Technology connects us 24/7. Like a drug it provides instantaneous reinforcement when searching for information and sending or receiving social messages. Millennials are the first generation of digital natives who are always connected–from being jarred awake by their cellphone alarm to checking email or Facebook just before sleep. They are unlike their parents who are digital immigrants and have experienced face-to-face communication instead of virtual/digital communication. The video below, Simon Sinek on Millennials in the Workplace, offers an interesting insight of in the lives of millennials.
“I have had headaches for six years, at first occurring almost every day. When I got put on an antidepressant, they slowed to about 3 times a week (sometimes more) and continued this way until I learned relaxation techniques. I am 20 years old and now headache free. Everyone should have this educational opportunity to heal themselves.” -Melinda, a 20 year old student
Health and wellness is a basic right for all people. When students learn stress management skills which include awareness of stress, progressive muscle relaxation, Autogenic phrases, slower breathing, posture change, transforming internal language, self-healing imagery, the role of diet, exercise embedded within an evolutionary perspective as part of a college class their health often improves. When students systematically applied these self-awareness techniques to address a self-selected illness or health behavior (e.g., eczema, diet, exercise, insomnia, or migraine headaches), 80% reported significant improvement in their health during that semester (Peper et al., 2014b; Tseng, et al., 2016). The semester long program is based upon the practices described in the book, Make Health Happen, (Peper, Gibney, & Holt, 2002).
The benefits often last beyond the semester. Numerous students reported remarkable outcomes at follow-up many months after the class had ended because they had mastered the self-regulation skills and continued to implement these skills into their daily lives. The educational model utilized in holistic health courses is often different from the clinical/treatment model.
Educational approach: I am a student and I have an illness (most of me is healthy and only part of me is sick).
Clinical treatment approach: I am a patient and I am sick (all of me is sick)
Some of the concepts underlying the differences between the educational and the clinical approach are shown in Table 1.
|Educational approach||Clinic/treatment approach|
|Focuses on growth and learning||Focuses on remediation|
|Focuses on what is right||Focuses on what is wrong|
|Focuses on what people can do for themselves||Focuses on how the therapist can help patients|
|Assumes students as being competent||Implies patients are damaged and incompetent|
|Students defined as being competent to master the skills||Patients defined as requiring others to help them|
|Encourages active participation in the healing process||Assumes passive participation in the healing process|
|Students keep logs and write integrative and reflective papers, which encourage insight and awareness||Patients usually do not keep logs nor are asked to reflect at the end of treatment to see which factors contributed to success|
|Students meet in small groups, develop social support and perspective||Patients meet only with practitioners and stay isolated|
|Students experience an increased sense of mastery and empowerment||Patients experience no change or possibly a decrease in sense of mastery|
|Students develop skills and become equal or better than the instructor||Patients are healed, but therapist is always seen as more competent than patient|
|Students can become colleagues and friends with their teachers||Patients cannot become friends of the therapist and thus are always distanced|
Table 1. Comparison of an educational versus clinical/treatment approach
The educational approach focuses on mastering skills and empowerment. As part of the course work, students become more mindful of their health behavior patterns and gradually better able to transform their previously covert harm promoting patterns. This educational approach is illustrated in a case report which describes how a student reduced her chronic migraines.
Case Example: Elimination of Chronic Migraines
Melinda, a 20-year-old female student, experienced four to five chronic migraines per week since age 14. A neurologist had prescribed several medications including Imitrex (used to treat migraines) and Topamax (used to prevent seizures as well as migraine headaches), although they were ineffective in treating her migraines. Nortriptyline (a tricyclic antidepressant) and Excedrin Migraine (which contains caffeine, aspirin, and acetaminophen) reduced the frequency of symptoms to three times per week.
She was enrolled in a university biofeedback class that focused on learning self-regulation and biofeedback skills. All these students were taught the fundamentals of biofeedback and practiced Autogenic Training (AT) every day during the semester (Luthe, 1979; Luthe & Schultz, 1969; Peper & Williams, 1980).
