Deepak Chopra _ Living Without Loneliness

Posted on July 18, 2019July 19, 2019 by Dr. Toni

The state of loneliness can be crippling. Though the majority of people don’t find themselves consumed by it, they do feel its effects. Their inner worlds shrink and dry up. For others, the issue looms over them like a specter in the future rather than as present reality.

The only real answer to loneliness is to experience your own fullness. Then and only then can you be sure that you will not look inside one day to find holes, gaps, unanswered fears and a sense of lack. Here are steps that enable you to become true to yourself. They aren’t magic bullets, and I recognize that loneliness, like every other psychological state, has degrees of severity. But whether you look on being lonely as a mild or severe issue, the same solution applies. The three steps are given in no order of priority; consider adopting all of them.

Step 1: Have a Vision That You Devote Time to Every Day

Happiness experts often advise that the best way to have a happy life is to have a happy day. I’d modify this a little. The best way to have a happy life is to have a happy day that looks forward to tomorrow. The future is something you build toward, and the place where you build is inside yourself. Society offers a different image, telling us that we should work hard for 20 or 30 years, postponing fulfillment until the end. This makes little sense to me. Why wait for golden years on the chance that you will still be strong, optimistic and full of promise?

It’s much easier to be that way now. Use your present energies to build your future in the following ways:

Write down a single vision, project or mission.

Set time aside every day to work on it.

Make sure that work consists of doing research; making connections; investigating your target audience or market; learning from projects similar to yours; challenging your assumptions; writing a proposal; seeking a mentor, a partner, or a confidant to bounce your ideas off of; and raising capital if needed.

Set interim deadlines that you can reasonably meet every month.

Be adaptable about changing your project as it unfolds.

If you can commit yourself to these steps, you will experience the kind of optimism and vitality that builds over time. Vision is the same as long-range purpose, which is something everyone needs. Someone might counter that I am simply giving career advice. If you do the kind of work that can embrace a long-range vision, that’s great. Not everyone is an entrepreneur or a top executive, however. For most people, a personal vision is just that—personal. They want something bigger than themselves to become dedicated to. The arena may be community and family. Whatever you choose, make sure that you are finding fulfillment every step of the way. Your vision aims at self-expansion.

Step 2: Put Yourself in a Context for Fulfillment

The solitary life is suitable for very few people; the vast majority prefer social connections. We all have them, but are yours the kind that fulfill you emotionally? If not, then the whole value of relationship is being missed. Proximity isn’t the same as bonding. There is a sliding scale for bonding, from least to most intimate, which is as follows:

I have nice friends and enjoy their company.

I have at least one close friend in whom I can confide; this friend is like a part of me.

I am bound with a loved one in a deeply personal relationship. We have our own private world together.

I have someone in my life who inspires me. I feel bigger and better in their presence.

I am on a deep spiritual path, and someone as dedicated as I am walks beside me.

I feel blessed to be in the presence of the divine, which I feel through everyone I meet.

Relationships reflect who you are inside, which is why the experience of bonding can go from shallow social contact to the merging of souls. If you want to be true to yourself, find the context in this scale that reflects your inner life, and if you don’t really know where that is, consult a friend, a confidant, a mentor or a therapist who can help. You need to speak with someone who can give you a clear view of yourself (which far more important than someone who is friendly and sympathetic).

Once you find the right context, build upon it. Relationships exist for the purpose of mutual fulfillment. If they exist for other reasons—status, financial security, feeling wanted, meeting the social norm—you can certainly be happy, perhaps for a long time. However, that’s not the same as being true to yourself deep down and allowing intimacy to move into the region of the soul.

Step 3: View Your Life as a Process, a Never-ending Journey

I know lots of people who say, “I want to feel young,” but very few who say, “I want to feel timeless.” As long as you live between the end points of birth and death, life is like a conveyor belt heading inexorably for a black tunnel. The only time that never ages is the present moment. “Living in the now” has become a spiritual cliché, but it isn’t always a useful one. Helpless infants live in the now, and so do Alzheimer’s patients. The now becomes eternal only when it is full. When your being is enough to sustain you, complete fullness is at hand. When just being here elicits bliss, you are timeless.

