After a catastrophic event occurs a person often becomes depressed as the future looks bleak. One may keep asking, ”Why, why me?” When people accept–acceptance without resignation— and concentrate on the small steps of the journey towards their goal, remarkable changes may occur. The challenge is to focus on new possibilities without comparing to how it was in the past. The limits of possibility are created by the limits of our beliefs. We may learn from athletes who aim to improve performance whereas clients usually come to reduce symptoms. As Wilson and Peper (2011) point out, “Athletes want to go beyond normal—they want to be superb, to be atypical, to be the outlier. It is irrelevant what the athlete believes or feels. What is relevant is whether the performance is improved, which is a measurable and documented event”. They have described some of the factors that distinguish work with athletes from work with clients which includes intensive transfer of learning training, often between 2 and 6 hours of daily practice across days, weeks, and months. This process is described by the Australian cross-country skier, Janine Shepherd, who had hoped for an Olympic medal — until she was hit by a truck during a training bike ride. She shares a powerful story about the human potential for recovery. Her message: You are not your body, and giving up old dreams can allow new ones to soar. Watch Janine Shepherd’s 2012 Ted talk, A broken body isn’t a broken person.
Wilson, V.E. & Peper, E. (2011). Athletes Are Different: Factors That Differentiate Biofeedback/Neurofeedback for Sport Versus Clinical Practice. Biofeedback, 39(1), 27–30.
Shepherd, J. (2012). A broken body isn’t a broken person. Ted talk. http://www.ted.com/talks/janine_shepherd_a_broken_body_isn_t_a_broken_person
When you woke up this morning, how did you feel? Were you looking forward to the day anticipating with joy what would occur or were you dreading the day as if once again you had to step on the treadmill of life?
Whenever I ask this question of college students in their junior or senior year at an urban university about 20% will answer that they are looking forward to the day. The majority answer, “Well not really”, or even “Oh shit, another day”. For many students the burden of living- working 40 hours a week to pay for rent and tuition, worrying about financial debt, and the challenge of commuting, and finding time to do the homework—feels and is overwhelming.
Asking this question about the quality—not quantity—of life is not just a question for students–it is applicable for all of us. The more one chooses to do actively what gives fulfillment and meaning, the higher the quality of life (I do not mean eating more chocolate).
In a remarkable study by Dr. Jennifer Temel and her many colleagues, patients with metastatic non-small-cell lung cancer were given the option of early palliative care versus standard aggressive end-of-life treatment. The patients who were assigned to the early palliative care group had significantly better quality of life, fewer depressive symptoms and lived on the average three months longer than the group who received standard treatment.
Even at the end of life there may be choices. Choosing quality of life and doing what gives meaning may nurture a peaceful transition in death. This process of choice has been tenderly described in the recent New York Times essay, The best possible day. Take a moment and read this article by clicking on the link. http://www.nytimes.com/2014/10/05/opinion/sunday/the-best-possible-day.html?smid=fb-share&_r=0
Then ask yourself each day, “Am I looking forward to my day and my activities?” If the answer tends to be “No,” begin to explore new options. Ask yourself, “What would I like to do and look forward to?” First begin to dream about possible options and then begin to plan how to implement your dreams so that you are on the path to where you want to be.
It is a challenging process; however, each of us can do something that will give meaning and joy to our lives. For suggestions, see the outstanding book by Dr. Lawrence LeShan, Cancer as a Turning Point, or explore the practices in our book by Drs. Robert Gorter and Erik Peper, Fighting Cancer- A Non-Toxic Approach to Treatment.
Temel, J. S., Greer, J. A., Muzikansky, A., Gallagher, E. R., Admane, S., Jackson, V. A., … & Lynch, T. J. (2010). Early palliative care for patients with metastatic non–small-cell lung cancer. New England Journal of Medicine, 363(8), 733-742.
“Don’t slouch! How many times do I have to tell you to sit up straight?”
“I couldn’t believe it, I could not think of any positive thoughts while looking down?
Body posture is part of our nonverbal communication; it sometimes projects how we feel. We may collapse when we receive bad news or jump up with joy when we achieve our goal. More and more we sit collapsed for many hours with our spine in flexion. We crane our heads forward to read text messages, a tablet, a computer screen or watch TV. Our bodies collapse when we think hopeless, helpless, powerless thoughts, or when we are exhausted. We tend to slouch and feel “down” when depressed.
