Tips for Resilient Aging 1

It’s well known that the population of the US and other Developed Countries is getting older, and this shift has many consequences.

A wide range of important stressors increase with age. Elderly people face many losses. Their friends and neighbors die, their appearance tends to drop below social standards for attractiveness, they typically become less agile and peppy. Eventually they often have to let go of their homes and many of their possessions; many people end up in assisted-living facilities with little beyond the things that fit into a small closet or chest.

This is, of course, only a tiny, hapharzardly selected, sample of stressors that tend to accompany the passage of years. Without regard to such details, the old quote from Bette Davis says it all “Getting old ain’t for sissies”. If you are smart, you will prepare for it.

Since it takes time and energy to develop techniques for enhancing resilience and turn them into personal habits, it is fortunate that resilience techniques are also have a myriad of benefits for dealing with any of life’s stages.

Several major studies have influenced our view of techniques that help us respond to aging with resilience. Our plan for this and the next few posts is to describe these influential bodies of evidence.

The first is based on research done by Herbert DeVries and colleagues. and summarized in a book entitled “Vigor Regained”.

DeVries determined “scientifically whether carefully planned and controlled exercise can help restore vigor to older people”, and solidly affirmed that it could. He found that sedentary people, even in their 70s,80s,or 90s were, after training, able to run a nonstop mile.

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Spirituality as a Resilience Asset: the Trapped Chilean Miners

We have not yet discussed the important resilience tool of Spirituality. This can take many forms,but is frequently expressed through ordinary religious practices.

Many people rely on spirituality as the center of their resilience assets. Many others may call upon spirituality only if the situation seems frightening or even desperate.

A perfect example of spirituality used in a dramatic crisis is that of the Chilean Miners who in August 2010 were trapped underground in the San Jose mine for 69 days.The story, narrated by Hector Tobar in his best-selling book, “Deep,Down,Dark” is, as we write, opening as a movie.

Tobar’s book is rich in descriptions of spiritual practices and attitudes that served as resilience tools, sustained the miners and, apparently played an important role in their ability to persevere and recover.

Spirituality helped keep the miners sane and helped them to apply their problem-solving abilities to assist those up top to save them before their health deteriorated beyond recovery.

Hector Tobar aptly titled the chapter where prayer by the miners were first described as “We have Sinned.”

One angry miner cried out for the miners to pray, seeing God as the only way out of the grave situation.

He turned to one Christian miner to lead them in prayer. Although many reacted with surprise and amusement, nevertheless all 33 men, as instructed dropped to their knees to humble themselves before their Creator. The miners came from relatively diverse religious backgrounds. They prayed open eyed, closed eyed, with and without tears.

The prayer leader began by stating “We aren’t the best men, but Lord have pity on us.” This statement had a big effect on several of the miners, leading them to acknowledge silently their sins and faults such as drinking too much, being too quick to anger, not being a good father, and infidelities. The miners were encouraged by the leader to humble themselves before God, asking God to guide the rescuers to them. It was common for the men to commit themselves to begin new lives as better men.

The prayers became a daily ritual which preceded the one very skimpy meal each miner had. Soon the prayers included asking out loud for forgiveness for the misdeeds and failings they delivered to family members at home. This morphed into “self-criticism” sessions with apologies to fellow miners for things such as raising their voice toward another, not helping with retrieving water and displaying anger toward another.

Turning to a more powerful force to help them changed the seemingly impossible situation to one that might set them free. They tried their skills to get free and knew at this point that rescuers were working for their release, but this seemed less than reliable and adequate. This daily prayer ritual brought them closer to each other and helped to create a buffer against all the fears and trials of their daily existence.

It provided some daily meaning to their lives and the expressions of gratitude for at least a short time distracted them from negative thoughts and fears. The communal nature of spirituality fostered the extremely valuable resource of connecting with each other as an asset and a means through troubling and challenging times.

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How to Develop Habits that Increase Resilience

Ultimately, resilience training should result in new habits that make you more resistant to stress.

We have pointed out a number of times that listening to a lecture or reading an article on coping with stress is not likely to be enough to result in more resilient habits. You may get useful information, maybe even inspiration, both of which can be valuable, but that is not enough to produce new habits.

Usually we recommend “practice, practice, practice”. We also described “mental contrasting”, a method that asks you to imagine yourself as you are now, and to alternate that with imagining yourself after you have developed a new resilience habit. This differs from a widely used method of simply imagining yourself as having achieved the desired goal. The latter method has proven to be ineffective.

Research shows that mental contrasting improves results. For example, see Amit Amin’s paper here. Details of how to practice mental contrasting were published in the Harvard Business Review here.

