This being December 25th, many of you woke up early and have already opened some pretty sweet gifts.  In the spirit of giving, I can’t help but share with you some recent research I read that really got my attention.  It offers you a simple way to change your behavior to give you a longer life, less risk of cancer, better mental health, and a lower risk of dementia.  This simple behavior change costs you nothing, but will give you so much.  I was so affected by this research, as a gift to me this holiday, I ask that you please read this week’s blog and consider the information for yourself.

In my work, when people come to see me and I ask them about their sleep, they are often embarrassed and think something is wrong because they need 8 or 9 hours of sleep (but of course rarely get that much).  They wonder if they have a sleep disorder or if they are depressed because they seem to need more sleep than other people.  No, I say, eight hours is the normal amount of sleep everyone should be getting, but as they are finding, is so hard to do.

In his new book, Why We Sleep, author and University of Berkeley neuroscientist Matthew Walker writes about what he considers a national crisis of sleep deprivation.  We as a modern culture pride ourselves in needing less sleep, in doing more with our time, and react as if needing sleep is a weakness.  According to Walker, in 1942 less than 8% of the population was trying to get by on 6 hours of sleep or less.  In 2017, nearly 50% of people do.  He believes the shift has to do with having access to light throughout the night, and stimulation, especially from phones, computers, and televisions.  In addition, the borders around work have diminished in addition to longer commute times.  No one wants to give up family or fun time, so we give up sleep instead.  (I know so many women who tell me that the only “alone’ time they get is after everyone else is asleep.)  And we are a more anxious society, that has higher rates of depression and loneliness, to which we use alcohol and caffeine to compensate.  

So here is some of Walker’s findings that might put you to bed.  After just one night of four or five hours of sleep, your natural killer cells, the ones that attack cancer cells that appear in your body every day, drop by 70%.  This is why a lack of sleep is linked to cancer of the bowel, prostate, and breast.  In fact, more than 20 large scale epidemiological studies all report a clear relationship that the shorter you sleep, the shorter you will live. For example, one study shows that with less than 6 hours of sleep a night, adults age 45 years or older are 200% more likely to have a heart attack or stroke in their lifetime compared with people who get seven or eight hours.  (Part of the reason has to do with blood pressure.  Just one night of modest sleep will speed the rate of a person’s heart, hour upon hour, and increase blood pressure).  A lack of sleep also interrupts your body’s control of blood sugar.  The cells of sleep deprived individuals appear to become less responsive to insulin and thus cause a pre-diabetic state of hyperglycemia.  This, together with the fact that inadequate sleep decreases the level of the satiety signalling hormone leptin and increases levels of hunger, both cause weight gain.  Tiredness also affects motivation; most often to exercise, eat healthy, and avoid other not so good for us substances.

Sleep has a powerful effect on the immune system.  We restore and repair our body when we sleep, and a chronic lack of it not only wears down our body, but chronically undermines its restoration and repair.  When you are ill, your body seeks sleep in order to fight off the disease.  Recent research shows that in deep sleep, our brains actually clean themselves of amyloid deposits, the toxic protein linked to dementia.  And overall, sleep increases our ability  to learn.  Dreaming states are actually linked to creativity and deep sleep seems to be when our minds process memories.

So what is a tired person to do?  Walker recommends setting an alarm that tells you when to go to sleep.  Just as we set an alarm to wake, we should set one to go to bed.  He also recommends trying to stick to the same schedule as close as possible every night.  Our bodies become very sensitive to sleep patterns, sending out signals when sleep time is approaching.  Pulling late nights, or the worst of all, all nighters, throws your body chemistry completely off.  In response, our bodies send out all kinds of hormonal and neurological messages that something needs to be attended to (the fight flight response) which can create great stress on our body and our psyche.  Walker is so alarmed by the population trends of sleep loss, that he goes so far as recommending sweeping changes in work site norms and home life culture.  He would love to see pubic health or workplace billboards that advocates nothing more than sleep.  He truly believes that we need to shift our priorities and actually incentivize sleep.

