mindfulness – Page 2 – Go Retire Psychiatrist

Remembrance of Dr. William R. Yates MD

I was thinking about the Clinical Problems in Consultation Psychiatry (CPCP) learning sessions which was introduced to me by one of my first teachers in the University of Iowa Dept of Psychiatry, Dr. William R. (Bill) Yates.

I had originally been thinking of posting one of my own CPCPs that I presented in 2015. It was about the psychosocial adjustment of patients to ostomy.

I searched widely and in vain on the web for any recent information about what Dr. Yates was doing now. I was surprised and saddened to discover his obituary. He died on January 19, 2023 in Tulsa, Oklahoma.

As the obituary says:

He served on the faculty at the University of Iowa for Psychiatry and Family Medicine before becoming Professor and Chair of Psychiatry at the University of Oklahoma College of Medicine in Tulsa. After retiring, he continued to dedicate his time as a volunteer research psychiatrist at OU and the Laureate Institute for Brain Research where he also served on the board of directors. He authored over 100 scientific manuscripts that were published in peer-reviewed journals.

He was an energetic, a great teacher, had a great sense of humor, and was easy to get along with. He published in many scientific journals and taught many trainees. He was an avid bird watcher and his blog Brain Posts highlighting neuroscience research findings is still visible on the web.

He published the paper along with a chief resident on problem-based learning used on the psychiatry consult-liaison service in 1996, the year I graduated psychiatry residency and joined the faculty at The University of Iowa Hospitals & Clinics (Yates, W. R. and T. T. Gerdes (1996). “Problem-based learning in consultation psychiatry.” Gen Hosp Psychiatry 18(3): 139-144.) You can read the abstract for it along with a description of the CPCP at the link above which takes you to my April 19, 2019 blog post “Clinical Problems in Consultation Psychiatry.”

When he was the leader of the psychiatry consult service, we were still using paper charts and his staffing comments were always very brief and encapsulated the assessment and plan succinctly without wasted verbiage—contrasting with my long-winded note.

His remarks about his role at Laureate Institute for Brain Research is still accessible:

“I work part-time as a research psychiatrist for the assessment team at the Laureate Institute for Brain Research. We do research diagnostic assessments for a variety of imaging, genetic and biomarkers studies in mood, anxiety and other brain disorders. I also provide review and analysis of neuroscience research on my blog Brain Posts that can be found at www.brainposts.blogspot.com. You can follow me on Twitter @WRY999. I also use my blog and Twitter feed to share my bird photography images.”

I respected and admired Dr. Yates, as I’m sure many learners did. I will always remember Bill as a gifted scientist and teacher.

I think a fitting tribute would be to go ahead and post my CPCP on the psychosocial adjustment of patients with ostomy. One of the most interesting articles in the bibliography is how the mindfulness meditation approach to that adjustment can be very helpful. The website United Ostomy Association of America website is also informative.

The presentation is also limited to a dozen slides. I often encouraged learners to keep the number of slides to a managed number so the presentations wouldn’t run too long. I called my slide sets the Dirty Dozens.

Many thanks to Dr. William R. Yates and my condolences to his family.

Move Your Way!

I saw the HHS Move Your Way campaign regarding the new strategy on encouraging older people to exercise, namely the Midcourse Report: Implementation Strategies for Older Adults.

There are many ways to get and stay fit. We could all do better, including me. I exercise pretty much daily for about 30 minutes. Following that, I usually sit in mindfulness meditation for 30 minutes.

The report says we should do moderate intensity aerobic activity for at least 150 minutes a week and muscle strengthening activity for at least 2 days a week.

I do a combination of stationary bicycle exercise, weight exercises with dumbbells, planks, body weight squats. I also do one leg stand, one minute each leg.

And juggling is great aerobic exercise. I struggle a bit with advanced thumb wrestling.

What Do the Personal Brain Specialists Recommend?

