The Comeback: Swimming's Four Step Program for eliminating insecurity!

STEP I: Recognize the general problem. Swimming's first step requires identifying whether or not you are insecure/not confident in general or in a particular instance. We all have insecurities in certain aspects of our lives. Some people are social butterflies, but completely shy in school or at work. Others are the exact opposite and have no issue vocalizing their thoughts in an academic or professional setting but struggle establishing social connections with others in a non-business forum. The first step to eliminating insecurity is to identify when and where it occurs. If you're struggling with identifying it then check out if any of the characteristics of low self-esteem creep into your life/conversation and then back-track to specifying when/where.

STEP II: Identify the characteristics of insecurity. There are some tell-tale signs of insecurity.
-Body language: do you shuffle your steps and hold your head down and look down when you walk? Do you try to cross your arms and legs and make yourself smaller in certain situations?
-Language/conversation: what kind of language do you use to describe yourself? what language do you use to voice your opinions? Is it surrounded by positive language? Or does your language begin with apologies or uncertainty? Do you easily get defensive or yield to/conform with others opinions?
Here are some classic characteristics of low self-esteem:
Heavy self-criticism 
Hypersensitivity to criticism  
Chronic indecision  
Excessive will to please and unwillingness to displease any petitioner. 
Perfectionism, which can lead to frustration when perfection is not achieved. 
Neurotic guilt, dwelling on and/or exaggerating the magnitude of past mistakes. 
Floating hostility and general defensiveness and irritability without any proximate cause. 
Pessimism and a general negative outlook. 
Envy, invidiousness, or general resentment

STEP III: Create an action plan. First practice, then create the habit, then transform into second nature!

Phase 1: Get creative on reminding yourself to be confident. I made cheat sheets to post around my apartment and posted positive words ("Fearless" and "Powerful" are two but there are many more) to constantly remember the mission. I also employed reminders on my phone throughout the day and worked with a few different affirmation apps for iphone along with power posing daily and being aware of when I'd slouch or cross my legs. Whatever mechanism you choose make sure you are constantly reminding yourself of what you want to be throughout the day and set that intention first thing in the morning. Fake it till you make it. 

Phase 2: Hand-in-hand with #2, be constantly aware of language that wreaks of insecurity. These are things that allude to guilt, self-deprecation/pessimism, perfection, appeasing others/yielding to others, indecision, overtly defensive. Create new vocabulary to speak positively about your position, yourself, and others. This is where the real legwork comes in. It's difficult to catch insecure language but it is imperative to change since anything you vocalize is physical energy that is getting sent out to the world and will eventually manifest itself in some way back into your life. I first started with reviewing the conversations I had with people each day, then listing everyday for one month all the things that fit the low self-esteem profile from #2 and then spent the following months attacking each to make peace and finding positive language to displace the insecurity.
-Be certain about what you want. It's infinitely more difficult to vocalize your opinions or thoughts if you are internally unsure of what you want. Be sure to establish real goals and sort out what you want for a certain endeavor and make sure that those things are measurable to some extent so that it can be quantified. (SMART goals!) This will help with indecisiveness.
-Be positive about others. I cannot emphasize this enough and this was something that came easy to me since I love giving kindness to others. In general, be kind, be interested in others, be positive about others. There are many ways to get ahead in life, but I believe that when all is said and done the kindness you share others is everlasting since it also inspires others to pay it forward. Make gratitude and compliments to others a habit to eliminate pessimism. I know many pessimists who masquerade as just being realistic. Truth be-told they may be buzz-kills but to cope with this I do the follow:
-If you find yourself getting defensive, the best strategy is to calmly ask questions and truly understand where the other person is coming from. The ability to empathize with others is important in life (but don't give up your own position on a matter.)

STEP IV: Employ action plan and hop to it!
A major aspect of this is being ok with constantly not being in your comfort zone. Where you are uncomfortable is where real growth is so embrace it. 

Musings: On Empathy

I'm not going to dive into the definition since I believe most people have an understanding of what the word itself means; however, I want to discuss some aspects of empathy and how I've tried to cultivate it.

The New Yorker explores empathy from its many standpoints, but what struck me the most was that "empathy is what makes us human." What an interesting ontological phenomenon; we need to empathize in order to be human. The Guardian published a piece on Friday noting a difference between empathy and compassion.

