Today’s teaching is about losing weight and not losing your mind during quarantine. How can we take ground and use our time wisely to get fit? Can we leverage the quiet to know our bodies and let them teach us how to stay healthy?
Today’s teaching is about losing weight and not losing your mind during quarantine. How can we take ground and use our time wisely to get fit? Can we leverage the quiet to know our bodies and let them teach us how to stay healthy?
Several days ago, reports surfaced that popular comedian John Crist isn’t as harmless and wholesome as the Christian persona he portrays–although perhaps the above .gif should have been a clue. Allegations of sexual manipulation, harassment and coercion, and what he admits as “destructive and sinful behavior” continue to come from multiple women.
At BEHAVE, we typically focus on bullying rather than sexual harassment. In many of these cases, opposing camps set up their preferred narratives and hashtags in advance, and the individual stories of exploitation become minefields riddled with casualties from the insensitive. But, this issue is especially important as we enter the holiday season. Stress increases, people let their guard down, and holiday parties combine alcohol and power imbalances. Just because you share a cubicle wall with that co-worker all year doesn’t mean you know and should trust them deeply.
That’s what we mean by the “duplicity of intention.” People may have much different goals than the ones they portray publicly. Although they felt weird about what was happening, several of the women involved with John Crist thought he wouldn’t do anything inappropriate. “What is your intention this evening?” might not be the smoothest start to a date, but it’s certainly something to keep in mind. We’re reminded of Malcolm Gladwell’s book “Blink,” which explains how sometimes we need to trust our gut to analyze a situation and form conclusions different from what our conscious mind can process. (For more about the conscious mind and the sense of self, see our previous post).
The answer is not to stand stiffly with pepper stray in hand at the first sign of an awkward social situation, nor is it to compartmentalize life into Tinder and non-Tinder (or non-Christian Mingle). The John Crist story documents numerous instances over many years. It seems that a majority of the woman expected to harmlessly flirt with a celebrity they admired. Because of the Christian culture shared with John Crist, they anticipated side rails, airbags–whatever metaphor best describes safety systems in place.
Pathetic as it sounds, we have to build our own guardrails, and we’re not speaking to potential victims only. Bosses, pastors, even social media personalities need to implement accountability systems they can’t thwart. What use is an ineffective boundary? If I fall, I want a sturdy nylon net to catch me, not a waffle fry from Chick-Fil-A. As we’ve seen, a false sense of security increases the chance for harm. Start with finding one person you can trust to call you out. There’s much more that we could add for the sake of completeness, but what are your thoughts?
Lastly, if someone has shown destructive patterns, believe them. Is your boss pushy, refusing to take no for an answer at work? Why would they be any different late at night when everyone else has left the office party? Don’t tolerate it. Before you give someone a second chance, wait to see a change in behavior. Otherwise…
Well, that’s a frightening sounding title. We talk so much at Behave Wellness about developing resilience to thrive in the rat race of corporate America. Even surviving work culture is all about Ego: self-promotion, achievement, resisting bullies, and self-care intense enough that the stress of work can’t follow you home. In cases of serious mental illness, the brain perpetually exists in survival mode, vigilant against any perceived threats (think PTSD) while trying to withstand the 9 to 5 one day at a time.
As most of you know, we’ve been instrumental in launching a clinic with counseling, psychiatry, and chronic pain services, Transcranial Magnetic Stimulation (see our last post on anxiety), and ketamine in Akron, Ohio. We’ve become a resource for the opioid crisis in our city with our novel techniques, and continue to refine our protocols for the challenging patients we’re receiving from all over the state. That’s where ego dissolution comes in. Because mental illness requires so much…brain power, really, where can the mind go to find rest and solace? Many psychiatric medications take weeks to work, and by then many employees find themselves out of a job.
Increasingly, one answer seems to be disassociation. That’s how we, three nurse anesthetists, all started on this journey; besides decreasing inflammation and regulating glutamate so it nourishes the brain, ketamine is a dissociative anesthetic. Instead of slowing down breathing and brain activity like narcotics, ketamine simply uncouples the emotional centers of the brain from the here and now. Time slows or stops, vision and hearing become distorted, pain disappears, and synaptogenesis and neuroplasticity form new connections in the nervous system to replace cyclical pathways of pain, OCD, and depression.
Most of the literature reports these side effects as necessary to quickly and permanently change the brain’s neurochemistry, but the newest data takes it one step farther. Higher intensity and longer duration of ego dissolution relates to better outcomes in the toughest cases, meaning that a select group of patients should experience a complete out of body experience. This post shouldn’t be considered medical advice, by the way, because it’s a blog, and despite compelling, carefully conducted research, more studies are needed.