Being isn’t a choice. We all possess it. Yet we spend endless hours trying to escape it. As the poet Wordsworth lamented, the world is too much with us late and soon. We run after external rewards; we feel restless and anxious if we look inward. In essence, we are desperately trying to escape ourselves. When we run out of energy, money, playmates and toys, what happens? Utter loneliness.

Life is a process of finding yourself and living in contentment with what you find. It’s not an expedition to reach a distant mountain peak. It’s not a trail marked by things you can tick off, like a college diploma, a first house, retirement in Florida. The process is at once intimate and simple. You learn to be. This is the highest meaning of being true to yourself.

You can learn to be every day:

Set aside some quiet time.

Meditate.

Be aware of areas of discomfort and address them.

Assess your state of well-being.

Commune with nature.

Become absorbed in a creative pursuit.

People will often call these things “losing yourself,” which is true in a limited way: You are losing the ego self, with its cares and desires, its restlessness and disquiet. But in a larger sense you are finding yourself. The core of yourself is calm, centered, unshakable and fulfilled. The reason we look outward to find fulfillment is that we haven’t yet settled on the place inside where being and fulfillment are the same. Working to find the same contentment after you grow up will get you to “organized innocence,” as it has been called. You have absorbed a wide range of life experiences. You know what you know and can do what you do. At the same time, there is a secure sense of being deep inside. Usually we think of this as spiritual seeking, but words like God, spirit, the soul, salvation, carry too many associations. Perhaps it’s better to call it “the process” and leave it at that.

The process of unfolding requires no work or struggle. You are totally connected to your being right now, as you always have been. The only thing you’ve lost is the awareness of your connection. As you expand and become more aware, what happens? You need less and less from the outer world and other people. You realize that security, love and joy are innate qualities of being. They can’t be lost, only forgotten. So the highest project you can devote yourself to is self-discovery. In the end, loneliness will seem like a phantom, something barely remembered. Yet even today, if you start to discover who you really are, every moment will be the opposite of lonely. You will be absorbed in the essence of life, and nothing is more fascinating.Read more: http://www.oprah.com/inspiration/living-without-loneliness-how-to-feel-more-fulfilled-deepak-chopra#ixzz4kvZLCMwe

A Doctor Speaks Out About Ageism In Medicine

Posted on June 7, 2019June 7, 2019 by Dr. Toni

By Judith Graham MAY 30, 2019

NAVIGATING AGING

Navigating Aging focuses on medical issues and advice associated with aging and end-of-life care, helping America’s 45 million seniors and their families navigate the health care system.

To contact Judith Graham with a question or comment, click here.

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Society gives short shrift to older age. This distinct phase of life doesn’t get the same attention that’s devoted to childhood. And the special characteristics of people in their 60s, 70s, 80s and beyond are poorly understood.

Medicine reflects this narrow-mindedness. In medical school, physicians learn that people in the prime of life are “normal” and scant time is spent studying aging. In practice, doctors too often fail to appreciate older adults’ unique needs or to tailor treatments appropriately.

Imagine a better way. Older adults would be seen as “different than,” not “less than.” The phases of later life would be mapped and expertise in aging would be valued, not discounted.

With the growth of the elder population, it’s time for this to happen, argues Dr. Louise Aronson, a geriatrician and professor of medicine at the University of California-San Francisco, in her new book, “Elderhood.”

It’s an in-depth, unusually frank exploration of biases that distort society’s view of old age and that shape dysfunctional health policies and medical practices.

In an interview, edited for clarity and length, Aronson elaborated on these themes

Q: How do you define ”elderhood”?

Elderhood is the third major phase of life, which follows childhood and adulthood and lasts for 20 to 40 years, depending on how long we live.

Medicine pretends that this part of life isn’t really different from young adulthood or middle age. But it is. And that needs a lot more recognition than it currently gets.

Q: Does elderhood have distinct stages?

It’s not like the stages of child development — being a baby, a toddler, school-age, a teenager — which occur in a predictable sequence at about the same age for almost everybody.

People age differently — in different ways and at different rates. Sometimes people skip stages. Or they move from an earlier stage to a later stage but then move back again.

Let’s say someone in their 70s with cancer gets really aggressive treatment for a year. Before, this person was vital and robust. Now, he’s gaunt and frail. But say the treatment works and this man starts eating healthily, exercising and getting lots of help from a supportive social network. In another year, he may feel and look much better, as if time had rolled backwards.