Empathy is a prime component of the medical profession. Without acknowledging how a patient's symptoms affect their quality of life or why a patient is struggling adds an extra layer of complexity to diagnosing and treating a patient. In my Lifestyles of Medicine course, I am learning that part of being a physician is being mindful before you even enter a patient's exam room: reminding yourself again and again that you are here for them; it's your job to connect and understand the complexities of both the disease and the symptoms that brought the patient into your clinic on this day. I found this interesting blog from a medical actor (an actor that plays a patient for med students to examine and get scored on). She digs into how, at different periods during the interaction between a patient and their physician, empathy plays a pivotal role in helping the patient both clinically and personally.

I've always been hyper-aware of the feelings of other people. When I was 8 my fourth grade teacher was recently widowed and I scolded a classmate for obliviously asking her about her husband. As a kid, my parents worked so I grew up outside of the house mostly in school (I was put in school very very young). Thus, I had to use my ability to relate to others in order to compile a social circle for myself and make sure I didn't purposely alienate someone. This taught me many things, but I think the greatest gift it has bequeathed upon me is my ability to recognize potential suffering.

One time in high school, during lunch I noticed that a middle school girl (our girls middle school shared a cafeteria with half of the upper school) with bright red hair was sitting on a makeshift table by herself because her friends did not make room for her at the table. I told my friend Rachel that I wanted to invite this girl to sit at our table. Her name was Leisel (I remember it still because the only other time I had heard that name was from the Sound of Music) and I told her that who cares that her friends won't make room for her and that there's always room at our cool high schooler table for her any time.

So why is it that some can muster empathy quite naturally whereas for others it's an emotional mountain to climb? I think as adults it becomes a choice to exercise empathy or ignore it and it's a case-by-case situation. We all have our empathetic moments and some where we wished we had been more present to someone else's feelings. One can definitely cultivate empathy, but our society is not conducive to empathizing with others as easily it used to be. I do not participate in Facebook. I had one of the first accounts in college when only a select number of universities were granted accounts, but I've since realized that I'm better off without it. Primarily because I realize that having friends requires care, time, and effort and I'm glad to invest that in others. I have also noticed that this philosophy has positively impacted my friends as well. To be my friend you have to interact with me. There's no way around that. Phone or in-person communication allows each of us to realize when boundaries are being crossed and when to back off. The act of expressing words is not only therapeutic, but also adds the element of human-ness that is so lacking through technological communication. Talking allows us to release energy and read someone else's energy. You listen to inflection, tone, feeling of another person and that is how you relate to them. (I learned in class that the term is called 'affective listening' and an attribute that physicians should incorporate into their practice as well.)

So concrete ideas and practices of mine:
(1) I don't have facebook--like I stated before, if you want to be my friend and know things about me you have to interact with me. Sorry to be old-fashioned, but there's no way around that. I also would like to note that facebook has its place in society--my cousins in India use it and if I were on it I would perhaps get to follow up with them more than our frequent emails. I think things like social media becomes an issue when it's the prime medium through which we connect with others. In my opinion: in person>phone>email/text>social media relates to happiest>happier>happy>not so happy. There's actual studies about this (refer to 'How facebook makes us unhappy' from the New Yorker).
(2) I write emails, letters, and have phone calls with my friends followed up with in person-contact.
(3) I don't use my phone when I'm having a conversation with someone in front of me.
(4) I never talk or text while driving. Aside from being dangerous, I want whoever is talking to me to get my full attention.
(5) I try to stay off Gchat: Thanks to rescuetime.com I've noticed that it's a giant time soak. It does allow me to keep in touch with my friends from different states, but it's tough because even after a long conversation I somehow walk away unfulfilled; we don't react expressively in the same as we do in actual physical good company.
(6) I meditate!
(7) I always question my approach. I think science dictates that we must question our beliefs in order to progress.
(8) Do something. I like to write, but I also like to play piano and tennis and do yoga. It's quite difficult to be on the phone when you're actually doing a real activity; but, what I have also found is that these activities allow me to express myself in many other ways. In tennis, I have to understand and predict my opponent's next move. With piano, I try to go beyond the notes on a page and really see how I can make a piece emotive by the way I play it. This allows me to play a piece of music that can perhaps resonate with someone else that has the same feelings. Writing is pretty therapeutic and important because the ability to express oneself through the written word allows us to engrave on to paper an experience that is engrained in our hearts.
(9) When working, I try to keep my phone on 'do not disturb' mode. This allows me to control my phone, not the other way around. Thus, when I want to call or text someone or respond it is a deliberate act instead of an impulsive reaction.
(10) Here are some things from the Times on teaching children empathy
*I have more tactics. This is just a start!

