Ask Dr. Rick About:

Health, Wellbeing

In considering the question of how much control we have over our own happiness, I was disappointed to learn 50% is genetics. How do we change genetics?

You are asking a deep important question, one at the heart of the “nature vs. nurture” debates over the centuries.

It’s really hard to tease apart two kinds of influences in our life: those we inherit, baked into DNA, and everything else. The exact balance depends on the individual person, but on average about a third, not half, of the variation in the population of psychological characteristics such as happiness is due to heritable factors…while everything else is up for grabs, a combination of external factors such as other people, social class, and good healthcare, and internal factors such as determination, mindfulness, and love.

In a nutshell, about two-thirds of what shapes a person’s experience of living is up to us, collectively and individually. Which for me is really good news…and calls us to responsibility, both in terms of how we make our society together and in how we chart our own individual lives. It’s hopeful! And this truth of things focuses us on doing all that we can with what is under our own influence, no matter what plusses or minuses we inherited from our grandparents.

Is your work considered a part of Positive Psychology?

People sometimes loosely locate my work under the umbrella of territory. Still, the way I would describe it is that I emphasize building psychological resources, based on using positive neuroplasticity to change the brain for the better, that people can use for healing old pain, being more effective in daily life, having more satisfying relationships, experiencing more well-being, and – if they like – growing in their own chosen spiritual practice. This approach is always grounded in realistic thinking, not “positive thinking,” and a fundamental self-reliance.

Why is it important to know about the Responsive and Reactive settings of the brain?

Taking in the good is a foundational practice that compensates for the brain’s preferential encoding of negative experiences and builds inner resources. More fundamentally, I am interested in naturalizing Buddhist psychology in a frame of evolutionary neuropsychology and operationalizing states and factors of non-craving (broadly defined in the Buddhist sense) in neuropsychological terms.

I’m using a conceptual framework that draws on polyvagal theory, Higgins work on promotion/prevention, and other work to posit three core motivational systems in the brain – Avoiding harms, Approaching rewards, and Attaching to others – which have two primary “settings.”

When a person experiences that his or her core needs are met for safety, satisfaction, and connection (tracking the three motivational systems), the related system tends to default to its Responsive setting, in which there is little or no basis for craving in that system; in this state, the body refuels and repairs itself and the mind rests in a basic sense of peace, contentment, and love (again, tracking the systems).

On the other hand, when the person experiences that one or more core needs are not being met, the related system shifts into its Reactive setting, there’s a fight-flight-freeze stress response cascade, the body burns resources, and the mind shifts into a basic sense of “hatred,” “greed,” and heartache (using two of the traditional Buddhist mental “poisons” in broad terms and tracking the three motivational systems).

While Reactive bursts can be adaptive, especially under the conditions in which our ancestors evolved, chronic Reactive states create significant allostatic load as well as a lot of unnecessary anxiety, irritation, frustration, drivenness, envy, interpersonal disturbances, and shame. Consequently, repeatedly taking in the good both down-regulates Reactivity and increases Responsivity in the moment plus gradually internalizes a felt sense of needs met as well as inner resources that together help stabilize a person in the Responsive mode even during challenging conditions, thus over time undoing many of the underlying neuropsychological causes of craving and thus suffering (broadly defined).

Can you help shed more light on how we live ``our Aspirations`` whilst not being selfish?

Check out the Aspiration chapter in Resilient.

In brief, healthy aspirations take into account our duties to others . . . and to ourselves. To simplify, duties are “have to” while aspirations are “want to.” Also check out Mother Nurture and my writings about sharing the load fairly when kids come along.

This said, in many people’s lives (though sadly and often unjustly, there are many exceptions), after handling duties there is still attention and time and often other resources available for personal aspirations – especially when we consider the power of many little moments of practice, and the power of relatively small amounts of time each day – 15 minutes? an hour? – that really add up over months and years.

How could you measure clinical interventions that encourage new cell growth and happiness?

This question gets at the remarkable fact under our noses all day long: our ineffable thoughts and feelings are making concrete, physical, lasting changes in the structure and function of our brains. Neurons that fire together, wire together. This is learning, including the emotional, motivational, attitudinal and skills learning that is our focus in therapy. In other words, the making of memory – especially implicit memory, the storehouse of emotional residues of lived experience, knowing “how to,” expectations, assumptions, models of relationship, etc. distinct from explicit memory, the much smaller storehouse of specific recollections and knowing “about” – the gradual change of the structure and function of the brain.

In this context, any kind of mental change is evidence of neural change. Since neuroscience is a baby science, our current, noninvasive, imaging technologies have limited capacities to measure neural change in human beings – especially given how physically fine, fast, and complex these changes are. You could put five of the cell bodies of a typical neuron side by side in the width of just one of your hairs, and five thousand of the synapses, the connections, between neurons in the width of just one hair.