Q: What might the stages of elderhood look like for a healthy older person?

In their 60s and 70s, people’s joints may start to give them trouble. Their skin changes. Their hearing and eyesight deteriorate. They begin to lose muscle mass. Your brain still works, but your processing speed is slower.

In your 80s and above, you start to develop more stiffness. You’re more likely to fall or have trouble with continence or sleeping or cognition — the so-called geriatric syndromes. You begin to change how you do what you do to compensate.

Because bodies alter with aging, your response to treatment changes. Take a common disease like diabetes. The risks of tight blood sugar control become higher and the benefits become lower as people move into this “old old” stage. But many doctors aren’t aware of the evidence or don’t follow it.

Q: You’ve launched an elderhood clinic at UCSF. What do you do there?

I see anyone over age 60 in every stage of health. Last week, my youngest patient was 62 and my oldest was 102.

I’ve been focusing on what I call the five P’s. First, the whole person — not the disease — is my foremost concern.

Prevention comes next. Evidence shows that you can increase the strength and decrease the frailty of people through age 100. The more unfit you are, the greater the benefits from even a small amount of exercise. And yet, doctors don’t routinely prescribe exercise. I do that.

It’s really clear that purpose, the third P, makes a huge difference in health and wellness. So, I ask people, “What are your goals and values? What makes you happy? What is it you are doing that you like best or you wish you were doing that you’re not doing anymore?” And then I try to help them make that happen.

Many people haven’t established priorities, the fourth P. Recently, I saw a man in his 70s who’s had HIV/AIDS for a long time and who assumed he would die decades ago. He had never planned for growing older or done advance care planning. It terrified him. But now he’s thinking about what it means to be an old man and what his priorities are, something he’s finally willing to let me help him with.

Perspective is the fifth P. When I work on this with people, I ask, “Let’s figure out a way for you to keep doing the things that are important to you. Do you need new skills? Do you need to change your environment? Do you need to do a bit of both?”

Perspective is about how people see themselves in older age. Are you willing to adapt and compensate for some of the ways you’ve changed? This isn’t easy by any means, but I think most people can get there if we give them the right support.

Dr. Louise Aronson(ANNA KUPERBERG PHOTOGRAPHY)

Q: You’re very forthright in the book about ageism in medicine. How common is that?

Do you know the famous anecdote about the 97-year-old man with the painful left knee? He goes to a doctor who takes a history and does an exam. There’s no sign of trauma, and the doctor says, “Hey, the knee is 97 years old. What do you expect?” And the patient says, “But my right knee is 97 and it doesn’t hurt a bit.”

That’s ageism: dismissing an older person’s concerns simply because the person is old. It happens all the time.

On the research side, traditionally, older adults have been excluded from clinical trials, although that’s changing. In medical education, only a tiny part of the curriculum is devoted to older adults, although in hospitals and outpatient clinics they account for a very significant share of patients.

The consequence is that most physicians have little or no specific training in the anatomy, physiology, pharmacology and special conditions and circumstances of old age — though we know that old people are the ones most likely to be harmed by hospital care and medications.

Q: What does ageism look like on the ground?

Recently, a distressed geriatrician colleague told me a story about grand rounds at a major medical center where the case of a very complex older patient brought in from a nursing home was presented. [Grand rounds are meetings where doctors discuss interesting or difficult cases.]

When it was time for comments, one of the leaders of the medical service stood up and said, “I have a solution to this case. We just need to have nursing homes be 100 miles away from our hospitals.” And the crowd laughed.

Basically, he was saying: We don’t want to see old people; they’re a waste of our time and money. If someone had said this about women or people of color or LGBTQ people, there would have been outrage. In this case, there was none. It makes you want to cry.

Q: What can people do if they encounter this from a doctor?

If you put someone on the defensive, you won’t get anywhere.

You have to say in the gentlest, friendliest way possible, “I picked you for my physician because I know you’re a wonderful doctor. But I have to admit, I’m pretty disappointed by what you just said, because it felt to me that you were discounting me. I’d really like a different approach.”

