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OCD Toolbox Flipping a Coin

I noticed a gap between my last two posts, ie. how did I get from vetting my food choices endlessly to having a mediocre lunch on Wednesday and going on with my day. As an aside, OCD perfectionism makes it hard to credit myself for any work I've done, as if somehow I was magically transported from point A to point B, in spite of my general wretchedness. But I know that's not what happened.

One of the most helpful strategies, that my ERP Therapist introduced me to, is flipping a coin. This short circuits all the OCD crap about choosing the "just right" item that won't trigger a cascade of obsessing and compulsing. Instead, I make the choice to jump into the fray, and accept whatever randomly comes up, and live with the anxiety it may cause, until it dissipates of its own accord.This is both terrifying and incredibly liberating.

Often, in facing a menu, I'd go back and forth, back and forth between 2 options, so as an exposure I'd say, If it's tails I'm getting the first item, if it's heads I'm getting the second item. I don't usually have a coin on me, so I started using my watch--if the second hand is in the first 30 seconds of the dial it's one, and in the second 30 seconds it's the other. This also works with digital watches--if the last digit is even vs. odd.

This works best with "yes" or "no" questions, or choosing between 2 things, and only if I go into it intentionally as an exposure, fully aware that I might not like what I end up eating, and get a spike of anxiety that I didn't adequately examine my choices.

It helps to remind myself that even with an hour of indecision, and thinking through every possible option, I could still end up with something I don't like, and I've wasted an hour. I have no special fortune telling powers, and no amount of menu perusing is going to guarantee an obsession free meal.

Of course OCD is clever and tries all sorts of ways to insinuate itself--should I use the coin toss? Is this the right time to do the coin toss? I would fight back by flipping a coin to answer that question.

Related Posts:
OCD Toolbox: Listening to Scripts

The Biochemical Basis for a Gratitude Practice Rerun

by Nina

In a Meadow by Melina Meza

 II.33 Upon being harassed by negative thoughts, one should cultivate counteracting thoughts. —translated by Edwin Bryant

For some time now, I’ve been intrigued by Facebook posts from certain friends that simply list things the person is grateful for. I particularly like the ones by my friend Liz because her lists include very simple things, mostly free and available to almost everyone.

Today's good things:

1. Walked six miles;
2. Dog therapy on campus today, in particular the golden retriever puppy;
3. Watching the bushtits (birds) flit in and out of the trees on campus;
4. Got a lot of items off my 'to do' list at work, moving forward with several work projects and learning new things.

I also happen to know this gratitude practice is a very serious one for Liz, because she suffers from a serious, chronic illness that affects her quality of life and requires quite a bit of time spent in the hospital. She says, “It’s been bumpy, but I saw research that said gratitude practice helps. And I set intentions at the beginning of each day and have seen improvement.”

Today's good things:

1. Three mile walk at lunch, great watching the hawks circle;
2. Very productive day at work, a lot of weeding and organizing;
3. Ran into a lovely friend whom I haven't seen in a while, always great to catch up;
4. Gluten-free ice cream sandwiches

So I was very intrigued when I learned that neuroscientist Alex Korb’s book The Upward Spiral: Using Neuroscience to Reverse the Course of Depression, One Small Change at a Time actually provides a scientific explanation of why this practice works. Apparently, cultivating gratitude actually has a beneficial chemical effect on the brain, boosting dopamine (a neurotransmitter that helps control the brain's reward and pleasure centers) and serotonin (a neurotransmitter that affects our mood) levels.

“The benefits of gratitude start with the dopamine system, because feeling grateful activates the brain stem region that produces dopamine. Additionally, gratitude toward others increases activity in social dopamine circuits, which makes social interactions more enjoyable …”

“One powerful effect of gratitude is that it can boost serotonin. Trying to think of things you are grateful for forces you to focus on the positive aspects of your life. This simple act increases serotonin production in the anterior cingulate cortex.” —Dr. Korb

When I was thinking about how this practice related to yoga (haha, I figured it must!), I came back to this sutra by Patanjali about cultivating the opposite (pratipaksa-bhavanam).

II.33 Upon being harassed by negative thoughts, one should cultivate counteracting thoughts. —translated by Edwin Bryant

Bryant explains in his commentary on this sutra that the “negative thoughts” being referred to are those that counter the yamas and niyamas. So thoughts that are the opposite of contentment (the niyama santosha), such as dissatisfaction, displeasure, and unhappiness, would count as negative thoughts that you should counteract. And the practice of being grateful for what you have, which is cultivating contentment, is indeed the practice of cultivating thoughts that counteract dissatisfaction, displeasure, and unhappiness.