So tonight when you go to bed, and its lights out, really make sure the lights are out.  It will be so tempting to try your latest gadget or catch up on Christmas day facebook posts.  Darken your room, keep it cool and comfortable, and close your eyes.  Rest is great medicine for all that ails you.  Think of poor Santa.  If he only  got more sleep, he just might be able to fit through more chimneys!

Ok, I couldn’t resist:

Say what, you may ask?  After all of these blog posts encouraging tolerance and being open minded to other and to all parts of yourself, you are writing to encourage us to make enemies?  Especially now, during hte holiday season?  Well, actually, yes.  Based on research I recently read about how we tend to thrive when we have a nemesis, I hereby not only approve, but encourage you to make an enemy, use it to help you improve, and have some fun with it!

In order to make progress in any goal, you have to make some changes.  And change, if meaningful, creates enemies – either within you or around you.  Change creates discomfort, and with it, there will be a natural push back to keep the status quo.  These enemies of change can be simply our own inner critic with words of self doubt,  a cigarette pack on the store shelf when you are trying to quit, or a tv commercial  luring you to snack on sweets.  

Research shows, and we know from our own experience, that we are very responsive to a good rivalry – your team versus the other, your party versus the opposition party, etc.  Besides the sense of belonging we crave as a tribal people, rivalry defines us.  When we choose a rival, we clarify the distinctions between us and we more clearly define ourselves.  Having a rival also pushes us to improve and to stick to our goals.  Would we have made it to the moon without the space race?  Would here be a Muhammed Ali without a Joe Frasier?  A rival can keep you focused on your improvements and drive you to maximize your potential.  

So in thinking about any goal or change, I am sure you can think of a few potential enemies that will no doubt get in the way.  If you are trying to write or complete a project, procrastination may be your enemy.  If you are trying to eat healthier, the donuts that your co-worker brings in every Friday may set you back.  Or, as many of us find, our own inner critic may be our worst enemy, with self hating statements that eat away at our confidence.  By identifying these threats to our goal as our rival, we create a distance from them.  And when we are tempted by them, we can identify their tricky lure as a way to get one over on us!  (I had someone in my quit smoking class that thought of cigarettes as the devil.  Each time he had a craving, he told himself that he was “no longer going to dance with that devil.”)

So, procrastination, I see you in that newspaper longing for me to leave the computer and read you!  And donut, looking so full of yummy frosting, you will not beat out my morning healthy routine.  And the shame I feel in mixing up a meeting time, beware.  I will not let you get the best of me this time, and not let you take over my self confidence today.  I am strong and I can do battle against my enemies of temptation and old patterns!  I am a healthier habit warrior!  Care to join my team?  I  bet we can have some pretty cool uniforms!

Like many people, Thanksgiving is my favorite holiday:  great food, togetherness, and very little commercialism. I also really love a holiday in which we take the time to think of all we have to be thankful for.  Most of us know by now the many psychological and health benefits of expressing and cultivating gratitude (the famous gratitude list in which each night you write down things you are grateful for really does decrease depression and increase positive feelings) from the field of positive psychology.  But I am thinking bigger about being thankful this year.  I feel the urge not only be thankful, but to truly give thanks.  Showing people that I appreciate them is such an easy thing to do, makes people feel so good, and yet, most all of us don’t do it as often as we could.

First I can start with just noticing things and saying words of thanks.  Over time I fall into routines with people, especially with my family.  I learn to expect certain things as part of our day to day living and the give and take of family life.  I could go out of my way to really say thanks and notice the little things that people do because of the bonds we have with one another.  I can see my husband’s hauling the trash down our hill as more than just a chore, but as a way that he shows us our family matters to him.  I can truly recognize how grateful I am to my friend who meets me each week to hike, even when it makes it hard on her schedule for us to go together.  

Another thing I can do to give thanks is to do something to be helpful.  I could appreciate being cooked for by doing dishes, or express my thanks to a neighbor by pulling in their trash cans.  I remember years ago, in our old house, our neighbor across the street mowed our lawn for us, without saying anything, just because he knew we did it every Sunday.  Sometimes those unexpected encounters, where we show someone we notice them by doing something to help them, makes us all feel more connected.   