We often shrink and collapse to protect ourselves from danger when we are threatened. In prehistoric times this reaction would protect us from predators as we were still prey. Now we may still give the same reaction we worry or respond to demands from our boss. At those moments, we may blank out and have difficulty to think and plan for future events. When the body reacts defensively, the whole body-mind is concerned with immediate survival. Rational and abstract thinking is reduced as we attempt to escape.
When standing tall we occupy more space and tend to project power and authority to others and to ourselves. When we feel happy, we walk erect with a bounce in our step. Emotions and thoughts affect our posture and energy levels; conversely, posture and energy affect our emotions and thoughts. At San Francisco State University, we have researched how posture changes physical strength and access to past memories. Experience this in the following practice (you will need a partner to do this).
How posture affects strength
Stand behind your partner and ask them to lift their right arm straight out as shown in figure 1. Apply gentle pressure downward at the right wrist while your partner attempts to resist the downward pressure. Apply enough pressure downward so that the right arm begins to go down. Relax and repeat the same exercise with the left arm. Then relax.
Figure 1. Experimenter pressing down on the arm while the subject resist the downward pressure
For the rest of this exercise, do the testing with the arm that most resisted to the downward pressure.
Have the person stand in a slouched position and then lift the same arm straight out. Again the experimenter applies enough pressure downward so that the arm begins to go down. Relax.
Then have the person stand a tall position and lift the arm straight out. Again, the experimenter now applies enough pressure downward so that the arm begins to go down. Relax.
Describe to each other how easy it was to resist the downward pressure and how much effort it took to press the arm down while standing tall or slouched.
In our just completed study in the Netherlands with my colleague Annette Booiman, we observed that 98% of the participants felt significantly stronger to resist the downward pressure when they stood in a tall position than when they stood in the collapsed position as shown in Figure 2.
Figure 2. The perceived strength to resist the down pressure on the arm in either the erect or collapsed position as observed by the subjects and the experimenters (Exp).
The subjective experience of strength may be a metaphor of how posture affects our thoughts, emotions, hormones and immune system. When slouching we experience less strength to resist and it is much more challenging to project authority, think creatively and successfully solve problem. Obviously, the loss of strength mainly related to the change in the shoulder mechanics; however, the collapsed body position contributes to feeling hopeless, helpless, and powerless.
With my colleague Dr. Vietta Wilson (Wilson & Peper, 2004), we discovered that in the collapsed position it was very difficult to evoke positive and empowering memories as compared to the upright position (for more information see the article by Wilson and Peper: http://biofeedbackhealth.files.wordpress.com/2013/01/the-effects-of-posture-on-mood.pdf).
Consistently, my students at San Francisco State University have reported that when they blank out on exams or class presentations, if they stop for a moment, change their posture and breathe, they can think again. Similarly, clients who are captured by worry and discomfort, when they shift position and look up, find it is easier to think of new options. Explore for this yourself.
How Posture effect Memory Recall
Sit comfortably at the edge of a chair and then collapse downward so that your back is rounded like the letter C. Let your head tilt forward and look at the floor between your thighs as shown in figure 3.
While in this position, bring to mind hopeless, helpless, powerless, and depressive memories one after the other for thirty seconds.
Then, let go of those thoughts and images and, without changing your position and still looking downward, recall empowering, positive, and happy memories one after the other for thirty seconds.
Shift position and sit up erect, with your back almost slightly arched and your head held tall while looking slightly upward as shown in figure 4.
While is this position, bring to mind many hopeless, helpless, powerless, or depressive memories one after the other for thirty seconds.
Then, let go of those thoughts and images and, without changing position and while still looking upward, recall as many empowering, positive, and happy memories one after the other for thirty seconds
Ask yourself: In which position was it easier to evoke negative memories and in which position was it easier to evoke empowering, positive, and happy memories?
Overwhelmingly participants report that in the downward position it was much easier to recall negative and hopeless memories. And, in the upright position it was easier to recall positive and empowering memories. In many cases, participant reported that when they looked down, they could not evoke any positive and empowering memories. It is not surprising that when people feel optimistic about the future, they say, “Things are looking up.”