Of course, when you are being “harassed by negative thoughts,” it often isn’t easy to find and focus on things you are grateful for. But Korb says, the effort alone provides the benefits.

“It’s not finding gratitude that matters most; it’s remembering to look in the first place. Remembering to be grateful is a form of emotional intelligence. One study found that it actually affected neuron density in both the ventromedial and lateral prefrontal cortex. These density changes suggest that as emotional intelligence increases, the neurons in these areas become more efficient. With higher emotional intelligence, it simply takes less effort to be grateful.”

Fascinating, isn’t it? Just like strengthening a muscle, a regular gratitude practice makes you stronger at being grateful over time. So that means getting better as it as you age, and eventually more time spent in a state of contentment. And those brain density changes? That sounds to me like the gratitude practice is improving brain strength—always a good thing.

And by the way, thank you Liz for agreeing to share your story with us. I'm grateful for your friendship and your honesty.

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Yoga is a great thing but

by Nina 

Stop Sign by Brad Gibson

“Yoga is a great thing but it is not everything or the only thing.”

That’s the sentence that popped into my mind while I was practicing yoga yesterday afternoon (a very enjoyable backbend practice, by the way). In the back of my mind, I was obviously mulling over a post I read on the It’s All Yoga Baby blog (see when the yoga doesn’t work: depression, failure & the purpose of practice), in which Roseanne talked about her depression and her feeling that she is “failing” at her yoga practice.

“Underneath it all, however, is a vague sense that I’m failing at my practice, that I’m as broken and fucked up as I was before I committed to yoga (chronic and clinical depression was what drove me to practice in the first place), that the practice isn’t working. There’s also the vague sense that I’m not allowed to be feeling this way – there are many stories of miraculous healing from depression (and everything else) through yoga, but nobody talks about the relapses. I feel like I’m doing something wrong.”

I’ve already mentioned in a couple of previous posts (see Practice As Many As You Can and Authentic Yoga) how reading Yoga Body by Mark Singleton brought home to me once again that most of what we consider to be “yoga” these days was developed in the 20th century. This means that, contrary to what some teachers claim, the yoga we know and practice these days is not some thousands-of-years-old practice that is the answer to everything, including depression and anxiety, as well as physical injuries and illnesses (though it can definitely help with those things for certain people). And I think those in the yoga community who promote it as such, do us all a disservice. Because the result for people like Roseanne is that when yoga doesn’t provide the answer for them, they feel as if they are at fault, that they are doing something wrong, or that they have “failed” in some way. And the truth is, yoga was probably only used to treat depression and anxiety starting in the 20th century.

When I teach yoga for emotional well-being (including depression, anxiety, stress, etc.), I always add that I while I consider yoga to be a powerful tool for improving mental health, it may not be the only answer for you. In fact, you may need to use it as a supplement to western medicine, including drugs and/or therapy. And I recommend that if you are in a crisis, you should consult with your family doctor or a mental health professional. You need to do whatever it takes to help you get better. And, please, no guilt or shame about this!

The truth is, many years ago, before I became serious about yoga but while I was taking regular classes, I had two nervous breakdowns (the diagnosis was agitated depression), within a five-year period. And I’m convinced that, especially during the second breakdown, that my family doctor and the drugs she prescribed for me prevented me from being hospitalized. Later on, life style changes, including a regular home yoga practice, helped me reduce the stress in my life that seemed to be the main trigger for my illness. And I’ve been well since then. But just as important, I believe that yoga has also helped me come to a state of self acceptance regarding my condition. And this included both overcoming my feeling of shame about taking medication for depression (my therapist encouraged me to stay on a low maintenance dose) and starting to talk—and write—about my experiences as a way of possibly helping others.

I want to be very clear that I’m not here giving any medical advice here. This post is not intended to tell anyone what the best way is to heal from depression. I just felt that it was very important to state that as wonderful as I feel yoga is, I believe it has its limits. And there's no shame in that. Really, all I’m trying to say here is summed up by the sentence that I opened this post with:

“Yoga is a great thing but it is not everything or the only thing.”