Because of the years she spent in the Mexican desert becoming a yogi, our founder Shannon would consider oneness with the universe the key to transformation. The most fascinating concept in ego dissolution is of instantaneous healing via mystical and insightful quantum changes. From Nick’s background as a Pentecostal Christian, it’s not dissimilar from the intense, life-changing moment of salvation and other spiritual experiences. Faith is grounding, in a necessary way that orders our lives and provides meaning, but an authentic and solid belief system should withstand the notion that we are nothing but electrical signals trying to increase output of brain derived neurotrophic factor. Outside of a purely spiritual phenomenon, intravenous ketamine supervised by anesthesia professionals, with support from mental health experts, is the safest way to shift the mind this way.
But, just because something is safe doesn’t mean it should be done. In the Western world, we increasingly take it for granted that feeling bad should be avoided at all costs, even if the alternative is bankruptcy, medications with side effects, social stigma, or feeling even worse down the road. What quick fix will last me until tomorrow? This goes back to our point about resilience: through counseling, can we teach patients to sit with their pain, to acknowledge the darkness, to take the longer path towards more complete wellness? If not, they’re not excellent candidates for ketamine, because to them it’s just the Next Big Thing, like TikTok for some Silicon Valley entrepreneur desperately trying to grow a scraggly beard into something long enough to accidentally dip into a soy mocha.
What do you think? Does this conversation remind you of hippies (or at least Phil Jackson) trying too hard to find meaning in life? Could the psychiatric effects of drugs like ketamine just be the result of lifting the veil between what is seen and the deeper realities of existence? Cave paintings of herb and mushroom influenced “spirit walks” from prehistoric times show these aren’t new ideas. The challenge now is to use the latest research responsibly, keeping Ego in dissolution.
Before we begin, our thoughts and prayers are with the people of Virginia Beach, where an employee of the city’s public works department killed 11 people before police shot him. The same circuitous conversations about mental health, gun control, and maybe toxic work environments may fade before even the first funeral, but the frequency of these incidents doesn’t negate the tragedy for affected communities.
No one is Immune
We get anxious too, leaving work at the office or operating room only to find the stress following us home. Too bad it’s so difficult to learn new skills and change the world without stepping out of your comfort zone. The three of us here at BEHAVE Wellness are part of the team that launched Alleviant Health Centers in Akron about a month ago. It’s a lot easier to talk about creating an oasis of wellness for employees than it is to form a business with a team of experts capable of treating complex patients who’ve been let down by conventional therapies.
Zap it with Medical Technology
Whether situational anxiety or an actual anxiety diagnosis, cultural norms in this country dictate trying to get rid of it, preferably in the most advanced manner possible. It’s the same philosophy that leads to unnecessary heart catheterizations and removal of helpful organs.
There’s nothing inherently wrong with desiring a quick fix rather than trying to earn wellness through the hard work of dietary changes, exercise, and self care. Either approach brings up issues of worthiness and identity. Starting this week at Alleviant, we’re offering Transcranial Magnetic Stimulation (TMS) for anxiety. Typically, insurance only covers a month’s worth of sessions in cases of treatment resistant depression. What we’ve quickly discovered is that the drug-less, pain-less technology is powerful and incredibly effective, but still works best in combination with a patient’s own efforts.
At the risk of resembling a “Top 10 Tips” clickbait article, we’ll list a few ways to reduce anxiety the three of us are using more than ever. Alone, each one may fail to move the needle, but shifting from a compartmentalized to a holistic approach is Step 1 to reduce anxiety. Feel free to leave a comment to learn more about Alleviant Health Centers or BEHAVE’s tools and workshops for corporate wellness!
Natural Anxiety Reducers
1. Probiotics. Seems unrelated, but we’ve seen dramatic differences due to this step in repairing the gut-brain connection. Herbal and mineral supplements decrease anxiety, but working with a qualified practitioner is best to find the right combination.
2. Eat right. In the same article, dietary changes reduced anxiety more than multi-strain, high quality probiotics.
3. Know your body. After all, although everyone knows sugar is bad and at least some exercise is good, we’re usually overwhelmed by the differing opinions about optimal lifestyle changes. Staying in tune with what the body wants answers questions such as, “Do I still feel good on this raw, plant-based diet three months in?”
4. Talk. Some people improve their self-awareness by talking to others. Find friends and family who can serve as a mirror to see what’s going on the inside. Professional counselors can also help sort through causes and solutions for anxiety.
5. Breathe. Several branches of alternative medicine focus on restoring the balance between the “fight or flight” and “rest and relax” portions of our nervous system. Slow, deep breaths allow the parasympathetic nervous system to regain control.
6. Cherish moments. Like dapples of sunshine reaching the forest floor, sometimes joy reappears. Live in these moments, not focusing on how long they will last or if we deserve it or the ten other things we should be doing with our time.