Mind and body affect each other. The increase in depression and fatigue may be in part be caused by the body position of sitting collapsed at work, at home and walking a slouched pattern. By shifting body movement and position from slouching to skipping one’s subjective energy may significantly increase (Peper & Lin, 2012) (for more information see: https://peperperspective.com/2012/09/30/take-charge-of-your-energy-level-and-depression-with-movement-and-posture/)
Take charge, lightening your mood and give yourself the opportunity to be empowered and hopeful. When feeling down, acknowledge the feeling and say, “At this moment, I feel overwhelmed, and I’m not sure what to do” or whatever phrase fits the felt emotions. When your energy is low, again acknowledge this to yourself: “At this moment I feel exhausted,” or “At this moment, I feel tired,” or whatever phrase fits the feeling. As you acknowledge it, be sure to state “at this moment.” The phrase “at this moment” is correct and accurate. It implies what is occurring without a self-suggestion that the feeling will continue, which helps to avoid the idea that this was, is, and will always be. The reality is that whatever we are experiencing is always limited to this moment, as no one knows what will occur in the future. This leaves the future open to improvement.
Remind yourself that you to shift your mood by changing your posture. When you’re outside, focus on the clouds moving across the sky, the flight of birds, or leaves on the trees. In your home, you can focus on inspiring art on the wall or photos of family members you love and who love you. When you hang pictures, hang them higher than you normally would so that you must look up. You can also put pictures above your desk to remind yourself to look up and to evoke positive memories.
These two studies point out that psychology needs to incorporate body posture and movement as part of the therapeutic and teaching process. Without teaching how to change body posture only one half of the mind-body equation that underlies health and illness is impacted.
Each time you collapse or have negative thoughts, change your position and sit up and look up. Arrange your world so that you are erect (e.g., stand while working at the computer, use a separate keyboard with your laptop so that the top of the screen is at eye level, or place a pillow in your lower back when sitting). Finally, every so often, get up and move while alternately reach up with your arms into the sky as if picking fruits which you can not quite reach.
After having done these two practices, I realized how powerful my body effects my mood and energy level. Now each time I am aware that I collapse, I take a breath, shift my position, look up, and often stand up and stretch. To my surprise, I have so much more energy and my negative depressive mood has lifted.
Gorter, R. & Peper, E. (2011). Fighting cancer-A nontoxic approach to treatment. Berkeley: North Atlantic Books.
Peper, E. & Lin, I-M. (2012). Increase or decrease depression-How body postures influence your energy level. Biofeedback, 40 (3), 126-130.
Wilson, V.E. and Peper, E. (2004). The Effects of upright and slumped postures on the generation of positive and negative thoughts. Applied Psychophysiology and Biofeedback.29 (3), 189-195.
 In an elegant study by Professor Amy Cuddy from the Harvard Business School, she demonstrated that two minutes of standing in a power position significant increased testosterone and decreased cortisol while standing in the collapsed position significantly decreased testosterone and increased cortisol. By changing posture, you not only present yourself differently to the world around you, you actually change your hormones (For more information, see Professor Amy Cuddy’s Ted talk: http://www.ted.com/talks/amy_cuddy_your_body_language_shapes_who_you_are).
Simple Ways to Manage Stress- An experiential lecture for people impacted by the March 11, 2011 Great East Japan EarthquakePosted: November 8, 2013
Stress can be reduced by simple pragmatic exercises. This 99 minute participatory lecture was presented in Sendei, Japan, on July 20, 2013 to people who were impacted by the 2011 Tohoku earthquake and tsunami disaster.* The lecture includes practices that demonstrate 1) how thoughts, emotions and images affect the body, 2) how simple movements can reduce muscle tension, 3) how breathing can be used to reduce stress, 4) how changing posture can change access to positive or negative memories, 5) how acceptance is the beginning step for healing. This approach based upon a holistic evolutionary perspective of stress and health can be used to reduce symptoms caused or increased by stress such as neck, shoulder and back tension, digestive problems, worrying and insomnia. The video lecture is sequentially translated from English to Japanese. Click on the link to watch the video lecture.