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When to Transition to a Gentler Practice Part 2

by Nina

Hidden Waterfall by Brad Gibson

"At ninety-three, he could still perform difficult asanas--including variations on the headstand many younger "masters" could not. When he was ninety-five, however, he fell and broke his hip. Because of the reputation of Krishnamacharya, several leading surgeons offered to operate—but he would have none of it. Instead, he rigged up pulleys and ropes by his bed and began to experiment with new Yogic techniques for his own rehabilitation. Within two months he was able to walk, but the loss of full freedom of movement depressed him." —from Health, Healing and Beyond by T.K.V. Desikachar (about his father Krishnamacharya)

In Baxter’s post yesterday When to Transition to a Gentler Practice, he quoted a letter we received from a reader asking for advice about when to transition to a gentler asana practice. This is not the first time we’ve received such a question; in fact, this is probably the most frequent question we get here on Yoga for Healthy Aging. I suspect that most people with this question are hoping for some kind of formula from us, saying for example, if you can no longer do x, y, and z poses, it is time for your transition or most people should make the transition by age 65. But as I said to Baxter, I really feel that if you are asking the question, it’s not time yet. Because when the time comes, you will know it. Maybe you will be like Krishnamacharya, who had to change when he was 95. Or maybe you will need to transition much earlier, the way I did.

In my forties I had a rather strong, what I like to call “semi-fancy” asana practice. I took an advanced yoga class, did challenging poses like arm balances, full Lotus, advanced backbends, etc., practiced about two hours a day, and did long inversions almost every day (including a ten-minute headstand with variations and a ten minute Shoulderstand). I quite enjoyed the athleticism of my practice, and the feeling of strength and physical wellbeing it brought to me. By my fifties, however, I developed certain physical problems, probably brought on by menopause, which forced me to change my practice. Mild arthritis in my right hip meant that I could no longer do Lotus or even half Lotus and that I had to start using props in certain other poses. And two rounds of frozen shoulder (who knew you could get it more than once?) temporarily restricted my range of motion in my shoulder so that I was very limited in what I could do with my upper body, and after the frozen shoulders abated, I was never able to get my full range of motion back (though I’m still flexible in that area, compared to some).

I practiced asana throughout all these difficulties, adapting my practice as my restrictions increased and then decreased. While my shoulder was frozen, I couldn’t even do Downward-Facing Dog pose, much less Headstand, Handstand, or Upward Bow pose. So my practice was by nature very gentle. After I got better, I began to gradually ease my way back into the poses I couldn’t do with my temporary injury, and I’m still working on getting back to where I was (realizing, of course, that I may never get there).

When I was able to do Headstand again, I made a conscious decision not to do it as often or as long as I used to. I felt that it was a pose I enjoyed so much, I didn’t want to risk losing it again, and I knew that both Headstand and Shoulderstand would be pretty hard on my neck. So I decided to practice it only about twice a week and only for about 5 minutes each time, instead of the way I used to practice it. I had absolutely no scientific evidence that this was a good idea, and it was not suggested to me by any of my teachers, it was just a feeling I decided to follow. And it can’t hurt to be cautious, right? Removing the long inversions from my practice also made it shorter, so now my practice is more in the 1 1/2 hour range (and sometimes shorter, if I’m tired). As it happens, I never had to leave my regular (intermediate) yoga class. That’s partly because I know how to make modifications to my poses (or do alternatives) when there is something I can’t do. But it’s also because my teacher has been very supportive and understanding. (Once he said something about me—thank you, Donald—that I’ll never forget: “Nina never gives up!”)

The point is, my transition has been a very organic process, in which I’ve responded to signals from my body (some rather loud, others perhaps not) and made adaptations along the way. It hasn’t all been a one-way process, either. During times of difficulty, my practice was very gentle, and when I was more able, I returned to a stronger practice. And I also know, the transition process is not over yet. Who knows what the future holds. Will I be still be doing Headstand at 95 like Krishnamacharya? Or will I have to give it up much earlier?

Baxter, too, has gone through a similar process, with physical problems (including a touch of hip arthritis) prompting him to modify his practice. And that’s how I think it will turn out for most of you, dear readers. Perhaps you will have an injury or illness that forces you to change your practice, either temporarily or permanently. Or perhaps you will simply reach a point (who knows at what age?) when you can just no longer do the poses you used to be able to do or get through an entire class the way you used to, and you’ll know deep down inside that now is that time for a change. Like the future, this process is both inevitable and completely unpredictable. But it is your own body that will guide you through it.

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