The Myth of Normal – by Dr. Gabor Maté and Daniel Maté
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A lot of popular beliefs (and books!) start with the assumption that everyone is, broadly speaking, “normal”. That major diversions from “normal” happen only to other people… And that minor diversions from “normal” are just something to suck up and get over—magically effecting a return to “normalcy”.
Dr. Maté, however, will have none of these unhelpful brush-offs, and observes that in fact most if not all of us have been battered by the fates one way or another. We just:
- note that we have more similarities than differences, and
- tend to hide our own differences (to be accepted) or overlook other people’s (to make them more acceptable).
How is this more helpful? Well, the above approach isn’t always, but Mate has an improvement to offer:
We must see flawed humans (including ourselves) as the product of our environments… and/but see this a reason to look at improving those environments!
Beyond that…
The final nine chapters of the books he devotes to “pathways to wholeness” and, in a nutshell, recovery. Recovery from whatever it was for you. And if you’ve had a life free from anything that needs recovering from, then congratulations! You doubtlessly have at least one loved one who wasn’t so lucky, though, so this book still makes for excellent reading.
Dr. Maté was awarded the Order of Canada for his medical work and writing. His work has mostly been about addiction, trauma, stress, and childhood development. He co-wrote this book with his son, Daniel.
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Say That Again: Using Hearing Aids Can Be Frustrating for Older Adults, but Necessary
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It was an every-other-day routine, full of frustration.
Every time my husband called his father, who was 94 when he died in 2022, he’d wait for his dad to find his hearing aids and put them in before they started talking.
Even then, my father-in-law could barely hear what my husband was saying. “What?” he’d ask over and over.
Then, there were the problems my father-in-law had replacing the devices’ batteries. And the times he’d end up in the hospital, unable to understand what people were saying because his hearing aids didn’t seem to be functioning. And the times he’d drop one of the devices and be unable to find it.
How many older adults have problems of this kind?
There’s no good data about this topic, according to Nicholas Reed, an assistant professor of epidemiology at Johns Hopkins Bloomberg School of Public Health who studies hearing loss. He did a literature search when I posed the question and came up empty.
Reed co-authored the most definitive study to date of hearing issues in older Americans, published in JAMA Open Network last year. Previous studies excluded people 80 and older. But data became available when a 2021 survey by the National Health and Aging Trends Study included hearing assessments conducted at people’s homes.
The results, based on a nationally representative sample of 2,803 people 71 and older, are eye-opening. Hearing problems become pervasive with advancing age, exceeding 90% in people 85 and older, compared with 53% of 71- to 74-year-olds. Also, hearing worsens over time, with more people experiencing moderate or severe deficits once they reach or exceed age 80, compared with people in their 70s.
However, only 29% of those with hearing loss used hearing aids. Multiple studies have documented barriers that inhibit use. Such devices, which Medicare doesn’t cover, are pricey, from nearly $1,000 for a good over-the-counter set (OTC hearing aids became available in 2022) to more than $6,000 for some prescription models. In some communities, hearing evaluation services are difficult to find. Also, people often associate hearing aids with being old and feel self-conscious about wearing them. And they tend to underestimate hearing problems that develop gradually.
Barbara Weinstein, a professor of audiology at the City University of New York Graduate Center and author of the textbook “Geriatric Audiology,” added another concern to this list when I reached out to her: usability.
“Hearing aids aren’t really designed for the population that most needs to use them,” she told me. “The move to make devices smaller and more sophisticated technologically isn’t right for many people who are older.”
That’s problematic because hearing loss raises the risk of cognitive decline, dementia, falls, depression, and social isolation.
What advice do specialists in hearing health have for older adults who have a hard time using their hearing aids? Here are some thoughts they shared.
Consider larger, customized devices. Many older people, especially those with arthritis, poor fine motor skills, compromised vision, and some degree of cognitive impairment, have a hard time manipulating small hearing aids and using them properly.
Lindsay Creed, associate director of audiology practices at the American Speech-Language-Hearing Association, said about half of her older clients have “some sort of dexterity issue, whether numbness or reduced movement or tremor or a lack of coordination.” Shekinah Mast, owner of Mast Audiology Services in Seaford, Delaware, estimates nearly half of her clients have vision issues.
