Dr Dilip Jeste and Dr Samantha Boardman – Build the Habit of “Good Enough”

Dr Samantha Boardman and Dr Dilip Jeste
Dr Samantha Boardman and Dr Dilip Jeste discuss the techniques you can use to be wiser. Hosted by Duff Watkins

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About Dr Dilip Jeste

Dilip Jeste is a neuropsychiatrist and professor at the University of California, San Diego.  He is author of Wiser: the scientific roots of wisdom (and 13 other books).  His 625 published scientific papers are among most cited in the world (he’s in the top .5% of publishing researchers).  He was the first Asian-American elected President of the American Psychiatric Association in its 175 year history which has over 40,000 members.  He is listed in “Best Doctors in America.”

About Dr Samantha Boardman

a New York based positive psychiatrist, who is committed to fixing what’s wrong and building what’s strong. Positive Psychiatry takes a more expansive approach, focusing on the promotion of wellbeing and the creation of health. private practice in Manhattan. published papers in journals including Translational Neuroscience, Nature Reviews Neuroscience, The American Journal of Psychiatry, and The Journal of Clinical Psychiatry. I’m also a frequent contributor to Psychology Today, The Wall Street Journal, and Thrive Global, and a guest on the Today Show and Good Day New York. Author of Everyday Vitality: turning Stress into Strength. Founder of PositivePrescription.com

Episode Notes

Lesson 1: What would X do? 02:46
Lesson 2: You won’t be wise until you regulate your emotions 09:48
Lesson 3: Move towards, not away; be pro-social not anti-social 16:53
Lesson 4: Practice compassion (start with yourself) 23:10
Lesson 5: Affirm a Value Today 32:16
Lesson 6: Think Best, Worst, Most Likely (accept uncertainty) 39:39
Lesson 7: Re-frame the meaning of so called ‘bad’ events 44:12
Lesson 8: Build the Habit of “Good Enough” 50:41
Lesson 9: Be Your Own Emotional Detective: channel your inner Sherlock Holmes
Lesson 10: Look Up! Find your spirituality 58:20

 

Dilip Jeste and Samantha Boardman

[00:00:00]

[00:00:08] Duff Watkins: hello. Welcome to the podcast, 10 Lessons that took me 50 years to learn, where we usually talk to leaders and luminaries and politicians and pundits and ask them about their life lessons today.

[00:00:19] However, I Duff Watkins, the host, wanted to do something different. I got to wondering. How can I be wiser right now? I want to be wise right now. It’s why I came up with the idea. I know. I’ll ask a psychiatrist who wrote a book about wisdom. No, wait. I’ll ask two psychiatrists who wrote books about wisdom that way.

[00:00:38] I can’t go wrong.

[00:00:39] And they’re with us here today. Dr. Dilip Jeste as a neuropsychiatrist and the professor at the University of California at San Diego. He is the author of Wiser the Scientific Roots of Wisdom. He’s on the West Coast, on the East Coast as Dr. Samantha Boardman, who is a positive psychiatrist.

[00:00:57] She’s going to explain that in just a second. She has also written numerous articles for academic and popular press, and she is the author of Everyday Vitality, Turning Stress Into Strength. You can find out more about her and her book and her blog on the website, positive prescription.com. Welcome Dilip. Welcome, Samantha.

[00:01:17] Dilip Jeste: Thank you, Duff.

[00:01:19] Samantha Boardman: Thrilled to be here.

[00:01:21] Duff Watkins: Samantha, I’ve worked with many psychiatrists. I’ve never come across one who is a professed positive psychiatrist. Is this something new? Tell us more.

[00:01:29] Samantha Boardman: Well, it’s been around for a little while. I’d say positive psychiatry is a close cousin of positive psychology

[00:01:37] And it was, you know, we are in the presence of Dilip Jest who really pioneered positive psychiatry when he was president of the American Psychiatric Association.

[00:01:47] Asking the questions really is that should psychiatrists be as concerned with wellbeing as we are with illness? And we had been so focused for so long on pathogenesis, the, the study of disease and the lessening of symptoms and the treatment of, illness. But what about focusing on Salutogenesis, the creation of health?

[00:02:09] So, positive psychiatry really in a nutshell is the science and practice of psychiatry that seeks to understand and to promote wellbeing through assessments in interventions. And it aims that enhancing behavioral and mental wellness, um, as well as mental health outcomes that we measure.

[00:02:26] Duff Watkins: And I’m glad that you mentioned that Dilip, is the former president of the American Psychiatrist Association. He was the first Asian American person to be president of that organization, and it only took him 175 years to get around to doing that.

[00:02:41] Let’s start with the 10 ways to become wiser now.

[00:02:46] Lesson 1: What would X do?

[00:02:46] Duff Watkins: Lesson number one. This, I think this is yours, Samantha, what would X do? Ask yourself, what would X do?

[00:02:55] Samantha Boardman: Sure. I mean, this is really to help with one of the sort of pillars of, wisdom and being wiser, and that that is about social decision making and asking yourself, what would X do?

[00:03:06] Performs a number of functions for us because when we’re stressed out and we’re overwhelmed, we often self-immerse. We get sort of so lost as we’re swimming in our own emotions is that it’s very hard to have any perspective. And we know this from ancient wisdom as well. There’s, um, King Solomon who was known for his tremendous wisdom and giving advice to others. But when it came to his own personal life, it was sort of a train wreck So when we sort of are able to distance ourselves, and that’s really what the psychological mechanism is, is when you’re able to distance yourself from your emotions, you’re able to gain some perspective.

[00:03:42] And one way to do that is to think of somebody you admire. Think of somebody who you have a tremendous respect for who could sort of help solve this problem. So rather than thinking about, you know, what do I Samantha want to do? Think of, you know, what might Michelle Obama do in this moment? Or it might be some, you know, they’ve done this study even looking at, at children.

[00:04:03] asking them to think of a superhero what would Batman do right now? And this actually helps them when they’re even given a tempting video game to play. Versus, you know, stay on task and do sort of a tedious math problem. If they’re channelling in almost, you know, impersonating that, that that character that they admire, they’re much more likely to do it.

[00:04:22] Samantha Boardman: So, if there are any parents out there, you know, maybe think, ask your kid if you want them to clean your room. What would Dora the Explorer do right now? But just to kind of help distance ourselves from our own immediate emotions. It’s a. A tremendously effective way to gain perspective and clarity and have that sort of 30,000-foot, vista to look down on, rather than when we’re so immersed in our emotions.

[00:04:45] Duff Watkins: What’s your take Dilip?

[00:04:47] Dilip Jeste: Yeah, no, I think Samantha gave really beautiful description of, deciding for yourself what would

[00:04:53] you do, um, and what would somebody else do. So, I’m want to look at it now from a different perspective at social advising in the sense, whom do we go to seek advice. Just like Samantha mentioned, we think about what would Michelle Obama do.

[00:05:11] So typically when people have questions who do they approach? Typical large family, it would be often the grandma not because she’s the most educated person, but because she’s the wisest person, she has a lot of experience. In a village, people go to the village elder, or we talk about senior statesmen for the country.

[00:05:31] So who is this person who is good at giving advice? Obviously that person has to be wise. A wise person who doesn’t give advice to others is not wise because one of the characteristics of wisdom is to help others. So, the wise person must be there to help others. So why do we choose somebody to go to?

[00:05:51] Because we expect that person to be so well regulated emotionally and otherwise that that person would give conflict free advice. The person would give advice that is not necessarily in his or her selfish interest, but what would be good for you. The person is objective. He has a lot of experience.

[00:06:11] Somebody we trust, somebody we respect their thinking. And these are things where we can’t do ourselves, you know, just like, uh, suppose Samantha and I are physicians, uh, and we take care of ourselves. But if we have some bigger problem, we will approach another physician. Lawyers would choose some other lawyer to represent them.

[00:06:30] Right. So, we need some outsider to help, And that outside person is somebody who is following social advising.

[00:06:38] Duff Watkins: Social advising.

[00:06:40] And so, you’re describing a person that is, Integrated enough themself, they’re together, you might say in English slang. They’re so together that you can go to them, and they’ll have something to say.

[00:06:52] Now, they may not be older than you, but they have some degree of, um, well, I’ll just use your word again. Integration that makes them, a worthy source of information.

[00:07:02] Dilip Jeste: That, That’s exactly right. I don’t think the age matters here. older people, uh, are more helpful because I have tons of experience, but that not necessarily the case.

[00:07:11] Again, the wiser person can be younger, than others because he has experience often through different ways if not personally, by watching others, uh, who have had that experience and being a good leader, so on.

[00:07:26] Duff Watkins: So, it’s, it isn’t the age, it’s the experience which contributes to the integration of the person.

[00:07:31] I have, an example of that as I was thinking about that.

[00:07:35] There’s a, is a true story. Remember the movie Sleepless in Seattle.

[00:07:40] Samantha Boardman: Yes. Yes.

[00:07:42] Duff Watkins: I think everybody on the planet except me has seen it. But I was talking with, or Jeff Arch, the guy that wrote the screenplay was telling me a story, a, a group of us and he said when his first child was born, it was a very difficult pregnancy and his wife was in danger at risk and there’s a lot of pressure on him, financial, family, and he was freaking out, and then he did exactly what you’re prescribing.

[00:08:07] He said,

[00:08:08] What would a hero do? If I was writing this scene? What would a hero do? If I’m going to write this screenplay, what, what action would they take? And he said he felt a calmness and assurity of mind descend upon him. And it’s the phrase that you’re using, Samantha, or the phrase I use is a Zen-like detachment from it so that the situation doesn’t overwhelm you and that somehow lead you to a calmness that helps you make.

[00:08:36] Well wiser decisions and it turned out well for Jeff and his and his wife and his family. So, I’m pleased about that. But, uh, the point is it works when you ask yourself, what would X do?

[00:08:47] Samantha Boardman: Yes. And there’s a certain amount of imagination, I think, and creativity that that invites. And I think, you know, Dr. Jeste writes about this in Wiser as well, is even when we engage with our imaginations and we sort of plant ourselves in the life of someone else, or even in those decision making positions that they have, and you, you watch a movie, you read a work of fiction and you sort of expand your emotional repertoire in some way.

[00:09:15] And those exercises, you know, in doing that I think can really help us reimagine our emotions and our decisions and, and kind of bring to it a different set of, you know, not just sort of overwhelming, wait, I’m swimming in this but actually perspective. And so, I think those can all be exercises in self distancing and.

[00:09:35] That sort of Zen like perspective you’re talking about?

[00:09:37] Well, I can tell you what I’m going to do. When I feel overwhelmed, I’m going to ask myself, what would Dilip Jeste do? And then I’m going to know the right thing.

[00:09:46] Duff Watkins: do that.

[00:09:48] Lesson 2: You won’t be wise until you regulate your emotions

[00:09:48] Duff Watkins: Point number two, you won’t be wise until you regulate your emotions.

[00:09:55] Samantha Boardman: So emotional regulation is obviously, I think a key component of wisdom and there are different strategies to regulate one’s emotions, but there’s the Dr. Gross model of emotion regulation and the process model of emotion regulation. And this idea is that you can sort of using flexible strategies

[00:10:15] When you regulate your emotions and so before you have an emotion, you can, There’s a sort of a way, like a continuum to think about before you even the emotion hits you. You can first, you can situations select, right? You can decide. For instance, if you were invited to go to a cocktail party where your ex is going to be, you could choose not to go.

[00:10:38] And then once you’re at the party, you could situation modify meaning in that context. Like what else could you do? Maybe that would be, I could go up and talk to that person, or I could choose not to. Then the next phase of sort of emotional, regulation would be attentional deployment. What am I going to attend to?

[00:10:56] Maybe I’ll go and watch karaoke over in the corner, or maybe I will just watch my, ex flirt with his new partner. And then the next stage of that is reappraisal. What can I learn from this? How could I see this differently? I could be furious about this, maybe. I should be happy. He’s happy. Um, something like that.

[00:11:13] And then the next phase would be how are you going to sort of, what will you, once the emotion is underway, how will you modulate it? That may be like, I’m going to hit the bar. I’m going to, go and like, go home by myself and cry. Or I’m going to suppress my emotions and dig into them. So, these are all different strategies.

[00:11:31] Some are before the emotion hits you, some actually occur afterwards. One could deploy. And the key is it’s all about flexibility, right? So, it’s not to say this is the one you should use all the time, but I think it’s, it was Aristotle who had said to feel these feelings at the right time, on the right occasion towards the right people and for the right purpose, um, and in the right manner.

