Sunday, May 22, 2011

Intro to Self-Destructive Behavior

Here's a section from the introduction to the book I'm working on, about self-destructive behavior. As I said, I truly would appreciate any and all comments, especially constructive criticism. Things I'm leaving out, false or unsupported assumptions I'm making, or things that just turn you off. Positive feedback is welcome too, of course.


Everyone has some self-destructive habits, and no one understands why. Procrastination, lack of assertion, disorganization, smoking, overeating, overworking, lack of exercise, poor sleep habits, lack of consideration, depressed shopping, internet addiction—all the way up through addictions and intentional mutilation. We know what we’re doing to ourselves, and we keep promising to reform. Indeed we do try, often enough, but these habits are hard to break. Every time we try but fail, we get more hopeless and more critical of ourselves. Self-destructive habits are probably the greatest source of unnecessary suffering in our lives.

Self-destruction covers the territory from not flossing to suicide, from binge eating to lack of assertion, from conscious to unconscious. We all have bad habits we'd like to stop, habits that get in the way of our success or happiness. Yours may be simply procrastinating, eating too much ice cream, or not exercising enough. It may be more handicapping than that—holding yourself back, staying stuck in a bad job or relationship. It may be what most people would consider a serious problem: abusing drugs or alcohol, cutting or otherwise harming yourself, taking foolish chances with your life, picking fights with authority figures. Whatever your particular situation is, simple will power isn’t strong enough to make you stop, and you probably don't understand why. You know very well what you should do. If it’s a real nuisance, you probably lecture yourself about it incessantly. The problem, whatever it is, is taking up a lot of space in your brain. It seems so clear: you can choose A, the "good" choice, or B, the "bad" choice. You want to choose A, but it seems like you always choose B. Why in the world can't you stop?

If that obvious inability to do the right thing wasn’t bad enough, there are also many self-destructive habits that we’re not aware of. Driving carelessly, being thoughtless, not listening, neglecting our health. A lot of this unconscious self-destructive behavior gets played out in relationships. When I see couples, I sometimes sit with a mounting sense of dread because I can see how one spouse is working himself up to say the exact words that are guaranteed to set off an explosion in the partner. It’s as if some unconscious script has been triggered, and there’s no way to interrupt it. I try to intervene, to reframe or distract, but often the spouse will go ahead and say exactly the phrase I had in mind—believing that this is going to help the situation somehow—and the other partner will blow up, or run from the room, or collapse into defeat and tears, and we’re back where we’d started from. It’s enough to get me to consider the idea that at least one spouse, who seems normal enough, harbors some very real evil intent toward the other that he’s completely unconscious of. We can follow unconscious scripts that lead us to say or do exactly the wrong thing, and we can’t understand why it’s wrong. Other people who may be self-destructive without realizing it include procrastinators and prescription drug abusers, people who are inconsiderate of others, and people who are too self-sacrificing. People who are stuck in bad relationships and people who just can’t learn to manage money. Sometimes we can see a problem, but not see at all how we contribute to it. If you have any suspicion that you might be one of these people, read on.

You may have noticed that I’ve used the word “unconscious” several times already. You won’t find this word in many self-help books these days. The concept is distinctly out of favor in professional circles; ironically, because the general public now accepts the idea that our choices in life can be motivated by forces we’re not aware of. If you have picked up this book you are probably aware that while you want to change, there’s another part that doesn’t want to—and it’s not just fear of change; our motives are more complex than that. But the idea of internal conflict doesn’t have much impact in psychology or psychiatry today. The unconscious is not a popular concept in the professional world because it’s really hard to study and get reproducible results from—the heart of the scientific method. It’s also not a popular concept in self-help literature because by definition we’re not aware of it, and it’s hard to control what we don’t see. We’ll discuss later what other approaches have to say; oddly enough, the unconscious is more accepted in cognitive psychology now--but for the time being let me observe that it’s just about impossible to explain self-destructive behavior without some concept of the divided self, of motives and feelings that we hide from ourselves, of a part of the mind that sometimes works against our own best interests. It’s like trying to explain the movements of the planets in our solar system while ignoring the gravitational force of the sun.(MORE TK IN CHAPTER 1)