And how about just listening?   We all underestimate how hard it is, but know how amazing it feels, to have someone just listen.   I am so quick to interrupt, give advice, or check my phone while someone is talking, without even realizing it.    Time and attention literally cost me nothing, and yet, they are the most precious commodities.  So many misunderstandings happen because people are so concerned with being heard, that they can’t really listen.  

So this year as Thanksgiving passes, I want to make sure my good intentions last longer than the five pounds I’ve gained.  I want to go beyond the words of gratitude I shared around the table before the meal (and before the NY Giants got beaten) and put my words into action.  It literally takes so little to make someone else feel so big.

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I have been hearing the words “survivor guilt” a lot lately from people in my community who survived the fire with their family and home intact.  They feel uncomfortable with their good fortune, as if they have something to feel badly about; as if their good fortune and other people’s bad fortunes were somehow related.  Survivor guilt is a common feeling after a tragic event, and adds a layer of suffering that also needs our attention for healing.

The term survivor guilt came from those who worked with Holocaust survivors.  Although they made it out of the horror of the Concentration camps, survivors often became depressed from the burden of knowing that so many millions did not.  It was also found in Veterans who made it home from war when their brothers in arms were killed or injured and in many people after 9/11.  SInce then, the concept of survivor guilt has been applied to a broad range of situations where people feel a burden from a comparison with someone close to them who has experienced a misfortune from which they were spared, such as surviving a disease, a car accident, or even drug abuse.

It can be hard to understand how someone who should be grateful can actually feel burdened, even for some to the point of having thoughts that they wish they, too, had died.  Even for the individual themselves, their mind tells them that they should be happy and make the most of their lives, but their psyche cannot let go of feeling guilty.  Researchers theorize that survival guilt represents our mind’s need to feel a sense of control, not able to accept the randomness or lack of control or influence that we have over our lives. Instead, we feel a sense of responsibility, as if there was something we should have or could have done to alter fate.  It is our mind’s effort to believe that life should be fair and therefore we, too, should suffer.

People who feel responsible for others, whether through a position of authority (leader, parent) or in an emotionally caretaking role are most vulnerable to survivor’s guilt.  Even children of alcoholics who often take the role of the caretaker in a dysfunctional family, can grow up with a sense of survivor guilt that ties them to unhealthy relationships.  Survivor’s guilt is the burden of an inflated sense of responsibility, as if your survival or good fortune was at the expense of someone else’s suffering.

I must confess that as I look up the hill from my home to the empty space of my mother’s home, I feel  twinges of survivor’s guilt.  It’s a pain very familiar to me in my earlier years.  As my sister struggled in her life, it was hard for me feel happy.  Even after her passing, each milestone, completing graduate school, getting married, and having children, was layered with a deep sadness I could not get a handle on.  It was as if there was not enough good fortune to go around, and my having good things happen was somehow at her expense.  I carried an overblown sense of responsibility, in some ways a child like understanding of my being at the center of all that happened around me.  It was a long and profound process of healing for me, that involved much forgiveness and letting go.  I can now be sad and grieve her loss, missing her sense of humor and wishing she could meet my daughters, without feeling guilty.

Healing from survivor’s guilt involves accepting that bad things happen, even to good people.  It also involves expanding our tolerance for having incompatible feelings, the absolute joy of gratitude together with the pain of grief.  One feeling does not negate the other.  Because you are grateful and joyous to be alive, does not mean you are not genuinely sad and compassionate for someone else’s loss.  It involves accepting that we are all vulnerable, and at times completely helpless. That although we wish we did more, or did things differently, there is nothing we can do to change a tragedy.  The best we can do is to make our lives meaningful and honor the memories of those we love and those we continue to live for.

The older I get, the more I understand that no one goes through life unscarred and unscathed.  We will all have our time for both good fortune and tragedy.  Our lives are not scorecards, where some people end up winners and others losers.  We all have relative burdens that tend to even out over our lifetimes. When I am the lucky one, that is the time to use my strength and resources to help other people with their burdens.  For certainly the tables will be turned, and I will need to lean on someone else, who will then be the lucky one, to help me get through.