[00:11:53] Like that’s sort of what counts. So, you have all these different strategies to regulate your emotions. And I think when we are a little bit thoughtful of, you know, sometimes if somebody cuts you off in traffic, like your emotions already underway, And you can choose to sort, you know, go into like maybe your knee-jerk responsive rage, but how else can you channel these emotions?

[00:12:13] And I think looking at situation selection, situation modification, attention deployment, reappraisal, and yeah, then emotional modification. Are just strategies and they sort of give you a buffet table to choose from.

[00:12:27] Duff Watkins: And your point is that there is tremendous choice available to us. I use the Smorgasbord model myself.

[00:12:34] I mean, all these emotional responses that we have, and most of us just go to the smorgasborg and choose the same damn thing over and over again. We’re not, we’re not very adventurous

[00:12:43] Dilip Jeste: Okay. Some of that described very well, sort of what do you do before the emotion hits you? Uh, and that’s really important. I want to think more about sort of what happens after the emotion hits you and you are overwhelmed by the emotion and, uh, My favorite example something in very common in California is road rage.

[00:13:04] Uh, you know, I’m going to my work. I’m already a little late and somebody cuts in front of me. I’m so mad. I’m so upset. that I start, screaming, cursing, tailgating, uh, and I’m just so angry. What, who is this jerk? I mean, why did he do that? And that really doesn’t help because. The risk is that, uh, if I continue this, actually I could have an accident and that could create far more problem.

[00:13:30] So how do I control that? So, the natural reaction is there, I think, most of us would be angry when somebody get in front of you when we are in a rush to go, But that’s the time. Then how do we control that very quickly. So how do you do that? The first and most important thing is, I think, thinking about the motivation for the other person for cutting in front of you.

[00:13:52] mean, I feel angry when somebody cuts in front of me because I feel personally insulted that that guy didn’t think highly of me, or he wanted to show off and he just rushed in front of me. But that may not be the case. So, what, why would the other person have cut in front of me and. Maybe that there’s a child sitting in the back of his car and suddenly the child had a seizure, or the child started throwing up, something like that.

[00:14:18] If that happened, what would you do? If you were doing that, you would also cut in front of others because you just want to rush to the emergency room or some of the place where you need help. So, if, and whether that is a real reason or not, that doesn’t matter, but you, because you don’t know the real reason.

[00:14:32] I mean, because you haven’t talked to that person. So, you’re imagining the real reason as being something bad for you, but it could be something that the other guy needs to do. So, if you think about that, then initially your anger goes away. Because you realize that Actually, no. I mean, this is something I was wrong in getting, mad at him that he needed to do that.

[00:14:52] Dilip Jeste: So that’s one. second is just distraction. If you’re listening to some music on the radio, just increase a volume. Think about that. But the third is accept the fact that you’re angry. You have a right to be angry, but let us move on. Because that anger is not going to help you. so emotional regulation is really both anticipating what would happen, as Samantha said, but also then when it happens, then controlling the emotion and what has to do that.

[00:15:19] I mean, that should become second nature. Uh, then only it will succeed

[00:15:23] Samantha Boardman: And it’s so interesting the way that I think our coping strategies are often counterproductive. And as you alluded to earlier

[00:15:29] too it’s sort of, it’s because it’s habit and sort of when we can uncouple those, those habits, and Dr. Jeste sort of alluding to this whole idea of correspondence bias. We judge ourselves by our thoughts. You know, I’m a good person. I’m cutting this somebody off because I’m late to visit someone in the hospital. But you know, we judge other people by their actions. And I think when we keep that in mind, that correspondence bias, this disconnect between, you know, how we judge ourselves by our thoughts, like, I’m really a good person.

[00:15:56] The reason I cut them off is because of this. But that guy cuts me off. You know, I’m enraged by that. That it, I think it again, puts those things, those sort of, once those emotions are underway into perspective, I mean, I think you’re still mad, but at least you have like sort of a sense of, wait, maybe I am jumping to conclusions.

[00:16:12] I am catastrophizing here over generalizing and just making assumptions based on this one action. And it’s to be used. That movie reference, there was that movie about the spy, and I remember him saying like when he was very worried and Tom Hanks was saying, Well, aren’t you anxious?

[00:16:26] Aren’t you worried? And he would say, Why would it help? And I think that that’s sort of a, a part of, um, a part of what we can learn. Like would that emotion help? Like, would that rage help? No.

[00:16:36] Duff Watkins: I have, uh, learned to do the opposite of that I have when somebody’s trying to come in. I like to imitate the Pope and give them that little wave, you know?

[00:16:45] Yes, my son, you may come ahead of me, and it just makes me feel so superior to them.

[00:16:53] Lesson 3: Move towards not a way. Be prosocial. Not antisocial

[00:16:53] Duff Watkins: All right. way number three. Move towards not a way. Be prosocial. Not antisocial.

[00:17:02] Dilip Jeste: Yes. I think you know of all the components of wisdom, the single most important component is prosocial behaviors, and that includes empathy, which means understanding and sharing somebody’s emotions of thought and compassion where you go out and help the other person.

[00:17:19] And that’s really critical for human society. We are a social species. We need compassion not only to survive, but also to thrive and flourish. We can’t do without. Compassion. And yet, compassion is sometimes harder because of this. It conflicts with a selfish interest, but this is something we need to practice consciously.

[00:17:42] So I think about three things actually one can do to increase the level of compassion towards others. One is what is called gratitude journal or gratitude diary. So typically, it means that before you go to bed, write a couple of things that made you feel grateful because some stranger helped you, but that’s not enough.

[00:18:02] I think we should also write a couple of things that made us feel proud of ourself because we help somebody else. So, we should be grateful, but we should also be proud of our ability to be compassionate and. It’s not a question of writing these things because I know many people don’t like to write this gratitude or diary or something, so you don’t have to write it.

[00:18:21] You can share your experiences with somebody. you can talk to your spouse, partner, friend, colleague, or you can even just record it, whatever it is, but just make a habit to do that. The second thing is volunteering. Set aside some hours in a week when you do something that’s not a part of your work.

[00:18:40] And whatever is feasible, of course, and whatever you enjoy, whether it means spending time in a nursing home to help some people with dementia or to work in a foster care home or place where there are children with, uh, autism spectrum disorder. When you do that even for a few hours a week, that makes those people feel very good.

[00:19:02] You feel proud of yourself. And your self-esteem goes up because you know that you’re helping others and they’re appreciating that. So volunteering is really important. And the third thing I stress is meeting people who are different from you, different or different in the color of your skin. different, in their age or, uh, different in their beliefs, whatever it is.

[00:19:26] Because typically we are brought up in a family and then in a community where most people are like us, you know, we go to school, and encountering people who are different from us is hard actually, because we are not used to that. And so, the initial reaction to that is sometimes fear, sometimes oftentimes anxiety, and sometimes anger.

[00:19:51] And the way to overcome that is, again, understanding those people. So just by meeting with them, we can understand sort of where they’re coming from, what is their rationale, and once we appreciate that, we don’t have to agree with them, or they don’t have to agree with us. But we have better understanding and more acceptance of the fact that they can have different, processes.

[00:20:12] I think that’s important for improving our compassion.

[00:20:15] Duff Watkins: So, gratitude, diary, volunteering and hanging out with people who are different than, than me, than you. Good sense.

[00:20:24] Samantha Boardman: No, I, I mean, I wholeheartedly agree with Dr. Jeste just said, and I, I think that In the West we really interiorized wellbeing this idea that like, sort of everything happiness comes from within and that. It’s such a narrow way, I think, for us to be thinking about our wellbeing.

[00:20:41] And really happiness comes from with doing things with others, for others and in the you know, in the service of something larger than what we are. And it’s with immediate loved ones, you know, It’s obviously with the importance of friends. I also think we value so much in the west.

[00:20:58] Our romantic partners and our immediate family and not considering how the importance of having friends and actually the importance of having friends and having great friends is also very good for marriages and, romantic relationships and also strangers, you know, people. And as, as Dr. Jeste also, comments on is people we don’t know.

[00:21:17] And in theory, I think in our imaginations, people who are different from us are much scarier, but it’s when we break bread. We’ve seen studies show that you can really reduce bias by encountering somebody, actually meeting somebody, having a coffee with somebody who is different than you are. A lot of those fears are dispelled, and certainly when you share something, share a meal, share a coffee, that also sort of helps dissipate it.

[00:21:39] But, prosocial acts, I mean, probably the most reliable. contributor to our wellbeing. And it’s not just, we know that it’s a, we have a fundamental human need to belong and to be valued, but I think also we have a fundamental human need to add value. And wisdom is really at the nexus of that because it is, you know, you, you see an individual’s qualities that can make them wiser, but also in the context then of, of their relationships, their occupation, their communities, that expanding world that they inhabit.

[00:22:13] And engaging in those pro-social acts. And what’s so interesting is people often forego opportunities to behave pro socially or to do something for someone else because they don’t think it’s going to make a difference. They think the person won’t notice or it won’t matter to them. And I say, I think there’s so many everyday opportunities that we’re not taking, or we assume we’re going to be just too hard or overwhelming, but as you said, sometimes it can be just, you know, waving the person in front of you in traffic.

[00:22:38] It can be sort of in these little micro moments of kindness in these small gestures. It can go a long way. And when people are actively engaging in those pro-social gestures with adolescent. Teenagers. The study was shown that, you know, even a month later, then they’re much more actively prosocial. It’s almost like a, a putting on a different pair of glasses and because it also makes them feel good.

[00:22:57] Duff Watkins: So, are you too suggesting that staring at my phone night and day when I’m at the dinner table or with other people is somehow less than Prosocial?

[00:23:05] Samantha Boardman: That’s definitely a vitality vampire.

[00:23:10] Lesson 4: Practice compassion, starting with yourself

[00:23:10] alright, way to wisdom number four, practice compassion, starting with yourself.

[00:23:18] Dilip Jeste: Yeah, I mean, this is, self-compassion is really part of compassion. We don’t often realize that, that when we talk about compassion, we talk about compassion to other, and that’s critical. Absolutely critical. But. Being compassionate to oneself is actually equally important. Um, you know, the usual example I give as people know that is, you’re sitting in a plane, the plane takes off, and the security video comes on and it says that, uh, if the air pressure falls, the masks will come out and put on your own mask first before helping others.

[00:23:53] And you say, How can you do that? There’s a child sitting on one side and a disabled person on the other side. You’re in the middle seat. How should you help not help them before helping yourself? And the reason is, of course, that it’ll take just a few seconds for you to put on your own mask, but then it’ll give you enough time to help the people on both sides and even others if needed.

[00:24:16] So we had to take care of ourselves before we can help others. I mean, I see we all see some very compassionate people, whether they’re priest, physicians, or others. Or very compassionate toward others, but on themselves, they don’t forgive themselves. That’s not a good idea. because your own wellbeing is important to allow you to help others and the ways to help with the self-compassion, there are several ways.

[00:24:46] One is, the sense of common humanity. If you make a mistake, Don’t blame yourself too much. Everybody makes mistakes, so accept the fact and then really find out why you made a mistake, how you won’t make the mistake next time, but don’t spend too much time and energy just criticizing yourself. You got to move on.

[00:25:06] Second is self-kindness. When a friend comes to you in a stressful situation, you say, Oh, it’s okay. Just calm down. If it’s all right, you know, things will get better. Why don’t you do that to yourself? So, there should be self-kindness. And the third thing is realizing that no matter almost what happens, but we have been there, and we have done that, and something goes wrong.

[00:25:28] It looks like it’s the end of the world. No, it’s not the end of the world. Things will come out and, One example of this actually was during Covid pandemic, both. Samantha and I are geriatric psychiatrist and, geriatric psychiatrists were very worried about what is going to happen with the older people because they had a very high risk of physical complications.

[00:25:48] They were more likely to be hospitalized, intubated, and die. Also, they didn’t have access to technology, unlike younger people, or they were not familiar with technology. So younger people, the social distancing guidelines didn’t impact too much because they could still connect with others. Older people couldn’t do that, so older people were at high risk, of feeling anxious, depressed, stressed out, you know, what happened?

[00:26:14] Numerous studies showed that older people handle Covid much better than younger ones. There is a study that was published, uh, recently in one of the journals, they found that 15%, one five, 15% of people over 65 had stress, anxiety, or depression. What was the incidence in younger people? People within 18 and 25?

[00:26:39] 75%? The younger people, although they had no physical problem, although they had access to all the technologies, very sophisticated, they were five times more likely to experience depression, anxiety, and stress. And one of the main reasons we talked to several older people that we worked with, number of them said the reason was.