We now have the concept of the habit loop, which can act as a guide on how to develop new habits. This model of habit change contrasts with a long familiar approach of just giving yourself rewards when you engage in the behavior you want to make habitual. Instead, it focuses heavily on turning attention to the cues or triggers that elicit the behavior. Continue reading

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The Path to Greater Resilience: From Attitudes to Skills and to Habits.

When we discussed the Sense of Coherence in our previous post, we said that it was a match for the first factor in our three factor model of resilience.

In both popular culture (e.g. Rev. Normal Vincent Peale’s “The Power of Positive Thinking” which had a huge impact in the United States and elsewhere) and scientifically developed theory (e.g. Barbara Frederickson’s book, “Positivity”), the value of positivity has been recognized as playing a major role in lives well-lived.

But we see a distinction between attitudes of positivity and positive skills that are closely connected to those attitudes.

Probably most people would predict that positive attitudes and thoughts are related to resilience. But having skills such as knowing ways to calm and soothe yourself when distressed have been given less attention. In addition, many of us possess the needed skills, but do not implement them.

Once we take the skills to the point where we actually implement them when they are needed, we have reached the third level of using resilience tools, the level of habit.

In sum, we have to go from attitudes to skills and on to habits.

Isn’t this a lot of work? It can be, but for the most part the process is very enjoyable, even exhilarating at times.

Do we need to say that we think you should give it a try?

If you decide to do that, this and this will help get you started.


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What Can We Learn from Those Who Survived Deadly Stress

In this post we take a look at ways people manage to live at the outer limits of survivable stress without totally breaking down.

Our rationale? If the methods have worked in the nastiest even potentially fatal settings, there is a good chance that some version of them will help most of us.

A look at the lives of people who have lived through an ultra-stressful period of their lives quickly reveals that there are striking differences in how well people handle intense, and even deadly stress.

For decades there seemed to be no way to tell who would survive such lethal environments and who would not.

Anne Applebaum has a deep knowledge of one such environment, the brutal Soviet “Gulag” prison camps.

Her profound study of the Gulags failed to provide her with any formula for predicting who might survive them. This passage illustrates her views:

“… almost everyone who lived through the experiences of the Gulag agrees that survival was impossible to predict in advance. The mildest people sometimes found an inner strength they had not known of before. The bravest sometimes could not accept the daily humiliation, and died quickly. The strongest sometimes suffered the most from the lack of food. The weakest sometimes survived because no one bothered to torment them. In the end, the very quirkiness of human nature defies even the most drastic attempts to predict or control it. It is hardly surprising, then, that it is difficult to predict as well.” Applebaum (2003).

Findings from controlled research on ultra-stressful environments also left the investigators baffled about what might enable people to deal with those situations.

One striking study done under the auspices of the U.S. Navy, “Project Sealab II”, was designed to identify qualities in people that helped them get through the experience of living deep under the ocean in a crowded, uncomfortable, often frustrating environment. Sealab largely disconnected them from the outside world and had settled at an angle that produced many problems, including impaired sleep. In addition, it was life-threatening because mistakes at the depths of the ocean could quickly result in death for oneself and others.

Before participants were transferred to Sealab, they were given an extensive array of psychological tests. Surely some of the tests would predict who would be resilient enough to excel in dealing with the challenges.

However, it is easy to summarize the results of this study: Consistent with Applebaum’s account of the unpredictable reactions to the Gulags, none of the psychological tests distinguished between who would do well and who would be overwhelmed.

There was one outstanding dissenter about whether breakdown and even death is likely to occur in the horrible settings we have been discussing. Victor Frankl, a Professor of Neurology and Psychiatry at the University of Vienna Medical School was, when the Nazis took over Austria, sent to a sequence of concentration camps. Well known ones were Auschwitz and Dachau. He wrote a number of books about his experiences in the camps and his analysis of people’s reaction.

He concluded that maintaining a sense of meaning, purpose, and hope was central to surviving. Some people would lose those qualities, and then die quickly.

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The Green Space Solution

People who are being damaged by stress are often in situations they see as unchangeable. Frequently they try meditation, take a Yoga class or go to lectures on dealing with stress. All of these can help, but let’s take another look at the possibility of changing the stressful environments that are triggering stress reactions.

If we think of these situations as a whole, it is very understandable why they seem unchangeable. If your job is the problem, it may also pay well or have other benefits that are hard to replace. Similarly, when the main source of stress is a marriage, you may have to face risks of damage to children, being thrown into a much more difficult financial situation, or getting trapped in a life of loneliness.

So the idea that exiting your situation is hopeless makes sense.

However, all of this fails to consider the potential of small changes. If you can’t get out of your situation, small changes in it may be a good alternative.

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The Core Principles of Progressive Relaxation.