For clients with dexterity challenges, Creed often recommends “behind-the-ear hearing aids,” with a loop over the ear, and customized molds that fit snugly in the ear. Customized earpieces are larger than standardized models.
“The more dexterity challenges you have, the better you’ll do with a larger device and with lots of practice picking it up, orienting it, and putting it in your ear,” said Marquitta Merkison, associate director of audiology practices at ASHA.
For older people with vision issues, Mast sometimes orders hearing aids in different colors for different ears. Also, she’ll help clients set up stands at home for storing devices, chargers, and accessories so they can readily find them each time they need them.
Opt for ease of use. Instead of buying devices that require replacing tiny batteries, select a device that can be charged overnight and operate for at least a day before being recharged, recommended Thomas Powers, a consultant to the Hearing Industries Association. These are now widely available.
People who are comfortable using a smartphone should consider using a phone app to change volume and other device settings. Dave Fabry, chief hearing health officer at Starkey, a major hearing aid manufacturer, said he has patients in their 80s and 90s “who’ve found that being able to hold a phone and use larger visible controls is easier than manipulating the hearing aid.”
If that’s too difficult, try a remote control. GN ReSound, another major manufacturer, has designed one with two large buttons that activate the volume control and programming for its hearing aids, said Megan Quilter, the company’s lead audiologist for research and development.
Check out accessories. Say you’re having trouble hearing other people in restaurants. You can ask the person across the table to clip a microphone to his shirt or put the mike in the center of the table. (The hearing aids will need to be programmed to allow the sound to be streamed to your ears.)
Another low-tech option: a hearing aid clip that connects to a piece of clothing to prevent a device from falling to the floor if it becomes dislodged from the ear.
Wear your hearing aids all day. “The No. 1 thing I hear from older adults is they think they don’t need to put on their hearing aids when they’re at home in a quiet environment,” said Erika Shakespeare, who owns Audiology and Hearing Aid Associates in La Grande, Oregon.
That’s based on a misunderstanding. Our brains need regular, not occasional, stimulation from our environments to optimize hearing, Shakespeare explained. This includes noises in seemingly quiet environments, such as the whoosh of a fan, the creak of a floor, or the wind’s wail outside a window.
“If the only time you wear hearing aids is when you think you need them, your brain doesn’t know how to process all those sounds,” she told me. Her rule of thumb: “Wear hearing aids all your waking hours.”
Consult a hearing professional. Everyone’s needs are different, so it’s a good idea to seek out an audiologist or hearing specialist who, for a fee, can provide guidance.
“Most older people are not going to know what they need” and what options exist without professional assistance, said Virginia Ramachandran, the head of audiology at Oticon, a major hearing aid manufacturer, and a past president of the American Academy of Audiology.
Her advice to older adults: Be “really open” about your challenges.
If you can’t afford hearing aids, ask a hearing professional for an appointment to go over features you should look for in over-the-counter devices. Make it clear you want the appointment to be about your needs, not a sales pitch, Reed said. Audiology practices don’t routinely offer this kind of service, but there’s good reason to ask since Medicare started covering once-a-year audiologist consultations last year.
We’re eager to hear from readers about questions you’d like answered, problems you’ve been having with your care, and advice you need in dealing with the health care system. Visit http://kffhealthnews.org/columnists to submit your requests or tips.
KFF Health News is a national newsroom that produces in-depth journalism about health issues and is one of the core operating programs at KFF—an independent source of health policy research, polling, and journalism. Learn more about KFF.
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How To Reduce Chronic Stress
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Sunday Stress-Buster
First, an important distinction:
- Acute stress (for example, when stepping out of your comfort zone, engaging in competition, or otherwise focusing on something that requires your full attention for best performance) is generally a good thing. It helps you do you your best. It’s sometimes been called “eustress”, “good stress”.
- Chronic stress (for example, when snowed under at work and you do not love it, when dealing with a serious illness, and/or faced with financial problems) is unequivocally a bad thing. Our body is simply not made to handle that much cortisol (the stress hormone) all the time.