Doctors are human beings, and we live in a super ageist society. They may have unconscious biases, but they may not be malicious. So, give them some time to think about what you said. If after some time they don’t respond, you should definitely change doctors.

Q: Do you see signs of positive change?

Absolutely. There’s a much larger social conversation around aging than there was five years ago. And that is making its way to the health system.

Surgeons are thinking more and more about evaluating and preparing older adults before surgery and the different kind of care they need after. Anesthesiologists are thinking more about delirium, which has short-term and long-term impact on older adults’ brains. And neurologists are thinking more about the experience of illness as well as the pathophysiology and imaging of it.

Then you have the age-friendly health system movement, which is unquestionably a step in the right direction. And a whole host of startups that could make various types of care more convenient and that could, if they succeed, end up benefiting older people.

Judith Graham: @judith_graham

What does Aging Mean for Women?

Posted on May 10, 2019May 10, 2019 by Dr. Toni

Gayle King moderates a Milken Institute panel on rethinking what aging means for women

By ELLEN OLIVIERMAY 01, 2019 | 3:05 PM

Appropriately enough, Katy Perry’s song “Roar” could be heard over the speaker system as guests filed out of the panel discussion “Coming of Age: Women Rise to the Top” at the Milken Institute Global Conference at the Beverly Hilton earlier this week.

Moderated by Gayle King, co-host of “CBS This Morning,” the April 29 event during the four-day conference consisted of women who had broken age and gender barriers to achieve powerful positions in a variety of industries and who had come together to talk about the need for society to rethink what age and aging represent.

“How do we feel about the phrase ‘women of a certain age?’” asked King, 64, plunging right into the topic.

"CBS This Morning" co-host Gayle King. — “CBS This Morning” co-host Gayle King. (Milken Institute)

“I like, ‘perennials — perennially young,’” said Sherry Lansing, 74, former chairman and chief executive of Paramount Pictures. Lansing said she has no problem revealing her age but hates the phrase “a certain age” and also the descriptors “seniors” and “older.”

“I’ve never felt better and more in tune with myself, more in tune with my business and more connected to the rest of the world,” said Sylvia Rhone, 67, chairman and chief executive of Epic Records.

Anastasia Soare, 61, joked that she still celebrates age 39 every year. Soare is the founder and chief executive of Anastasia Beverly Hills, a cosmetics company that has more than 19 million Instagram followers.

Former congresswoman Jane Harman, currently the director, president, and chief executive of the Wilson Center, speaks during the April 29 panel discussion. (Milken Institute)

Not surprisingly a proponent of makeup, Soare talked about cosmetics’ ability to lend women confidence and give “the power to women to control what they want to look like.”

“You have to look good in order for people to listen to what you have to say,” said former congresswoman Jane Harman, 73, currently director, president and chief executive of the Wilson Center.

Harman said she first became passionate about politics as a young girl after meeting Eleanor Roosevelt and feeling “an aura about her.”

Lansing then suggested that Roosevelt’s beauty came not from outside but from her energy, charisma and substance, and that beauty as women age should also be judged in other than superficial ways.

Anastasia Soare, founder and chief executive of cosmetics company Anastasia Beverly Hills, was among the panelists at the April 29 event. (Milken Institute)

“I thought I’d be dead by 70,” Lansing said. “So instead of thinking that 70 is old or 80 is old or 90 is old, can’t we accept the way it is? I’m too scared to let my hair grow gray. … But if we’re really going to be role models and we’re really going to redefine aging, some of us have to do that.”

Donna Karan, 70, said that although her daughter thinks she should retire, the designer said, “I’m [just] beginning. … I’m an artist. You never give that up. There is no age about it.”

Then, offering a fashion tip, the founder of Urban Zen and Donna Karan International recommended clothes that bare the shoulder. “Your shoulder never gains weight,” she said. “That’s why I did the ‘cold shoulder.’ … The shoulder never gets wrinkled.”

Harman had two more suggestions for success. The first: “Be confident. It’s very hard for women to learn self-confidence,” she said. “When you’re confident, you put yourself out there in ways you wouldn’t otherwise.”

Her second piece of advice: “Be the most qualified person in the room. … Don’t say, ‘Well, I’m the girl’ and ‘Gee, it’s stacked against me.’ … If you’re good, it’s amazing what can happen and what continues to happen even at this ripe ‘young’ age.”