Nonetheless, even though the ethics of animal research trouble and even alarm many, including me, it is the case that more invasive research on animal learning – including emotional, motivational learning, that has some parallels to therapy – has established many fine-grained details of the ways in which experiences of stress, frustration, and trauma, as well as experiences of caring, success, and safety change the nervous system.

So we presume that neural change must be occurring if there is mental change. In this light, there are now many studies with human beings that show structural and functional changes after interventions such as training in mindfulness, compassion, body awareness, and psychotherapy. The cortex – the outer shell or “skin” of the brain – gets measurably thicker due to new synapses and greater infusion by capillaries for blood flow; key regions are more readily activated; there is also greater connectivity between regions, so they are more integrated and work better together; there are even changes in the expression of genes – tiny strips of atoms in the twisted up molecules of DNA in the nuclei of neurons.

And as your mind changes your brain for the better, these changes in your brain feed back to change your mind for the better as well. As these positive structural and functional changes in the brain occur, people become more capable and happy. For instance, training in mindfulness increases activation in the left prefrontal cortex, which supports a more positive mood.

As to new cell growth, I assume this is a reference to neurogenesis, the birth of new baby neurons, primarily in the hippocampus. We can encourage the birth of these neurons through exercise, and encourage their survival and wiring into memory networks through engaging in complexity and stimulation.

Here’s the takeaway: we can be confident in our own lives, and in our work with clients, that our efforts are bearing fruit in actual, physical changes in the nervous system. And since motivation is one of the primary factors shaping outcome in psychotherapy – and in life as a whole – this is heartening, wonderful news.

Your idea about achieving happiness is to fill your implicit memory with good experiences rather than negative ones. Have I got that right?

Filling implicit memory with good experiences is one way to achieve greater happiness – and to help heal old pain and increase resources for coping. Other ways to accomplish these ends include increasing mindfulness, releasing negative beliefs and feelings, learning to activate the parasympathetic nervous system, and taking constructive action. That said, taking in the good is really important, both on general grounds and to compensate for the brain’s innate negativity bias.

Does having an implicit memory full of positive experiences make you less dependent on day-to-day or moment-to-moment events for your happiness?

Exactly right!

People who have not internalized positive experiences and other resources are dependent upon the outside world for the provision of them – or they get stoic or defended and deny their need for such experiences. This is a mistake since they are a universal, human need, as well as the basis for coping and for the strength of mind and heart it takes to stick up for those we love and make this world a better place.

But if you do take in positive experiences – particularly the ones that are key resources for a history of lacks or wounds (e.g., current experiences of feeling cared about are critically important for healing old experiences of abandonment, rejection, dismissal, loneliness) – then you fill up your own cup and become less dependent on external conditions; in effect, your happiness becomes increasingly unconditional.

Why pursue happiness practices like the ones you suggest rather than pouring 100% of one’s energy into work that saves/elongates lives?

My small answer to your big question is in three parts. First, it is of course not either-or, one can both pursue mental interventions that increase mental health while also pursuing physical interventions that increase physical health. Second, happiness practices and other mental interventions are very effective in increasing physical health, in terms of addressing the stress and lifestyle factors that are a major source of disease burden, especially in the developed world. Third, mental interventions are good for physicians and other healthcare providers themselves, in terms of improving decision-making and reducing burnout.

How do I reconcile awareness of suffering with a feeling of well-being?

First, I try to develop my capacity to sit in both compassion and equanimity, opening the heart to pain while also being undisturbed in my core about it. A long-term project in my case, to be sure!

Second, I try to see the whole mosaic of reality, which includes both beings that will be harmed and beings that will be loved. Recognizing the good (using that word loosely) does not mean not recognizing and feeling moved by the bad; and seeing the good can help us bear and sometimes improve the bad.

Is there a basic first step to break the patterns we have in life?

The first step is always self-awareness; without it, we’re flying blind. Try to step back in your mind and observe your reactions without being swept away by them.

Then bring compassion – the simple wish that a being not suffer – to yourself. Researchers have found that self-compassion builds resilience and well-being, plus it helps us treat others better; many studies have shown that people are more able and willing to be patient, reasonable, and kind when their own cup runneth over.

I also like to try to help myself feel the rewards that will come to me from breaking my patterns and acting more skillfully in the future. This helps incline my brain in that direction – sort of like the proverbial rider dangling a carrot in front of a donkey.

Are brain supplements backed by scientific evidence of their effectiveness?

I appreciate your comment, and share your stickler-ness! As to supplements, there is considerable published evidence for the efficacy of nutrients such as essential fatty acids or B-vitamins as supports for mood if there is a deficiency. There is also considerable research support for supplementing 5-hydroxytryptophan for mild to moderate depression.

As context, you may know of the recent high profile finding in Great Britain that there was no research evidence at all for about half of all medical practices. This does not mean that the practices are bad; as you know, absence of evidence is not evidence of absence. But it does suggest that there is double standard in insisting on research evidence for nutrients the body has evolved to metabolize but not insist on research evidence for off-label uses of medications that are artificial molecules the body did not evolve to metabolize.