Know the dangers of too much cortisol
We covered this as a main feature last month: Lower Your Cortisol! (Here’s Why & How)
…but it bears mentioning again and for those who’ve joined us since then:
A little spike of cortisol now and again can be helpful. Having it spiking all the time, or even a perpetual background low-to-moderate level, can be ruinous to the health in so many ways.
The good news is, the physiological impact of stress on the body (which ranges from face-and-stomach fat deposits, to rapid aging), can be reversed—even the biological aging!
Read: Biological age is increased by stress and restored upon recovery ← this study is so hot-of-the-press that it was published literally two days ago
Focus on what you can control
A lot of things that cause you stress may be outside of your control. Focus on what is within your control. Oftentimes, we are so preoccupied with the stress, that we employ coping strategies that don’t actually deal with the problem.
That’s a maladaptive response to an evolutionary quirk—our bodies haven’t caught up with modern life, and on an evolutionary scale, are still priming us to deal with sabre-toothed tigers, not financial disputes, for example.
But, how to deal with the body’s “wrong” response?
First, deal with the tiger. There isn’t one, but your body doesn’t know that. Do some vigorous exercise, or if that’s not your thing, tense up your muscles strongly for a few seconds and then relax them, doing each part of your body. This is called progressive relaxation, and how it works is basically tricking your body into thinking you successfully fled the tiger, or fought the tiger and won.
Next, examine what the actual problem is, that’s causing you stress. You’re probably heavily emotionally attached to the problem, or else it wouldn’t be stressing you. So, imagine what advice you would give to help a friend deal with the same problem, and then do that.
Better yet: enlist an actual friend (or partner, family member, etc) to help you. We are evolved to live in a community, engaged in mutual support. That’s how we do well; that’s how we thrive best.
By dealing with the problem—or sometimes even just having support and/or something like a plan—your stress will evaporate soon enough.
The power of “…and then what?”
Sometimes, things are entirely out of your control. Sometimes, bad things are entirely possible; perhaps even probable. Sometimes, they’re so bad, that it’s difficult to avoid stressing about the possible outcomes.
If something seems entirely out of your control and/or inevitable, ask yourself:
“…and then what?”
Writer’s storytime: when I was a teenager, sometimes I would go out without a coat, and my mother would ask, pointedly, “But what will you do if it rains?!”
I’d reply “I’ll get wet, of course”
This attitude can go just the same for much more serious outcomes, up to and including death.
So when you find yourself stressing about some possible bad outcome, ask yourself, “…and then what?”.
- What if this is cancer? Well, it might be. And then what? You might seek cancer treatment.
- What if I can’t get treatment, or it doesn’t work? Well, you might die. And then what?
In Dialectic Behavior Therapy (DBT), this is called “radical acceptance” and acknowledges bad possible/probable/known outcomes, allows one to explore the feelings, and come up with a plan for managing the situation, or even just coming to terms with the fact that sometimes, suffering is inevitable and is part of the human condition.
It’ll still be bad—but you won’t have added extra suffering in the form of stress.
Breathe.
Don’t underestimate the power of relaxed deep breathing to calm the rest of your body, including your brain.
Also: we’ve shared this before, a few months ago, but this 8 minute soundscape was developed by sound technicians working with a team of psychologists and neurologists. It’s been clinically tested, and found to have a much more relaxing effect(in objective measures of lowering heart rate and lowering cortisol levels, as well as in subjective self-reports) than merely “relaxing music”.
Try it and see for yourself:
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A Tale Of Two Cinnamons
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Cinnamon’s Health Benefits (But Watch Out!)
Cinnamon is enjoyed for its sweet and punchy flavor. It also has important health properties!
Let’s take a look at the science…
A Tale Of Two Cinnamons
In your local supermarket, there is likely “cinnamon” and if you’re lucky, also “sweet cinnamon”. The difference between these is critical to understand before we continue:
“Cinnamon” = Cinnamomum cassia or Cinnamomum aromaticum. This is cheapest and most readily available. It has a relatively high cinnamaldehyde content, and a high coumarin content.