[00:27:00] They knew that they have been there, they have been through that, and they have done that. They have experienced other crisis, like war, uh, or drought, financial recession losses. So, for them it was not the world’s worst thing to happen. For many younger people, it was. So that’s a good way of looking at self-compassion is knowing that you have been through stresses, you came out of that, and you’ve come out of this also.

[00:27:28] Samantha Boardman: And that dovetails so well with, you know, those studies looking at. Young people who know the arc of their family story, they know that there have been good times. They know that there have been really challenging times that they know that their family went through this really difficult. Phase their great grandparents, had a very difficult time and they, they know the arc and the ups, and the downs actually are also more resilient.

[00:27:54] Um, having that sense of a family history, because like, I think again, it gives them some sense of context. And it’s Daniel Gilbert at Harvard who talks about. This idea of having compassion and self-compassion, that the key to having it is, is courage, even more than kindness because you have to have the courage to be willing even to, to see into the nature and the cause of suffering of your own or for some of, of somebody else’s. And we often have these sort of, you know, I think we’ll, we’ll sort of end up in these thinking traps or catastrophizing or overgeneralizing. This is the worst possible case scenario.

[00:28:29] You take things personally, it seems permanent, it seems pervasive. Nothing will ever get better. And I think that explanatory style that, that, you know, well, maybe this, you know, it’s temporary, maybe. Is there something I could learn here? You know, maybe this other pandemics have ended, that kind of thing.

[00:28:48] And I think when you sort of do treat yourself as one, would a friend, it almost reminds me of that new Adele song Go Easy on me. Like, can you go easy on yourself in some way. one strategy or one exercise I’ve used with patients is just arguing with your inner critic saying, you know, what evidence do you have for that?

[00:29:04] And is this sort of trying to sort of be a lawyer there and say, you know, is this a fact or an opinion?

[00:29:09] Duff Watkins: On a previous podcast I had Dilip quoting Michael Jackson. Now I’ve got you quoting Adele. So Well, okay, now, now that reminds me of something. The Dali Lama was at a, no, I think a US university.

[00:29:23] And somebody. Participant in this seminar that they did not like themselves. They felt bad about themselves, and the Dali Lama was absolutely astonished because it was such a weird concept for him. So, he went around the room, and everyone pretty much said the same thing, that they didn’t like themselves very much.

[00:29:44] They felt bad towards themselves, and he thought this was so totally abhorrent in nature and of course. He’s right, because it is, and yet it is so, so very, very common. And that’s why I think the importance, two important things about this, this way is yes, practice, compassion, start with yourself cuz you’re probably the person that needs it most.

[00:30:07] And the other thing that I wish to underscore, and I’d like your comments about this. To me the most important word in that phrase is practice. Practice. So, practicing compassion, starting with yourself, does that ring a bell with you folks?

[00:30:19] Dilip Jeste: Yes, absolutely. I think all these good things we talk about that we need to do; they should become second nature. Then only we will succeed. I mean, if we had to think about that and practice it are once in a while, that’s not going to work. I mean, good example is physical exercise, right?

[00:30:38] I mean, if you do a lot of exercise one day and then, uh, are sedentary for the rest of the week. That’s not going to help at all. So too small. Increase the amount of things you do, but you must practice it continuously. No question about that.

[00:30:54] Samantha Boardman: Yeah, I would think that wisdom is a verb. You know, it’s something that one has to sort of practice and do on a daily basis, and I think even sometimes it’s like Groundhog Day for many of us, even though we know something makes us feel better or we know that.

[00:31:08] this is important. We still might not do it. I think we underestimate sometimes just how unbelievably lazy most of us are. So sometimes how important it is just to make that thing that you want to do easier to even at once a week have a sort of check in. State of the Union, am I doing those things that I, you know, claim to want to do? There’s an exercise that Robert Brooks has written about asking, what three words would you hope that your children or your partner, or your friends or your co-workers would use to describe you?

[00:31:39] Samantha Boardman: And, um, Then what do you do on a regular basis to invite those, that those descriptions of you? And then the third question is, what do you think? What words do you think they would actually use to describe you? And then the fourth part of that is, you know, how could you close that gap and have more overlap between you know, what you do and how they experience you as well.

[00:32:02] Just the idea really around that being like, are we walking our walk? Are we affirming our values? Are we embodying what we care about in, in an everyday way? And I think it is, it is a, a practice. And that’s why I think wisdom truly is a, is a verb.

[00:32:16] Lesson 5: Affirm a value today

[00:32:16] Duff Watkins: Which takes us to. Lesson number five, Affirm a value today. My first question is, what’s a value?

[00:32:25] Samantha Boardman: you know, people often will tell me when we do, I often, on the first time I meet them, I’ll ask them to do some kind of values, affirmation, exercise, say name three things you value most and it’s something people don’t think about, they don’t reflect on.

[00:32:39] And I’ll usually then sort of give them a list and ask them just like, what is most meaningful to you? What do you stand for? what matters most to you? and just asking them to come up with a list. Maybe it’s their health, it’s their a relationship with friends, family, their being, being creative, being artistic, whatever those sort of three to five core values. Identifying them and then also describing like, why is this important to you? Why is this meaningful to you? And this isn’t just hollow sort of self-esteem boosting work. It’s really kind of asking them to reflect on, on what matters. And then I often will ask them then, all right, how do you spend your time?

[00:33:18] Or even especially your free time, and what did you do for instance, on Saturday? And, you know, they say, Well, I fell down this, you know, internet hole and I lay in bed. Or I, you know, I wasn’t sort of doing those things that, that I do value. And then kind of trying to create more overlap between what you deeply value and hold dear, and, and that that helps you feel that that’s the core of who you are and then actually what you’re doing and that you’re walking your walk.

[00:33:45] And to go back to this idea of positive psychiatry, It’s not just sort of, I think we’ve been so focused on what’s the matter in traditional psychiatry, What’s the matter with you? And then this is really looking at what matters to you. And having our, our patients and, and having all of us, I think, can benefit from doing more of what matters.

[00:34:06] And that’s really, I think what the sort of values, uh, affirmation exercise is about.

[00:34:11] Dilip Jeste: Yeah, that, that’s really very well said. exactly. I think this is, uh, we don’t ask people, and again, as physicians, the questions we ask is, So what brought you here? What is wrong with you? What are the symptoms? We never ask them, What do you like about yourself?

[00:34:28] What are your strengths? What would you like to do? And because the value is also in a way related to the purpose in life, that if we value something highly, that really becomes a purpose in life for us to achieve. But we don’t think about that. Most people don’t. And you know, we just asking that question actually sets these things going.

[00:34:49] And sometimes just actually asking a question, assessment itself becomes intervention, right? So, for the first time, Wow. I mean, nobody asked me what my strengths were or what my values were or what my purpose was because then you set up, start prioritizing things. I mean, we all have to do a bunch of different things to survive, but there are other things which we really enjoy, and we don’t think about them.

[00:35:12] So this kind of questioning is really helpful, to set up self-reflection. And just as you are talking, earlier about, making it, habit, so saying practice, I think this is especially necessary for self-reflect. You know, we set aside time for physical exercise. Most of us too, you know, that at least five days a week in the evening, or three days a week or in the morning, whatever, Why don’t we set aside time for self-reflection.

[00:35:40] It doesn’t need to be huge amount of time, but let’s say half an hour, twice a week, once on a weekend, once on a weekday, and where they think about ourselves, what we have been doing, what made us happy, what made us stressed out. If we do that, we’ll understand ourselves better because there is a pattern of things that emerges.

[00:36:00] We sort of similar things that. Make us stressed out and similar things that make us happy, but we don’t think about that. So just thinking about that, actually we’ll bring them to the fore. We’ll start to understand the pattern, and then we can do something to change it as needed.

[00:36:17] okay. Let me explain to you the problem with all that.

[00:36:20] Duff Watkins: Right now, I’ve lived in Australia for 40 years. I’m not in Australia. I’m in Brazil at the moment, but here is the problem I’ve had over and over again. I’ll tell it as a joke, but it’s true. I could give a blank piece of paper and a pen to an Australian kid or adult, and I say, Write down five things you like about yourself.

[00:36:39] And they’d go, Ah, gee, do I have to, Now I could do the same exercise with an American kid or an adult, and the American kid would. I’m going to need more paper. I’m just, I’m just going to need more paper, man. I mean, just this one sheet, you know? So, it is just really difficult for some people to, you pose that question, but they got no answer.

[00:37:03] So, so what do we do then? How do we help them articulate and get in touch and, and espouse these good things they have within them?

[00:37:11] Samantha Boardman: One question that I’ve found to be helpful to sort of dig through that is, you know, tell me about a time when you were at your best. Tell me about like a moment where you were really proud, you know, of, of something you did, where you felt you know, strong and that you felt proud and that you could describe it.

[00:37:27] Can you even write about that if they can write even a paragraph about it and then kind of pick out like, well, That, that, you know, you’re so animated as you speak about that. Can, can we, we hear more about that? Wow. It sounds like you were really being creative if you did that, or that was, I mean, most people when they talk about this, it’s really, it’s so rarely individually based.

[00:37:45] It’s always in the context of others. Even, you know, when people ever come to see us. It might be because they have a problem, but then you realize it’s always somehow inter relational in some way. But it’s also when people are truly at their best, even asking people who are psychotic, you know, asking them about like, tell me, even on the unit, what was something that was good that happened this week.

[00:38:05] It’s always, Well, you know, I made this piece of, I made this drawing, and I gave it to somebody else here. The nurse really liked it. You know that there’s something that is reflected back to them. Again, that goes into this idea of that not only are they valued, but they’re adding value somewhere else, and that really is the definition of mattering in the world.

[00:38:23] And so if we can sort of maybe through the back door get to that, those, those values, and maybe it is telling you about a time that you’re at your best or. What are you looking forward to this week? What are you going to do again, closing that intention, action gap for them, so it’s not just something that’s living in your head.

[00:38:40] And I think Dilip and I both feel really strongly about this, that happiness isn’t just in your head. It’s sort of in the actions you take and the connections you make and how you participate out in the world. I think Samantha makes a very real terrific point that you need to think about the situations.

[00:38:55] Dilip Jeste: I think when we ask an abstract question like what you like about yourself, it’s really hard to think about that. But if you ask about situations in which you like yourself most, You were most proud of, most happy with. That actually helps because they’re the stories that they remember. And so same thing applies again for self-reflection, where you think about what stressed you out and what made you happy.

[00:39:21] So again, if you do that regularly, we start realizing what are our strengths and what are our limitations. And they might be different from what we were thinking about because now because we are associating them with specific situations, You can see a pattern emerging.

[00:39:38] Duff Watkins: Okay. Okay.

[00:39:39] Lesson 6: Think best, worst, and most likely

[00:39:39] Duff Watkins: Well, let’s proceed to way number six.

[00:39:43] Think best, worst, and most likely. That is to say, think in terms of what’s best, what’s worst, and what’s most likely to occur.

[00:39:53] Dilip Jeste: let me answer that question. So, this really is a question of accepting uncertainty. and in a way this goes to issue of humility, which is that if I think that I know the best and I know what will happen, obviously I’m wrong because I don’t, there is so much uncertainty because I don’t know so much.

[00:40:17] Let alone being able to predict something. so, humility is actually an integral part of wisdom, which is part of self-reflection in a way. So, self-reflection means understanding your strength, but also importantly understanding your limitation. So, people kind and self-compassion is important, but people who are narcissistic, who are a lot of self-compassion, they’re not self-reflecting either.

[00:40:39] And that was one of Socrates’ point, he said that anybody who thinks, uh, his wise is a fool because a wise person knows how much he doesn’t know. that there is so much uncertainty. There is no single right way to do that. That there are multiple ways that we to find out what’s the right way. So, to me it’s sort of more question of accepting sort of diversity of perspectives and lack of confidence in certainty.

[00:41:05] I think that’s, uh, what is important here to me.

[00:41:08] Samantha Boardman: absolutely. That like epistemic humility just to bring to everything. And even having that around. You know, one’s feelings and emotions. That’s probably one of the most fundamental tenets of CBT is that your feelings aren’t facts. You know that just because you feel a certain way.

[00:41:22] It’s really, you have beliefs usually about something and then that leads to other feelings about it. So how do you uncouple your beliefs about, you know, Maybe that person didn’t wave at me across the street, it means that they hate me. Maybe my friend now isn’t going to invite me to something, but that’s sort a belief.