Also as context, in America medical error is the third leading cause of death, about 200,000 fatalities a year here, the great majority due to problems with medications. By comparison, the risks of things like essential fatty acids or B-vitamins are vastly smaller.

Personally, I have known people who are dogmatically holistic as well as people who are dogmatically anti-holistic. In my own case I try to find the path between the two.

What role does gratitude play in developing a “Buddha brain” and why?

A “Buddha brain” is one that knows how to be deeply happy, loving, and wise. We develop ourselves in this way by cultivating wholesome qualities and uprooting unwholesome ones. In a sense, we plant flowers and pull weeds in the garden of the mind – which means that we are gradually changing the brain for the better.

Gratitude is a powerful tool in this “garden” since what you rest your attention upon is what will shape your brain the most. That’s because “neurons that fire together, wire together.” Gratitude shifts your attention away from resentment, regret, and guilt – and therefore stops you from building up the neural substrates of these known factors of mental and physical health problems. Gratitude also focuses your awareness on positive things, simple good facts such as having enough water to drink, the laughter of children, the kindness of others, or the smell of an orange.

To reap the rewards of gratitude, rest your attention on a good fact, noticing details about it, staying with it for at least a few seconds in a row. Then allow a natural emotional response of gratitude to arise. Continue to pay attention to this feeling of gratitude for another few seconds – or even longer: it’s delicious! Taking these few extra seconds will help you weave gratitude into the fabric of your brain and your Self. And you can practice gratitude both on the fly, as you move through your day, and at specific occasions, such as at meals or just before bed.

What are the health benefits to thankfulness?

The mental and physical health benefits of gratitude are hot topics these days. Researchers have found that gratitude helps calm down the stress response – and this strengthens your immune system so you can better fight off colds this season. Gratitude also supports the neurochemistry of well-being, and protects against depression. It builds resilience, so we get less rattled by events and bounce back faster. And gratitude turns us toward others as we appreciate the people we care about, and this sense of connection and what’s called “social support” provides additional health benefits itself.

So every day this season, take your Vitamin G: gratitude!

What methods can you recommend to help boost memory?

I suggest starting by making sure you are in super health and ruling out any physiological factors. I’m not a physician, but have heard that things like estrogen imbalances, yeast overgrowths, etc. can affect memory.

Doing mental activities that work the memory “muscles” could help. Like playing bridge and having to remember key cards, learning a new language, or taking a class that calls for considerable memorization.

And if you’re not doing meditation routinely, I suggest it, too. Among its benefits are strengthening executive oversight of mental processes, which aids memory plus provides more influence over one’s thinking.

Do you have any thoughts on the new technology coming out that uses self-administered neurofeedback to promote well-being?

Here are my general thoughts:

  • I haven’t used these devices personally
  • There is emerging scholarly and anecdotal evidence that they can be helpful.
  • Some people seem to get a lot out of them, some a little, some not at all, and some are bothered by them. You basically don’t know which group you’re in unless you try them.
  • I think of these devices pragmatically: are they helpful, but might they also crowd out more self-directed, inside-out training of the mind/brain system.
  • I think these can be great if they are helpful, but long-term it’s good to be able to incline the mind/brain towards good states without external help.

The bottom-line is whether they work for a person, and you don’t know if it’ll work until you try it. Maybe check out one of these devices that a friend may have, if possible, before buying one.

Do you have any research reference for the impact of the “hand on heart / belly” practice you use?

It’s a great question, and to my knowledge not one study has been published about this practice, in terms of either its purported psychological or physiological effects. Personally, I try to be careful to claim that there is any such research.

This said, as you may have heard, there is a saying that “the absence of evidence is not evidence of absence.” Just because there is no study about something does not mean it does not work.

I find the hand on heart practices to be plausibly beneficial; certainly many people report such benefits. And there is much evidence that the touch of others is beneficial . . . so perhaps touching oneself in a region of the body that is so associated with soothing and kindness might have similar benefits. And who knows what might be happening with energy systems that science has not yet identified.

How do I reap the brain benefits of single-minded focus for five minutes?

When we try to open to, encourage, evoke, kindle, call forth, etc. a positive mental factor during meditation – e.g., relaxing the body, feeling more protected and thus safer, finding some well-being even happiness in awareness, feeling a sense of spaciousness in experience – you’re right there is a focusing of attention on that factor. In the background of awareness there may also from time to time be a sense of body sensations, perhaps those of breathing, but there is no attempt to be simultaneously and equally aware of both the breath and the positive mental factor: that is a difficult if not impossible balancing act and stressful to attempt as you have experienced.