While preparing our previous post on using breath control to relax, we ran into some technical barriers to uploading one of our relaxation audios to the post. Rather than add delays to uploading the post, we decided to select from the multitude of videos offered on You Tube.

We were aghast to find that almost all of the videos made a fundamental mistake that would likely keep people from developing the awareness of muscular tension that is central to relaxation training in which you deliberately alternate tensing and relaxing carefully attending to and contrasting the two states.

Most of the videos instructed people to tighten muscles very strongly, even “as hard as you can”.

The central idea of progressive relaxation is to become sensitive even to slight amounts of tension and learn to shut that tension off.

Contracting strongly will relax you briefly because it is isometric exercise. It do little to teach you to recognize the tensions of anxiety or to control them.

Progressive Relaxation (PR) was developed by Edmund Jacobsen, an M.D. Ph.D with a strong background in physiological research. He also introduced a newly developed tool, the electromyography, so could measure tension objectively.

Anyone who has observed the direct readings of muscular tension that an EMG provides can tell you that it is common for people to report being totally relaxed when they are still far from it.

The main focus of PR was to learn to recognize muscular tension and how to release it. Jacobson’s technique started with learning to recognize tension when you place your forearm, bottom side down, on a flat surface and then gently point your fingers up toward the ceiling. At a later stage, he even had trainees lift the fingers only a small distance upward. This is far from tensing “as hard as you can”!

He also had trainees go through these procedures progressively, throughout the body until they reached a point where they were aware even of slight amounts of tension and knew how to shut the tension down.

PR has played an important role in many effective stress coping techniques so it’s worthwhile to review its core principles.
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Breath Control to Shed Symptoms and Increase Resilience

In two earlier posts on tactical breathing, here and here, we discussed several ways to change your breathing patterns in order to deal effectively with events that are difficult or even terrifying.

Today we will discuss chronic hyperventilation (overbreathing), a very damaging pattern of breathing, and ways to deal with it. It happens that a major branch of classic yoga is pranayama, a discipline dedicated to breath-training.

But isn’t breathing automatic? When you fall asleep or even are knocked unconscious, you continue breathing. There is no need to understand
how you breathe because it is regulated by primitive parts of the brain at its very deepest levels, even without guidance from higher parts of the brain.

However, breathing can also be controlled by higher areas of the brain, including the most advanced cortical areas. And pranayama, tactical breathing, and some modern research on chronic hyperventilation all suggest that learning new breathing patterns, and especially turning them into ingrained habits, can help us to be more resilient in stressful situations and to shed symptoms that are due to faulty patterns of breathing.

What kind of symptoms are we talking about?

The answer to this question is most readily found in papers on the effects of chronic hyperventilation. The symptoms are incredibly diverse, and are often viewed as “in your head”, “neurotic” or “due to anxiety”. These patients go from one doctor after another and rarely get real relief.

A good short list of the symptoms can be found in a paper by L.C. Lum, Table 1. They include symptoms of diseases of the heart, lungs, intestines, nervous system as well as psychological symptoms, e.g. anxiety, tension, etc.

How can such a variety of symptoms result from something as simple as a pattern of breathing? It does, indeed, seem to treat breath control as a kind of cure-all. But the linkage of this array of symptoms and overbreathing makes sense because this kind of breathing results in a rapid drop of blood carbon dioxide by 50%, and carbon dioxide rapidly and dramatically changes the activity of nerve tissue. (If you are interested in technical details, see this article by R.A. Cluff. Be sure to click link to the complete article.)

What You Should Do If You Think You May Be Hyperventilating?

The two links mentioned in the first sentence of this post provide several useful ways to change your breathing pattern to increase your resilience. They can give you relief on the spot. However, to make longer term changes, you will have to practice regularly for some time.

If you want to go beyond those options, and get some coaching and support from others, many programs are available. Try looking into yoga studios, checking whether they have courses that emphasize pranayama or at least give it some priority. Pranayama is based on almost 3000 years of varying and practicing breath patterns and carefully observing their effects. So it is the most thorough breath control discipline.

Papworth hospital in Cambridge, England has a method of retraining hyperventilators that succeeds in a very large proportion of cases, but Papworth is not easily accessible for most of us, and their technique involves inpatient training.

First they show the patient that they can reproduce their symptoms by rapid, shallow breathing from the chest. Then they train them twice daily to do slow, diaphragmatic deep breathing, until their breathing rate is around six times per minute, which tends to be about one third of their original rate.

To help you try out diaphragmatic breathing, watch this video, then practice regularly. There are many more videos teaching diaphragmatic breathing on Youtube done by teachers of Yoga, Pilates, Hand Therapy, Physical Therapy, and more. Obviously, if you want personal training, it is widely available.