Put very simply, it seems as if we have a thoughtful, conscious, deliberative self, and an automatic self. The automatic self is guided by unconscious motives, frames of reference, patterns of relating—and directs much of our behavior, especially spontaneous actions. The conscious self can be in charge when we take the time to think about our choices. The automatic self has us eat the potato chip, while the conscious self regrets it. In view of the concept of the divided self, it might be more accurate to say that much of what appears to be self-destructive behavior is motivated by a desire to protect an aspect of the self that remains unconscious, perhaps detrimental or irrelevant to current reality but very much in line with another reality, one that we do not like to acknowledge to ourselves.

But, as we will see, it’s not impossible to see our unconscious motives and assumptions at work. It requires a discipline in self-awareness, the practice of certain skills that don’t occur to us naturally. This may seem a lot to ask in an age of quick fixes, when pills are supposed to cure us instantly and insurance companies pay for eight weeks of psychotherapy. But if you’ve struggled with self-destructive behavior for any amount of time, you know there are no quick fixes. We seem to be perpetually drawn back to our old, bad habits as if we’re caught in an Undertow too powerful for us to overcome. So bear with me as we talk about how to get to the heart of your self-destructive behavior and learn to control the hidden motives behind the Undertow.

Most approaches to understanding and stopping self-destructive behavior have been ineffective because they provide a "one size fits all" solution—change your thinking, get yourself organized, or delve into your unconscious. In actuality, there are several different motivations/scenarios that drive us to handicap or hurt ourselves: a self-destructive rebellion against some authority; an unconscious self-hate; fears of success, independence, love; a desire for someone else to make us stop; a belief that the usual rules don’t apply to ourselves; and a few others.

[INSERT AND SET OFF AS ART ON A NEW PAGE] Some self-destructive behavior patterns Suicide Suicidal gestures Smoking Anorexia/bulimia Overeating Neglecting health Substance abuse Gambling Self-mutilation Social isolation Sex addiction Procrastination Always late Obvious lying Inconsiderate Not exercising Poor sleep habits Self-sacrificing gift giving Not paying attention Overwork Unable to relax Won't ask for help Unable to express yourself Suffering in silence Inability to prioritize—too many balls in the air Picking hopeless fights with authority Attracted to the wrong people Too much television Avoiding the chance to express your talents Unassertive behavior Staying in bad situations—jobs, relationships Excessive risk-taking Antisocial behavior Internet addiction Passive-aggressive behavior Depressed shopping Not managing money; accruing debt and not saving Computer games Self-dosing your medications …and many more [END INSERT]

These are not things that people are usually aware of (except in the most soul-searching moments), but only emerge after some therapeutic investigation into the nature of the self-destructive behavior. My experience with reaching people through books tells me that by careful explanation, sympathetic case examples, questionnaires, and exercises, I can help the reader see these patterns within himself—and then begin to overcome them.

New Book on Self-Destructive Behavior

Hello again, it's been a long time since I posted anything. Now I want to use this blog to solicit your feedback on a new book I'm writing, tentatively titled "Self-Destructive Behavior: Why You Do It, How to Stop." I truly would appreciate any and all comments, especially constructive criticism. Things I'm leaving out, false or unsupported assumptions I'm making, or things that just turn you off. Positive feedback is welcome too, of course. Look for a new post soon, part of a chapter. Richard