Then, after the mental factor has been activated, we can either make it the object of focused attention or shift to the breath (or something else, such as a saying like “may beings be at peace”). If you are working on steadying the mind, a good focus especially in the beginning and intermediate stages of meditating, then you would probably give yourself over to the sensations of breathing, abiding as a body breathing, with from time to time a passing but beautiful sense of relaxing, the mind quieting, peace growing, opening, being here, being now. Pretty sweet!

Do you think playing computer solitaire fulfills the goal of mindfulness and meditation?

Well, with all the respect in the world for your mother – and as someone who works with children and routinely says that a mother’s intuition is gold – I’ve got to come down on your side here.

Sure, the “circle” of mental activities – and thus the neural processes and gradually building of neural structure – of meditation overlaps the “circle” of these while playing solitaire on the computer (or playing other games in other ways), but there is a lot about each circle that is distinct from the other one.

Game playing will strengthen intellectual and other cognitive capacities (e.g., visual processing, perceptual analysis) that meditation will not.

On the other hand, meditation will building other capacities, such as strengthening attention (because of the relatively non-stimulating nature of breath sensations or other common targets of contemplative attention), the capacity to disengage from mental processes to observe them peacefully rather than getting swept away in chasing mental carrots or dodging mental sticks, and insight into both personal psychological material (e.g., the hurt lingering underneath resentments) and the general nature of mental phenomena as transient and usually not worth getting one’s knickers in a twist about. Plus meditation confers many other benefits, including stress reduction, managing anxiety, and reducing the distress and sometimes symptom intensity of many medical conditions. (Check out this slide set from a workshop I gave to psychiatrists for more on this.)

While intellectually stimulating activities such as game playing have been shown to help protect against cognitive decline with aging, preliminary studies have also shown that religious and spiritual activities (which include prayer and meditation – though a person can meditate outside a religious frame and still get most if not all of its mental and thus neural benefits) also offer protections against cognitive decline, here too through overlapping “circles” of factors.

Bottom-line: I say do both! Have fun with solitaire, and find some contemplative practice that suits you. If you like, commit to meditating at least one minute a day, even if it’s the last minute before you fall asleep. And like many things, there is a dosing effect: the more meditation you do, the better for your brain.

Is the experience of peace and happiness synonymous with activating the parasympathetic wing of the nervous system? If so, what are the three most successful techniques for activating the PNS?

It’s a great question, since there is sometimes a misunderstanding of the nervous system that equates parasympathetic activation with positive states of being and sympathetic activation with negative states.

Yes, activating the parasympathetic nervous system (PNS) can foster the calming and easing that underlie many positive states of being. On the other hand, excessive PNS activation leads to the “freeze response” – in humans this is the equivalent of animals playing dead – which can feel like sleepiness, dissociation, inertness, numbing, tuning out, or shutting down, often accompanied by negative emotions such as dread or shame.

And yes, activating the sympathetic nervous system (SNS) can foster fight or flight states of being, often with associated negative emotions such as anger or fear. On the other hand, SNS activation combined with positive emotions such as eagerness, confidence, success, pleasure, affection, and gratification can foster wholesome actions such as cheering on your child in a race, making love, asserting yourself, dancing with your whole heart, or pursuing an ambition.

Overall, a balance of PNS and SNS activation is best. In a culture that prizes SNS activation (and which often stimulates negative emotions such as drivenness or envy), it is particularly important to be strong and skillful in PNS activation. And throughout, keep planting and nourishing seeds of positive emotions, thoughts, somatic states, and desires.

In terms of what activates the PNS, anything that helps you relax will do this. If you want three “go-tos” that I like myself, here they are:

  • Exhaling
  • Touching your lips
  • Hugging someone you care about

Do you have any articles that address short term memory and ability to read information?

I feel for those with memory issues. I assume/hope that if you do experience this, you have worked with licensed healthcare professionals about them.

Here are some thoughts:

  • I’m not offering medical advice here, and please discuss my comments with your doctor(s). You may have already pursued some if not all of them.
  • I suggest you consult with a neurologist, including to rule out any issue with your brain itself.
  • You could read up on what’s called the cytokine theory of depression, about how stress and inflammatory processes can affect the brain.
  • If you are old enough for this to be relevant, talk with your gynecologist or a endocrinologist about how changes in estrogen and related reproductive hormones could be affecting your memory, and if so, what you might be able to do about that.
  • Regular exercise might help.
  • Be thoughtful about anything that might be inflammatory for you, including in your diet.
  • You could try Lumosity type training. The reviews on it are mixed, but you might see for yourself what you get out of it, if anything.
  • You could consult with a physician practicing “functional medicine” to get a fine-grained overall assessment and to explore possible factors in your body such as dysbiosis in your GI tract or less than optimal metabolism that might be affecting memory or other kinds of neural functioning.

How do I develop an inner protector?