[00:41:40] And then you’ll have these emotions as a consequence of that. And sort of bringing humility to this and thinking How else could I explain this in some way? And I think we’ve been hearing so much about uncertainty during the pandemic and how difficult it is. But I agree with Dr. Jeste that certainty is almost more toxic in some way. And having certainty is an illusion at best, being certain about anything. And there’s a, I think it’s Chris Conlan who has this fascinating, he calls him emotional equations and he writes anxiety. Equals uncertainty times, powerlessness and uncertainty is a lack of knowledge.

[00:42:17] And powerlessness is a lack of control. But actually, there’s a lot that we do have, you know, that we do know. And there’s actually quite a lot that we can control. So, you can really dial down your anxiety when you make a list of it. Okay, well what? What do I actually know? And there are some facts here that aren’t just opinions.

[00:42:35] And actually, what do I have power over? Maybe I’m, I feel like I’m not sleeping at all, but I do have the power to turn my phone off and leave it in another room rather than checking it all night, you know? So, what are those things that you kind of have something over and when you’re really overwhelmed with like anxiety about uncertainty, you can consider the worst-case scenario, like what would be the epic disaster here?

[00:42:55] Then what would be the extreme opposite? What would be the best-case scenario, and then what would be the most likely. Outcome. We also know for people who are managing uncertainty and who are really having a hard time waiting, and human beings really don’t like to wait for things. And we know people would rather get electric shocks than have to wait long periods of time in, in a lab.

[00:43:13] We’re, we’re just really bad at waiting is really almost, the antidote for that is finding flow in something. Mihaly Csikszentmihalyi idea of flow when you can lose yourself in some activity if it’s. If it’s walking in the park, if it’s reading a book, if it’s playing an instrument, if it’s cooking, if it’s gardening, whatever that activity is, because it’s a very helpful and productive way to manage that stress of uncertainty.

[00:43:38] and we are living in a time of radical uncertainty is a phrase that I read recently, but we always have been. And it’s just how we insulate ourselves. your comment, Samantha, about, you know, impatience, unwillingness to wait. It reminds me of a friend of mine said decades ago. He said I was the only person he ever watched stand in front of a working microwave, muttering hurry up, God damnit, as if radiation isn’t fast enough for me.

[00:44:05] Duff Watkins: So, it’s sad, but it’s true. It’s very funny.

[00:44:09] Well, okay, Samantha’s talking about, um, reframing.

[00:44:12] Lesson 7: Reframe the meaning of these so called ‘bad events’

[00:44:12] Duff Watkins: So that takes us to our next point, and I reckon this may be one of the single most important things anyone can learn, can hear, reframe the meaning of these so-called bad events.

[00:44:25] so we define good or bad event, based on the immediate outcome, it’s the short-term outcome. So, it is like, you know, in, uh, sports, in the baseball game, the coach selects a reliever for the 9th innings. and it turns out to be a wrong decision because somebody on the opposite side, they hit a home run and they win the match, and it’s a bad event.

[00:44:53] Dilip Jeste: However, what happens to the team is that they realize that they made a mistake and they’re now behind. So, they work very hard, and they win the next five games and then they go into the playoffs. So, what was actually bad event became a good event and so on and so forth. So, there is this fable that many people know about, a farmer and a horse.

[00:45:12] That the farmer had a horse and that was his prize possession, the only prize possession. And one day the horse died. So, he was totally desperate, distraught, and he said that his life almost is, has ended. But the villagers, they realized that he has lost what was most important. So, they bought three horses for him.

[00:45:32] So what was a bad event? Turned to be a good event that he got three horses and then his son was training them. He fell and broke his leg, so that became a bad event. But then there was a draft. People were conscripted into the military and his son was not drafted because of his injury. So that became a good event.

[00:45:52] So, So that’s the thing. That could beget bad, bad begets good, and that goes on and on and on. So, our judging, something as good or bad. Based on short term outcome is wrong, longer-term outcome would be different. And so, we need the patients to see how it works out rather than immediately jump into conclusions based on immediate, short-term outcomes.

[00:46:17] Samantha Boardman: Yes. And, and that idea of kind of this binary bias, things are good or they’re bad, I think our, our brains go to that sort of black and white thinking. But you know, when we are able to see things in context, and fascinatingly, this huge study just came out, I think it was across 87 countries, over 20,000 participants, and.

[00:46:36] The researchers were asking this simple question like; Can we help people feel better during the pandemic? And the answer was yes. And it was asking them to learn the most basic skill of cognitive reappraisal, which you know, was what can I learn from this? Is there anything positive that, that could come of this?

[00:46:55] And being able to sort of just take that different type of perspective and uncouple again, your thoughts from your emotions. It’s so key because. When we’re so sort of mired in something that we, it’s kind of impossible to see that. But if you take that step back and think, is there something here that I can learn?

[00:47:12] Maybe there, maybe it’s really hard being in lockdown, but maybe I could, you know, start baking or I can spend some more time with family. It’s kind of meaningful to me. So, I think that there’s potential there. That said I think we have to be super careful about like that slippery slide into toxic positivity and that there’s always something good here.

[00:47:31] You know, sometimes things can be maybe unequivocally bad and there isn’t that positive sense. Um, you know, that there isn’t necessarily some silver lining post traumatic growth or post pandemic growth is not necessarily always a given outcome. But is there something to learn from this? And the good news is human beings are extremely resilient.

[00:47:53] People tend to bounce back. It is the norm. It’s not the exception. And I think that’s something we forget quite a bit as well, that, that resilience is really in our nature and in our bones. Obviously, it has to do with social support and wisdom and a lot of other factors, but it’s, it’s more likely to happen to us than not. And it’s, it’s part of a skillset as well.

[00:48:13] you mentioned, Samantha, CBT, cognitive Behavior Therapy, and which is basically a way of thinking yourself out of whatever you’re into thinking yourself healthy.

[00:48:24] Samantha Boardman: It interrupts that catastrophizing, you know, that that spiraling into this is, you know, the end of the world.

[00:48:31] This is always going to happen to me. Woe is me. And so, it really just robs you of that ability to have perspective and to actually learn from it. And we underestimate, and I think it’s something I really underestimated in my training to become a psychiatrist. We underestimate the role of positive emotions.

[00:48:47] These are sort of are lifeblood, and I’m not talking about sort of rainbows and unicorns, but actually genuine positive emotions, that sense of joy, those transcendent emotions of gratitude that one can feel or awe. You know, when you witness something, spectacular. But that, that when we can cognitively reappraise something in the context of CBT, we, we give ourselves the opportunity to have positive emotions and we can even have, we have this emo diversity.

[00:49:14] Even when we’ve looked at studies of caregivers or people, you know, dying with the terminal illness, those were able to say, Well, there was this funny moment when we looked out the window and saw this, You. Pigeon going to the bathroom on the, you know, on, on, on the, on the window or there was something funny.

[00:49:28] And being able to find even that sort of joy within the, the sadness and even that wellness within illness is something that we need to sort of remind ourselves to do. And again, that skill building of what’s good here, and not in a Pollyanna way, but actually in a very meaningful, impactful way.

[00:49:46] Duff Watkins: You mentioned toxic positivity, which I wrote down. So what? What is that? I think I got a pretty good idea, but I want to hear your view of it.

[00:49:54] Samantha Boardman: Just that idea of like, Oh, put a smile on your face. Everything’s going to be just fine. we have emotions about our emotions, you know, And so this pressure to be happy all the time.

[00:50:06] and that you sort of have pathologized some of the very normal reactions of, of feeling disappointed, feeling. Being down about something, or being stressed out. Even these are normal. And I think sometimes there is this pressure to sort of have that rainbows and unicorns life and just think everything’s going to be just great.

[00:50:25] And people are grieving sometimes and maybe. Psychiatrists are we jumping in there to sort of like, let me, help you through this. Where sometimes these are just natural processes that are occurring in natural emotions to, to be feeling and, and to allow for them? and to learn from them.

[00:50:41] Lesson 8: Build the habit of good enough

[00:50:41] Duff Watkins: Proceeding two lesson number. Eight, Build the habit of good enough. First of all, how do we build that?

[00:50:49] Samantha Boardman: This is idea. It’s around, I think being decisive. It is such a, also an important component of wisdom. It’s how, how can we decide to decide and not living in that sort of tumbleweed zone where we’re sort of feeling blown about by, by other people’s whims and other schedules and that kind of thing.

[00:51:08] And it, people who are, you can see what’s called maximizers or satisfiers. Maximizers are the ones. Do everything they can. They’re doing all the research. Should I order that hamburger, or should I order that tuna melt and what’s going to be better? And they’ll find, read reviews on online to see which one’s better.

[00:51:26] But the exhaustion that goes into that or the are just what’s good enough. And so kind approaching decisions with that in mind. And I think we, we have many occasions in our everyday life to practice satisfying. And so, you can just sort of help reduce your stress by. You know when you’re going to buy some salad dressing or some toothpaste just reaching for it blindly, just grab that one rather than sort of thinking, doing all the research.

[00:51:52] Should I get this one? Should I get that one? Because the problem with maximizing when we’re doing so much work, we’re pouring so much into these decisions, is we end up. With regret, and regret is a very complex emotion, but this idea should have, would’ve, could have, that we are sort of ruminating about, and we’re stuck swimming in that.

[00:52:13] And so it only makes us, it makes it impossible to joy to enjoy what we’ve chosen. And we’re also sort of living in this like liminal space of what, what we should have done otherwise. And so, I think being comfortable in with Satisficing, you know, it could be as much as what should I order for lunch? I think one of the, the best.

[00:52:30] treatments or antidotes for this also is gratitude what Dr. Jeste was talking about. It’s almost impossible when you’re practicing gratitude or thinking about what you’re grateful for to be regretful about something. And so just sort of being grateful that you even have an option and then choosing it and not looking back and thinking, Oh, I, you know, we’re looking at pictures of what you could have been doing or whatever.

[00:52:55] Samantha Boardman: Was the better choice to make. And I think being comfortable with that because, and understanding that even being disappointed is kind of a part of life and otherwise we can get stuck and ruminated it and then we can all get better at being satisfiers. a satisfier. How would you describe that to a person who’s never heard the term?

[00:53:12] Satisficing is a strategy of decision making where you’re, we are willing to make a good enough decision rather than striving for the very best decision because we, you know, put out a lot of energy and time and money, you know, sometimes looking to make the very best decision and we will. End up when we are, when we are maximizing, which is, you know, when we’re looking for the very best possible decision where we’re spending that time and money and energy and effort looking for that, we often end up disappointed, frustrated, and we idealize the alternative.

[00:53:42] Samantha Boardman: Like, Oh, if only I had done that, if only I had. Chosen this one and we end up sort of full of regret. And so, making peace with the good enough. Uh, and it’s not, this isn’t compromising, I think, or settling, but I think making peace with that good enough option can help us and be sort of one of those, those strategies, it really does, um, help us to be more decisive.

[00:54:05] Another one I found to be super helpful is looking at pre-mortem decision making. when if you are faced with a decision, you know, and you can look, you’re sort of imagining yourself into the future and you’ve made that decision and thinking, you know, and everything actually worked out, it was the wrong decision to have made.

[00:54:21] Sort of tracing back those breadcrumbs, thinking, what led you to do that? And so just as a way to be a little bit more thoughtful because. It’s something that we don’t, as psychiatrists, I think take seriously enough, is the ability to be decisive and how that contributes to our wellbeing. Because feeling passive, feeling like you’re a tumbleweed, feeling that life is happening to you is really devitalizing in every way, and actually sort of feeling like you’re in charge and taking control and having that sense of agency is really like a contributor to flourishing.

[00:54:50] And I think obviously wisdom too.

[00:54:52] I think when we talk about decisiveness, sometimes people confuse that with making quick decisions that’s actually not the case. Some decisions need to be quick. There’s no question about that. For example, for soldiers in a war, you know, I mean, they have to make instantaneous decisions, but most decisions in life are not like that.

[00:55:15] And what one should remember is that perfect should not be the enemy of good, that we strive her perfection when it is not possible. I mean, just like ideal is ideal because it is not achievable. So, we shouldn’t try to do that,

[00:55:31] Samantha Boardman: Well, I think sometimes there’s this sort of even allergy to feeling those negative emotions and that we’re just so reactive to them. So, we, we feel anger, we feel hostility, you know, we feel rage in some way and then, we’ll, it’ll bubble up in our behaviors.

[00:55:46] But, so really what, what I’m asking people to do then is not to suppress them at all. I mean, I think that’s probably one of the worst things we can do for our, our blood pressure and our heart rate. And we know long term, that’s not a good strategy for anybody. But just to be able to sort of shine that flashlight and say, What can I learn from this?