Healthcare is all about “critical thinking,” which occasionally prevents us from getting stuff done and actually healing patients. Click the picture to take our new course about communication and acting on properly processed information. That’s a major challenge at any workplace: removing the distorted lens of perception and seeing things as they are. Is the boss terrible, or does corporate culture just place that mantle of ineptitude on everyone in leadership? Are coworkers clear and brutally honest, or are you being bullied? And finally, do I really use phrases like “mantle of ineptitude” when internally asking myself questions? Yes.
Our last post discussed the importance of outside perspectives, but let me illustrate with a story how to achieve a more holistic viewpoint. I (Nick) rent out my house as part of the snowbird process. The final step will be driving 20 miles under the speed limit wherever I go. It’s surprisingly difficult to clean your house for others, because I’m used to my own mess. I mopped the floors and polished the furniture, but almost missed coffee stains on the kitchen cabinets. They’ve probably been there a while, but long ago my brain told my eyes, “There’s nothing to see here. Let’s concentrate on other things.” Take a step back and will your mind to see things for the first time. It may be an emotional undercurrent at the office, or an automatic response to a seemingly neutral stimulus, or even the way coworkers treat certain employees without apparent cause. Notice normal reactions and those that seem out of place. Culture is extremely powerful, especially during times of conflict, stress, and grief. I read a story today of a funeral home simultaneously hosting calling hours for an American–stoic, somber, whispers of dull platitudes such as “God needed an angel” and a Filipino–kids climbing around the casket, people talking loudly, etc. We revert to traditional ways of doing things, and it’s helpful to ask the simple question, “Why?” Why is the best for the patient, client or customer, and why do we think this way is the best way? None of us could work effectively turning over every stone inquisitively, but pick your battles and see what you uncover.
Our new course isn’t the only project we’ve been working on. “Critical Doing” is certainly entertaining, especially the interactive videos filmed underwater in Greece and Florida (very relevant to the nursing process), during hurricanes, and while wandering around forests and crowded malls. We are starting a pain and mental health clinic in Akron, Ohio. We have about a dozen employees, and it’s past time to stop talking about corporate wellness and see if we can actual materialize our idealistic views. By putting employees first, we hope their joy will be contagious and lead to much better patient outcomes than the current cookie-cutter methods of care. We’ll continue to update you all on our progress, triumphs, and failures as we do our part to change the broken healthcare system and practice critical doing.
No, we’re not talking about whips and chains and safe words, although healthcare workers do seem to attract narcissistic lovers more than average. I’m talking about negative work situations that may or may not qualify as bullying, even after familiarization with related definitions. Let me explain with a story instead of yet another helpful link that might take you away from this life-changing blog post.
I (Nick) am typing this from Greece. It doesn’t rain all summer, and the landscape turns so brown and dry I fear that halitosis from all the garlic I’m eating might set this island ablaze. My first time here, when I was 10 years old, someone scolded me for wasting water while brushing my teeth. I was a precocious, old-soul type of child, so I didn’t resent the scolding (which we Greeks invented about the same time as democracy and geometry). Instead, I thought, “Oh great, I just reinforced this lady’s stereotypes of wasteful Americans.”
Well, just now as I tried to wet my toothbrush with a trickle of water, I realized something. Greek life features many paradoxes. The precious H2O they try to conserve roars out of the faucets like a pressure washer. It wasn’t my fault at age 10. Careless engineers smearing tsanziki and spanakopita filo all over the plumbing blueprints are to blame. I’m not encouraging everyone to search through every memory and find new people at fault in boring stories about indoor plumbing like mine or even life-altering situations. However, re-visiting memories, even those with black and white details lacking shades of gray, does allow for new perspectives–that’s why we emphasize role playing in our anti-bullying programs. Sometimes we can’t see the crucial detail our perspective is missing in the moment or by ourselves.
Granted, the concept of truth gets watered down when we reduce any situation to individual perspectives, but singular perspectives limit learning and creativity. This is the sentence in almost every BEHAVE post with the word “holistic” in it. We don’t naturally focus on what matters while ignoring the microscopic that will take care of itself. The water tower at the beach where I live (in Florida, not Greece, because remember, they don’t have water here) features a beach ball on top. Every tourist spends twenty minutes taking a perspective picture hugging or squeezing the beach ball, as if they were the first ones to think of it.
Trying an objective approach by taking yourself out of the equation and/or empathizing with the other person’s point of view is one technique to expand your understanding and limited perspective. I’d also suggest you ask friends at work, “Am I being bullied?” and “Is this normal?” I’ll tolerate a naturally surly person much longer than someone who chooses not to be nice to me. All of us at BEHAVE Wellness have real jobs. We’re much more practical than bullying activists who would insist on not tolerating incivility for a second. They’re right, in a sense, but who really wants to hire or work with an overly sensitive person? By waiting to bring up an issue until you validate exactly what’s going on, you’ll be taken more seriously. If no one at work is trustworthy enough to ask these questions, that’s a problem right there. We’ve mentioned before that any relationship can tolerate so much more if there’s grace, occasional pockets of fun and joy, and the freedom to be who you are. Friends at work act as shock absorbers when customers, managers, and co-workers start grating you like a good Greek cheese.