I'll conclude this post with a clip that basically summarizes my sentiments on this front from comedian Louis CK. "You need to build an ability to just be with yourself."

Food for thought: Food Safety

In honor of my 1-year anniversary of learning to cook chicken properly, I'll be posting some food safety tips:

(1) Did you know that you shouldn't leave freshly cooked food out for more than 2 hours or bacteria begins to grow?
http://www.foodsafety.gov/keep/basics/chill/index.html

(2) Did you know that you shouldn't wash poultry before cooking?  Who knew?!
http://www.foodsafety.gov/keep/basics/mistakes/

(3) Here are the minimum safety cooking temps of certain meats:
 http://www.foodsafety.gov/keep/charts/mintemp.html

(4) Here are food storage days. Who knew you're only supposed to keep cooked chicken 3-4 days?
http://www.foodsafety.gov/keep/charts/storagetimes.html 

(5) Here's something for fun. A quick lesson of what's the difference between certain foods/spices. Ever wonder what's the difference between Scallions adn green onions? or Paprika and Cayenne? Find out here:
http://www.all-food-considered.com/2012/09/culinary-lesson-9-whats-difference.html

(6) Here's a nice recipe I've been using lately. These avocado egg boats are delicious! You can dress them up with sauces and spices too!
http://www.theironyou.com/2014/04/eggs-baked-in-avocado-boats.html
http://thehealthyfoodie.com/eggs-avocado-boat/

(7) Here's some info on nuts: http://greatist.com/health/types-of-nut-infographic 

(8) For good measure, here's a nice Q&A on the low carb/fat diet that's been recently debated:
http://well.blogs.nytimes.com/2014/09/05/new-answers-about-carbs-and-fat/?action=click&contentCollection=Science&module=MostEmailed&version=Full&region=Marginalia&src=me&pgtype=article 

(9) Here are 26 ways to use apple cider vinegar: http://greatist.com/grow/ways-use-apple-cider-vinegar

Heart Health!

Lorde-Glory and Gore

In light of Swimming's cholesterol, I'll be posting here some information on how to take control of your heart health. For ten years now, Swimming has controlled elevated LDL and overall cholesterol (genetic) through diet and exercise; each year being more active and healthier than the previous. Please note that if you have problematic H. pylori (the bacteria that is the cause of most duodenal ulcers--we all have it but certain cases it becomes out of control) can also increase LDL levels (due to inflammation that the bacteria causes in the intestines) and can also lead to  atherosclerosis. The literature is limited on this relation, however, it points to something interesting that might be occurring. As a side note: anyone dealing with GERD or ulcers that haven't subsided with short-term use of medication should also have their gastrin levels checked. 

(1) Several months ago the American Heart Association and American College of Cardiology just released new guidelines for cholesterol levels and therapeutics:
Here's the reader's digest version.
Here's the longer Times summary. 
Here is the AHA's summary of their 4 new guidelines.  
Here's their online calculator to figure out your risk of heart disease and stroke.  
Lastly, here's AHA guideline resource center which has more info on CV disease, diabetes, obesity and the guidelines.
Here are the full guidelines (NB: both these organizations have industry disclosures.) 
-Anyone dealing with this or at risk read the guidelines and if you have questions ask (myself and I'll consult with my resources or your own physician.) The new guidelines account for the multitude of side-effects the may come with the use of cholesterol-lowering drugs. (FYI all drugs are not created equal. Unfortunately I've personally seen these drugs handed out like candy after a pharm rep dropped off a bunch of samples at a Cardiologist's office.) I personally have been incredibly vigilant about modifying lifestyle as much as possible so I can delay the use of medication by keeping my overall cholesterol to <200 and my LDL to around 100 or less (my earlier discussion reg. my ulcer has totally messed this up for me.) Statins are extremely effective at lowering cholesterol but for many the use of statins come at a high price. Anyone on the border that could avoid statin use with diet and exercise should strongly consider doing everything they can to delay their start of statins therapy (esp if you're like me and are in your 20s or 30s.) Statins are powerful at lowering the risk of Cardiovascular disease and this coupled with the other advancements (Stents etc...) in cardiology have collectively decreased cardiovascular deaths in the past 30 years tremendously and have also increased the life span of humans. With that said, please please please do your part to take care of your heart! How? read further! 