[00:56:07] How can this help me even re-go right now I’m feeling a certain way, but this is data. This is data that I can take in. This is information that is being fed to me. I mean, think of it as like you’re looking at a spreadsheet so I can turn my back on it. I can ignore. Or even, you know, I can repeat the same mistake over and over again, or what can I learn from this?

[00:56:33] And I, I really think if you can take that as data and information of like, maybe I’m deeply offended by this. Maybe this reminds me of something where I felt totally useless in the past. Maybe I, you know, that you can kind of understand it a little bit more, and I think this way you’ll get off the merry go round of just having these knee jerk responses to things when you understand where these emotions, like these underlying emotions are coming from.

[00:56:56] if you, you have a hypothesis. We always are. We have a hypothesis like, this happened because that person’s awful. Or you know, I have to wear a mask because the world is crazy. Or, you know, this person voted for that candidate because that, you know, that this person must also be an awful person.

[00:57:11] Samantha Boardman: You know, these assumptions that we make about the world and about other people, and actually like one of, I think the most important things to learn, and it’s really contributed to wisdom, is the importance of being wrong. and actually, you know, sort of celebrating that and even seeing, I mean, I think I’ve never been more gratified when I’ve made assumptions about a patient that probably, you know, wouldn’t be able to recover maybe from substance abuse or, , I didn’t imagine having a certain trajectory and running into them in the street several years later, and just the ability to be wrong, to acknowledge you’re wrong and we wrong all the time. We need to celebrate that more.

[00:57:46] Duff Watkins: I have a colleague who said, and I, it is a phrase he used one time, and I’ve used it ever since.

[00:57:51] If I’m wrong, I’m happy because I’ve learned, you know, we learned a better way. And so, I, I say that to myself, personally, uh, and frequently, to Samantha’s point, making an effort trying to investigate your own thoughts and feelings, it will lead you somewhere to something, and then you simply flash that light on it, and something will move within you. Something will shift, maybe a little, maybe or lot, but worth a try.

[00:58:20] Lesson 10: Look up, Find your own spirituality

[00:58:20] Duff Watkins: All right, well then let us proceed to, tip number 10.

[00:58:25] Look up, Find your own spirituality.

[00:58:28] Dilip Jeste: Yeah. So, so our original review of wisdom and the conference, uh, that we talked about did not include spirituality, mainly because this is somewhat controversial entity. So, after definitions of wisdom that have been used, If you look at the ancient definitions in the scriptures, of course all of them talk about not just spirituality, but religiosity belief in God organized religion.

[00:58:57] Spirituality is different from religiosity. You know, an atheist can be spiritual. So, to me, spirituality means feeling connected to something or someone that we don’t see hear or perceive. People may call it spirit or soul or consciousness or God, that doesn’t matter, whatever it is. But there are also, I find many people who actually strongly object to spirituality as a component of wisdom.

[00:59:25] My feeling is that part of that comes from the terminology, the word spirit is not really a good, good term. I mean, it is somewhat, uncertain, almost esoterical, and people have different conceptions of that. So, I wish we could replace that word spirit with something else. People will accept that because I do think that we all need to have a belief in something.

[00:59:49] That will not change in our own mind, not in reality, but in our own mind. We need that. We need that a source of comfort, no matter what the stress is at, that won’t happen with other human beings because human being, they have their own stresses, so they won’t always be able to support us. So, this concept behind is that having something or someone, whatever that you believe in.

[01:00:14] So when something goes wrong, instead of blaming yourself or I mean others, you said, that is, that was meant to happen. And actually, it is meant because it’ll lead to something good later on. So, I grew up in India. And in India there is belief in reincarnation and, Again, it’s not a question of whether it happens or not.

[01:00:33] I mean, not very likely it doesn’t, but that belief in reincarnation is actually very helpful because when people get old, when they get very sick, they’re about to die, they talk about what they will do in the next birth, and they talk about, We will, I hope that you are my spouse in my next birth. Or you’re not my spouse in my next birth, whatever, it’s

[01:00:58] So it gives you a feeling of continuity and that makes you feel good. There’s something you believe in. So instead of resorting to drugs or some other things that people do when they’re stressed out, what is wrong in believing in something that may or may not exist? People may not agree with that, but if that, for that person, that’s a sense of comfort.

[01:01:21] I don’t think there’s anything wrong with that. And actually, there are a number of empirical studies now coming out about not just spirituality, but religiosity that have clearly shown that objective majors show that religiosity. Is associated with better health, not just mental health, better physical health, cognitive function, and even longevity.

[01:01:43] And I think, I really think that that’s probably true. And the reason is not the specific religion or the specific belief it teaches. Having that source of comfort, belief, trust you have that cannot be changed for you. It is great to have that when you can go and approach that when you are stressed out.

[01:02:03] Samantha Boardman: And that, sense of, community that, you know, that that provides, but also the, those self-transcendent emotions that are so important to our wellbeing when, we’re not so self-absorbed or self-immersed when we are able to. transcend that. me, myself, and I sense of self, and I’ve always been fascinated by even those studies looking at atheists when you know something negative happens, there’s some negative life event that they too will often say, Well, you know, something happens for a reason.

[01:02:36] Like there is something, some kind of explanation that even somebody who unequivocally says, I don’t believe in any of this stuff. Does sort of seek some other explanation, something larger than oneself. And, and you know, we know that it’s actually helped people manage the pandemic that, to get through that.

[01:02:56] And it’s, been valued. And I guess it’s really the question comes down to how do we define spirituality or, or religion if it’s not in a formal way, but it’s, um, in a way somebody experiences, in their community and with self-transcendent experiences.

[01:03:12] Duff Watkins: Okay, I think we will finish there today. You’ve been listening to the podcast 10 lessons. It took me 50 years to learn. My name is Duff Watkins and our guest have been Dr. Dilip Jeste, neuropsych psychiatrist at the University of California, San Diego, and also Dr. Samantha Boardman from private practice at Manhattan.

[01:03:29] She is the author of the book. Everyday vitality, turning stress into strength. And Dr. Jeste, author of the book Wise, The Scientific Roots of Wisdom, You’ve heard from us. We’d like to hear from you. You can email us podcast@10lessonslearn.com

[01:03:45] and while you’re at it. Go ahead and get to subscribe button because this podcast is the one that makes the world a wiser place.

[01:03:51] Lesson by lesson.

 This episode is produced by Robert Hossary. Sponsored as always by Professional Development Forum, which office insights, community or discussions, podcasts, parties, anything you want here, but they’re unique and it’s all free online. You can find the www.professionaldevelopmentforum.org you’ve heard from us we’d like to hear from you. Email us it’s podcast@10lessonslearned.com. Remember, this is the podcast the only podcast. That’s makes the world wiser lesson by lesson.

 
Dr Samantha Boardman and Dr Dilip Jeste

Dr Dilip Jeste and Dr Samantha Boardman – Build the Habit of “Good Enough”

Dr Samantha Boardman and Dr Dilip Jeste discuss the techniques you can use to be wiser. Hosted by Duff Watkins

About Dr Dilip Jeste

Dilip Jeste is a neuropsychiatrist and professor at the University of California, San Diego.  He is author of Wiser: the scientific roots of wisdom (and 13 other books).  His 625 published scientific papers are among most cited in the world (he’s in the top .5% of publishing researchers).  He was the first Asian-American elected President of the American Psychiatric Association in its 175 year history which has over 40,000 members.  He is listed in “Best Doctors in America.”

About Dr Samantha Boardman

a New York based positive psychiatrist, who is committed to fixing what’s wrong and building what’s strong. Positive Psychiatry takes a more expansive approach, focusing on the promotion of wellbeing and the creation of health. private practice in Manhattan. published papers in journals including Translational Neuroscience, Nature Reviews Neuroscience, The American Journal of Psychiatry, and The Journal of Clinical Psychiatry. I’m also a frequent contributor to Psychology Today, The Wall Street Journal, and Thrive Global, and a guest on the Today Show and Good Day New York. Author of Everyday Vitality: turning Stress into Strength. Founder of PositivePrescription.com

Episode Notes

Lesson 1: What would X do? 02:46
Lesson 2: You won’t be wise until you regulate your emotions 09:48
Lesson 3: Move towards, not away; be pro-social not anti-social 16:53
Lesson 4: Practice compassion (start with yourself) 23:10
Lesson 5: Affirm a Value Today 32:16
Lesson 6: Think Best, Worst, Most Likely (accept uncertainty) 39:39
Lesson 7: Re-frame the meaning of so called ‘bad’ events 44:12
Lesson 8: Build the Habit of “Good Enough” 50:41
Lesson 9: Be Your Own Emotional Detective: channel your inner Sherlock Holmes
Lesson 10: Look Up! Find your spirituality 58:20

 

Dilip Jeste and Samantha Boardman

[00:00:00]

[00:00:08] Duff Watkins: hello. Welcome to the podcast, 10 Lessons that took me 50 years to learn, where we usually talk to leaders and luminaries and politicians and pundits and ask them about their life lessons today.

[00:00:19] However, I Duff Watkins, the host, wanted to do something different. I got to wondering. How can I be wiser right now? I want to be wise right now. It’s why I came up with the idea. I know. I’ll ask a psychiatrist who wrote a book about wisdom. No, wait. I’ll ask two psychiatrists who wrote books about wisdom that way.

[00:00:38] I can’t go wrong.

[00:00:39] And they’re with us here today. Dr. Dilip Jeste as a neuropsychiatrist and the professor at the University of California at San Diego. He is the author of Wiser the Scientific Roots of Wisdom. He’s on the West Coast, on the East Coast as Dr. Samantha Boardman, who is a positive psychiatrist.

[00:00:57] She’s going to explain that in just a second. She has also written numerous articles for academic and popular press, and she is the author of Everyday Vitality, Turning Stress Into Strength. You can find out more about her and her book and her blog on the website, positive prescription.com. Welcome Dilip. Welcome, Samantha.

[00:01:17] Dilip Jeste: Thank you, Duff.

[00:01:19] Samantha Boardman: Thrilled to be here.

[00:01:21] Duff Watkins: Samantha, I’ve worked with many psychiatrists. I’ve never come across one who is a professed positive psychiatrist. Is this something new? Tell us more.

[00:01:29] Samantha Boardman: Well, it’s been around for a little while. I’d say positive psychiatry is a close cousin of positive psychology

[00:01:37] And it was, you know, we are in the presence of Dilip Jest who really pioneered positive psychiatry when he was president of the American Psychiatric Association.

[00:01:47] Asking the questions really is that should psychiatrists be as concerned with wellbeing as we are with illness? And we had been so focused for so long on pathogenesis, the, the study of disease and the lessening of symptoms and the treatment of, illness. But what about focusing on Salutogenesis, the creation of health?

[00:02:09] So, positive psychiatry really in a nutshell is the science and practice of psychiatry that seeks to understand and to promote wellbeing through assessments in interventions. And it aims that enhancing behavioral and mental wellness, um, as well as mental health outcomes that we measure.

[00:02:26] Duff Watkins: And I’m glad that you mentioned that Dilip, is the former president of the American Psychiatrist Association. He was the first Asian American person to be president of that organization, and it only took him 175 years to get around to doing that.

[00:02:41] Let’s start with the 10 ways to become wiser now.

[00:02:46] Lesson 1: What would X do?

[00:02:46] Duff Watkins: Lesson number one. This, I think this is yours, Samantha, what would X do? Ask yourself, what would X do?

[00:02:55] Samantha Boardman: Sure. I mean, this is really to help with one of the sort of pillars of, wisdom and being wiser, and that that is about social decision making and asking yourself, what would X do?

[00:03:06] Performs a number of functions for us because when we’re stressed out and we’re overwhelmed, we often self-immerse. We get sort of so lost as we’re swimming in our own emotions is that it’s very hard to have any perspective. And we know this from ancient wisdom as well. There’s, um, King Solomon who was known for his tremendous wisdom and giving advice to others. But when it came to his own personal life, it was sort of a train wreck So when we sort of are able to distance ourselves, and that’s really what the psychological mechanism is, is when you’re able to distance yourself from your emotions, you’re able to gain some perspective.

[00:03:42] And one way to do that is to think of somebody you admire. Think of somebody who you have a tremendous respect for who could sort of help solve this problem. So rather than thinking about, you know, what do I Samantha want to do? Think of, you know, what might Michelle Obama do in this moment? Or it might be some, you know, they’ve done this study even looking at, at children.

[00:04:03] asking them to think of a superhero what would Batman do right now? And this actually helps them when they’re even given a tempting video game to play. Versus, you know, stay on task and do sort of a tedious math problem. If they’re channelling in almost, you know, impersonating that, that that character that they admire, they’re much more likely to do it.