Not being able to find an inner protector is a real fact of the inner of world of many people. Developing one is a matter of committed practice toward one’s own well-being, which will gradually change the brain. Some steps along the way:

  • Look for little natural moments when there is a feeling, no matter how small, of ease, relaxation, loosening of contraction, exhaling, satisfaction of a need (e.g., drinking water when thirsty), sinking into the sofa at the end of the day, crawling into bed, or whatever else. Then deliberately rest your mind upon them, stay with them in awareness, savor them, and let them sink in for a dozen seconds or longer. As you persist in this little practice – several times a day or more – open to it becoming a more general felt sense of settling in the body, feeling more ease, less tension . . . even a growing sense of refuge or a bit of safety in this general easing.
  • Look for moments when others are at all kind, supportive, friendly, companionable, and inclusive, or even valuing, appreciative, affectionate, and loving! Consciously recognize the fact of what is happening. You may personally think you are not worthy of this positive attention or caring, but it is an undeniable fact that the other person thinks you are! Next, gently prod yourself to let this factual recognition become an emotional experience, even a subtle or mild one, of feeling cared about – that you matter even if it’s in a small way. Then, in the same way as before, try to stay with this experience in your mind of feeling liked, appreciated, seen, understood, supported, or loved for a dozen seconds or more. Sense that it is sinking into you.

If you do these two things, over and over again, you will gradually plant the seeds that will grow into an inner protector.

There are other methods as well, and I encourage you to look into my book, Just One Thing, and its practices on self-compassion, getting on your own side, taking in the good, and seeing the good in yourself.

Hang in there with this. Look out at the world, with its 7+ billion human beings, and countless other living plants and animals and microbes on the earth, in the water, and in the air. I am sure you wish those beings well. You would wish that they would have and experience an inner protector (or the animal, plant, or microbe equivalent). Well, you are one of those beings! No different from the other humans, no less deserving of true happiness and its causes, including an inner protector. Much as you would wish an inner protector for all those beings, you could rightfully wish one for yourself. I wish one for you – and I bet so would everyone else who knows you, if they thought about it. It’s alright to join this club!

How can I simplify the holidays so I actually enjoy myself and my loved ones?

Commit to less. Do as much as possible in advance. Ask others to pick up their fair share of the additional tasks. Don’t get too attached to fixed ideas of how things need to be. Focus on the essentials, the point of the holidays: time off, relaxing, being with loved ones, generosity and gratitude – and if this is meaningful to you, honoring the original spiritual purposes of this time of year.

What does it mean to have a simple holiday?

For me it means having realistic expectations about what you can actually get done, and not over-committing. Alongside, keeping a sense of perspective and humor about the madness of parking lot traffic jams, weird in-law vibes, crazed children jacked up on sugar and other stimulants, packed stores, long lines, credit card denials, you name it.

It’s also good to have realistic expectations about how great one will actually feel. Sometimes we get upset that we don’t feel happier. This is where the wisdom traditions can be real helpful: events and our reactions to them come and go; usually, anticipated pains are not as bad as they’re billed to be, nor are anticipated pleasures as sweet as we thought they’d be.

Enjoy what’s pleasant without trying to grab onto it, and get through what’s unpleasant without struggling with it.

Will you offer a few other suggestions for implementing your practices through the holidays and the New Year?

The old-fashioned saying that “practice makes perfect” is as true for one’s well-being or relationships, so pick just one thing to think about or do in your mind each day. Keep it simple. But stick with it. For example, drawing on a few practices in my book, Just One Thing:

  • Notice that you truly are basically alright right now several times a day, which would help undo the anxious background murmur we inherited through evolution.
  • Really enjoy your hands, drawing you into more intimate and sensual contact with things around you.
  • “Fill the hole in your heart” by sensing that key positive experiences are sinking down into you and touching places of old lack or pain. For example, since I was a shy and nerdy kid who felt lonely and unwanted, I’ll deliberately sense that experiences these days of feeling included and valued are soothing and feeding the younger layers of my mind. Neurologically, this gradually infuses resources into old wounds, helping to heal them in the process.
  • Take refuge a few times each day in one or more things that are sources of strength, refueling, or inspiration for you. Simply say to yourself, “I take refuge in _______ ,” or just get a feeling of being connected with this refuge, as if it you are already in it.

Whatever your practice is, take a moment to recognize its value for you. Keep bringing it to mind, at least once or twice a day. If you take care of your practice, it will take care of you.

What are some simple tips for practicing gratitude on Thanksgiving?

Keep bringing your attention back to simple good facts, such as having enough water to drink, the laughter of children, the kindness of others, or the smell of an orange. Rest your attention on this good fact, noticing details about it, staying with it for at least a few seconds in a row. Then allow a natural emotional response of thankfulness to arise. Continue to pay attention to this feeling of gratitude for another few seconds – or even longer: it’s delicious.

Taking these few extra seconds will help you weave gratitude into the fabric of your brain and your self. And you can practice thankfulness both on the fly, as you move through your day, and at specific occasions, such as at meals or just before bed.

What are the unique contributions of being religious to happiness?