Dr. George Dawson’s post “The Freak Show” reminded me of how coarse and cruel we can be to each other, even when we’re not aware of it. Maybe I should say especially when we’re not aware of it. Dr. Dawson emphasizes the importance of the empathic approach. In the same way, Dr. Moffic in the articles in his column, “Psychiatric Views on the News” draws attention to the need for a socially responsible way for us to relate to one another. The Goodenough Psychiatrist blog expresses poignantly the emotional and courageously humanistic ways we can (or could) relate to each other. Dr. Ronald Pies has highlighted the importance of how human interaction with artificial intelligence must help us find a way to treat each other with respect, and teach that to AI because AI learns from humans.

This reminds me of a character in the book “The Hitchhiker’s Guide to the Galaxy” by Douglas Adams. The character is named Gag Halfrunt who is the personal brain specialist for a couple of other characters. In fact, he’s a psychiatrist who orders the destruction of planet Earth, which is a sort of computer program designed to give us the ultimate question to the ultimate answer for life, the universe, and everything. The reason Gag Halfrunt wants to destroy Earth is, if the ultimate question is revealed, it would put psychiatrists out of work because then everyone would be happy.

Just as a personal comment, I’m pretty unhappy with the author’s position on psychiatrists in general, which tends to overemphasize our importance. And I’m pretty sure psychiatrists are not that important, having been employed as one for many years and seeing how much impact of any kind we have. We can’t make people more or less happy at all.

In fact, Adams also takes a shot at philosophers, who are also upset at being thrown out of work should the ultimate question to the ultimate answer be revealed (the ultimate answer, by the way, is 42 if you’re interested).

Giving psychiatrists and philosophers and anyone else who might have a stake in taking credit for making people happy is nonsense. We all bear responsibility for ourselves. You can argue about whether or not we have any responsibility for each other.

Rather than arguing about it, we could give something else a try. We could try a mindfulness approach like the Lovingkindness Meditation. I’m not an authority or expert on this, but you can check it out on the Palouse Mindfulness website, the link to which is in the menu on my blog. You can find the link to the Lovingkindness Meditation there.

There is no guarantee the Lovingkindness Meditation will make you or anyone else happy. But it doesn’t hurt anything to try it and, as far as I know, Gag Halfrunt is not opposed to it.

Gardening Works as Mindfulness Meditation

When I think of Sena learning to juggle and find her juggling balls on the floor where she drops them after a 2- or 3-minute practice, I now think of her gardening.

I wondered if gardening could be a form of meditation and did a web search like I did yesterday for juggling. It turns out many people think of gardening as a kind of mindfulness meditation. It’s another one of those moving meditations, kind of like the walking dead meditation as I and some of my peers described it at a mindfulness retreat 9 years ago.

Sena has been gardening for a long time. I remember she turned our back yard into a park many years ago.

She is always on the lookout for something new to plant. I don’t always remember the exact names of them, but they’re very pretty. And the Amaryllis house plant stem is 22 inches tall!

I found one article on Headspace, “How to practice mindful gardening” which laid it all out about the subject. The key takeaways about mindful gardening:

Being fully present in the garden can help improve mood
In this setting, we might also become more aware and accepting of change
Check in with your senses before getting your hands dirty

Sena can work in the garden all day, sometimes in 100 degree plus heat—which I don’t recommend. On the other hand, she really gets a charge out of digging holes in the yard, pulling up turn to make room for more flowers and shrubs, and tilling the soil. She has kept the Amaryllis stalk thriving; it’s 22 inches tall! She’s not sure what to do yet with the Easter Lily plant, but she’ll figure something out.

I still do sitting meditation, which is what I learned from the Mindfulness Based Stress Reduction (MBSR) class. And I now have begun to think of juggling as a kind of moving mindfulness meditation.

On the other hand, I’m not keen on gardening in any sense, including mindfulness. Partly, it’s because a fair amount of dirt is involved.

I think it would be difficult for me to do gardening all day like Sena does. I could stick it out for about as long as she practices juggling—about two or three minutes. I would put my tools away, though.

I’m beginning to think of juggling practice as a kind of meditation, especially since I started to learn the shower juggling pattern. Doing that for more than 15-20 minutes at a time usually doesn’t result in much improvement—at the time. But I think I sprout more brain connections as I’m doing it because I notice gradually smoother timing and coordination.