[00:04:22] Samantha Boardman: So, if there are any parents out there, you know, maybe think, ask your kid if you want them to clean your room. What would Dora the Explorer do right now? But just to kind of help distance ourselves from our own immediate emotions. It’s a. A tremendously effective way to gain perspective and clarity and have that sort of 30,000-foot, vista to look down on, rather than when we’re so immersed in our emotions.

[00:04:45] Duff Watkins: What’s your take Dilip?

[00:04:47] Dilip Jeste: Yeah, no, I think Samantha gave really beautiful description of, deciding for yourself what would

[00:04:53] you do, um, and what would somebody else do. So, I’m want to look at it now from a different perspective at social advising in the sense, whom do we go to seek advice. Just like Samantha mentioned, we think about what would Michelle Obama do.

[00:05:11] So typically when people have questions who do they approach? Typical large family, it would be often the grandma not because she’s the most educated person, but because she’s the wisest person, she has a lot of experience. In a village, people go to the village elder, or we talk about senior statesmen for the country.

[00:05:31] So who is this person who is good at giving advice? Obviously that person has to be wise. A wise person who doesn’t give advice to others is not wise because one of the characteristics of wisdom is to help others. So, the wise person must be there to help others. So why do we choose somebody to go to?

[00:05:51] Because we expect that person to be so well regulated emotionally and otherwise that that person would give conflict free advice. The person would give advice that is not necessarily in his or her selfish interest, but what would be good for you. The person is objective. He has a lot of experience.

[00:06:11] Somebody we trust, somebody we respect their thinking. And these are things where we can’t do ourselves, you know, just like, uh, suppose Samantha and I are physicians, uh, and we take care of ourselves. But if we have some bigger problem, we will approach another physician. Lawyers would choose some other lawyer to represent them.

[00:06:30] Right. So, we need some outsider to help, And that outside person is somebody who is following social advising.

[00:06:38] Duff Watkins: Social advising.

[00:06:40] And so, you’re describing a person that is, Integrated enough themself, they’re together, you might say in English slang. They’re so together that you can go to them, and they’ll have something to say.

[00:06:52] Now, they may not be older than you, but they have some degree of, um, well, I’ll just use your word again. Integration that makes them, a worthy source of information.

[00:07:02] Dilip Jeste: That, That’s exactly right. I don’t think the age matters here. older people, uh, are more helpful because I have tons of experience, but that not necessarily the case.

[00:07:11] Again, the wiser person can be younger, than others because he has experience often through different ways if not personally, by watching others, uh, who have had that experience and being a good leader, so on.

[00:07:26] Duff Watkins: So, it’s, it isn’t the age, it’s the experience which contributes to the integration of the person.

[00:07:31] I have, an example of that as I was thinking about that.

[00:07:35] There’s a, is a true story. Remember the movie Sleepless in Seattle.

[00:07:40] Samantha Boardman: Yes. Yes.

[00:07:42] Duff Watkins: I think everybody on the planet except me has seen it. But I was talking with, or Jeff Arch, the guy that wrote the screenplay was telling me a story, a, a group of us and he said when his first child was born, it was a very difficult pregnancy and his wife was in danger at risk and there’s a lot of pressure on him, financial, family, and he was freaking out, and then he did exactly what you’re prescribing.

[00:08:07] He said,

[00:08:08] What would a hero do? If I was writing this scene? What would a hero do? If I’m going to write this screenplay, what, what action would they take? And he said he felt a calmness and assurity of mind descend upon him. And it’s the phrase that you’re using, Samantha, or the phrase I use is a Zen-like detachment from it so that the situation doesn’t overwhelm you and that somehow lead you to a calmness that helps you make.

[00:08:36] Well wiser decisions and it turned out well for Jeff and his and his wife and his family. So, I’m pleased about that. But, uh, the point is it works when you ask yourself, what would X do?

[00:08:47] Samantha Boardman: Yes. And there’s a certain amount of imagination, I think, and creativity that that invites. And I think, you know, Dr. Jeste writes about this in Wiser as well, is even when we engage with our imaginations and we sort of plant ourselves in the life of someone else, or even in those decision making positions that they have, and you, you watch a movie, you read a work of fiction and you sort of expand your emotional repertoire in some way.

[00:09:15] And those exercises, you know, in doing that I think can really help us reimagine our emotions and our decisions and, and kind of bring to it a different set of, you know, not just sort of overwhelming, wait, I’m swimming in this but actually perspective. And so, I think those can all be exercises in self distancing and.

[00:09:35] That sort of Zen like perspective you’re talking about?

[00:09:37] Well, I can tell you what I’m going to do. When I feel overwhelmed, I’m going to ask myself, what would Dilip Jeste do? And then I’m going to know the right thing.

[00:09:46] Duff Watkins: do that.

[00:09:48] Lesson 2: You won’t be wise until you regulate your emotions

[00:09:48] Duff Watkins: Point number two, you won’t be wise until you regulate your emotions.

[00:09:55] Samantha Boardman: So emotional regulation is obviously, I think a key component of wisdom and there are different strategies to regulate one’s emotions, but there’s the Dr. Gross model of emotion regulation and the process model of emotion regulation. And this idea is that you can sort of using flexible strategies

[00:10:15] When you regulate your emotions and so before you have an emotion, you can, There’s a sort of a way, like a continuum to think about before you even the emotion hits you. You can first, you can situations select, right? You can decide. For instance, if you were invited to go to a cocktail party where your ex is going to be, you could choose not to go.

[00:10:38] And then once you’re at the party, you could situation modify meaning in that context. Like what else could you do? Maybe that would be, I could go up and talk to that person, or I could choose not to. Then the next phase of sort of emotional, regulation would be attentional deployment. What am I going to attend to?

[00:10:56] Maybe I’ll go and watch karaoke over in the corner, or maybe I will just watch my, ex flirt with his new partner. And then the next stage of that is reappraisal. What can I learn from this? How could I see this differently? I could be furious about this, maybe. I should be happy. He’s happy. Um, something like that.

[00:11:13] And then the next phase would be how are you going to sort of, what will you, once the emotion is underway, how will you modulate it? That may be like, I’m going to hit the bar. I’m going to, go and like, go home by myself and cry. Or I’m going to suppress my emotions and dig into them. So, these are all different strategies.

[00:11:31] Some are before the emotion hits you, some actually occur afterwards. One could deploy. And the key is it’s all about flexibility, right? So, it’s not to say this is the one you should use all the time, but I think it’s, it was Aristotle who had said to feel these feelings at the right time, on the right occasion towards the right people and for the right purpose, um, and in the right manner.

[00:11:53] Like that’s sort of what counts. So, you have all these different strategies to regulate your emotions. And I think when we are a little bit thoughtful of, you know, sometimes if somebody cuts you off in traffic, like your emotions already underway, And you can choose to sort, you know, go into like maybe your knee-jerk responsive rage, but how else can you channel these emotions?

[00:12:13] And I think looking at situation selection, situation modification, attention deployment, reappraisal, and yeah, then emotional modification. Are just strategies and they sort of give you a buffet table to choose from.

[00:12:27] Duff Watkins: And your point is that there is tremendous choice available to us. I use the Smorgasbord model myself.

[00:12:34] I mean, all these emotional responses that we have, and most of us just go to the smorgasborg and choose the same damn thing over and over again. We’re not, we’re not very adventurous

[00:12:43] Dilip Jeste: Okay. Some of that described very well, sort of what do you do before the emotion hits you? Uh, and that’s really important. I want to think more about sort of what happens after the emotion hits you and you are overwhelmed by the emotion and, uh, My favorite example something in very common in California is road rage.

[00:13:04] Uh, you know, I’m going to my work. I’m already a little late and somebody cuts in front of me. I’m so mad. I’m so upset. that I start, screaming, cursing, tailgating, uh, and I’m just so angry. What, who is this jerk? I mean, why did he do that? And that really doesn’t help because. The risk is that, uh, if I continue this, actually I could have an accident and that could create far more problem.

[00:13:30] So how do I control that? So, the natural reaction is there, I think, most of us would be angry when somebody get in front of you when we are in a rush to go, But that’s the time. Then how do we control that very quickly. So how do you do that? The first and most important thing is, I think, thinking about the motivation for the other person for cutting in front of you.

[00:13:52] mean, I feel angry when somebody cuts in front of me because I feel personally insulted that that guy didn’t think highly of me, or he wanted to show off and he just rushed in front of me. But that may not be the case. So, what, why would the other person have cut in front of me and. Maybe that there’s a child sitting in the back of his car and suddenly the child had a seizure, or the child started throwing up, something like that.

[00:14:18] If that happened, what would you do? If you were doing that, you would also cut in front of others because you just want to rush to the emergency room or some of the place where you need help. So, if, and whether that is a real reason or not, that doesn’t matter, but you, because you don’t know the real reason.

[00:14:32] I mean, because you haven’t talked to that person. So, you’re imagining the real reason as being something bad for you, but it could be something that the other guy needs to do. So, if you think about that, then initially your anger goes away. Because you realize that Actually, no. I mean, this is something I was wrong in getting, mad at him that he needed to do that.

[00:14:52] Dilip Jeste: So that’s one. second is just distraction. If you’re listening to some music on the radio, just increase a volume. Think about that. But the third is accept the fact that you’re angry. You have a right to be angry, but let us move on. Because that anger is not going to help you. so emotional regulation is really both anticipating what would happen, as Samantha said, but also then when it happens, then controlling the emotion and what has to do that.

[00:15:19] I mean, that should become second nature. Uh, then only it will succeed

[00:15:23] Samantha Boardman: And it’s so interesting the way that I think our coping strategies are often counterproductive. And as you alluded to earlier

[00:15:29] too it’s sort of, it’s because it’s habit and sort of when we can uncouple those, those habits, and Dr. Jeste sort of alluding to this whole idea of correspondence bias. We judge ourselves by our thoughts. You know, I’m a good person. I’m cutting this somebody off because I’m late to visit someone in the hospital. But you know, we judge other people by their actions. And I think when we keep that in mind, that correspondence bias, this disconnect between, you know, how we judge ourselves by our thoughts, like, I’m really a good person.

[00:15:56] The reason I cut them off is because of this. But that guy cuts me off. You know, I’m enraged by that. That it, I think it again, puts those things, those sort of, once those emotions are underway into perspective, I mean, I think you’re still mad, but at least you have like sort of a sense of, wait, maybe I am jumping to conclusions.

[00:16:12] I am catastrophizing here over generalizing and just making assumptions based on this one action. And it’s to be used. That movie reference, there was that movie about the spy, and I remember him saying like when he was very worried and Tom Hanks was saying, Well, aren’t you anxious?

[00:16:26] Aren’t you worried? And he would say, Why would it help? And I think that that’s sort of a, a part of, um, a part of what we can learn. Like would that emotion help? Like, would that rage help? No.

[00:16:36] Duff Watkins: I have, uh, learned to do the opposite of that I have when somebody’s trying to come in. I like to imitate the Pope and give them that little wave, you know?

[00:16:45] Yes, my son, you may come ahead of me, and it just makes me feel so superior to them.

[00:16:53] Lesson 3: Move towards not a way. Be prosocial. Not antisocial

[00:16:53] Duff Watkins: All right. way number three. Move towards not a way. Be prosocial. Not antisocial.

[00:17:02] Dilip Jeste: Yes. I think you know of all the components of wisdom, the single most important component is prosocial behaviors, and that includes empathy, which means understanding and sharing somebody’s emotions of thought and compassion where you go out and help the other person.

[00:17:19] And that’s really critical for human society. We are a social species. We need compassion not only to survive, but also to thrive and flourish. We can’t do without. Compassion. And yet, compassion is sometimes harder because of this. It conflicts with a selfish interest, but this is something we need to practice consciously.

[00:17:42] So I think about three things actually one can do to increase the level of compassion towards others. One is what is called gratitude journal or gratitude diary. So typically, it means that before you go to bed, write a couple of things that made you feel grateful because some stranger helped you, but that’s not enough.

[00:18:02] I think we should also write a couple of things that made us feel proud of ourself because we help somebody else. So, we should be grateful, but we should also be proud of our ability to be compassionate and. It’s not a question of writing these things because I know many people don’t like to write this gratitude or diary or something, so you don’t have to write it.

[00:18:21] You can share your experiences with somebody. you can talk to your spouse, partner, friend, colleague, or you can even just record it, whatever it is, but just make a habit to do that. The second thing is volunteering. Set aside some hours in a week when you do something that’s not a part of your work.