Wednesday, November 11, 2009

The Three Stooges of the Mind

If you sit still and try to clear your mind, as in meditation, one of the first things you’ll notice is how quickly you start judging your experience and yourself. This is boring. My back hurts. I must not be doing this right. Meditation isn’t for me. This is the voice of your judging mind, your Inner Critic. All of us have one. The voice is a product of stress, of the need we feel to classify our experiences quickly into simple categories without experiencing them too deeply—so we can quickly move on to the next thing stressing us. When we’re scared or anxious, that Critic is most active, putting down your friends and loved ones, your accomplishments, and yourself. It’s the voice that gives you a disproportionate share of the blame when things go wrong. It’s the voice that makes mountains out of molehills. What’s wrong with you? There’s nothing to be scared of, don’t be such a baby! Why haven’t you started exercising yet? You can’t stick to anything! Sound familiar? It’s something most of us hear whenever we’re feeling stressed. Automatic judging like this your frontal lobe, the “higher” mental center, trying desperately to hold on to control, while you’re trying to clear your mind. Most of us, when we’re unhappy, are caught between that Inner Critic and another part of the self that is busy defending ourselves. I call it the Timid Defender. It wants to silence the Critic, but it can’t, because it uses the usual habits of the mind—denial, rationalization, dissociation. Alcohol and drugs. Shopping and overeating. It has us trying to escape or forget about the Critic, but that only works for a little while, because while we’re escaping or forgetting, we’re giving the Critic more ammunition. You idiot, pretending to be something you're not. Trying to drown your sorrows. You can’t get rid of me that easily! The critic and the defender are both sealed up together in the same little tuna fish can, and they’re not even trying to get out, they’re so preoccupied with each other. When we’re bouncing around between the Inner Critic and the Timid Defender, who’s at the controls? Who’s running our lives, making our decisions? It’s like we have the Three Stooges up in our heads. Moe the brutal sadist, torturing us while the ineffectual Larry whines pathetic excuses. Curly, the id in this metaphor, full of appetites and drives, causes all the trouble in the first place. Nobody’s in charge of our lives, and the plane is yawing and swooping all over the sky, never getting anywhere and always in danger of crashing. And this is how unhappiness persists. We blame ourselves far too much, and make ourselves more miserable. Then we defend ourselves ineffectively, and perpetuate a vicious circle. We have to try something radically different. That’s what therapy does. I don’t turn off the Inner Critic and I don’t strengthen that Defender for my patients; instead, I help people detach from this struggle. That’s what mindfulness does too. A good friend of mine uses the phrase compassionate curiosity to describe the ideal therapist’s attitude toward the patient. We begin therapy with a much more compassionate, kind, understanding stance toward the patient and his problems than the patient has himself. And we are curious, in a calm, unafraid way—we want to understand how things got to be so bad, and we assume that by fearlessly facing reality we will help the patient find relief from his distress. Compassionate curiosity is the attitude most of us, depressed or not, need to apply to ourselves as well. What a change that would be for almost everyone I know! That battle between the Inner Critic and the Timid Defender is much like the way inconsistent parents treat their children. When the Defender is in charge we indulge and spoil ourselves; we let ourselves off the moral hook, we make promises to ourselves we know we won't keep. But that Inner Critic is still there, waiting for our defenses to slip—as they always do—ready to condemn us, always finding that we don't measure up. We vacillate between spoiling ourselves and punishing ourselves. And, as with children who are raised that way, we end up frightened and traumatized, with no self-esteem and a lot of self-hate. Compassion replaces all that with patience, gentleness, love, grace, mercy, concern. It suggests giving up judging and replacing it with empathy, a willingness to face the truth and all your feelings about it, without fear but with confident strength. Curiosity suggests a little cool detachment from the emotional heat, a desire to understand objectively why we feel what we feel, why we do what we do—especially when it’s troublesome or self-defeating. Why did I get angry just then? What’s making me so blue today? We look at ourselves, not to torture ourselves, not to give ammunition to the Critic, not with desperation for a quick fix, but with compassion, sincere interest, and the belief that there are answers that make sense. No matter how nonsensical our behavior, no matter how odd our feelings, there are always reasons—and knowing the truth will help set us free. We look a little deeper than usual, with more objectivity, and we don’t just slap ourselves on the wrist and make an empty promise to do better next time. Why? What’s bothering me? Why am I afraid to look? We understand that our feelings are just human; they won’t destroy us or drive us crazy. Most likely, they are tapping on our shoulder, trying to tell us something important.