*The program was organized by Toshihiko Sato, Ph.D., Dept. Health and Social Services, Faculty of Medical Sciences and Welfare Tohoku Bunka Gakuen University, Sendai.
Are you full of pep and energy, ready to do more? Or do you feel drained and exhausted? After giving at the office, is there nothing left to give at home? Do you feel as if you are on a treadmill that will never stop, that more things feel draining than energizing?
Feeling chronically drained is often a precursor for illness and may contribute to errors; conversely, feeling energized enhances productivity and creativity and encourages health. An important aspect of staying healthy is that one’s daily activities are filled more with activities that contribute to our energy than with tasks and activities that drain our energy. Energy is the subjective sense of feeling alive and vibrant. An energy gain is an activity, task, or thought that makes you feel better and slightly more alive—those things we want to or choose to do. An energy drain is the opposite feeling—less alive and almost depressed—those things we have to or must do; often something that we do not want to do. Energy drains can be doing the dishes and feeling resentful that your partner or children are not doing them, or anticipating seeing a person whom you do not really want to see. An energy gain can be meeting a friend and talking or going for a walk in the woods, or finishing a work project. Energy drains and gains are always unique to the individual; namely, what is a drain for one can be a gain for another. The challenge is to identify your energy drains and gains and then explore strategies to decrease the drains and increase the gains. Use the following five step process to increase your energy:
- Monitor your energy drains and energy gains. Keep a log of events, activities, thoughts, or emotions that increase or decrease energy at home and at work.
- Identify common themes associated with energy drains and energy gains.
- Describe in behavioral detail how you will increase your energy gain and decrease the energy drains.
- Record your experiences on a daily log.
- After a week assess the impact of your practices.
1. Use the following chart to monitor your energy drains and gains at home and at work by using the following chart.
Energy Gains (Sources)
2. Identify one energy gain that you will increase and one energy drain that you will decrease this week
Energy Gain (Source)
3. Describe in detail how you will increase an energy gain and decrease an energy drain. Be so specific that it appears real and you can picture how, where, when, with whom, and under which situations you are performing it. Be sure to anticipate obstacles that may interfere with your plan and develop ways to overcome these obstacles.
Write out your detailed behavioral description for increasing an energy gain:
Write out your detailed behavioral description for decreasing an energy drain:
4. Record your experience on a daily log. By recording your experiences you can assess the efficacy of your changes.
- Day 1
- Day 2
- Day 3
- Day 4
- Day 5
- Day 6
- Day 7
5. After a week, review your daily log and ask yourself some of the following questions:
- What benefits occurred by increasing energy gains?
- What factors impeded increasing energy gains?
- What benefits occurred by decreasing energy drains?
- What factors impeded decreasing energy drains and how did you cope with that?
- What strategies did you use to remind yourself to decrease the energy drains and increase the energy gains?
- If you could have done the practice again, how would you have done it differently?
*Adapted from: Gorter, R. & Peper, E. (2011). Fighting Cancer-A Nontoxic Approach to Treatment. Berkeley: North Atlantic Books, 107-200.
I felt depressed when I looked down walking slowly. I realized that I walk like that all the time. I really need to change my walking pattern. When doing opposite arm and leg skipping, I had more energy. Right away I felt happy and free. I automatically smiled. –Student
Hunched forward at the computer, collapsed in front of the TV, bent forward with an I-pad and smart phone while answering emails, updating Facebook, playing games, reading or texting—these are all habits that may affect our energy level. Students may also experience a decrease in energy level and concentration when they slouch in their seats.
The low tech solution is not caffeine or medications; it is episodic movement and upright posture. In the controlledresearch study published October 5, 2012 in the journal Biofeedback, Erik Peper, PhD of San Francisco State University and I-Mei Lin, PhD of Kaohsiung Medical University, Taiwan, showed that subjective energy level can quickly be increased.
In this study 110 participants rated their immediate subjective energy level and their general depression level. The participants either walked in a slouched position or engaged in opposite arm and leg skipping (see Figure 1).
Figure 1. Illustration of slouched walking (left) and opposite arm and leg skipping (right). Reproduced from Peper & Lin (2012).