[00:18:40] And whatever is feasible, of course, and whatever you enjoy, whether it means spending time in a nursing home to help some people with dementia or to work in a foster care home or place where there are children with, uh, autism spectrum disorder. When you do that even for a few hours a week, that makes those people feel very good.

[00:19:02] You feel proud of yourself. And your self-esteem goes up because you know that you’re helping others and they’re appreciating that. So volunteering is really important. And the third thing I stress is meeting people who are different from you, different or different in the color of your skin. different, in their age or, uh, different in their beliefs, whatever it is.

[00:19:26] Because typically we are brought up in a family and then in a community where most people are like us, you know, we go to school, and encountering people who are different from us is hard actually, because we are not used to that. And so, the initial reaction to that is sometimes fear, sometimes oftentimes anxiety, and sometimes anger.

[00:19:51] And the way to overcome that is, again, understanding those people. So just by meeting with them, we can understand sort of where they’re coming from, what is their rationale, and once we appreciate that, we don’t have to agree with them, or they don’t have to agree with us. But we have better understanding and more acceptance of the fact that they can have different, processes.

[00:20:12] I think that’s important for improving our compassion.

[00:20:15] Duff Watkins: So, gratitude, diary, volunteering and hanging out with people who are different than, than me, than you. Good sense.

[00:20:24] Samantha Boardman: No, I, I mean, I wholeheartedly agree with Dr. Jeste just said, and I, I think that In the West we really interiorized wellbeing this idea that like, sort of everything happiness comes from within and that. It’s such a narrow way, I think, for us to be thinking about our wellbeing.

[00:20:41] And really happiness comes from with doing things with others, for others and in the you know, in the service of something larger than what we are. And it’s with immediate loved ones, you know, It’s obviously with the importance of friends. I also think we value so much in the west.

[00:20:58] Our romantic partners and our immediate family and not considering how the importance of having friends and actually the importance of having friends and having great friends is also very good for marriages and, romantic relationships and also strangers, you know, people. And as, as Dr. Jeste also, comments on is people we don’t know.

[00:21:17] And in theory, I think in our imaginations, people who are different from us are much scarier, but it’s when we break bread. We’ve seen studies show that you can really reduce bias by encountering somebody, actually meeting somebody, having a coffee with somebody who is different than you are. A lot of those fears are dispelled, and certainly when you share something, share a meal, share a coffee, that also sort of helps dissipate it.

[00:21:39] But, prosocial acts, I mean, probably the most reliable. contributor to our wellbeing. And it’s not just, we know that it’s a, we have a fundamental human need to belong and to be valued, but I think also we have a fundamental human need to add value. And wisdom is really at the nexus of that because it is, you know, you, you see an individual’s qualities that can make them wiser, but also in the context then of, of their relationships, their occupation, their communities, that expanding world that they inhabit.

[00:22:13] And engaging in those pro-social acts. And what’s so interesting is people often forego opportunities to behave pro socially or to do something for someone else because they don’t think it’s going to make a difference. They think the person won’t notice or it won’t matter to them. And I say, I think there’s so many everyday opportunities that we’re not taking, or we assume we’re going to be just too hard or overwhelming, but as you said, sometimes it can be just, you know, waving the person in front of you in traffic.

[00:22:38] It can be sort of in these little micro moments of kindness in these small gestures. It can go a long way. And when people are actively engaging in those pro-social gestures with adolescent. Teenagers. The study was shown that, you know, even a month later, then they’re much more actively prosocial. It’s almost like a, a putting on a different pair of glasses and because it also makes them feel good.

[00:22:57] Duff Watkins: So, are you too suggesting that staring at my phone night and day when I’m at the dinner table or with other people is somehow less than Prosocial?

[00:23:05] Samantha Boardman: That’s definitely a vitality vampire.

[00:23:10] Lesson 4: Practice compassion, starting with yourself

[00:23:10] alright, way to wisdom number four, practice compassion, starting with yourself.

[00:23:18] Dilip Jeste: Yeah, I mean, this is, self-compassion is really part of compassion. We don’t often realize that, that when we talk about compassion, we talk about compassion to other, and that’s critical. Absolutely critical. But. Being compassionate to oneself is actually equally important. Um, you know, the usual example I give as people know that is, you’re sitting in a plane, the plane takes off, and the security video comes on and it says that, uh, if the air pressure falls, the masks will come out and put on your own mask first before helping others.

[00:23:53] And you say, How can you do that? There’s a child sitting on one side and a disabled person on the other side. You’re in the middle seat. How should you help not help them before helping yourself? And the reason is, of course, that it’ll take just a few seconds for you to put on your own mask, but then it’ll give you enough time to help the people on both sides and even others if needed.

[00:24:16] So we had to take care of ourselves before we can help others. I mean, I see we all see some very compassionate people, whether they’re priest, physicians, or others. Or very compassionate toward others, but on themselves, they don’t forgive themselves. That’s not a good idea. because your own wellbeing is important to allow you to help others and the ways to help with the self-compassion, there are several ways.

[00:24:46] One is, the sense of common humanity. If you make a mistake, Don’t blame yourself too much. Everybody makes mistakes, so accept the fact and then really find out why you made a mistake, how you won’t make the mistake next time, but don’t spend too much time and energy just criticizing yourself. You got to move on.

[00:25:06] Second is self-kindness. When a friend comes to you in a stressful situation, you say, Oh, it’s okay. Just calm down. If it’s all right, you know, things will get better. Why don’t you do that to yourself? So, there should be self-kindness. And the third thing is realizing that no matter almost what happens, but we have been there, and we have done that, and something goes wrong.

[00:25:28] It looks like it’s the end of the world. No, it’s not the end of the world. Things will come out and, One example of this actually was during Covid pandemic, both. Samantha and I are geriatric psychiatrist and, geriatric psychiatrists were very worried about what is going to happen with the older people because they had a very high risk of physical complications.

[00:25:48] They were more likely to be hospitalized, intubated, and die. Also, they didn’t have access to technology, unlike younger people, or they were not familiar with technology. So younger people, the social distancing guidelines didn’t impact too much because they could still connect with others. Older people couldn’t do that, so older people were at high risk, of feeling anxious, depressed, stressed out, you know, what happened?

[00:26:14] Numerous studies showed that older people handle Covid much better than younger ones. There is a study that was published, uh, recently in one of the journals, they found that 15%, one five, 15% of people over 65 had stress, anxiety, or depression. What was the incidence in younger people? People within 18 and 25?

[00:26:39] 75%? The younger people, although they had no physical problem, although they had access to all the technologies, very sophisticated, they were five times more likely to experience depression, anxiety, and stress. And one of the main reasons we talked to several older people that we worked with, number of them said the reason was.

[00:27:00] They knew that they have been there, they have been through that, and they have done that. They have experienced other crisis, like war, uh, or drought, financial recession losses. So, for them it was not the world’s worst thing to happen. For many younger people, it was. So that’s a good way of looking at self-compassion is knowing that you have been through stresses, you came out of that, and you’ve come out of this also.

[00:27:28] Samantha Boardman: And that dovetails so well with, you know, those studies looking at. Young people who know the arc of their family story, they know that there have been good times. They know that there have been really challenging times that they know that their family went through this really difficult. Phase their great grandparents, had a very difficult time and they, they know the arc and the ups, and the downs actually are also more resilient.

[00:27:54] Um, having that sense of a family history, because like, I think again, it gives them some sense of context. And it’s Daniel Gilbert at Harvard who talks about. This idea of having compassion and self-compassion, that the key to having it is, is courage, even more than kindness because you have to have the courage to be willing even to, to see into the nature and the cause of suffering of your own or for some of, of somebody else’s. And we often have these sort of, you know, I think we’ll, we’ll sort of end up in these thinking traps or catastrophizing or overgeneralizing. This is the worst possible case scenario.

[00:28:29] You take things personally, it seems permanent, it seems pervasive. Nothing will ever get better. And I think that explanatory style that, that, you know, well, maybe this, you know, it’s temporary, maybe. Is there something I could learn here? You know, maybe this other pandemics have ended, that kind of thing.

[00:28:48] And I think when you sort of do treat yourself as one, would a friend, it almost reminds me of that new Adele song Go Easy on me. Like, can you go easy on yourself in some way. one strategy or one exercise I’ve used with patients is just arguing with your inner critic saying, you know, what evidence do you have for that?

[00:29:04] And is this sort of trying to sort of be a lawyer there and say, you know, is this a fact or an opinion?

[00:29:09] Duff Watkins: On a previous podcast I had Dilip quoting Michael Jackson. Now I’ve got you quoting Adele. So Well, okay, now, now that reminds me of something. The Dali Lama was at a, no, I think a US university.

[00:29:23] And somebody. Participant in this seminar that they did not like themselves. They felt bad about themselves, and the Dali Lama was absolutely astonished because it was such a weird concept for him. So, he went around the room, and everyone pretty much said the same thing, that they didn’t like themselves very much.

[00:29:44] They felt bad towards themselves, and he thought this was so totally abhorrent in nature and of course. He’s right, because it is, and yet it is so, so very, very common. And that’s why I think the importance, two important things about this, this way is yes, practice, compassion, start with yourself cuz you’re probably the person that needs it most.

[00:30:07] And the other thing that I wish to underscore, and I’d like your comments about this. To me the most important word in that phrase is practice. Practice. So, practicing compassion, starting with yourself, does that ring a bell with you folks?

[00:30:19] Dilip Jeste: Yes, absolutely. I think all these good things we talk about that we need to do; they should become second nature. Then only we will succeed. I mean, if we had to think about that and practice it are once in a while, that’s not going to work. I mean, good example is physical exercise, right?

[00:30:38] I mean, if you do a lot of exercise one day and then, uh, are sedentary for the rest of the week. That’s not going to help at all. So too small. Increase the amount of things you do, but you must practice it continuously. No question about that.

[00:30:54] Samantha Boardman: Yeah, I would think that wisdom is a verb. You know, it’s something that one has to sort of practice and do on a daily basis, and I think even sometimes it’s like Groundhog Day for many of us, even though we know something makes us feel better or we know that.

[00:31:08] this is important. We still might not do it. I think we underestimate sometimes just how unbelievably lazy most of us are. So sometimes how important it is just to make that thing that you want to do easier to even at once a week have a sort of check in. State of the Union, am I doing those things that I, you know, claim to want to do? There’s an exercise that Robert Brooks has written about asking, what three words would you hope that your children or your partner, or your friends or your co-workers would use to describe you?

[00:31:39] Samantha Boardman: And, um, Then what do you do on a regular basis to invite those, that those descriptions of you? And then the third question is, what do you think? What words do you think they would actually use to describe you? And then the fourth part of that is, you know, how could you close that gap and have more overlap between you know, what you do and how they experience you as well.

[00:32:02] Just the idea really around that being like, are we walking our walk? Are we affirming our values? Are we embodying what we care about in, in an everyday way? And I think it is, it is a, a practice. And that’s why I think wisdom truly is a, is a verb.

[00:32:16] Lesson 5: Affirm a value today

[00:32:16] Duff Watkins: Which takes us to. Lesson number five, Affirm a value today. My first question is, what’s a value?

[00:32:25] Samantha Boardman: you know, people often will tell me when we do, I often, on the first time I meet them, I’ll ask them to do some kind of values, affirmation, exercise, say name three things you value most and it’s something people don’t think about, they don’t reflect on.

[00:32:39] And I’ll usually then sort of give them a list and ask them just like, what is most meaningful to you? What do you stand for? what matters most to you? and just asking them to come up with a list. Maybe it’s their health, it’s their a relationship with friends, family, their being, being creative, being artistic, whatever those sort of three to five core values. Identifying them and then also describing like, why is this important to you? Why is this meaningful to you? And this isn’t just hollow sort of self-esteem boosting work. It’s really kind of asking them to reflect on, on what matters. And then I often will ask them then, all right, how do you spend your time?

[00:33:18] Or even especially your free time, and what did you do for instance, on Saturday? And, you know, they say, Well, I fell down this, you know, internet hole and I lay in bed. Or I, you know, I wasn’t sort of doing those things that, that I do value. And then kind of trying to create more overlap between what you deeply value and hold dear, and, and that that helps you feel that that’s the core of who you are and then actually what you’re doing and that you’re walking your walk.

[00:33:45] And to go back to this idea of positive psychiatry, It’s not just sort of, I think we’ve been so focused on what’s the matter in traditional psychiatry, What’s the matter with you? And then this is really looking at what matters to you. And having our, our patients and, and having all of us, I think, can benefit from doing more of what matters.