Epic Records’ Rhone said her success came not only from being good at what she does, but also from hard work, surrounding herself with good people and being fearless. “I’m very fearless,” she said, “and that’s what gets me through. There’s not a lot of things that can put me down. And, if there are, it’s just for a moment until I recalibrate, and then I’m back again.”

Former congresswoman Jane Harman, left, listens while former Chairman and Chief Executive of Paramount Pictures Sherry Lansing speaks at the panel discussion “Coming of Age: Women Rise to the Top.” (Milken Institute)

Summarizing the sentiment in the room, King ended the session with a declaration: “70 is the new 50 — I’ll leave you with that.”

The talk about aging didn’t end at the door. In a post-event conversation, Lansing said, “My generation marched for civil rights. We marched for the women’s movement. We marched for gay marriage, and now we have to be the culture to redefine what aging is and what beauty is. I wish I had the courage to let my hair grow gray, but I can’t because there’s a stigma attached to it. Aging can’t be a negative thing. It has to be a positive thing, and every birthday has to be celebrated.”

Of course, for some women, aging naturally may not be realistic and may depend upon a woman’s profession.

“I’m under no illusion that if I were gray-haired, white-haired or 50 pounds overweight with wrinkles on my face, the reality is I would not have a job on television,” King said, just after the session. “I look at that as that’s just the way it is. I don’t run away from aging and I have no hang-ups about telling my age, but if you’re in a business where you have to look good, that’s the reality.”

Ellen Olivier is founder of Society News LA.

Aging is a Triumph, Not a Tragedy

Posted on November 16, 2018November 16, 2018 by Dr. Toni

So spake the great geriatrician, psychiatrist and elder advocate, Robert N. Butler, who died in December 2010. According to his biographer, W. Andrew Achenbaum, he helped

“…to transform the study of aging from a marginal specialty into an intellectually vibrant field of inquiry.”
Personally, I doubt I would have become an elder advocate myself without having had Butler’s books to teach me.

Robert N. Butler cover artRobert N. Butler, M.D. is the title of this just-published biography of the great man who won a Pulitzer Prize for his 1975 book, Why Survive? Being Old in America and before that, in 1968, coined the term “ageism” as an analog to racism and sexism.

”Butler well understood that ignorance, prejudice, and stereotypes clouded the vision of vital, productive, fruitful aging that he wished to promulgate,” writes Achenbaum.

“In late life,” he continues, “Butler concluded that ageism was even more pernicious than he initially had realized…Butler now called ageism a disease, a morbid fear of decline and death that crippled individuals.”
Robert Butler may not have crushed ageism during his long career but his other achievements transformed attitudes and beliefs about old age that continue to help elders’ well being now and will continue to do so into the future.

Butler was appointed by President Gerald Ford to be the first director of the National Institute on Aging. Later he established the first U.S. department of geriatrics at Mount Sinai Medical Center in New York City.

In 1990, he founded the International Longevity Center (ILC-USA) to pursue the study of health and productivity of old people. Among the organization’s projects was the Age Boom Academy created in 2000 to

”…deepen the understanding on the part of 150 journalists of how the perils and promises of societal aging affected their respective news beats. Ideas germinated in the academy often found mass circulation,” explains Achenbaum.
In 2009, I was privileged to be one of the dozen journalists that year at the week-long Age Boom Academy – all expenses, as every year, paid in full. Dr. Butler brought together the crème de la crème of age researchers and experts from every sub-field imaginable and by the end, it was like being granted a masters degree in aging. Here is one of my stories about the Age Boom Academy.

[DISCLOSURE: Achenbaum quotes from my 2008 interview interview with Dr. Butler which you can read here.]

Achenbaum, who is professor of social work and history in the Graduate School of Social Work at the University of Houston, does a fine job of recounting Butler’s achievements that benefit elders – the remarkably large number of reasons the book is subtitled, Visionary of Healthy Aging.

But it is the many quotations from Achenbaum’s previously unpublished conversations with Butler along with the book’s epilogue – Butler’s unfinished “life review” in his own words – that most captured my attention.