In sitting meditation, counting your breaths is generally frowned upon. On the other hand, counting my throws (especially out loud) during juggling actually helps me focus my attention. I see each throw as sort of like a single breath. I still have to consciously adjust my posture so that the “horizontal” pass doesn’t end up being more like an underhand throw. And when I modify the throws so they stay in the so-called jugglespace (not so close the balls bounce off my head, not so far out front I have to lunge for them), and space the balls out just right, I find it’s easier to get more throws in.

I don’t think Sena counts the number of dirt clods she tosses aside.

Can Juggling and Mindfulness Meditation Complement Each Other?

I read this article about mindfulness today and it got me thinking about how juggling might be two different aspects of the same activity.

I think they both help focus the attention. There a number of articles on the web which essentially say that juggling can be a sort of meditation.

I know hardly anything about the default mode network (DMN) in the brain, but from what little I know, I suspect that both juggling and mindfulness meditation could disrupt the DMN. There’s a published study showing that meditation tends to reduce DMN activity. That would be a good thing. The DMN has been described as a brain network which may tend to lead to mind wandering and self-related thinking. That may not be the healthiest way to use your time.

I’ve been doing mindfulness meditation for about 9 years now. I still sometimes wonder whether I’m “doing it right.” On the other hand, when I miss more than a day or two of mindfulness practice, I notice that I feel more edgy and out of sorts. When I return to mindfulness practice daily, I notice less of that scattered and nervous mental state.

I took up juggling last October and I notice that it does something similar to mindfulness. I have to pay close attention to what I’m doing while I’m juggling. Otherwise, I just drop balls constantly.

Just searching the web with the question “Is there a juggling meditation?” turns up quite a lot of articles. Some suggest that juggling is a kind of “moving meditation.” That reminds me of the walking meditation, which I’ve referred to as the “walking dead meditation,” based on my Mindfulness Based Stress Reduction (MBSR) course in 2014. At the retreat toward the close of the course, we did this walking meditation thing, which for all the world seemed to more than a few learners as resembling the way zombies walk.

I think I’d have a tough time trying to juggle like a zombie walks. You can’t be herky-jerky when you juggle, you know. I guess that’s why you never see a zombie juggle. Zombies don’t meditate either, probably because they’re too busy looking for brains to munch on.

Now I get the urge to juggle when I feel the need to clear my head. It’s reinforcing for learning new juggling tricks. Sena is learning juggling now and her efforts remind me of the challenges I had. One of them is learning how to let go of the damn ball in a pattern like the three-ball cascade. You get stuck at certain stages. I hit several walls learning the cascade. And then there came a day when I just started doing the pattern right, often because I just let go.

That reminds me of a quote by Juggleman about juggling, “Doing it wrong makes you an artist.”

I’m probably doing mindfulness the way I ought to be “doing” it. Nowadays, the way I judge that is by noticing I feel better when I stick to it.

“Stink, Stank, Stunk!”

I’m just puzzled lately over what seems like a contradiction between two ideas I’ve seen in the news and in TV commercials. It’s all about body odor.

There is this study that was recently published about stinky armpit odor possibly making the practice of mindfulness meditation more effective.

This contrasts with the usual meaning of body odor, which is that it’s to be avoided and prevented at all costs. And, the newest total body odor eliminator product is getting heavy rotation in TV commercials and its name rhymes, (possibly fittingly) with “looney.” I’m just going to frankly admit that I can’t stand watching the commercial.

There is this old timer product called Ex-Odor that was marketed in the early 1900s by a company called Gordon Gordon, Ltd. The label said it “Removes All Body Odors.” It was touted as “safe, sure, lasting” and it cost only ten cents. The original label actually did italicize the word “All.” On the other hand, Looney is a lot more expensive—just sayin’.

The armpit odor study and Looney definitely send opposite messages about body odor.

In fact, there is a psychiatric disorder marked by an intense preoccupation with smelling bad. I think it’s still called Olfactory Reference Disorder (ORD). Almost any part of the body could stink and could lead to showering several times a day or visits to ENT doctors to get “infected” and therefore smelly tonsils removed. The disorder not uncommonly gets requests for consultation-liaison psychiatrists to get involved.