In the class, students practiced with surface electromyography (SEMG) feedback to identify the presence of shoulder muscle overexertion (dysponesis), as well as awareness of minimum muscle tension. Additional practices included hand warming, awareness of thoracic and diaphragmatic breathing, and other biofeedback or somatic awareness approaches. In parallel with awareness of physical sensations, students practiced behavioral awareness such as alternating between a slouching body posture (associated with feeling self-critical and powerless) and an upright body posture (associated with feeling powerful and in control). Psychological awareness was focused on transforming negative thoughts and self-judgments to positive empowering thoughts (Harvey and Peper, 2011; Peper et al., 2014a; Peper et al, 2015). Taken together, students systematically increased awareness of physical, behavioral, and psychological aspects of their reactions to stress.
The major determinant for success is to generalize training at school, home and at work. Each time Melinda felt her shoulders tightening, she learned to relax and release the tension in her shoulders, practiced Autogenic Training with the phrase “my neck and shoulders are heavy.” In addition, whenever she felt her body beginning to slouch or noticed a negative self-critical thought arising in her mind, she shifted her body to an upright empowered posture, and substituted positive thoughts to reduce her cortisol level and increase access to positive thoughts (Carney & Cuddy, 2010; Cuddy, 2012; Tsai, et al., 2016). Postural feedback was also informally given by Melinda’s instructor. Every time the instructor noticed her slouching in class or the hallway, he visually changed his own posture to remind her to be erect.
Melinda’s headaches reduced from between three and five per week before enrolling in the class to zero following the course, as shown in Figure 2. She has learned to shift her posture from slouching to upright and relaxed. In addition, she reported feeling empowered, mentally clear, and her acne cleared up. All medications were eliminated. At a two year follow-up, she reported that since she took the class, she had only few headaches which were triggered by excessive stress.
Figure 2. Frequency of migraine and the implementation of self-practices.
The major factors that contributed to success were:
- Becoming aware of muscle tension through the SEMG feedback. Melinda realized that she had tension when she thought she was relaxed.
- Keeping detailed logs and developing a third person perspective by analyzing her own data and writing a report. A process that encouraged acceptance of self, thereby becoming less judgmental.
- Acquiring a new belief that she could learn to overcome her headaches, facilitated by class lecture and verbal feedback from the instructor.
- Taking active control by becoming aware of the initial negative thoughts or sensations and interrupting the escalating chain of negative thoughts and sensations by shifting the attention to positive empowering thoughts and sensations–a process that integrated mindfulness, acceptance and action. Thus, transforming judgmental thoughts into accepting and positive thoughts.
- Becoming more aware throughout the day, at school and at home, of initial triggers related to body collapse and muscle tension, then changing her body posture and relaxing her shoulders. This awareness was initially developed because the instructor continuously gave feedback whenever she started to slouch in class or when he saw her slouching in the hallways.
- Practicing many, many times during the day. Namely, increasing her ongoing mindfulness of posture, neck, and shoulder tension, and of negative internal dialogue without judgment.
The benefits of this educational approach is captured by Melinda’s summary, “The combined Autogenic biofeedback awareness and skill with the changes in posture helped me remarkably. It improved my self-esteem, empowerment, reduced my stress, and even improved the quality of my skin. It proves the concept that health is a whole system between mind, body, and spirit. When I listen carefully and act on it, my overall well-being is exceptionally improved.”
Carney, D. R., Cuddy, A. J., & Yap, A. J. (2010). Power posing brief nonverbal displays affect neuroendocrine levels and risk tolerance. Psychological Science, 21(10), 1363-1368.
Cuddy, A. (2012). Your body language shapes who you are. Technology, Entertainment, and Design (TED) Talk, available at: http://www.ted.com/talks/amy_cuddy_your_body_language_shapes_who_you_are
Harvey, E. & Peper, E. (2011). I thought I was relaxed: The use of SEMG biofeedback for training awareness and control (pp. 144-159). In W. A. Edmonds, & G. Tenenbaum (Eds.), Case studies in applied psychophysiology: Neurofeedback and biofeedback treatments for advances in human performance. West Sussex, UK: Wiley-Blackwell.
Luthe, W. (1979). About the methods of autogenic therapy (pp. 167-186). In E. Peper, S. Ancoli, & M. Quinn, Mind/body integration. New York: Springer.