Sunday, November 1, 2009

Mental Health and Healthcare Reform

Now that it looks like some form of health care reform will be passed this year—barring a catastrophe like Joe Lieberman—we have some idea of how the eventual act will affect mental health services. All of the plans now under consideration will mean some real improvements for mental health consumers, and there doesn’t seem much likelihood of these improvements being cut out before passage. However, it appears that individuals and employers will still have to purchase their insurance from private insurance companies, without competition from a strong public option like Medicare available for everyone. Nevertheless, the “reform” aspect of the bill would require private insurers to make some real changes in how they treat mental health issues. Here are the key benefits:

· “Parity” for mental health and substance abuse services. As it is now, when you see a mental health provider, your insurance company will probably pay him or her less for your visit than they would pay your GP or specialist for a similar service. They might require a higher copay from you for a mental health service than a GP visit. They might limit your total annual or lifetime benefits for mental health services. For instance, I have many chronic depression clients who need year-round supportive therapy, but their annual benefits run out in August or September. Most patients have to pay me a $30 or $40 copay from their own pockets, rather than the $10 or $15 that their GP charges. With a reform bill, private insurers would have to end these practices. That will make it much more possible for patients to receive the care they need without added expense. It will also make it possible for patients who need medication to see a specialist, and not have to rely on the family doctor to prescribe medications he’s not really expert at. Eventually, it may lead to more practitioners entering mental health, a real benefit because credentialed providers are in short supply.

· No discrimination based on pre-existing conditions. The fact that insurers currently can, and do, refuse to insure you for pre-existing conditions is one of the major factors that keeps consumers tied to their jobs. It also forces them to contort themselves anxiously through COBRA plans and sensitive negotiations with their employers to stay on their old plan. And of course the old plan is currently still free to let you go, cap your benefits, or charge you a higher rate for those pre-existing conditions. This doesn’t hurt only mental health consumers, of course, but also those with cancer, heart disease, diabetes, or any other chronic/recurring illness. The current policy thus causes a great deal of stress for many, many consumers, which hopefully will be greatly eased by the new legislation.

· No rate changes based on health status. With reform, insurers will no longer be able to raise your rates because you develop a chronic or expensive condition. All subscribers in the same age group will pay the same rate.

· Greater availability of insurance, at lower cost. Though the details haven’t been worked out yet, all the bills have as a major goal greater availability of insurance plans to individuals and to people who can’t afford healthcare now. Many people with mental health disorders like long-term depression are not able to sustain themselves in challenging or stressful jobs, resulting in poverty or underemployment. The current economic collapse and the fact that insurance rates keep rising more than twice as much as the general cost of living has put health insurance out of reach for many. Reform is meant to make insurance much more available.

· Expansion of Medicaid. Medicaid is the government-run healthcare plan available to the poor. It’s a program that works well, and though there are some problems they are nothing like the problems with private insurance. The bill would basically expand the definition of the poor to include more working-class, low-income families. The fact that so many households have parents working two or three part-time jobs, none of them providing private insurance, means that Medicaid expansion and the greater availability of low-cost private plans will take a tremendous worry off of working people’s backs.

These are all great steps forward, especially for everyone who sees a therapist or takes an antidepressant or other psychiatric medication—or needs to. However, the devil is always in the details. Here are some potential pitfalls I haven’t seen addressed in the reform plans.

· “Managed” care. Over the last twenty years, private insurers have added huge expenses to the cost of care by employing thousands of people whose sole job is to restrict benefits. For instance, many plans will only pay for a few counseling sessions before requiring the provider to file a form justifying continued treatment. This is sometimes referred to as “Mother may I” care. The insurer is free to make arbitrary decisions to change the treatment plan or limit the kind of care available to the patient. The army of bureaucrats employed to run managed care programs has provided a way for insurers to vastly add to the cost of care, in the name of controlling the cost. Obviously some form of management is necessary to prohibit greedy practitioners from overcharging and overprescribing, but I haven’t seen anything in the bills that would control or regulate this practice. This may lead to the point where some practitioners will not accept some plans because they require unnecessary hassle to pay legitimate claims. This is the case now in my geographic area, and doctors accept some plans and not others because of this. Consumers have no means of knowing about this practice, so they often choose a plan that none of their providers will accept. If there were some form of standardizing these practices, most providers would then accept all, making comprehensive health care much more accessible, and reducing insurance company’s overhead.

