counting calories, you may try taking a “mindful eating” approach to diet.
However! If you want to do this for weight loss, be aware, that you will have to practice it all the time, not just for one meal here and there.
You can read more on how to do “mindful eating” here:
Dr. Rupy Aujla: The Kitchen Doctor | Mindful Eating & Interoception
Take care!
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Do We Need Sunscreen In Winter, Really?
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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 keep seeing advice that we shoudl wear sunscreen out in winter even if it’s not hot or sunny, but is there actually any real benefit to this?❞
Short answer: yes (but it’s indeed not as critical as it is during summer’s hot/sunny days)
Longer answer: first, let’s examine the physics of summer vs winter when it comes to the sun…
In summer (assuming we live far enough from the equator to have this kind of seasonal variation), the part of the planet where we live is tilted more towards the sun. This makes it closer, and more importantly, it’s more directly overhead during the day. The difference in distance through space isn’t as big a deal as the difference in distance through the atmosphere. When the sun is more directly overhead, its rays have a shorter path through our atmosphere, and thus less chance of being blocked by cloud cover / refracted elsewhere / bounced back off into space before it even gets that far.
In winter, the opposite of all that is true.
Morning/evening also somewhat replicate this compared to midday, because the sun being lower in the sky has a similar effect to seasonal variation causing it to be less directly overhead.
For this reason, even though visually the sun may be just as bright on a winter morning as it is on a summer midday, the rays have been filtered very differently by the time they get to us.
This is one reason why you’re much less likely to get sunburned in the winter, compared to the summer (others include the actual temperature difference, your likely better hydration, and your likely more modest attire protecting you).
However…
The reason it is advisable to wear sunscreen in winter is not generally about sunburn, and is rather more about long-term cumulative skin damage (ranging from accelerated aging to cancer) caused by the UV rays—specifically, mostly UVA rays, since UVB rays (with their higher energy but shorter wavelength) have nearly all been blocked by the atmosphere.
Here’s a good explainer of that from the American Cancer Society:
UV (Ultraviolet) Radiation and Cancer Risk
👆 this may seem like a no-brainer, but there’s a lot explained here that demystifies a lot of things, covering ionizing vs non-ionizing radiation, x-rays and gamma-rays, the very different kinds of cancer caused by different things, and what things are dangerous vs which there’s no need to worry about (so far as best current science can say, at least).
Consequently: yes, if you value your skin health and avoidance of cancer, wearing sunscreen when out even in the winter is a good idea. Especially if your phone’s weather app says the UV index is “moderate” or above, but even if it’s “low”, it doesn’t hurt to include it as part of your skincare routine.
But what if sunscreens are dangerous?
Firstly, not all sunscreens are created equal:
Learn more: Who Screens The Sunscreens?
Secondly: consider putting on a protective layer of moisturizer first, and then the sunscreen on top. Bear in mind, this is winter we’re talking about, so you’re probably not going out in a bikini, so this is likely a face-neck-hands job and you’re done.
What about vitamin D?
Humans evolved to have more or less melanin in our skin depending on where we lived, and white people evolved to wring the most vitamin D possible out of the meagre sun far from the equator. Black people’s greater melanin, on the other hand, offers some initial protection against the sun (but any resultant skin cancer is then more dangerous than it would be for white people if it does occur, so please do use sunscreen whatever your skintone).
Nowadays many people live in many places which may or may not be the places we evolved for, and so we have to take that into account when it comes to sun exposure.
Here’s a deeper dive into that, for those who want to learn:
Take care!
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