The Papworth method also includes a version of progressive relaxation training. Relaxation training instruction is widely available for free on You Tube. Unfortunately, most of the videos have serious errors that are incompatible with the core concepts of Progressive Relaxation, which appears to be the method they are striving to demonstrate.

The central goal of Progressive Relaxation is for people to really learn the difference between tension and relaxation. To do so, they have to train themselves to recognize increases in bodily tension as clearly as they recognize sights and sounds.

Most of the free videos demonstrate exercises that are inconsistent with learning to sense tension. For example, they have people tighten muscles as hard as possible without damaging themselves. That makes sensations of pain and strain that get in the way of observing ordinary tension.

We will explain other details of Progressive Relaxation in future posts. For now, here is an audio you can use for deep relaxation.


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Yoga or Resilience Training: Do We Have to Choose?

What are the main differences between yoga and resilience training? Would it be a good idea to do both, or are they a bad mix?

Around a year ago Debbie asked for a Yoga class as her birthday present. It was a great suggestion, and Yoga has helped her to cope with a stage in her life in which she has agreed to take responsibility for decisions about health care for her mother. Yoga worked for her and continues to be an important part of her life.

More recently a longstanding friend of mine suggested that I enroll in a beginner’s course in Yoga, and Debbie also urged that I take the course. For many years, I have been dealing with severe, chronic pain due to an arthritic spine that creates impingements on my spinal cord that result in chronic pain and problems with controlling how I walk.

I had just finished a very successful series of Physical Therapy interventions, so was interested in retaining the gains I had made through various forms of stretching and balancing.

Why did Debbie and I both reach out for help from another system instead of relying on the resilience techniques we already knew? Abraham Lincoln summarized one of the major reasons in a widely used quote about lawyers: “He who represents himself has a fool for a client.”

It’s helpful to get training from someone other than yourself. Distance provides a useful perspective.

In addition to that, though resilience training and Yoga superficially seem to have little in common, they are really very much alike. Both approaches use a wide range of techniques that enable you to know yourself at a deeper level and to soothe and calm yourself.

Yoga, as it is typically practiced in the United States, emphasizes working on changes of the body, and most resilience programs emphasize changes at the level of mind.
But change in the body results in change in the mind and change at the level of the mind results in change in the body.

For example, if you are getting agitated, slowing and deepening your breathing pattern tends to calm both your mind and your body.

Similarly, you can make yourself salivate by imagining sucking on a lemon and you can make your hands get warmer by imagining yourself at the beach lying on a big towel and picturing the sun warming your hands.

For quite a few years a significant body of research in scientific psychology has focused a lot of its efforts on conducting studies to determine whether ancient techniques work. For the most part, those techniques have passed the tests and been integrated into psychological methods of treatment.

So our view is that ancient disciplines from the Far East tend to fit comfortably into recent, science-based resilience programs.


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Distractions Play a Central Role in Producing the Benefits of Meditation

When you meditate, your experiences fall into two categories : 1. The object on which you intend to focus, and 2. Distractions.
Here we want to focus on distractions, particularly on where they come from and what you should do with them.

At first we may be inclined to say that distractions are mere chaos of the mind. When we call them “chatter” we come close to implying that view of them.If you take a step back and observe distractions, you can see that they are meaningful. In our ordinary, non-meditative life, they are calls to needed actions, attempts to solve problems that we face, strategies for fending off painful thoughts, etc.

During meditation, they are not allowed to take center stage.We keep our attention on the object of our meditation by gently turning away from the distractions. We do not wage an internal war against them. Instead we take a calm, passive attitude toward them, and let the distractions pass through, neither grasping them nor fighting them off.

What happens as you get better and better at letting thoughts that have usually driven you to action go unappeased is that the distraction loses its power over you, and you start remaining calm and centered instead of jumping to action.
You can see why meditation can make you calm, relaxed, and in control of your own actions.

Autogenic Discharge

One particular type of distraction calls for special attention. We call it “discharge”, a term taken from Autogenic Training, which can be observed over a wide range of techniques that involve calming the mind and body. For example, in Zen meditation it is called “Makyo”, and Zen masters inquire about it regularly with their students.

These discharges may include a wide range of symptoms such as dizziness, anxiety, headache, nausea, twitching, disturbing images, crying etc. In some ways their texture is similar to that of experiences people may have just before they go to sleep.

The best thing to do when you have these experiences is to gently turn your attention back to the object of your meditation. Generally, such experiences are self-limiting. If you stay with your meditative focus, they will fade away.

However, if they feel unbearably disturbing, stop meditating. It’s best not to try toughing out the experience.

A number of adjustments can be made in your meditation routine in order to minimize the occurrence of such highly disturbing experiences. Continue reading

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