Note – I came across a treatment group for Veterans that I was very moved by.  It is a group for combat survivors experiencing survivor guilt.  In the group, each member shared their story and their sense of burden,  “confessing” their mistakes as leaders or soldiers that they can never undo.  The group listens and contemplates, and then makes a ruling regarding the culpability of the member.  Along with this, they give the Veteran an act of penance that they must do to be absolved of their burden.  The focus is to help each member, with the judgment of their peers, to experience a realistic sense of culpability and then to move it through by taking action.

 A picture taken on the side of my house.

This past week, many of the neighborhoods that had burned to the ground in my hometown opened to the public again. Personally I have been sifting through the pit of gray soot and ash that was my mother’s house, looking for whatever we can recover of her belongings. Nothing is more humbling than witnessing the power of fire. Plastic, wood, metal, and even stone are disintegrated in its wake.  As I drive through the streets that were the bustling neighborhoods of my friends, I am deeply stricken by a profound experience of impermanence.

It is no wonder that ashes are a symbol of repentance and humility: ashes to ashes.  There is a ghostly feeling as you witness the complete annihilation of the rows of dwellings we don’t just call home, but where we feel home.  With houses destroyed, displacement happens, neighborhoods and families torn apart.  For me, my mother had to move thousands of miles away.  For a dear friend, because of health issues, her family has had to split up to keep her husband away from the potentially unhealthy environment.  Students struggle to attend classes now that they are homeless.  Life becomes unbearably chaotic when even the basic necessities become a challenge.  At our local Junior College, hundreds of young students are dropping out, too burdened with finding a place to sleep and with no notes or binders to study from. Even in the high school choir concert we attended last night, the performers wore polo shirts and jeans, because the formal wear of so many students is gone.  My daughter notices how many of her fellow students now wear the same shoes and jackets day after day.

The layers of losses to our community are staggering.  And the pain ripples out to the stress of others feeling so inadequate and useless to be of help, no matter how much we would like to be.  There are no words that can make things better or bring back what has been destroyed. Profound loss changes us.  I have heard the term Zero Point used in grief groups.  The Zero Point is the instant everything changed, from which every future event would be dated and every previous plan or expectation had to be mourned.  Attachment is the root of suffering, Buddha teaches.  Healing involves an intense process of letting go.

And yet, already on our hill, green grass is poking through the charred cinders of burned foliage.  In my local coffee shop, tables are filled with people reviewing architectural plans and FEMA tents and United Way donation centers pop up around town on a daily basis.  It will take a long, long  time to clean up and rebuild, and some may never be able to replace what they have lost. But for all of us survivors, our lives will inevitably move forward, as nothing stays the same.  We will forever be both blessed and burdened with with a new understanding that will rise from the ashes.  A friend who lost everything in a flood several years back told me, while it was a hellish period of her life, the blessing was that possessions never had as much power over her again.  The experienced bereaved will tell you with great wisdom that the Zero Point is not just an ending, but also a beginning.  

Readers,

Last Monday was the first time in 3 years of doing my blog that I did not post “on schedule.”    As many know, I live in the beautiful hills of Santa Rosa, CA.  And yes, I have been affected by the fires.  I am safe, my family is safe, but we have had a lot of inconvenience.  Right now I am filled with so much gratitude and loss, but I will be posting as soon as I can.  Thank you for your thoughts and prayers for our community.

Cynthia

This past week was the Jewish New Year, a time when we’re encouraged to reflect on our lives and make reparations for the things we regret, especially with important people in our lives.  I was thinking a lot about how powerful relationships are and with this, how much responsibility there is when we hold this power with someone.  Some types of power come in the form of appointed positions of authority, perhaps as a boss, teacher, or leader of an organization.  Other types of relational power come simply from being loved by someone, as parents, partners, friends, or sister-in-laws, even.  Our opinions and the way we use our power really matters and our words can be extremely impactful.  Often we’re so focused on how others are treating us, that we miss the influence we do have, or could have, on someone in our lives.  