“Sweet cinnamon” Cinnamomum verum or Cinnamomum zeylanicum. It has a lower cinnamaldehyde content, and/but a much lower (almost undetectable) coumarin content.
You may be wondering: what’s with the “or” in both of those cases? Each simply has two botanical names in use. It’s inconvenient and confusing, but that’s how it is.
Great! What’s cinnamaldehyde and what’s coumarin?
Cinnamaldehyde is what gives cinnamon its “spice” aspect; it’s strong and fragrant. It also gives cinnamon most of its health benefits.
As a quick aside: it’s also used as the flavoring element in cinnamon flavored vapes, and in that form, it can cause health problems. So do eat it, but we recommend not to vape it.
Coumarin is toxic in large quantities.
The recommended safe amount is 0.1mg/kg, so you could easily go over this with a couple of teaspoons of cassia cinnamon:
Toxicology and risk assessment of coumarin: focus on human data
…while in Sweet/True/Ceylon cinnamon, those levels are almost undetectable:
Medicinal properties of ‘true’ cinnamon (Cinnamomum zeylanicum): a systematic review
If you have a cinnamon sensitivity, it is likely, but not necessarily, tied to the coumarin content rather than the cinnamaldehyde content.
Summary of this section before moving on:
“Cinnamon”, or cassia cinnamon, has about 50% stronger health benefits than “Sweet Cinnamon”, also called Ceylon cinnamon.
“Cinnamon”, or cassia cinnamon, has about 250% stronger health risks than “Sweet Cinnamon”, also called Ceylon cinnamon.
The mathematics here is quite simple; sweet cinnamon is the preferred way to go.
The Health Benefits
We spent a lot of time/space today looking at the differences. We think this was not only worth it, but necessary. However, that leaves us with less time/space for discussing the actual benefits. We’ll summarize, with links to supporting science:
“Those three things that almost always go together”:
Heart and blood benefits:
- Reduces triglyceride levels
- Reduces high blood pressure
- Reduces insulin insensitivity
- Reduces fasting blood sugar levels
Neuroprotective benefits:
The science does need more testing in these latter two, though.
Where to get it?
You may be able to find sweet cinnamon in your local supermarket, or if you prefer capsule form, here’s an example product on Amazon
Enjoy!
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CBD Oil’s Many Benefits
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CBD Oil: What Does The Science Say?
First, a quick legal (and practical) note:
CBD and THC are both derived from the hemp or cannabis plant, but only the latter has euphoriant psychoactive effects, i.e., will get you high. We’re writing here about CBD derived from hemp and not containing THC (thus, will not get you high).
Laws and regulations differ far too much from place to place for us to try to advise here, so please check your own local laws and regulations. And also, while you’re at it, with your doctor and/or pharmacist.
As ever, this newsletter is for purposes of education and enjoyment, and does not constitute any kind of legal (or medical) advice.
With that in mind, onwards to today’s research review…
CBD for Pain Relief
CBD has been popularly touted as a pain relief panacea, and there are a lot of pop-science articles out there “debunking” this, but…
The science seems to back it up. We couldn’t find studies refuting the claim (of CBD as a viable pain relief option). We did, however, find research showing it was good against:
Note that that latter (itself a research review, not a single study, hence covering a lot of bases) describes it matter-of-factly, with no caveats or weasel-words, as:
“CBD, a non-euphoriant, anti-inflammatory analgesic with CB1 receptor antagonist and endocannabinoid modulating effects”
As a quick note: all of the above is about the topical use of CBD oil, not any kind of ingestion
CBD for Anxiety/Depression
There’s a well-cited study with what honestly we think was a bit of a small sample size, but compelling results within that:
A study published in the Brazilian Journal of Psychiatry tested the anxiety levels of 57 men in a simulated public speaking test.
Compared to placebo…
- Those who received 300mg of CBD experienced significantly reduced anxiety during the test.
- Those who received either 150mg or 600mg of CBD experienced more anxiety during the test than the 300mg group
- This means there’s a sweet spot to the dosage
There was also a clinical study that found CBD to have anti-depressant effects.