· No reform of drug industry practices. The pharmaceutical industry is no longer honest or reliable when their drugs are reviewed in academic journals. The FDA has been fooled regularly by tainted research. In work on depression, some highly respected researchers have taken drug industry payments under the table—as much as $500,000—to distort their findings in favor of a particular drug, or to support drug use in general. Your home-town psychiatrist can receive payments of $5- or $10,000 for adding their name to ghost-written research, and their prescribing habits can be monitored by drug companies, giving them a powerful incentive to prescribe a particular drug. I’m sure the same practices apply to drugs for other diseases. These developments are not addressed at all in this round of reform, and they should have been. They add tremendously to the cost of care, and they often result in patients not getting the best medication available.

· No real guarantees of reduced cost. There’s a long time between when a bill is passed and the actual practical guidelines are worked out. Given the influence of insurance and drug industry lobbying, there’s a lot of opportunity to find ways for costs to be passed on to consumers. I fear that whatever final bill is passed, it will lack the teeth to enforce some of the benefits we’ve described.

· No emphasis on preventive care. Relatively simple screening tools for depression, anxiety disorders, and other conditions are available and effective. If they were implemented routinely, a lot of pain and suffering would be alleviated and the overall cost of health care would decrease. Public attitudes about mental health issues need to change. The biggest obstacles to treatment remain the patient’s own self-blame and fear about what mental health services are like. Though there is some promise in some of the bills for services to address these needs, this is a soft area that remains vulnerable to misguided cost-cutting.

· Lack of a real public option. If there were some form of universal, government-administered plan like Medicare available to everyone, private insurers would need to compete with it—and Medicare is much more cost-effective than private insurance. Every other developed country in the world offers a government plan of some sort. All of them have their good points and bad points, which we could learn from. But Americans pay twice as much for health care as the next most expensive country (Belgium) and receive second-rate care. By most measures of public health, we rank well below the top ten of all countries. A good public option would change all this; our total healthcare expenses would drastically decline, resulting in a vastly improved economy. Employers would be spared the expense and administrative costs of providing care (we’re also the only country in the world that ties health insurance to employment).

I work with several Medicare patients. They don’t abuse services, but they take advantage of what’s available to them. Without Medicare, their depression would leave them withdrawn, isolated, unable to make the best decisions, and panicked about their future. And that’s exactly the state many depressed people are in right now—all those who lack insurance or have restricted care. I think we as a society are better than that.

SO—like most of life, it’s good news and bad news. The planned reforms should make health insurance cheaper and more available to everyone. Those who need mental health services will no longer be made to feel like second-class citizens because the care they need is more expensive and more restricted. Mental health consumers out-of-pocket expenses for their care should decline. People won’t have to worry so much about losing their insurance if they require expensive care or change jobs. People who don’t have insurance now will be able to get it more easily. But as it is now, reform leaves a lot to be desired. Private insurers will still play a central role, and their incentive is always to make a profit rather than provide the best care. You will have no guarantee that the doctor or therapist you want will accept your insurance plan. The drug industry will continue to drive up the cost and reduce the quality of care. Without a strong public option, there’s no real guarantee that our individual health care expenses will be greatly reduced. Still, we will probably see big steps in the right direction, which may gather enough support that the further reform we need will take place without such great resistance.

Friday, August 28, 2009

Adjusting the Happiness Thermostat

My last book, Happy at Last, borrowed from psychology, economics, brain science, and social research to identify how we can be happier. It turns out that each of us has our own set point for happiness, like on a thermostat. Some of us are constitutionally bubbly, others seem to be natural grumps. When good things happen to us, those who are on the grumpy side can feel good for a while, but they usually return to their previous set point. If we want to stay happier, we have to put in focused attention and practice. The good news is that it really works. Both brain research and the social sciences have shown that we can make a permanent adjustment in our happiness quotient by making a few changes in how we think and what we pay attention to.