In thinking about the potential that comes with this power, I am reminded of something I read about Nelson Mandela.  He was the son of a tribal chief, and recalled two important lessons from watching his father at tribal meetings. First they would always sit in a circle.  Second, his father was always the last to speak.  To be an effective leader, Mandela came to understand, you must gather the opinions and ideas of all involved, making sure that everyone has been heard and contributes.  While listening, you only ask clarifying questions to better understand.  This, he explains, creates an environment where everyone feels valued, and the leader benefits from the ideas of the group without influencing them with his authority.  If the leader speaks first, he might silence someone from sharing information or an important perspective, even a dissenting one.

Whether as a boss or a loving partner, our approval and opinions really have great influence.  We need to be aware of how our critical opinions can hurt or even shame someone, and how our support, encouragement, or acknowledgment can bring joy.  Even the simple act of noticing someone’s efforts, especially in the mundane routines of our daily lives, can have great effect.  Being thanked for our work, asked for our ideas, being given the benefit of the doubt for our intention even if we made a mistake, or being appreciated for our uniqueness by someone we respect and care for can shape our self image and give us resilience against the many challenges we face.

As Mandela learned from his father, by holding our tongues, especially when we have the authority to speak, we can often be most effective in our relationships.   This year, I am going to work to be more aware of this vulnerability with both my staff at work and with my loved ones at home.  I will remember the difference between choosing carefully to be the last to speak and forcefully needing to have the last word.  One is a loving focus on listening, the other, a selfish tactic to impose our authority.   It is an honor when someone depends on me and even a higher honor to be blessed with their love.  I must hold this as a precious gift, delicate and in need of great care.  Power may be appointed, but trust must be earned.

This past month we’ve been inundated with images of hurricane damage that’s left so many people with demolished homes and the loss of all their belongings.  We can feel the overwhelm, even while sitting safely in our homes miles and miles from the devastation.  Our hearts are so moved as we watch, because even if we’ve never even experienced a hurricane before, we all know what it’s like to face a loss or a crisis that knocks us off our feet and leaves us feeling like we’ll never be able to get up again.  Sometimes the situation hits quickly, like the forceful winds, and sometimes it’s like the flooding, a slow build up over time, layering its impact little by little.  But what is common is the feeling of paralysis, that our life as we knew it has been so lost, we have no idea how to find a way back.

This situation is what brings a lot of people into the clinic where I work.  But even then, in telling their stories, people have little hope that anything can be of help.  It’s usually a friend or a loved one who sends them to us, because they’re worried about the person’s depression or have been worn down by helplessly watching a person they care about suffer.  I must admit, in the face of some tragedies, I, too, feel an initial panic of how to help someone in what seems like an impossible situation.  I can so empathize with the lack of control they experience, that it seems hard to imagine any way out.  

But then I remind myself we don’t have to deal with everything at once.  And just because we FEEL a complete loss of control, there are still things we can indeed control.  (I remind myself of the wise writer and neurologist Victor Frankl, and how he kept his sense of personal freedom while a prisoner in a concentration camp).  Starting with the simplest of things, as tiny or as insignificant as it may seem, we can always find one thing we can do.  “But that is so very little,” people say, and I encourage them not worry about it, and just do the little thing they can.  For the point I know from my training and experience is, it’s not the thing you do that matters.  It’s the fact that you did something.  And this small thing will give you the confidence to do one more small thing and then maybe another, until the momentum picks up and you feel a little more in control again.

With some people it helps to actually make lists.  I have two columns, one with “Things I CAN”T Control” and one with “Things I CAN Control.”  I ask them to start thinking of what goes in each category.  At first the “Can’t” list fills up quickly, with items big and daunting.  But then they think of a few very little things that go on the “CAN” control list, such as what they eat or who they talk to.  As this list develops, the next step is to make it concrete.  What exactly will you you eat, or who in particular will you call to talk with.  I ask them to just pick one thing and go ahead and do it.  Even with the simplest of activities, such as taking a shower, borrowing someone’s car, or going to the library, a path is created that moves someone forward and life begins to be lived again.