The methodology was a lot more robust, but the subjects were mice. We can’t have everything in one study, apparently! There is probably a paucity of human volunteers to have their brain slices looked at after tests, though.
Anyway, what makes this study interesting is that it measured quite an assortment of biological markers in the brain, and found that the CBD had a similar physiological effect to the antidepressant imipramine.
CBD for Treating Opioid Addiction
There are a lot of studies for this, both animal and human, but we’d like to put the spotlight on a human study (with the participation of heroin users) that found:
❝Within one week, CBD significantly reduced cravings, anxiety, resting heart rate, and salivary cortisol levels. No serious adverse effects were found.❞
This is groundbreaking because the very thing about heroin is that it’s so addictive and the body rapidly needs more and more of it. You might think “duh”, but most people don’t realize this part:
Heroin is attractive because it offers (and delivers) an immediate guaranteed “downer”, instant relaxation… with none of the bad side effects of, for example, alcohol. No nausea, no hangover, nothing.
The problem is that the body gets tolerant to heroin very quickly, meaning your doses need to get bigger and more frequent to have the same effect.
Before you know it, what seemed like an affordable “self-medication for a stressful life” is very much out of control! Many doctors have personally found this out the hard way.
So, it’s ruinous:
- first to your financial health, as the costs rapidly spiral
- then to your physical health, as you either suffer from withdrawal or eventually overdose
Consequently, heroin is an incredibly easy drug to get hooked onto, and incredibly difficult to get back off.
So CBD offering relief is really a game-changer.
And more…
CBD has been well-studied and found to be effective for a lot of things, more than we could hope to cover in a single edition here.
Some further reading that may interest you includes:
- CBD against Diabetes in mice / in vitro / in humans
- CBD against neurological diseases (in general, in humans)
- CBD against arthritis in mice / in humans
- CBD specifically against the pain of rheumatoid arthritis / of osteoarthritis
Let us know if there’s any of these (or other) conditions you’d like us to look more into the CBD-related research for, because there’s a lot! You can always hit reply to any of our emails, or use the feedback widget at the bottom
Read (and shop, if you want and it’s permitted where you are):
10 Best CBD Oils of 2023, According to the Forbes Health Advisory Board
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The Glucose Goddess Method – by Jessie Inchausspé
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We’ve previously reviewed Inchausspé’s excellent book “Glucose Revolution”. So what does this book add?
This book is for those who found that book a little dense. While this one still gives the same ten “hacks”, she focuses on the four that have the biggest effect, and walks the reader by the hand through a four-week programme of implementing them.
The claim of 100+ recipes is a little bold, as some of the recipes are things like vinegar, vinegar+water, vinegar+water but now we’re it’s in a restaurant, lemon+water, lemon+water but now it’s in a bottle, etc. However, there are legitimately a lot of actual recipes too.
Where this book’s greatest strength lies is in making everything super easy, and motivating. It’s a fine choice for being up-and-running quickly and easily without wading through the 300-odd pages of science in her previous book.
Bottom line: if you’ve already happily and sustainably implemented everything from her previous book, you can probably skip this one. However, if you’d like an easier method to implement the changes that have the biggest effect, then this is the book for you.
Click here to check out The Glucose Goddess Method, and build it into your life the easy way!
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The Recipe For Empowered Leadership – by Doug Meyer-Cuno
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This is not a “here’s how to become a leader, you young would-be Machiavelli”; it’s more a “so you’re in a leadership role; now what?” book. The book’s subtitle describes well its contents: “25 Ingredients For Creating Value & Empowering Others”
The book is written with the voice of experience, but without the ego-driven padding that accompanies many such books. Especially: any anecdotal illustrations are short and to-the-point, no chapter-long diversions here.
Which we love!
Equally helpful is where the author does spend a little more time and energy: on the “down to brass tacks” of how exactly to do various things.
In short: if instead of a lofty-minded book of vague idealized notions selling a pipedream, you’d rather have a manual of how to actually be a good leader when it comes down to it, this is the book for you.
Pick Up The Recipe For Empowered Leadership On Amazon Today!
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