The Sports Doc Chalk Talk

As a clinician who regularly assists people trying to overcome various mental, emotional, and behavioral problems, I have long been fascinated by the power of the placebo effect.  Honestly, “fascinated” doesn’t even begin to describe how in awe I am by the power of belief — and how powerful belief and suggestion can be when it comes to self-healing and improvement (Changing Habits for Life Success). Hey, who wouldn’t want to relieve stress, improve weight loss motivation, and decrease the likelihood of future mental health issues because of the help of placebos?!

A recent study by Kaptchuk (2010) has revealed an even more amazing discovery, one that offers even more hope when it comes to the efficacy rates when using placebos to help people overcome various pains and problems.  Until recently, most experts agreed that the “magic” of placebos (i.e. sugar pills, irrelevant suggestions, token products, etc.) lied in the deception portrayed by the healer.  In other words, if your doctor suggested that you eat blueberries to help with the headaches you have been experiencing (assuming there has been no empirical evidence blueberries help with headaches), and your headaches immediately disappear after eating blueberries, then it can be assumed that it was the suggestion by the doctor – and not the blueberries – that accounted for the healing.  Of course, most patients will immediately say it was the blueberries that caused the headaches to stop, but in reality this is an example of how the placebo effect deceptively works.

Interestingly, when “experts” tell us how to address our problems we almost always believe them, and often things do in fact get better — but whether the change is due to the intervention or belief about the intervention will always be the question.  Experts can be doctors, but they can also be mechanics, computer technicians, or police officers — so long as someone is viewed as an expert, people tend to stop using critical thinking skills and instead start believing just about anything the expert says if it sounds like it could help.  For example, a mechanic might tell you to constantly run your fan inside your car to prevent carbon build up in your motor — if you know little about cars, would you believe him?    Assuming you never have engine problems in the future, you might really believe that your car has been maintained because of always running the fan — even though this has nothing to do with engine performance.

When it comes to medicine, placebos would really help patients overcome a lot of their problems, but it is also unethical to deceive patients into believing something about a product that has no medicinal value (like a sugar pill).  Of course, this saddens a lot of physicians as they know that:a) more patients would heal faster, andb) there are no side effects with placebos.This has led to quite a conundrum, but Kaptchuk’s recent study may have shed new light on how we can use the placebo while avoiding ethical concerns and still see the same positive effects!

Kaptchuk’s study revealed that when subjects were recommended to use a placebo for their irritable bowel syndrome (IBS) but told that while the placebo pills had no direct medicinal value, the pills could improve IBS symptoms through the “mind-body healing process.”  Amazingly, 59% of the subjects in this condition reported adequate relief, versus only 35% for the control group who did not receive the placebo.Think about that for a moment — the patients knew they were receiving an inactive drug (a sugar pill), but told that the “mind -body healing process” would still kick in, helping patients overcome their IBS symptoms.  Amazingly, even when patients knew they were receiving a placebo, they still showed marked improvement versus subjects not prescribed a placebo!

This new finding is quite incredible as it may remove the deception variable that has always been assumed to be the main agent of change when it comes to the placebo effect.  In the future, it’s possible more doctors, clinicians, and various other helping professionals may turn to placebos, but instead of tricking their patients they might actually tell them they are prescribing placebos!

For more about this research study check out the May 2011 issue of Psychology Today.

www.drstankovich.com

Liquid Lunches, Binge Eating, and Other Risky Behaviors…

When we get “stressed out” in life, we are ultimately left to face the classic dilemma of “fight or flight” (Optimal Balance).  In some cases, we roll up our sleeves, take a deep breath, and courageously tackle (or “fight”) the stressor head on with great enthusiasm. While this is the textbook response we would love to employ on a regular basis, we also know that it isn’t always that easy – and that in some instances the issues and problems we face in life cause us to want to take a break from the stressor (the “flight” option) and do other, more pleasurable things rather than fight the stressor. It is these compensatory actions we do (i.e. over-eat, drink, etc.) instead of taking on stressors that oftentimes makes situations worse and prevents us from becoming our best.