Olfactory Reference Disorder can lead to severe, even disabling, social anxiety. It can lead to beliefs that have delusional intensity.

Often, those with ORD firmly believe they emit a foul odor, often from armpits, or inguinal, anal, and oral areas. Some seek surgical treatment. There are many other disorders which consultation-liaison psychiatrists need to remember in order to distinguish ORD from them. Combined cognitive behavioral therapy, possibly along with medication can be recommended as treatment.

Look on the Bright Side

Yesterday was the first day of Autumn. Happy Autumn! Was that too cheerful? You know, I used to watch the show Monty Python’s Flying Circus years ago. I thought it was outrageously funny.

What reminded me of the show was Sena telling me that on Wednesday night, a member of the Flying Circus cast, Eric Idle, was on The Masked Singer, one of her favorite shows. I didn’t watch it. He was Hedgehog and sang the Beatles number, “Love Me Do.” Eric said something about how you should look on the happy side of life. He mentioned there was song with that title.

We looked it up and found “Look on the Bright Side of Life.” It’s a catchy tune and reminded me of Monty Python’s Flying Circus attitude. I guess Eric Idle wrote the song and sang it on The Life of Brian.

While the song seemingly is about looking steadily on the bright side of life, it has that slightly edgy, ironic attitude to it which was typical of the Flying Circus.

While some think that the Covid-19 pandemic is over (not mentioning names), there’s probably a more balanced way of looking at that and other challenges in life. The PennStateExtension published an article on June 12, 2020, “Realistic and Optimistic: Managing Mindset in Challenging Times,” by Suzanna Windon, Ph. D, Assistant Professor, Youth and Adult Leadership, and Mariah Stollar, Former Part-Time Research Assistant, Penn State University.

Their list of ways to look on the bright side while being mindful of potential pitfalls attributable to things like overweening pride and fantasy are good to remember in these trying times (see original article by the authors for full details):

“Practice mindfulness.
Observe and adjust your patterns of thinking.
Believe in yourself, but do not underestimate challenges.
Look forward to the future, but be realistic things may not quickly change.
Keep yourself informed, but limit media intake.
Reflect on messages you are sending to employees, volunteers, and loved ones. ”

In other words, look on the bright side but don’t kid yourself.

Holes in Our Heads

I remember getting a trephination of my fingernail a long time ago when I was working as a surveyor’s assistant. We were out taking elevation shots with a level and a rod measuring the depth of sewer pipes.

This required us to remove the manhole covers, which are very heavy. I got one of my fingers pinched and man that hurt. My crew drove me to the emergency room where an ER doctor drilled a tiny hole in my fingernail. The immediate pain relief resulting from the release of the subungual hematoma pressure felt miraculous.

That was trephination of the fingernail. I’ll bet some of you thought of my skull when you read the word in my first sentence, though.

Trephination is just the word for the medical procedure of making a hole in the body for some reason. In order to relieve pressure and severe pain from getting your finger mashed, a doctor can make a hole in your fingernail.

Trephination can also mean making a hole in your skull to treat brain injuries or to let the evil spirits out. That was done thousands of years ago, but making burr holes in the skull for other medical reasons is still being performed, including to relieve pressure.

It’s the origin of the old saying, “Well, I’ll be bored for the simples,” where the term “simples” means feeble-mindedness and “bored” refers to the obvious treatment.

Anyway, boring holes in either your mashed finger or your head can relieve certain kinds of pressure and pain.

Figuratively speaking, we can feel under pressure in our heads for all kinds of reasons. In fact, we’re born with several kinds of holes in our heads that can lead to the pressures of anger, anxiety, sorrow and fear.

Our eyes can fool us, even to the point of making us believe we see Bigfoot when all we’re really seeing are pictures or videos that are very blurred and pixelated. I didn’t say nobody ever sees Bigfoot. I’m saying that there’s a term for some forms of visual misperception, one of them being pareidolia—the tendency to perceive meaningful images in random or ambiguous visual patterns.