Skipping even for even one minute significantly increased energy level and alertness for all subjects. On the other hand, walking in a slouched pattern reduced the energy level significantly for those participants who had high levels of depression as shown in Figure 2.
Figure 2. Self-rating of energy level for the top and bottom 20% of the students’ self-rating of depression. Reproduced from: Peper & Lin, (2012).
For people with a history of depression, their energy level may covertly increase or decrease depending upon posture and movements. When individuals have less energy, they feel that they can do less, and this feeling tends to increase depressive thinking. They also tend to label the lower energy state as the beginning of depression instead being tired. At the same time, the lower energy state tends to evoke depressive memories and thoughts which escalate the experience of depression. This process can be interrupted and reversed by shifting body posture and performing movement.
This study offers a strategy for people with depression to reverse conditioned cues associated with posture that evoke depressive thoughts and feelings. Wilson and Peper (2004) showed previously that ‘‘sitting collapsed’’ allowed easier access to hopeless, helpless, powerless, and negative memories than sitting upright and looking up. Posture appears to be aan overlooked aspect in the prevention of depression.
There is hope if you tend to become depressed and experience low energy. Numerous participants reported that after they performed opposite arm/leg skipping they did not want to walk in a slouched position. This suggests that this type of movement my act as a protective mechanism to avoid energy decrease and depression. Some participants with attention deficit disorders reported that after skipping they could focus their attention much better. I recommend being more aware of your body posture during the day and increasing your arm and leg skipping movements.
*Adapted from: Peper, E. & Lin, I-M. (2012). Increase or decrease depression-How body postures influence your energy level. Biofeedback, 40 (3), 126-130.
The recent book, Anatomy of an Epidemic, by Robert Whitaker is a must read for anyone who is planning or taking medications to treat mood disorders such as depression, anxiety, or panic attacks. His in-depth evidence based book, which reads like a novel, suggests that psychiatric drug benefits are mainly a myth and contribute significantly to creating life-long dysfunction and worsening of the symptoms. He cites study after study demonstrating this for depression, children with ADHD, biopolar disorder, panic attacks, anxiety and even schizophrenia. For example he cites a Canadian study of 1,281 people who went on on short-term disability for depression. Only 19 percent of those who took an antidepressant ended up on long-term disability, versus 9 percent of those who didn’t take the medication.
More importantly, when people are treated for panic attacks with benzodiazepine such as Xanax, the placebo groups does much better in the long term than the drug treatment group after medication is tapered off. Whitaker illustrates this concept by showing the following research data that was part of the FDA approval for the medication.
This Upjohn’s study of Xanax, patients were treated with the drug or placebo for eight weeks. Then this treatment was slowly withdrawn (weeks 9 through 12), and during the last two weeks patients didn’t receive any treatment. The Xanax patients fared better during the first four weeks, which is the result that the Upjohn investigators focused on in their journal articles. However, once the Xanax patients began withdrawing from the the drug, they suffered many more panic attacks than the placebo patients, and at the end of the study were much more symptomatic. Source: Ballenger, C “Alprazolam in panic disorder and agoraphobia.” Archives of General Psychiatry 45 (1988): 413–22. Pecknold, C “Alprazolam in panic disorder and agoraphobia.” Archives of General Psychiatry 45 (1988): 429–36.
This book and the scientific evidence suggests that non-pharmacological treatment approaches should be the first strategy for treatment–it may save your life.
There are so many factors that contribute to our health: diet, social support, preventative medical screening, etc. Yet, what is one single most important procedure that gives largest return of investment for your health? Listen to Dr. Mike Evans describe the procedure that if is used as treatment- one hour a day three times a week- reduces pain by 47% for patients with arthritic knees; if the treatment is done most days, patients with diabetes reduce the progression of their disease by 58%; post menopausal women who have the treatment four times a week reduce hip fractures by 41%; the treatment also reduces anxiety by 48% and patients with depression who receive a low dose of this treatment experience relief of depression by 30% while those on a high dose experience a 47% relief; in addition, it is the number one treatment of fatigue.
The treatment is 30 minutes of exercise–mostly walking–as described in the superb YouTube video, 23 and 1/2 hours: What is the single best thing we can do for our health?