Luthe, W., & Schultz, J.H. (1969). Autogenic therapy (Vols. 1-6). New York, NY: Grune and Stratton.
Peper, E., Booiman, A., Lin, I-M., & Shaffer, F. (2014a). Making the unaware aware-Surface electromyography to unmask tension and teach awareness. Biofeedback. 42(1), 16-23.
Peper, E., Gibney, K.H. & Holt. C. (2002). Make health happen: Training yourself to create wellness. Dubuque, IA: Kendall-Hunt. ISBN-13: 978-0787293314
Peper, E., Lin, I-M, Harvey, R., Gilbert, M., Gubbala, P., Ratkovich, A., & Fletcher, F. (2014b). Transforming chained behaviors: Case studies of overcoming smoking, eczema and hair pulling (trichotillomania). Biofeedback, 42(4), 154-160.
Peper, E., Nemoto, S., Lin, I-M., & Harvey, R. (2015). Seeing is believing: Biofeedback a tool to enhance motivation for cognitive therapy. Biofeedback, 43(4), 168-172. doi: 10.5298/1081-5937-43.4.03
Peper, E. & Williams, E.A. (1980). Autogenic therapy (pp. 131-137). In: A. C. Hastings, J. Fadiman, & J. S. Gordon (Eds.). Health for the whole person. Boulder: Westview Press.
Tsai, H. Y., Peper, E., & Lin, I. M. (2016). EEG patterns under positive/negative body postures and emotion recall tasks. NeuroRegulation, 3(1), 23-27.
Tseng, C., Abili, R., Peper, E., & Harvey, R. (2016). Reducing acne-stress and an integrated self-healing approach. Poster presented at the 47th Annual Meeting of the Association for Applied Psychophysiology and Biofeedback, Seattle WA, March 9-12, 2016.
 Adapted from: Peper, E., Miceli, B., & Harvey, R. (2016). Educational Model for Self-healing: Eliminating a Chronic Migraine with Electromyography, Autogenic Training, Posture, and Mindfulness. Biofeedback, 44(3), 130–137. https://biofeedbackhealth.files.wordpress.com/2011/01/a-educational-model-for-self-healing-biofeedback.pdf
Sweating, finger temperature, muscle tension, breathing, heart rate, posture and other body signals covertly and overtly display your emotional state. The feedback from these signals can facilitate awareness and control to promote your health. Watch my presentation, The skin you’re in and other signals “Tells” of emotional state, presented at the TransTech-Transformative Technology Conference, Sofia University, Palo Alto, CA, Oct 14, 2016.
After the umpteenth interruption and not answering the questions, I hit the OFF button on the television. I can recognize when a speaker interrupts the other speaker or does not answer the questions and only mouths campaign slogans. Did he never learn the simple rules of debate allowing the other person to speak in the allotted time period without interrupting? Did he never study and master critical thinking in college so that he could logically answer a question? How come the moderator did not implement simple classroom management skills to moderate a discussion? When debaters do not follow the rules of engagement, we need to treat them as unruly children. The debaters need to learn basic respect for others and understand the difference between facts and fiction (lies). For the next debate adapt the rules which have been implemented in many settings ranging such as scientific meetings, family therapy, Native American gatherings, and Quaker meetings.
- No interruptions when a person is speaking for his/her allotted time.
- Hand the person a “speaking stick” that indicates he/she has the floor and cannot be interrupted.
- MUTE the mike of the non-speaking candidate.
- Install a traffic light in front of each candidate: Green O Go– your time to speak, Yellow O Warning-30 seconds time left, Red O Stop– the microphone is turned off.
- Interrupt the speaker after one minute of debating if the speaker has not answered the question. The moderator simply states, “You did not answer the question, Please answer it”.
- Reward or punish for good or bad behavior. If the debater interrupts, give an additional minute to the speaking candidate. If the candidate does not to answer the question after being reminded by the moderator, shut off the microphone and give the remaining time to the other candidate.
- Post real time fact checking score by having a panel rate the accuracy of the answers.
By following these simple rules there can be a debate instead of an out of control slugfest.