With that in mind, here are some suggestions that will add both joy and satisfaction to your life:

1. Happiness is a skill. It’s not an innate gift. It requires that we pay close attention to our experience and see objectively what makes us happy. Our minds and our culture tell us a lot of lies about what might make us happy (getting rich, beating out the competition, acquiring a lot of things). We have to get past those assumptions and systematically learn what makes us happy.

2. Practice mindfulness meditation at least four days a week for a half hour. Just sit, clear your head, focus on your breath, and listen to the noise your brain makes while you're trying to disengage from it. Your brain really doesn’t want to give up control. But as you practice this, you will become healthier, calmer, less stressed, more aware of hidden meanings and patterns in your life, and less subject to anxiety running away with you. By some measures, experienced meditators are the happiest people in the world.

3. Practice mindful thinking and observation. Because we’re under so much stress, we feel we have to quickly categorize our experience into simple, black and white categories. This makes us miss out on the rich details of life. If you practice noticing how you judge, slowly you’ll begin to stop. View yourself and the world with compassionate curiosity, the desire to understand and the belief in your own worth. Learn to be noncategorical, detached, willing to let go, willing to think independently, willing to take responsibility. Cultivating mindfulness will make you more aware of opportunities for joy, help you make better decisions so you’ll reduce unnecessary misery and experience greater satisfaction and meaning.

4. Exercise aerobically for a half hour, three to four times a week. There’s an enormous body of research out there to prove a very simple point: the more you exercise, the better you feel.

5. Don’t fall for the belief that you’ll be happy when you get what you want. Inevitably, when you get what you want, you’ll quickly get used to it and start wanting something else. And while you’ve been waiting, you’ve missed out on a lot of opportunities for joy.

6. Work on wanting what you have. Look around you and try to appreciate your possessions and possibilities as if you were Ben Franklin popped into the 21st century. Central heating, air conditioning, indoor plumbing, a stove and refrigerator. A vehicle that will take you 600 miles in a day, in comfort, on paved roads. An orchestra you can carry in your pocket. If Franklin doesn’t do it for you, simply look carefully at your surroundings. Your furniture, books, possessions. There’s beauty and memories there. Savor them.

7. Contemporary living conditions are not what our bodies and minds were designed for. We’re designed to live in small cooperative groups; to work no more than four hours a day; and to spend the rest of the time communing with each other, making music, making art. So don’t assume there’s something wrong with you if you’re not happy. Being happy in today’s world takes effort.

8. Most unhappy people have an Inner Critic in their brains. The Inner Critic is the voice that blames you whenever things go wrong and is never satisfied no matter how well you do. It’s your brain looking for someone to blame for your stress and disappointment, and settling on the most convenient suspect—you. You can’t argue with this Inner Critic, because it doesn’t play by the rules of logic. It’s a result of crossed wires in your nervous system. Imagine that you have a volume control for it. When you hear the voice of your Inner Critic, turn the volume down a little and distract yourself with other things. The more you practice this, the easier it will get to ignore the Inner Critic.

9. Happiness is smaller than you think. Cultivate small pleasures. Learn to cook. Eat well. Cook for friends. Expose yourself to awe and beauty; get out in nature, and pay attention. Watch less television. Play more. Get a dog. Join a laughter club. Get more touching into your life.

10. At bedtime, let yourself go to sleep thinking about three things to be grateful for, things that made you happy, or simply the best memories of the day. As you do this, pay attention to the feelings in your body: the smiling reflex, a warmness in your heart, the flow of tension out of your neck and shoulders. Whenever you feel good, let your body express it. Just doing this exercise every night has been proven to raise your happiness quotient as long as you keep it up.