For most adults, having a cocktail is sure better than completing an arduous work task; and over-indulging in good food is a lot more enjoyable than having to pay bills or resolve interpersonal disagreements amongst co-workers. In fact, over-eating, drinking, smoking, and all other unhealthy coping mechanisms are actually effective when it comes to stress response! The reason these coping mechanisms are effective is because they do (temporarily) allow us to forget about our stress and keep our sanity, showing that these responses do “work” as far as short-term stress-relief goes. The problem is these types of responses are not healthy – for one, they often lead to even bigger problems (i.e. obesity, alcoholism, etc.) and secondly they prohibit us from actually working on the stressor (and, consequently, reducing our level of stress!).

Effective & Healthy Stress Response

Remaining in a chronically stressful environment is never a good thing, and over time will almost certainly lead to cognitive, emotional, and physical breakdowns. In fact, Dr. Hans Seyle in his General Adaptation Syndrome theory on stress, discusses how the body will go through an alarm, resistance, and exhaustion pattern when exposed to ongoing stress. Using this model, it can be argued that for us to not only survive, but also thrive in life, we must find ways to take a break from the stressors we face – especially the really tough stressors. It is what we do in these moments of “life timeouts” that makes all the difference in the world, and separates healthy and effective people from unhealthy and ineffective people.

As I mentioned earlier, just about anything you do in response to stress is effective if it allows you to get away from the stressful situation. As crazy as it sounds, getting drunk is effective in that it momentarily allows you to not think about the stress in your life. However, even though getting drunk provides a temporary escape, it is an unhealthy way to cope with stress, and in the long run will likely only make things worse. The key, then, is to develop coping mechanisms that are both effective and healthy, allowing you to take a quick “timeout” from the stressor, while at the same time helping you stay positive, focused, and determined to come back fighting once you end your short break from the stressor.

So What Types of Coping Mechanisms are We Talking About??

While it’s easy to come up with all the bad ways we cope with stress, it’s important to discuss some of the good things we should be doing. The funny thing is, there really are no surefire healthy coping mechanisms, nor are there “one-size-fits-all” ways for all people to deal with stress. For example, while exercise is certainly a good thing for us to do on a regular basis, people who over-indulge in exercise may end up battling body image and vanity issues, eating disorders, or even complications with performance supplements if they are using them. On the other hand, while over-indulging in alcohol is obviously a risky endeavor; some studies have shown that a single glass of wine may in fact help the circulatory system. The truth is, there is no one single perfect way to deal with stress, but if you ask yourself the following two questions you should be in relatively good shape when it comes to coping with stress:

1. Is this an effective mechanism that allows me to have a short break from the stressor without causing more problems?

2. Is this a healthy behavior that won’t lead to even bigger problems – emotionally, financially, physically, or otherwise?

Tips & Strategies

• Take a close look at how you typically respond to stress – are your behaviors effective? Are they healthy?• Taking a break from your stress is not a bad thing. In fact, Dr. Seyle’s model would suggest it is imperative that you do take breaks in order to avoid complete breakdowns. It’s what you do during your break that can make (or break) what happens next in your life.

• Try to come up with at least five things you can consider doing in times of stress that are both effective and healthy. Once you have these ideas jotted down, be sure to consider using them during times of stress.

www.drstankovich.com

“I’m So Stressed Out!”

When you think of the word “stress,” what immediately comes to mind? For many people, the symptoms of stress are usually first described (i.e. headaches, upset stomach, loss of sleep, etc.), but when it comes to exactly what stress is and it’s impact on mental health, it is often quite difficult to describe (Optimal Balance). In fact, in reviewing the dozens of Introductory Psychology textbooks I own for a mutually agreed upon definition, I was amazed at how different and varied each author was in his or her description of stress.

Stress Impacts Everything We Do

As a result of these varying opinions, I decided a fairly good “hybrid” definition is that stress is a psychological, emotional, and behavioral response to a perceived threat, characterized by the perception of changes in habits and rituals and exacerbated by loss of control. In other words, we “stress” when we feel threatened and think we are losing control and potentially helpless, and our reaction to the threat is typically manifested through our thoughts (“What am I going to do about this?”), our emotions (“I feel very sad and depressed about the situation”), and our behaviors (“I don’t have time to get to the gym, but I do have time for a quick drink after work”). If these reactions continue over time, many bad things can occur, including mental and physical health issues, as well as drug/alcohol dependence in response to coping with the stressor(s). The perception of something stressful activates many adaptive responses within the body, sometimes leading to headaches, stomach aches, and ulcers.