An officer and suspect interaction is fraught with danger especially if the police anticipate DANGER. The interaction may trigger an evolutionary based defense reaction that may mean that our analytical reflective thinking fades out and we focus only on immediate survival. You may interpret any cues as potentially dangerous and that your life could be in danger. At that point the information is not processed rationally; since, it reaches the amygdala 22 milliseconds faster than to the cortex where thinking would take place. You react instead of act!
Adapted from: Ropeik, D. (2011). How Risky Is It, Really? Why our fears don’t always match the facts. New York: McGraw Hill
We all have experienced this automatic response. Remember when you were pissed off and angry at a close family member or friend? In the heat of the argument (or was it the battle for survival?), you said something that was cruel and painful–a real zinger. As the words left your mouth, you realized that you should not have said what you said. You wished you could reel the words back. Immediately you know that this would be very difficult to repair. At that moment, you reacted in self-defense from the amygdala before the cortex was aware.
Similarly, an officer and you may react automatically without thinking when they perceive personal danger. How you behave and move could automatically signal DANGER or SAFETY to the officer . To deescalate the situation when stopped by the police, behave in a way that signals to the officers that you are NOT a danger to them.
I highly recommend the short YouTube video by country singer, Coffey Anderson, Stop the Violence Safety Video for when you get pulled over by the Police. They share, what to do actually when you get pulled over by the police? It offers strategies to help diffuse tension at traffic stop, it gives solid steps into ways of staying safe, and getting home. SHARE this. It’s a must for all to see. If you have the opportunity, role-play the situation with your friends so that it becomes your new automatic response.
The video is on YouYube: https://www.youtube.com/watch?v=MnoLAtu0Wjk
“I opened the exam booklet and I went blank.”
“When I got anxious, I took a slow breath, reminded myself that I would remember the material. I successfully passed the exam.”
“I was shocked, when I gasped, I could not remember my girlfriend’s name and then I could not remember my mother’s name. When breathed slowly, I had no problem and easily remembered both”
Blanking out the memorized information that you have studied on an exam is a common experiences of students even if they worked hard (Arnsten, Mazure, & Sinha, 2012). Fear and poor study habits often contribute to forgetting the material (Fitkov-Norris, & Yeghiazarian, 2013). Most students study while listening to music, responding to text message, or monitoring social network sites such as, Facebook, twitter, Instagram, or Pinterest (David et al., 2015).. Other students study the material for one class then immediately shift and study material from another class. While at home they study while sitting or lying on their bed. Numerous students have internalized the cultural or familial beliefs that math is difficult and you do not have the aptitude for the material—your mother and father were also poor in math (Cherif, Movahedzadeh, Adams, & Dunning, 2013). These beliefs and dysfunctional study habits limit learning (Neal, Wood, & Drolet, 2013).
Blanking out on an exam or class presentation is usually caused by fear or performance anxiety which triggers a stress response (Hodges, 2015; Spielberger, Anton, & Bedell, 2015). At that moment, the brain is flooded with thoughts such as, I can’t do it,” “I will fail,” “I used to know this, but…”, or “What will people think?” The body responds with a defense reaction as if you are being threatened and your survival is at stake. The emotional reactivity and anxiety overwhelms cognition, resulting in an automatic ‘freeze’ response of breath holding or very shallow breathing. At that moment, you blank out (Hagenaars, Oitzl, & Roelofs, 2014; Sink et al., 2013; Von Der Embse, Barterian, & Segool, 2013).
Experience how your thinking is affected by your breathing pattern. Do the following practice with another person.
Have the person ask you a question and the moment you hear the beginning of the question, gasp as if you are shocked or surprised. React just as quickly and automatically as you would if you see a car speeding towards you. At that moment of shock or surprise, you do not think, you don’t spend time identifying the car or look at who is driving. You reflexively and automatically jump out of the way. Similarly in this exercise, when you are asked to answer a question, act as if you are as shocked or surprised to see a car racing towards you.
Practice gasping at the onset of hearing the beginning of a question such as, “What day was it yesterday?” At the onset of the sound, gasp as if startled or afraid. During the first few practices, many people wait until they have heard the whole phrase before gasping. This would be similar to seeing a car racing towards you and first thinking about the car, at that point you would be hit. Repeat this a few times till it is automatic.