“Religious” covers a lot of ground. Double-check me, but I think it’s true that the majority of Americans engage spiritual practices (e.g., yoga, mindfulness meditations, mystical connection with nature, sense of the Divine as the Ground of everything rather than an omniscient and omnipotent personality) outside the conventional Judeo-Christian frame, or are agnostic or atheist. It would be helpful at the outset to be clear what we mean by this word.

While the average religious person may be happier than the average non-religious person, that’s just about averages. Lots of religious people are unhappy, and lots of non-religious people are happy.

There is tons of science about how all people, religious or not, can affect their happiness. Basically, we can become happier by taking action in the world (e.g., doing crafts with your hands, giving to charity, planting a tree, getting a less stressful job, finding a loving partner), the body (e.g., losing weight, getting exercise, healing an illness, getting enough iron), or the mind.

While I can speak with authority on ways to boost happiness through action in the world or body, my expertise is the mind. In the mind, major factors that increase happiness include controlling negative emotions, controlling stress, savoring positive experiences (which defeats the negativity bias of the brain that makes it like Velcro for negative experiences but Teflon for positive ones), focusing on what one can do (how you’re like a hammer instead of a nail), positive self-talk instead of anxious or self-critical rumination, developing interpersonal skills that produce healthier relationships, gratitude, feeling connected with others, and feeling a sense of purpose and meaning in life.

Because of experience-dependent neuroplasticity – a mouthful that simply means that what we think and feel and want changes our brains – the mental factors and activities just above gradually build up strengths in the brain, much like building a muscle. The classic saying in brain science is: neurons that fire together, wire together.

The last three factors just above – gratitude, feeling connected to others, and purpose and meaning – are strong in most religious people, though of course they don’t have a monopoly on them. Your question hits the bullseye: what are the unique contributions of being religious to happiness?

A way to frame this could be, what can non-religious people learn from religious people about happiness? With a point made about how this learning can change the brain for the better.

Religious practice often involves a specific mental activity – focused attention on prayer or meditation: in other words, some kind of contemplative practice – that has good research on how it changes the brain. For example, Christian nuns recalling a profound spiritual experience and thus momentarily lighting up parts of their brains that control attention, tune into oneself, and feel rewarded. Or how the brains of long-time mindfulness meditators are changed in lasting ways, also building up layers of neural tissue in parts of the brain that control attention and tune into oneself. Non-religious people could also take up some kind of contemplative practice, even if they don’t think of it as religious or spiritual, such as meditation on the breath or really focusing on the body while doing Pilates, etc.

There is a lot of research coming out about the benefits of mindfulness training – outside a religious context – for controlling attention, improving response to medical treatment, and increasing happiness.

As a religious person myself – a Buddhist who believes in the Divine – I think there are certain aspects of religious life that you have to be, er, religious to benefit from, such as a sense of a personal relationship with God (by whatever name). I don’t know of any specific studies on this unique factor – though there may be some – but I can speak personally about it and report what others say, which is that it brings a sense of peace and joy.

You write: ``When stress, worry, pressure, or pain appear in the mind, see that the fabric of this suffering – the underlying operating of the mind – is itself fine, is always already fine.” I do not understand how “the fabric of this suffering” is the underlying operating of the mind. If we feel worry, pressure, or pain, how could the underlying operating of the mind be fine?

Thank you for this question. You have zeroed in on a big matter that I tried to describe in one small sentence!

What I was trying to say is that the contents of mind – anger, worry, pleasure, thoughts, perceptions, sensations, desires, etc. – are a part of the mind that may be troubled (even horribly so), but mind as a whole – including the awareness aspects of mind – is usually operating just fine.

So shifting awareness from the contents of mind to mind itself (as a whole) – put differently, shifting awareness to experience as a whole, including its awareness elements – can disengage us from upsetting thoughts and feelings and ground us in a reassuring sense of mind as a whole.

Try this experientially and see what you find. The sense of mind as a whole can be hard to sustain, but keep at it and it will get more stable. Also note that as soon as we (naturally) create a concept of mind-as-a-whole, that conceptualizing is a part of mind-as-a-whole and draws us out of it as a whole. Conceptualizing is OK, but keep letting go of it to open into again and again mind-as-a-whole.

How to you balance equanimity and cultivation?

To use the language of Buddhism there is a place for Right Mindfulness, but also a place for Right Effort. Mindfulness is the doorway to equanimity, which is gradually developed as virtue, concentration and wisdom deepen. Along this path, we also need to pull weeds and plant flowers in the garden of the mind: Right Effort, in other words. Cultivating wholesome states and factors of mind – by activating them, installing them through taking in the good, and then reactivating and reinstalling them again and again on life’s path, in a wonderful positive cycle – is a kindness to oneself and others.

With time, the fruits of this process of cultivation become increasingly second nature, woven into the fabric of the brain, the body, and them mind. Then conscious cultivation – Right Effort – gradually falls away and we abide without effort in spacious balanced peaceful beautiful equanimity.