(2) Cooking for lower cholesterol 
and here's some more information on a low fat diet.
-This is really just good information. I have been on a low fat, low sodium, high fiber diet for some time now and the initial transition I had to make when I was 18 was difficult but well worth it. I haven't really had fast food in a very long time, I just don't even go for anything fried (this was easy to give up since fried foods also cause acid reflux). I love steamed veggies! Letting go of cookies and ice cream is just plain hard since I love both. I'm not fully there yet but I would say now every few months I allow myself these treats (mainly seasonal.) 

(3) Good background information on fats and cholesterol. 

(4) Warning: fish oil supplements have also been known to raise LDL.  

(5) Some last links--info and debate on statins (from the evidence I've read I see that they are beneficial, but I always think the first line of defense should be diet and exercise):
http://www.bmj.com/content/338/bmj.b2376
http://www.nytimes.com/2013/11/14/opinion/dont-give-more-patients-statins.html?_r=0
http://www.bmj.com/content/347/bmj.f6123

Carrots, Eggs, Coffee

Arianna Grande-Problem
Here is a wonderful metaphor:
http://www.soulcast.com/post/show/59487/A-carrot,-an-egg,-and-a-cup-of-coffee


A young woman went to her mother and told her about her life and how things were so hard for her. She did not know how she was going to make it and wanted to give up She was tired of fighting and struggling. It seemed as one problem was solved, a new one arose.
Her mother took her to the kitchen. She filled three pots with water and placed each on a high fire. Soon the pots came to boil. In the first she placed carrots, in the second she placed eggs, and in the last she placed ground coffee beans. She let them sit and boil; without saying a word.
In about twenty minutes she turned off the burners . She fished the carrots out and placed them in a bowl. She pulled the eggs out and placed them in a bowl.
Then she ladled the coffee out and placed it in a bowl. Turning to her daughter, she asked, "Tell me what you see."
"Carrots, eggs, and coffee," she replied.
Her mother brought her closer and asked her to feel the carrots. She did and noted that they were soft. The mother then asked the daughter to take an egg and break it. After pulling off the shell, she observed the hard boiled egg.
Finally, the mother asked the daughter to sip the coffee. The daughter smiled as she tasted its rich aroma. The daughter then asked, "What does it mean, mother?"
Her mother explained that each of these objects had faced the same adversity: boiling water. Each reacted differently. The carrot went in strong, hard, and unrelenting. However, after being subjected to the boiling water, it softened and became weak. The egg had been fragile. Its thin outer shell had protected its liquid interior, but after sitting through the boiling water, its inside became hardened. The ground coffee beans were unique, however. After they were in the boiling water, they had changed the water.
"Which are you?" she asked her daughter. "When adversity knocks on your door, how do you respond? Are you a carrot, an egg or a coffee bean?
Think of this: Which am I? Am I the carrot that seems strong, but with pain and adversity do I wilt and become soft and lose my strength?
Am I the egg that starts with a malleable heart, but changes with the heat? Did I have a fluid spirit, but after a death, a breakup, a financial hardship or some other trial, have I become hardened and stiff? Does my shell look the same, but on the inside am I bitter and tough with a stiff spirit and hardened heart?
Or am I like the coffee bean? The bean actually changes the hot water, the very circumstance that brings the pain. When the water gets hot, it releases the fragrance and flavor. If you are like the bean, when things are at their worst, you get better and change the situation around you. When the hour is the darkest and trials are their greatest, do you elevate yourself to another level? How do you handle adversity? Are you a carrot, an egg or a coffee bean?


“In life, things happen to us and things happen around us, but the only thing that truly matters is what happens within us."
"What Lies Behind Us and What Lies Before Us are Tiny Matters Compared to What Lies Within Us" ~Ralph Waldo Emerson

Wisdom

This post is entirely inspired by a friend who is participating in Landmark. I'd like to share two interesting facts: Antidepressants and antianxiety med users are the fastest growing population in our country. The fastest growing age group of antidepressants and anti-anxiety meds are preschoolers. Yes. I've fact-checked this one from multiple reliable sources.