Now change the breathing pattern from gasping to slow breathing and practice this for a few times.
When you hear the beginning of the question breathe slowly and then exhale.” Inhale slowly for about 4 seconds while allowing your abdomen to expand and then exhale softly for about 5 or six seconds. Repeat practicing slow breathing in response to hearing the onset of the question until it is automatic.
Now repeat the two breathing patterns (gasping and slow breathing) while the person asks you a subtraction or math questions such as, “Subtract 7 from 93.”
In research with more than 100 college students, we found that students had significantly more self-reported anxiety and difficulty in solving math problems when gasping as compared to slow breathing as shown Figure 1 (Lee et al, 2016; Peper, Lee, Harvey & Lin, 2016).
Fig 1. The effect of breathing style on math performance. Diaphragmatic breathing significantly increased math performance and decreased anxiety (from: Peper, Lee, Harvey & Lin, 2016).
As one 20 year old college student said, “When I gasped, my mind went blank and I could not do the subtraction. When I breathed slowly, I had no problem doing the subtractions. I never realized that breathing had such a big effect upon my performance.”
When you are stressed and blank out, take a slow diaphragmatic breath to improve performance; however, it is only effective if you have previously studied the materials effectively. To improve effective learning incorporate the following concepts when studying.
- Approached learning with a question. When you begin to study the material or attend a class, ask yourself a question that you would like to be answered. When you have a purpose, it is easier to stay emotionally present and remember the material (Osman, & Hannafin, 1994).
- Process what you are learning with as many sensory cues as possible. Take hand written notes when reading the text or listening to your teacher. Afterwards meet with your friends in person, on Skype and again discuss and review the materials. As you discuss the materials, add comments to your notes. Do not take notes on your computer because people can often type almost as quickly as someone speaks. The computer notes are much less processed and are similar to the experience of a court or medical transcriptionist where the information flows from the ears to the fingers without staying in between. College students who take notes in class on a computer or tablets perform worse on exams than students who write notes. When you write your notes you have to process the material and extract and synthesis relevant concepts.
- Review the notes and material before going to sleep. Research has demonstrated that whatever material is in temporary memory before going to sleep will be more likely be stored in long term memory (Gais et al., 2006; Diekelmann et al., 2009). When you study material is stored in temporary memory, and then when you study something else, the first material tends to displaced by the more recent material. The last studied material is more likely stored in long term memory. When you watch a movie after studying, the movie content is preferentially stored in permanent memory during sleep. In addition, what is emotionally most important to you is usually stored first. Thus, instead of watching movies and chatting on social media, discuss and review the materials just before you go to sleep.
- Learning is state dependent. Study and review the materials under similar conditions as you will be tested. Without awareness the learned content is covertly associated with environmental, emotional, social and kinesthetic cues. Thus when you study in bed, the material is most easily accessed while lying down. When you study with music, the music become retrieval trigger. Without awareness the materials are encoded with the cues of lying down or the music played in the background. When you come to the exam room, none of those cues are there, thus it is more difficult to recall the material (Eich, 2014).
- Avoid interruptions. When studying each time you become distracted by answering a text message or responding to social media, your concentration is disrupted (Swingle, 2016). Imagine that learning is like scuba diving and the learning occurs mainly at the bottom. Each interruption forces you to go to the surface and it takes time to dive down again. Thus you learn much less than if you stayed at the bottom for the whole time period.
- Develop study rituals. Incorporate a ritual before beginning studying and repeat it during studying such as three slow breaths. The ritual can become the structure cue associated with the learned material. When you come to exam and you do not remember or are anxious, perform the same ritual which will allow easier access to the memory.
- Change your internal language. What we overtly or covertly say and believe is what we become. When you say, “I am stupid”, “I can’t do math,” or “It is too difficult to learn,” you become powerless which increases your stress and inhibits cognitive function. Instead, change your internal language so that it implies that you can master the materials such as, “I need more time to study and to practice the material,” “Learning just takes time and at this moment it may take a bit longer than for someone else,” or “I need a better tutor,”
When you take charge of your study habits and practice slower breathing during studying and test taking, you may experience a significant improvement in learning, remembering, accessing, and processing information.