What do you mean by the “undoing of suffering?”

When you are already everything, already partaking of the unconditioned, and always – in terms of phenomenology, the experience of the constructed world – and feeling the floor of it drop away from beneath your feet even as it is endlessly renewed, well, that is the waking from ignorance and thus the undoing of suffering.

How much time do you spend on technology each day? Do you think using technology is healthy for your brain?

I use my computer about 3-5 hours a day, some days a lot more. I use my cell phone mainly for calls. I watch TV maybe an hour or so a day.

I think that moderate amounts of technology use are good for the brain in some ways, such as increasing cognitive stimulation for older people. But more than moderate usage has bad side effects:

  • Making people in a sense addicted to high levels of stimulation so that anything less seems boring.
  • Promoting passive consumption of experiences rather than active creation of them.
  • Promoting relationships with many people that are superficial and distant rather than deep and close.

What are the limitations of visualization and “harnessing the power of the mind” for health?

As a psychologist, I am not giving medical advice. In that context, as a general statement, it is clear that mental factors such as stress on the one hand and gratitude or feeling cared about on the other can play a significant role in a person’s health journey . . . much as purely physical factors such as infection or cancer or effective medications can play a significant role as well.

Speaking personally, I try to approach my own health issues on both levels, mental and physical, based on sensible and individualized methods that have reasonable evidence, including the evidence of whether they are actually producing results for me.

Additionally, as an individual choice, I also include what could be called the spiritual level, distinct from the natural processes within our big bang universe, which include our thoughts and feelings, hopes and dreams . . . as well as our organs and DNA. Others may not want to do this, and I respect that choice.

I have no problem with people who include the possibility of spiritual factors in their healing of a medical condition. I do think it is foolish to do this in a way that excludes or minimizes the role of the physical level in our healing. We have real bodies, they are full of real cells and molecules and microbes, and this physical stuff really matters, and modern medicine has many effective ways to deal with it. Sure, doctors can make mistakes, and we need to be aware of the financial incentives such as from pharmaceutical companies that tilt medical treatments toward certain approaches and away from others. I turn to doctors who listen carefully, don’t patronize, individualize their approach to me rather than “one size fits all,” and recognize the potential usefulness of complementary and holistic methods. But I would not want to use the spiritual level to crowd out sensible, standard medical interventions.

What do you think about medical doctors who operate on the fringe of medical science?

As you know, there is a range of opinions about good health practices, including from highly credentialed clinicians and researchers. In that range, at one end are those who are skeptical of changes to established practices and at the other end are those who are exploring innovations. We’ve seen this range throughout history and we’ve seen it in our lifetimes.

For example, there is a joke in medicine about how progress occurs:

  • Stage 1: That’s crazy, it should be outlawed, anyone who does that should lose their license.
  • Stage 2: It shows promise but needs more studies.
  • Stage 3: We knew it all along.

In my view it is important to find a middle way between dogmatic resistance to innovation on the one hand and wild-eyed adoption of dangerous unproven methods on the other. For me, there are three markers of this middle path:

  1. The proposed innovation (e.g., reducing carbohydrates to treat Type 2 diabetes) has proposed mechanisms of action that are grounded in an underlying frame of biological science (rather than, say, some kind of mysterious cosmic energy from Mt. Shasta).
  2. The innovation is not recommended to be done instead of a well-established medical technique (e.g., if your leg is broken, don’t think that rubbing essential oils into your leg will make the bones reknit properly).
  3. The risks of the innovation are relatively low (e.g., if you’re not pregnant, supplementing vitamin D up to 5000 I.U./day has next to no risks, and it might help reduce the consequences of getting Covid-19).

Regarding #3, if the risks of a medical intervention are high, then the evidence for it should be equally high. On the other hand, if the risks are low, then the threshold of evidence for trying something can be low as well. This is a key point.

For example, the third leading cause of death in America is medical error, causing about 200,000 deaths per year, mainly involving medications. (Which is a more serious problem, the Goop Lab or deaths due to medical error?) The tools used by physicians are powerful, so they need to be very very well justified. Interestingly, in the Lancet a few years ago, it was acknowledged that about half of the methods that medical professionals use every day, in hospitals and outside them, do not have a single study that supports them. This does not mean they are malpractice. But I think it suggests that there should not be a double standard in which high risk medical interventions – often backed by the potent lobbying efforts of pharmaceutical companies – are used routinely with minimal research evidence while low risk health recommendations such as “reduce carbohydrates and eat more whole foods” are challenged for not having enough studies behind them.

As to what is “unscientific,” if this term means that something requires multiple excellent studies to be credible…then that view is itself truly unscientific. First, many things are true that no scientific study can prove. For example, if you love someone, no study in the world can prove it. Second, just because there wasn’t yet a study that vitamin D may reduce the consequences of Covid-19 did not mean that this was not true all along. As the genuinely scientific saying puts it: “The absence of evidence is not evidence of absence.” For me, “unscientific” means something contrary to what science has clearly shown to be true, such as biological evolution.