First I'd like to point this discussion to some interesting and thought-provoking articles:
http://online.wsj.com/news/articles/SB10001424052702303649504577493112618709108
in particular this sentence "Learning how exercise, diet and sleep bear on mood gives us tools to use in caring for ourselves." (This is part of the mission I'm taking on when I become a doctor and have already geared an entire segment on this blog towards helping others get all those aspects in tune.) I also definitely agree that confronting pain is a vital part of the human experience that allows us to connect to each other.

Here are some fast facts.

http://content.time.com/time/health/article/0,8599,1914604,00.html

I am only going to comment on the use of these meds in minors. I went to a grade school where a fairly good amount of students were on anti-depressants and anti-anxiety medication. Most of them turned out to have successful careers. Whether the meds made the difference I don't know. What I do know is that no matter what the good effects may be one can never fully understand every single biochemical side effect of a drug long term or short term. There is absolutely a place for these prescriptions in medicine, but there is also no doubt that they are over-prescribed as an easy fix.

I was blessed and lucky to have had parents that sincerely tried to give me the world. As a child I relentlessly journaled and I now have several diaries that document my life and all the emotional ups and downs. If I were to change one thing from my upbringing it would be that for whatever reason I wish I had been passionate about one or two things or causes or activities and that I had followed through on those passions back then. I wish there was more of a push or urgency for me to find and follow that passion when I was younger (and not jaded by the real world.) It took me a while to figure out that medicine was something I was really passionate about. I do believe in fatalism and that the road I took to get here was required. I had to experience the different things I experienced in order to recognize that I wanted to be a doctor. I can't help but wonder what it would have felt like to have had that feeling back in high school. To have been as passionate about a cause bigger than myself back then would've given me the perspective that school was just the vehicle to allow me to do what I wanted to do; my daily toils weren't a big deal since school would've only been a fragment of my life.

I feel that parents are the ones who become the final decider to allow their children to be placed on these meds when they are minors. I don't know the back-stories and I don't want to criticize parents who have made this choice. I do want to inspire parents, with all their wisdom and experiences, to also not entirely rely on these medications to fix a problem that they may feel helpless about. If I was a high schooler and I had the meaning in my life as I do now, I would definitely have felt more empowered and less narcissistic (as evident by the pages and pages where I poured my heart out about what really was trivial problems.) As parents, it should be their job to aid their progeny to becoming a fully-functional human being. I feel that can only occur by exposing children to the possibility that they can do anything and helping their children connect to their higher purpose or a greater cause that's beyond the hallowed halls of high school. High school, no doubt, is tougher now with social media and technology. But the classmates of mine that are settled were those that were truly committed to things beyond just high school at the time (whether it be excelling and truly dedicating themselves to a sport or to music or to a human rights cause or to anything really like art or science or the humanities.)

I've definitely felt a great deal of pain and sorrow myself throughout the years, but I forced myself to engage with something higher and that's when real growth came. As an example, in what I consider my darkest hour is also when I chose to become a hospice volunteer. I also want to take a minute and point out that health, sleep, exercise, and sprituality/philosophy are crucial aspects of ones existence. If these aren't all in tune for adults who are parents it becomes extremely difficult to raise children who are also well-rounded. Just some food for thought.

Lastly, I'm going to close this post by pointing out that my friend has created an acronym out of wisdom to jumpstart this movement: Wisdom IS Doing me.

Here is another article:

The Anti-depressant Generation: "We need a greater focus on building resilience in emerging adults."

Some nice quotes today

Ed Sheeran-Sing

Our deepest fear is not that we are inadequate.  Our deepest fear is that we are powerful beyond measure.  It is our light, not our darkness that most frightens us.  We ask ourselves, Who am I to be brilliant, gorgeous, talented, fabulous?  Actually, who are you not to be?  You are a child of God.  Your playing small does not serve the world.  There is nothing enlightened about shrinking so that other people won't feel insecure around you.  We are all meant to shine, as children do.  We were born to make manifest the glory of God that is within us.  It is not just in some of us; it is in everyone.  And as we let our own light shine, we unconsciously give other people permission to do the same.  As we are liberated from our own fear, our presence automatically liberates others.  
Marianne Williamson