Tuesday, August 18, 2009

In the garden

One of my great joys of middle age has been perennial gardening. In addition to other benefits, it has proven to be a great stress reducer. I freely acknowledge having no conception whatever of garden design. I buy one of any plant I like and stick it in where I have room, with just a little thought to color combinations and space. As a result my garden from afar looks like a crazy quilt.

But I like to look at it from up close, to see the growth of individual plants that interest me, how their leaves and stems spring up from the earth, how they blossom and flourish in the summer heat. There is something about the rebirth of the world in spring, the cycle through summer and even into the fall, when I can see the plants preparing themselves for the winter to come, that I find deeply satisfying and calming. It seems to me to have to do with the cycle of death and rebirth, something about how I experience my own body aging but my children coming into full maturity, that gives me a sense of continuity and some degree of acceptance of my own mortality. And it's more than just a state of mind. I get up early in the morning and go out to see what I see new in the garden. I come home from work and can't wait to go weeding or transplanting. I feel energy throughout my body.

But the Zen-like peace that I find in the garden only lasts through the waning days of fall. By February I'm bored, grouchy, sorry for myself, withdrawn, a bear who can't get to sleep. The intensity of the change certainly feels to me as if it comes from something more than being deprived of my favorite leisure activity. It feels qualitatively different. There are plenty of other things I can do besides gardening, but I don't want to do them; and I have trouble enjoying the other things I normally enjoy. I can usually force myself out of this mood, but it requires a deliberate act of will.

My little meltdown in winter is a microcosm, I think, for the situation far too many of us face today. We're deprived of the opportunity to be in touch with nature, and that is a very real stress, and stress hurts us in ways science is just beginning to understand. Humans were designed to live in harmony with the cycles of the day and night and seasons. We were surrounded with reminders to be humble—that earth and the universe were much bigger than us, that birth and death were all around us, that hunger was always just around the corner. We had a lot of quiet time when we could let our minds shift into a contemplative state—watching the sun rise, waiting for the fish to bite, hauling water, tending the garden.

It turns out that contemplative state is necessary for our mental health. When we have the opportunity to lean on the hoe and just be, we're letting our left brains—the creative, impressionistic, coherent side—take over and giving the right brain time to rest. The right brain is terribly overworked by all the decisions we face every day, the busy schedules we keep, the overstimulation of traffic and television. When we can use the left brain, we can see ourselves in our own mind's eye—consider the self as a whole person, connected with the real world—and get our priorities back on track. Scientists who have been studying the effects of regular meditation have found it has wonderful effects on the mind and body: it helps us with major depression, chronic pain, anxiety and panic; it makes our mood more positive and our immune systems stronger. I think it won't be long before science proves that activities like walking in the sunshine, petting the dog, and planting, watering, weeding and just viewing the garden, have the same kind of healthful benefits. They make us slow down, be patient, pay attention; stop striving so hard all the time and get in harmony with the world.

Tuesday, August 11, 2009

Getting Organized

There is a simple tool that can be used for organizing our lives so that more time is available for the things we like to do. It also helps us focus on our own goals, and planning how to achieve them. We can classify all tasks and activities on two dimensions, importance and urgency.

1. urgent

but unimportant

2. urgent

and important

3. not urgent

and not important

4. not urgent

but important

When people do this, they generally find that they are spending most of their time in cells 1 and 2, activities that seem urgent but may or may not be important. If we fall behind the pace of contemporary life, we have to spend far too much time in Cell 1, “Urgent but Unimportant”—paying the bills just before they come due, rushing a deposit to the bank to cover them. On a broader scale, if you neglect your child’s emotional needs now, you may have to spend a lot of time later in family therapy or family court.

It’s especially dismaying to recognize how little of our time is spent in cell 4, on activities that may be very important but carry little urgency. Most people realize that, if they were able to address the important but nonurgent items, many of the urgent but unimportant things would take care of themselves. Cell 4 is preventive maintenance: getting the car in for oil changes, having our teeth cleaned, setting up an automatic deduction to pay the mortgage so you don't have to scramble at the end of the month to get the payment in on time, and paying attention to your relationships.