It really rings true that every journey begins with a small step.  And after a while of doing a very small thing after a very small thing, you can start to see a difference between where you have been and where you are now.  Of course there are setbacks and bad days, and life will never be the same as it was before the loss, but the sense of agency can return and with it a vision for a new way of being in the world.  As one person I worked with told me, when she felt her life was crashing around her, “my “I CAN” list is my escape route.”

Victor Frankl quotes:

“Between stimulus and response there is a space. In that space is our power to choose our response. In our response lies our growth and our freedom.”

“Everything can be taken from a man but one thing: the last of the human freedoms—to choose one’s attitude in any given set of circumstances, to choose one’s own way.”

My older daughter went back for her Sophomore year of college and somehow I thought her leaving would be easier the second time around.  We’ve definitely learned some lessons (like scheduling more frequent visits, using Amazon prime to send her things quickly, and coordinating conversations in the different time zones) and we’ve gained the confidence of knowing that we can still be close, even if we’re far away. Having gone through it before, though, I’m frustrated that it’s still is as hard as it is. We always hope to learn from experience, so why is it that even when we’ve been through things before, we struggle?  So, I thought this would be a good week to reflect on “second time arounds” to help me better manage this second year.

When you do something for the first time, you go in with expectations, but when you do something the second time around, you go in with a set of real consequences from your first effort.  In some cases your experience was really good, and yet, it can make the second time harder.  Most novelists will tell you, the hardest novel to write is the one after their first successful one.  They agonize with self doubt and the pressure of having to create another success or be an “imposter.”  And if the first effort ended in “failure,” the second time around is filled with the burden of the baggage of disappointment, perhaps with a touch of resentment.  Second marriages actually have a 17% higher divorce rate than first marriages, and third marriages are 23% more likely than firsts to end in divorce.

In reviewing the literature on creating sustained success, or rebounding from hardship, a critical component is self honesty and awareness.  You can only learn from things if you are honest about what brought you to where you are.  It is crucial to take ownership for what you did that worked well (you are talented, you are forgiving) and what you need to improve (having more discipline or not being as reactive).  People often fear “failure” or making mistakes because they equate the failed experience with BEING a failure.  Our culture does not give much room for learning from mistakes.  In order to take advantage of our experience, we must take responsibility for ourselves.  Some people feel that if they agree to change, this means there is something wrong with them.  In order to protect our egos, we then look to external circumstances or what others did in a blaming way.  It’s often more comfortable to list everything wrong with an ex-spouse than admit we could have listened earlier on to what she or he was unhappy about.

Another critical step to sustained success or overcoming a setback is feedback.  We are often blind to our own selves, even if we are trying to be honest.  Even though it may be extremely painful, being open to the opinions, even criticisms of others, especially if it is a repeated theme, is a key to getting out of a trap of repeated patterns.  Getting other people’s perspectives can be really helpful and give us fresh eyes to a situation.  Identifying what went wrong as well as  what went right are both critical things to know.  What can you bring to your second effort that brought you success in your first?  Where might things have gone awry?  What would you do differently and what would you do again?  Sometimes we need other people to give us advice, new skills or just help us be accountable.

Most often I notice that when people look back to get perspective on a situation they’ve experienced, they get a much broader perspective.  Our minds tend to want to view experiences in all or nothing terms, such as “it was a complete disaster” or “it was the best thing that ever happened to me,” which rarely is ever true.  Life breaks down into smaller moments and thousands and thousands of little decisions, opportunities, and choices.  It was really never one action, one person, or one event that sums it all up.  Life is complex and always in a state of change.  Keeping open to what we can learn and letting go of how things went in the past is liberating as well as empowering.

So in thinking about second times around, I feel a bit lighter.  Because in fact, we never really do anything twice.   If we are learning from the past and staying open to the present, we can create a very different future.  This year, I may miss my daughter even more than I did last year, but I can also stay open to creating a new relationship with my bittersweet feelings regarding her growing up.  She is wiser, I am stronger, and we are definitely going to have a great time when I visit her in November since now she now knows all the fun things to do!  Experience tells her that Insomnia Cookies delivers warm snickerdoodles until 3 am!