Our ears can also fool us. Mondegreens are misperceived song lyrics. One of the most common mondegreens is a line I was very embarrassed by for years, “Wrapped up like a douche, another runner in the night” from the song Blinded by the Light by Manfred Mann’s Earth Band. It’s actually “Revved up like a deuce, another runner in the night.” A deuce is a kind of automobile that was often converted into a hotrod in the 1930s, usually a Ford.

Those are just a couple of examples of how holes in our heads can sometimes lead to trouble getting along with each other. All you have to do to prove this is to look at news headlines. Everybody’s slamming each other.

There’s no magic cure for interpersonal conflict, although there have been plenty of efforts to help us understand how it may arise from misperceptions and misunderstandings, often arising from missteps in communication. I doubt making more holes in our heads would be helpful.

For example, I could have chosen to show you a picture of which one of my fingers got pinched in a manhole cover. How I might have done that could have been unnecessarily provocative and even offensive—even if I only meant it as a joke. A prominent scientist recently published a picture on social media of what he called a new star he said was taken by the Webb telescope. It later came out it was actually a picture of a slice of chorizo, which is a sausage. Many people didn’t think it was funny, but that was his explanation for the post.

I don’t have to say anything more to convey the message that being mindful of what and how we are communicating is vital to making ourselves understood while remaining respectful and kind.

Practicing mindfulness is one way to facilitate clear communication that can help solve problems without hurting the feelings of others and triggering vengeful counterattacks. We’ve all been there.

Not everybody gets the idea about mindfulness. I think the blogger thegoodenoughpsychiatrist does a great job discussing it in the post “Reflecting on DBT and Mindfulness.”

As the blogger says, “Sometimes, you just need to be brought back down to earth.”

And if that doesn’t work, we can always try trephination.

Do You Get the Zoomies or the Zennies?

Does your pet dog, cat, or sloth ever get the zoomies? We don’t have pets; I just read about animals getting the zoomies the other day. It’s an interesting phenomenon. Right after a bath, a dog might race around the yard, getting all dirty again. They look like they’re having great fun and veterinarians say it’s harmless.

It would be great if we could catch a sloth with the zoomies. Not only would that be a first for zoology. Maybe it would outrun the fungus and other parasites growing on its hair, making it easier to gather by scientists. Some of that stuff might have potential for use in developing medicines for humans.

Other animals including those in the wild can get the zoomies, and some version of it might be done by Springbok antelope, although it’s called pronking. They just run around and leap, maybe for no apparent reason. Some claim that dogs occasionally pronk, but I wonder if it’s just a special case of the zoomies.

The veterinary term for zoomies or (and maybe pronking) is Frenetic Random Activity Periods (FRAP).

Technically, I don’t think humans get the zoomies although some would debate the issue. Many of us try to do the opposite, especially nowadays. One example is mindfulness, which I’ve been doing for the last 8 years. It’s difficult for me to describe, but you’re really not trying to do anything, not even trying to relax, per se.

But I try to be still and notice whatever is unfolding, nonjudgmentally. It’s a little hard not to scratch that itch right next to my temple. I’ve seen on the web that some people call it the zennies—maybe we could call it Focused Regular Awareness Periods (FRAP).

I guess dogs and cats enjoy their brand of FRAP, or at least it looks that way. It’s really hard to tell what’s going on if you just watch people doing the human brand of FRAP. Sometimes they just look like they might be asleep—which occasionally happens.

Zoomies or zennies; could they be different paths to the same place?

My Updated Easy Exercises

Okay, so I’m nobody’s personal trainer, but I have an update on my exercise routine, which I’m doing daily for the most part. I spend about a half hour on the “workout” which starts with a floor yoga warm up. I get on the exercise bike for 5 minutes. Then I do 3 sets of body weight squats, dumbbells, and planks. I finish off with another 5 minutes on the bike.

Obviously, my goal is not to be ripped. I just want to keep my bowels moving, to sleep OK, and stay reasonably fit for a geezer. I also do daily mindfulness meditation.

I still have a lot of work to do on being more well-rounded. And I mean a lot.