Clinical Psychopathology

Two of the more common mental issues that can occur as a result of perceived stress include anxiety and depression. While it can certainly be argued that human psychopathological conditions, like anxiety and depression, may be more organically based (genetic in nature); most experts would still agree that how one deals with stress is often the true mechanism and catalyst for shifts in mood state and arousal levels (upward and downward). In other words, for most people their symptoms will temper when they feel good and are in control of their life, and their symptoms will “spike” when they feel out of control, hopeless, and threatened by the stressor(s).

Human Perception & Stress

The following is a simple example of how human perception directly activates the stress response cycle. When a person feels challenged by something, a positive adrenaline rush usually occurs, leading to increased self-confidence and greater motivation and resiliency. Conversely, when a person feels threatened by something, the exact opposite occurs with the result often being negative, counterproductive anxiousness, physical tremors, and a host of other behavioral symptoms (i.e. becoming sick).

Amazingly, two people can have the same exact task in front of them, but one will perceive the situation as a challenge, while the other will see it as a threat. Take for example person receiving news that their current job will be downsized after the holidays.  Obviously, nobody wants to be downsized and out of a job, but we all realize it is sometimes a reality in life. For one person, she may view the situation optimistically and challenge herself to “roll up her sleeves” and make the best of a tough situation. In this example, she might prepare for this task by eating right, exercising, developing a game plan after carefully reviewing options, finally deciding on the best course of action. From there, she will prepare to execute a new game plan for finding meaningful work, always looking for ways to continue to grow in a positive direction for the future.  Sure, there will be tough times ahead as life is rarely easy, but she realizes that in the big picture sometimes smaller changes are required for bigger gains.

For a second person faced with a similar job loss situaiton, he will follow an entirely different road – one that is laced with pessimism and hopelessness. Even though there are many unknowns, he instead has already made up his mind that terrible things are about to occur, and as a result his thinking becomes convoluted with negative thoughts, and his actions become haphazard (i.e., not paying attention to important details) and maybe even reckless (i.e. drinking to numb the anxiety). Consequently, he “stresses” terribly over the situation, does not adequately review all options, is shoddy in his planning, does not eat right, sleep, or exercise. In this example, his coping patterns actually exacerbate the stress!

Human perception plays a big role in how we appraise situations, and consequently what we do after our initial appraisals are made. This is not to say that all psychopathology would go away if we just looked at the world with an optimistic, confident view; but what it does suggest is that our human perception – something we have 100% under our complete control – has a direct and major impact on level of our human wellness. Looking for “silver linings” through a realistic world lens is a healthy thing for people to do, and does not mean that you are irresponsible, short-sighted, or not qualified to make big, important decisions in your life. Even in the toughest of times, human beings have always shown resiliency and the ability to fight back, and often good results have followed.

Tips & Strategies

• Realize that stress impacts people in many different ways, including through thoughts, emotions, and behaviors.

• Often our thoughts, emotions, and behaviors follow the path we want them to go – quite simply, view the things in your life as challenges and they will go in a positive, constructive direction; or view things as threats and they will go in a negative, destructive direction.

• Human perception is an individual experience that can be modified and tweaked so that what you “see” is a healthy battle and not a negative, destructive force. Like the saying goes, “One man’s garbage is another man’s treasure.” In fact, e-bay exists because what is perceived as useless to one person is often of great value to another.

• Your thinking impacts your behaviors, while your behaviors impact your thinking. For example, simply thinking about good things will turn negative anxiety into positive arousal (adrenaline). On the other hand, sometimes making yourself do something (i.e. go to the gym) will result in a healthy change in thinking (i.e. feeling great after a good, healthy sweat). The good news is that you control both your thinking and behaviors!

• Don’t take for granted how much you control your own wellness, happiness, and even stress levels. By taking control of your life, perceiving the world around you accurately and with a positive enthusiasm, and setting goals for life success, you will experience less negative stress and more life success!www.drstankovich.com