Arnsten, A., Mazure, C. M., & Sinha, R. (2012). This is your brain in meltdown. Scientific American, 306(4), 48-53.
Cherif, A. H., Movahedzadeh, F., Adams, G. E., & Dunning, J. (2013). Why Do Students Fail?. Higher Learning, 227, 228.
David, P., Kim, J. H., Brickman, J. S., Ran, W., & Curtis, C. M. (2015). Mobile phone distraction while studying. new media & society, 17(10), 1661-1679.
Diekelmann, S., Wilhelm, I., & Born, J. (2009). The whats and whens of sleep-dependent memory consolidation. Sleep medicine reviews, 13(5), 309-321.
Eich, J. E. (2014). State-dependent retrieval of information in human episodic memory. Alcohol and Human Memory (PLE: Memory), 2, 141.
Fitkov-Norris, E. D., & Yeghiazarian, A. (2013). Measuring study habits in higher education: the way forward?. In Journal of Physics: Conference Series (Vol. 459, No. 1, p. 012022). IOP Publishing.
Gais, S., Lucas, B., & Born, J. (2006). Sleep after learning aids memory recall. Learning & Memory, 13(3), 259-262.
Hagenaars, M. A., Oitzl, M., & Roelofs, K. (2014). Updating freeze: aligning animal and human research. Neuroscience & Biobehavioral Reviews, 47, 165-176.
Hodges, W. F. (2015). The psychophysiology of anxiety. Emotions and Anxiety (PLE: Emotion): New Concepts, Methods, and Applications, 12, 175.
Lee, S., Sanchez, J., Peper, E., & Harvey, R. (2016). Effect of Breathing Style on Math Problem Solving. Presented at the 47th Annual Meeting of the Association for Applied Psychophysiology and Biofeedback, Seattle WA, March 9-12, 2016
Neal, D. T., Wood, W., & Drolet, A. (2013). How do people adhere to goals when willpower is low? The profits (and pitfalls) of strong habits. Journal of Personality and Social Psychology, 104(6), 959.
Osman, M. E., & Hannafin, M. J. (1994). Effects of advance questioning and prior knowledge on science learning. The Journal of Educational Research,88(1), 5-13.
Peper, E., Lee, S., Harvey, R., & Lin, I-M. (2016). Breathing and math performance: Implication for performance and neurotherapy. NeuroRegulation, 3(4),142–149.
Spielberger, C. D., Anton, W. D., & Bedell, J. (2015). The nature and treatment of test anxiety. Emotions and anxiety: New concepts, methods, and applications, 317-344.
Sink, K. S., Walker, D. L., Freeman, S. M., Flandreau, E. I., Ressler, K. J., & Davis, M. (2013). Effects of continuously enhanced corticotropin releasing factor expression within the bed nucleus of the stria terminalis on conditioned and unconditioned anxiety. Molecular psychiatry, 18(3), 308-319.
Swingle, M. (2016). i-Minds: How cell phones, computers, gaming and social media are changing our brains, our behavior, and the evolution of our species. Gabriola Island, BC, Canada: New Society Publishers.
Von Der Embse, N., Barterian, J., & Segool, N. (2013). Test anxiety interventions for children and adolescents: A systematic review of treatment studies from 2000–2010. Psychology in the Schools, 50(1), 57-71.
*I thank Richard Harvey, PhD. for his constructive feedback and comments and Shannon Lee for her superb research.
** This blog was adapted from: Lee, S., Sanchez, J., Peper, E., & Harvey, R. (2016). Effect of Breathing Style on Math Problem Solving. Presented at the 47th Annual Meeting of the Association for Applied Psychophysiology and Biofeedback, Seattle WA, March 9-12, 2016
Many illness may be prevented or reversed when we life in harmony with our evolutionary origins such as diet, movement, and circadian rhythm. The focus is to teach skills and not pills; since, many medications have long term negative side affects. By applying behavioral life style changes that supports our evolutionary patterns, we may be able to prevent or even reverse numerous illnesses such as epilepsy, eczema, diabetes, Crohn’s disease, allergies, ADHD, depression, anxiety, cancer, stress related symptoms.
Enjoy the wide ranging lecture presented at the 2012 meeting of the International Society for Neurofeedback and Research.