Some thoughts from Butler you too may find provocative:

“Why do we have so much trouble enjoying the moment? This was not as true when we were children.”
“When a young person writes a novel he writes an autobiography; when an old person writes an autobiography, he writes a novel.”
“There is a dark side to the lives of those of wealth and privilege; they do not need to carry out the most elemental aspects of existence, the preparing of their own food and taking care of their own personal needs. In a perverse sense, elementality is a luxury of poverty.”
“Old age is no longer equivalent to disease, infirmity, frailty, decrepitude and slowing down. The brain is proving to be subject to repair and growth and this plasticity promises greater cognitive health.”
“The challenge is how to better understand, shape and value this new old age. Older persons themselves should define this portion of their lives, and not passively allow the culture to do so.

“They are the pioneers who have interest into the redefined old age and do not accept aging and disability as inevitable, unpreventable and untreatable. Society and culture, of course, have catching up to do.”

Fighting ageism

Posted on March 22, 2018 by Dr. Toni

Geropsychologists are striving to stop negative age stereotypes and meet the growing mental health needs of older adults.

By MELISSA DITTMANN

Monitor Staff

May 2003, Vol 34, No. 5

The number of Americans 60 and older is growing, but society still isn’t embracing the aging population, geropsychologists say. Whether battling “old geezer” stereotypes or trying to obtain equal standing in the workplace, those who are 60 or older may all too often find themselves the victims of ageism.

In fact, in a survey of 84 people ages 60 and older, nearly 80 percent of respondents reported experiencing ageism–such as other people assuming they had memory or physical impairments due to their age. The 2001 survey by Duke University’s Erdman Palmore, PhD, also revealed that the most frequent type of ageism–reported by 58 percent of respondents–was being told a joke that pokes fun at older people. Thirty-one percent reported being ignored or not taken seriously because of their age. The study appeared in The Gerontologist (Vol. 41, No. 5).

And what’s worse, ageism also seeps into mental health care. Older patients are often viewed by health professionals as set in their ways and unable to change their behavior, aging experts say. Mental health problems–such as cognitive impairment or psychological disorders caused at least in part by complex pharmacological treatments–often go unrecognized and untreated in this growing demographic, many researchers believe.

The deficit in treatment comes at a time when those over the age of 85 make up the fastest-growing segment of the U.S. population. Nearly 35 million Americans are over 65 years old, according to the 2000 U.S. Census, and that number is expected to double by 2030 to 20 percent of the population.

Those numbers come as no surprise to geropsychologists, who–as they mark Older Americans Month this May–continue working to get the word out about the need for better elder care. Their ultimate aim is to expand training and research opportunities in this area and eliminate ageism in all facets of society–from demeaning stereotypes portrayed in the media to the public’s personal biases.

The effects of ageism

Not only are negative stereotypes hurtful to older people, but they may even shorten their lives, finds psychologist Becca Levy, PhD, assistant professor of public health at Yale University. In Levy’s longitudinal study of 660 people 50 years and older, those with more positive self-perceptions of aging lived 7.5 years longer than those with negative self-perceptions of aging. The study appeared in the Journal of Personality and Social Psychology (Vol. 83, No. 2).

On the other hand, people’s positive beliefs about and attitudes toward the elderly appear to boost their mental health. Levy has found that older adults exposed to positive stereotypes have significantly better memory and balance, whereas negative self-perceptions contributed to worse memory and feelings of worthlessness.

“Age stereotypes are often internalized at a young age–long before they are even relevant to people,” notes Levy, adding that even by the age of four, children are familiar with age stereotypes, which are reinforced over their lifetimes.

Fueling the problem is the media’s portrayal of older adults, Levy says. At a Senate hearing last fall, Levy testified before the Special Committee on Aging about the effects of age stereotypes. Doris Roberts, the Emmy-award winning actress in her seventies from the T.V. show “Everybody Loves Raymond,” also testified at the hearing.

“My peers and I are portrayed as dependent, helpless, unproductive and demanding rather than deserving,” Roberts testified. “In reality, the majority of seniors are self-sufficient, middle-class consumers with more assets than most young people, and the time and talent to offer society.”

Indeed, the value that the media and society place on youth might explain the growing number of cosmetic surgeries among older adults, Levy notes. Whether this trend is positive or negative in combating ageism is one of many areas within geropsychology that needs greater research, she says.