Do I really have to spend unnecessary time with them when I already see their unattractive faces five days out of seven? The point is not to make fellow employees your besties or use them as an invincible bullying shield. It’s simply that enjoying their company makes “microaggressions” and annoying slights disappear, so when unruly behavior catches your attention, it probably is bullying. When someone is being rude to me at the hospital, one of my first thoughts is, “This is going to be a great story. I can’t wait to change enough details so it’s not gossip and tell all my work friends about this.” Granted, I’m weird and pride myself on being unoffendable, but grit your teeth and be friendly–it’s the only way to make friends.
What do you think? Am I making light of behavior you should report right away? Tell me your perspective in the comments, even if it’s wrong. Just kidding. If part of the problem is the learning curve at a new healthcare job, I’ve recently written guests posts about ventilators and CRNAs (including more thoughts about paradoxes and OR culture) you’re welcome to use as a resource.
The three of us (Shannon, Gina, and Nick) had a meeting the other day. We recently contributed to Nurse.com, Pfizer, and Minority Nurse, posting similar articles to our Media page, and wanted to discuss future projects. “You know what I’m not going to do? I’m not writing any more posts about Rick & Morty or Bitcoin or some other pop culture topic and force it into a blog post about bullying and job satisfaction,” said Nick. He lied.
True Memoirs of an International Assassin is a Netflix movie about a lonely writer plunged into dangerous situations he only understands theoretically. Everyone assumes his knowledge of explosives, weapons, and espionage originated from years of hands-on experience instead of Google searches to make his novel better. Watching Kevin James bumble on stage–by this point screenwriters needn’t bother with a different name for the earnest, hapless, chubby characters he always plays–reminded me of the saying, “If you can’t do, teach.” More specifically, I remember my undergraduate professors struggling to make themselves useful on nursing units while the employees mumbled, “She’d be a lot more helpful if she tried not to help.” I usually compare the differences between the academic and the clinical or practical approach in terms of a pointy-haired boss making the rules and subordinates following them, but sometimes there is more conflict and frustration when work relationships aren’t clearly defined. However, don’t idolize complete harmony–creative tension at work allows us to raise uncomfortable points that are usually more beneficial than forced tranquility and unity.
I started my career resembling the bespectacled gif above, frustrated with co-workers who could only articulate their decision making process as, “I just had a hunch” or, “I’ve seen this before so I know how to react.” Why couldn’t they see that their own experience limited the range of options in any situation? To those tasked with creating rules and procedures, the quick decisions others make based on immediately available data must seem like chaos. I felt patronized rather than heard, which of course is a huge complaint for many unappreciated employees. Bullying existed on both sides–I’d make fun of those who wouldn’t recognize a beta 1 adrenergic receptor if it made their heart pump furiously, earning the dubious nickname of “Tricky Nicky.” In return, they made a point of showcasing to everyone when my extensive theoretical knowledge caused me to miss something obvious and mundane. Although some people fall in the middle, the main difference between the two groups is this: either the idea of a rule, or not having a set of rules to follow, is terrifying.
Now I am on the extreme edge of those, um, working it. If someone announces a new protocol, I automatically probe it for loopholes and speculate how long I’ll have to appear to follow it before doing my own thing. Usually this mellows into “individualized care” for the patient, just like those with rule-based roles or tendencies excuse their propensities with phrases like “research based” or “the literature shows.” Often in my job, the classic example is the pharmacists who’ve read the latest studies and the nurse anesthetists who used the drug on a patient ten minutes ago. Even if the rule makers aren’t directly in charge of the people who make the product or provide the service, tension and the potential for conflict always exists. The rules and bureaucracy are out of touch and irrelevant. The quick fixes and Macguyverish behavior of the realists is reckless or short sighted.
By the end of the film, Kevin James is lethal. His creative ability to conjure mayhem and outsmart dictators and revolutionaries accustomed to a life of violence is only matched by his cerebral calculations and decision making. Perhaps it’s wishful thinking to hope the same at your workplace. If some sort of clipboard toting, machinery wielding hybrid doesn’t quite fit your job description, consider another way–an easier start, to be honest. Empathy. Understanding the other side. Realizing that they too have a job filled with constraints and tough decisions about what can be compromised. Giving that seemingly chaotic or boring coworker some grace is an easy start to a more cooperative and productive relationship.
Not to channel a creepy version of Mr. Rogers, but what kind of person are you? Do you bend rules whenever possible as Nick does, go above and beyond policies like Shannon, or fit in the middle like Gina?