Dr. Ramani Durvasula is a licensed clinical psychologist, author, and expert on the impact of toxic narcissism. She is a Professor of Psychology at California State University, Los Angeles, and also a Visiting Professor at the University of Johannesburg.

The focus of Dr. Ramani’s clinical, academic, and consultative work is the etiology and impact of narcissism and high-conflict, entitled, antagonistic personality styles on human relationships, mental health, and societal expectations. She has spoken on these issues to clinicians, educators, and researchers around the world.

She is the author of Should I Stay or Should I Go: Surviving a Relationship With a Narcissist, and Don't You Know Who I Am? How to Stay Sane in an Era of Narcissism, Entitlement, and Incivility. Her work has been featured at SxSW, TEDx, and on a wide range of media platforms including Red Table Talk, the Today Show, Oxygen, Investigation Discovery, and Bravo, and she is a featured expert on the digital media mental health platform MedCircle. Dr. Durvasula’s research on personality disorders has been funded by the National Institutes of Health and she is a Consulting Editor of the scientific journal Behavioral Medicine.

Dr. Stephen Porges is a Distinguished University Scientist at Indiana University, Professor of Psychiatry at the University of North Carolina, and Professor Emeritus at both the University of Illinois at Chicago and the University of Maryland. He is a former president of the Society for Psychophysiological Research and has been president of the Federation of Behavioral, Psychological, and Cognitive Sciences, which represents approximately twenty-thousand biobehavioral scientists. He’s led a number of other organizations and received a wide variety of professional awards.

In 1994 he proposed the Polyvagal Theory, a theory that links the evolution of the mammalian autonomic nervous system to social behavior and emphasizes the importance of physiological states in the expression of behavioral problems and psychiatric disorders. The theory is leading to innovative treatments based on insights into the mechanisms mediating symptoms observed in several behavioral, psychiatric, and physical disorders, and has had a major impact on the field of psychology.

Dr. Porges has published more than 300 peer-reviewed papers across a wide array of disciplines. He’s also the author of several books including The Polyvagal Theory: Neurophysiological foundations of Emotions, Attachment, Communication, and Self-regulation.

Dr. Bruce Perry is the Principal of the Neurosequential Network, Senior Fellow of The ChildTrauma Academy, and a Professor (Adjunct) in the Departments of Psychiatry and Behavioral Sciences at the Feinberg School of Medicine at Northwestern University in Chicago and the School of Allied Health at La Trobe University in Melbourne, Australia. From 1993 to 2001 he was the Thomas S. Trammell Research Professor of Psychiatry at Baylor College of Medicine and chief of psychiatry at Texas Children's Hospital.

He’s one of the world’s leading experts on the impact of trauma in childhood, and his work on the impact of abuse, neglect, and trauma on the developing brain has impacted clinical practice, programs, and policy across the world. His work has been instrumental in describing how traumatic events in childhood change the biology of the brain.

Dr. Perry's most recent book, What Happened to You? Conversations on Trauma, Resilience, and Healing, co-authored with Oprah Winfrey, was released earlier this year. Dr. Perry is also the author, with Maia Szalavitz, of The Boy Who Was Raised As A Dog, a bestselling book based on his work with maltreated children, and Born For Love: Why Empathy is Essential and Endangered. Additionally, he’s authored more than 300 journal articles and book chapters and has been the recipient of a variety of professional awards.

Dr. Allison Briscoe-Smith is a child clinical psychologist who specializes in trauma and issues of race. She earned her undergraduate degree from Harvard and then received her Ph.D. in clinical psychology from the University of California, Berkeley. She performed postdoctoral work at the University of California San Francisco/San Francisco General Hospital. She has combined her love of teaching and advocacy by serving as a professor and by directing mental health programs for children experiencing trauma, homelessness, or foster care.

Dr. Briscoe-Smith is also a senior fellow of Berkeley’s Greater Good Science Center and is both a professor and the Director of Diversity, Equity, and Inclusion at the Wright Institute. She provides consultation and training to nonprofits and schools on how to support trauma-informed practices and cultural accountability.

Sharon Salzberg is a world-renowned teacher and New York Times bestselling author. She is widely considered one of the most influential individuals in bringing mindfulness practices to the West, and co-founded the Insight Meditation Society in Barre, Massachusetts alongside Jack Kornfield and Joseph Goldstein. Sharon has been a student of Dipa Ma, Anagarika Munindra, and Sayadaw U Pandita alongside other masters.

Sharon has authored 10 books, and is the host of the fantastic Metta Hour podcast. She was a contributing editor of Oprah’s O Magazine, had her work featured in Time and on NPR, and contributed to panels alongside the Dalai Lama.

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