[00:34:06] And that’s really, I think what the sort of values, uh, affirmation exercise is about.

[00:34:11] Dilip Jeste: Yeah, that, that’s really very well said. exactly. I think this is, uh, we don’t ask people, and again, as physicians, the questions we ask is, So what brought you here? What is wrong with you? What are the symptoms? We never ask them, What do you like about yourself?

[00:34:28] What are your strengths? What would you like to do? And because the value is also in a way related to the purpose in life, that if we value something highly, that really becomes a purpose in life for us to achieve. But we don’t think about that. Most people don’t. And you know, we just asking that question actually sets these things going.

[00:34:49] And sometimes just actually asking a question, assessment itself becomes intervention, right? So, for the first time, Wow. I mean, nobody asked me what my strengths were or what my values were or what my purpose was because then you set up, start prioritizing things. I mean, we all have to do a bunch of different things to survive, but there are other things which we really enjoy, and we don’t think about them.

[00:35:12] So this kind of questioning is really helpful, to set up self-reflection. And just as you are talking, earlier about, making it, habit, so saying practice, I think this is especially necessary for self-reflect. You know, we set aside time for physical exercise. Most of us too, you know, that at least five days a week in the evening, or three days a week or in the morning, whatever, Why don’t we set aside time for self-reflection.

[00:35:40] It doesn’t need to be huge amount of time, but let’s say half an hour, twice a week, once on a weekend, once on a weekday, and where they think about ourselves, what we have been doing, what made us happy, what made us stressed out. If we do that, we’ll understand ourselves better because there is a pattern of things that emerges.

[00:36:00] We sort of similar things that. Make us stressed out and similar things that make us happy, but we don’t think about that. So just thinking about that, actually we’ll bring them to the fore. We’ll start to understand the pattern, and then we can do something to change it as needed.

[00:36:17] okay. Let me explain to you the problem with all that.

[00:36:20] Duff Watkins: Right now, I’ve lived in Australia for 40 years. I’m not in Australia. I’m in Brazil at the moment, but here is the problem I’ve had over and over again. I’ll tell it as a joke, but it’s true. I could give a blank piece of paper and a pen to an Australian kid or adult, and I say, Write down five things you like about yourself.

[00:36:39] And they’d go, Ah, gee, do I have to, Now I could do the same exercise with an American kid or an adult, and the American kid would. I’m going to need more paper. I’m just, I’m just going to need more paper, man. I mean, just this one sheet, you know? So, it is just really difficult for some people to, you pose that question, but they got no answer.

[00:37:03] So, so what do we do then? How do we help them articulate and get in touch and, and espouse these good things they have within them?

[00:37:11] Samantha Boardman: One question that I’ve found to be helpful to sort of dig through that is, you know, tell me about a time when you were at your best. Tell me about like a moment where you were really proud, you know, of, of something you did, where you felt you know, strong and that you felt proud and that you could describe it.

[00:37:27] Can you even write about that if they can write even a paragraph about it and then kind of pick out like, well, That, that, you know, you’re so animated as you speak about that. Can, can we, we hear more about that? Wow. It sounds like you were really being creative if you did that, or that was, I mean, most people when they talk about this, it’s really, it’s so rarely individually based.

[00:37:45] It’s always in the context of others. Even, you know, when people ever come to see us. It might be because they have a problem, but then you realize it’s always somehow inter relational in some way. But it’s also when people are truly at their best, even asking people who are psychotic, you know, asking them about like, tell me, even on the unit, what was something that was good that happened this week.

[00:38:05] It’s always, Well, you know, I made this piece of, I made this drawing, and I gave it to somebody else here. The nurse really liked it. You know that there’s something that is reflected back to them. Again, that goes into this idea of that not only are they valued, but they’re adding value somewhere else, and that really is the definition of mattering in the world.

[00:38:23] And so if we can sort of maybe through the back door get to that, those, those values, and maybe it is telling you about a time that you’re at your best or. What are you looking forward to this week? What are you going to do again, closing that intention, action gap for them, so it’s not just something that’s living in your head.

[00:38:40] And I think Dilip and I both feel really strongly about this, that happiness isn’t just in your head. It’s sort of in the actions you take and the connections you make and how you participate out in the world. I think Samantha makes a very real terrific point that you need to think about the situations.

[00:38:55] Dilip Jeste: I think when we ask an abstract question like what you like about yourself, it’s really hard to think about that. But if you ask about situations in which you like yourself most, You were most proud of, most happy with. That actually helps because they’re the stories that they remember. And so same thing applies again for self-reflection, where you think about what stressed you out and what made you happy.

[00:39:21] So again, if you do that regularly, we start realizing what are our strengths and what are our limitations. And they might be different from what we were thinking about because now because we are associating them with specific situations, You can see a pattern emerging.

[00:39:38] Duff Watkins: Okay. Okay.

[00:39:39] Lesson 6: Think best, worst, and most likely

[00:39:39] Duff Watkins: Well, let’s proceed to way number six.

[00:39:43] Think best, worst, and most likely. That is to say, think in terms of what’s best, what’s worst, and what’s most likely to occur.

[00:39:53] Dilip Jeste: let me answer that question. So, this really is a question of accepting uncertainty. and in a way this goes to issue of humility, which is that if I think that I know the best and I know what will happen, obviously I’m wrong because I don’t, there is so much uncertainty because I don’t know so much.

[00:40:17] Let alone being able to predict something. so, humility is actually an integral part of wisdom, which is part of self-reflection in a way. So, self-reflection means understanding your strength, but also importantly understanding your limitation. So, people kind and self-compassion is important, but people who are narcissistic, who are a lot of self-compassion, they’re not self-reflecting either.

[00:40:39] And that was one of Socrates’ point, he said that anybody who thinks, uh, his wise is a fool because a wise person knows how much he doesn’t know. that there is so much uncertainty. There is no single right way to do that. That there are multiple ways that we to find out what’s the right way. So, to me it’s sort of more question of accepting sort of diversity of perspectives and lack of confidence in certainty.

[00:41:05] I think that’s, uh, what is important here to me.

[00:41:08] Samantha Boardman: absolutely. That like epistemic humility just to bring to everything. And even having that around. You know, one’s feelings and emotions. That’s probably one of the most fundamental tenets of CBT is that your feelings aren’t facts. You know that just because you feel a certain way.

[00:41:22] It’s really, you have beliefs usually about something and then that leads to other feelings about it. So how do you uncouple your beliefs about, you know, Maybe that person didn’t wave at me across the street, it means that they hate me. Maybe my friend now isn’t going to invite me to something, but that’s sort a belief.

[00:41:40] And then you’ll have these emotions as a consequence of that. And sort of bringing humility to this and thinking How else could I explain this in some way? And I think we’ve been hearing so much about uncertainty during the pandemic and how difficult it is. But I agree with Dr. Jeste that certainty is almost more toxic in some way. And having certainty is an illusion at best, being certain about anything. And there’s a, I think it’s Chris Conlan who has this fascinating, he calls him emotional equations and he writes anxiety. Equals uncertainty times, powerlessness and uncertainty is a lack of knowledge.

[00:42:17] And powerlessness is a lack of control. But actually, there’s a lot that we do have, you know, that we do know. And there’s actually quite a lot that we can control. So, you can really dial down your anxiety when you make a list of it. Okay, well what? What do I actually know? And there are some facts here that aren’t just opinions.

[00:42:35] And actually, what do I have power over? Maybe I’m, I feel like I’m not sleeping at all, but I do have the power to turn my phone off and leave it in another room rather than checking it all night, you know? So, what are those things that you kind of have something over and when you’re really overwhelmed with like anxiety about uncertainty, you can consider the worst-case scenario, like what would be the epic disaster here?

[00:42:55] Then what would be the extreme opposite? What would be the best-case scenario, and then what would be the most likely. Outcome. We also know for people who are managing uncertainty and who are really having a hard time waiting, and human beings really don’t like to wait for things. And we know people would rather get electric shocks than have to wait long periods of time in, in a lab.

[00:43:13] We’re, we’re just really bad at waiting is really almost, the antidote for that is finding flow in something. Mihaly Csikszentmihalyi idea of flow when you can lose yourself in some activity if it’s. If it’s walking in the park, if it’s reading a book, if it’s playing an instrument, if it’s cooking, if it’s gardening, whatever that activity is, because it’s a very helpful and productive way to manage that stress of uncertainty.

[00:43:38] and we are living in a time of radical uncertainty is a phrase that I read recently, but we always have been. And it’s just how we insulate ourselves. your comment, Samantha, about, you know, impatience, unwillingness to wait. It reminds me of a friend of mine said decades ago. He said I was the only person he ever watched stand in front of a working microwave, muttering hurry up, God damnit, as if radiation isn’t fast enough for me.

[00:44:05] Duff Watkins: So, it’s sad, but it’s true. It’s very funny.

[00:44:09] Well, okay, Samantha’s talking about, um, reframing.

[00:44:12] Lesson 7: Reframe the meaning of these so called ‘bad events’

[00:44:12] Duff Watkins: So that takes us to our next point, and I reckon this may be one of the single most important things anyone can learn, can hear, reframe the meaning of these so-called bad events.

[00:44:25] so we define good or bad event, based on the immediate outcome, it’s the short-term outcome. So, it is like, you know, in, uh, sports, in the baseball game, the coach selects a reliever for the 9th innings. and it turns out to be a wrong decision because somebody on the opposite side, they hit a home run and they win the match, and it’s a bad event.

[00:44:53] Dilip Jeste: However, what happens to the team is that they realize that they made a mistake and they’re now behind. So, they work very hard, and they win the next five games and then they go into the playoffs. So, what was actually bad event became a good event and so on and so forth. So, there is this fable that many people know about, a farmer and a horse.

[00:45:12] That the farmer had a horse and that was his prize possession, the only prize possession. And one day the horse died. So, he was totally desperate, distraught, and he said that his life almost is, has ended. But the villagers, they realized that he has lost what was most important. So, they bought three horses for him.

[00:45:32] So what was a bad event? Turned to be a good event that he got three horses and then his son was training them. He fell and broke his leg, so that became a bad event. But then there was a draft. People were conscripted into the military and his son was not drafted because of his injury. So that became a good event.

[00:45:52] So, So that’s the thing. That could beget bad, bad begets good, and that goes on and on and on. So, our judging, something as good or bad. Based on short term outcome is wrong, longer-term outcome would be different. And so, we need the patients to see how it works out rather than immediately jump into conclusions based on immediate, short-term outcomes.

[00:46:17] Samantha Boardman: Yes. And, and that idea of kind of this binary bias, things are good or they’re bad, I think our, our brains go to that sort of black and white thinking. But you know, when we are able to see things in context, and fascinatingly, this huge study just came out, I think it was across 87 countries, over 20,000 participants, and.

[00:46:36] The researchers were asking this simple question like; Can we help people feel better during the pandemic? And the answer was yes. And it was asking them to learn the most basic skill of cognitive reappraisal, which you know, was what can I learn from this? Is there anything positive that, that could come of this?

[00:46:55] And being able to sort of just take that different type of perspective and uncouple again, your thoughts from your emotions. It’s so key because. When we’re so sort of mired in something that we, it’s kind of impossible to see that. But if you take that step back and think, is there something here that I can learn?

[00:47:12] Maybe there, maybe it’s really hard being in lockdown, but maybe I could, you know, start baking or I can spend some more time with family. It’s kind of meaningful to me. So, I think that there’s potential there. That said I think we have to be super careful about like that slippery slide into toxic positivity and that there’s always something good here.

[00:47:31] You know, sometimes things can be maybe unequivocally bad and there isn’t that positive sense. Um, you know, that there isn’t necessarily some silver lining post traumatic growth or post pandemic growth is not necessarily always a given outcome. But is there something to learn from this? And the good news is human beings are extremely resilient.

[00:47:53] People tend to bounce back. It is the norm. It’s not the exception. And I think that’s something we forget quite a bit as well, that, that resilience is really in our nature and in our bones. Obviously, it has to do with social support and wisdom and a lot of other factors, but it’s, it’s more likely to happen to us than not. And it’s, it’s part of a skillset as well.

[00:48:13] you mentioned, Samantha, CBT, cognitive Behavior Therapy, and which is basically a way of thinking yourself out of whatever you’re into thinking yourself healthy.

[00:48:24] Samantha Boardman: It interrupts that catastrophizing, you know, that that spiraling into this is, you know, the end of the world.

[00:48:31] This is always going to happen to me. Woe is me. And so, it really just robs you of that ability to have perspective and to actually learn from it. And we underestimate, and I think it’s something I really underestimated in my training to become a psychiatrist. We underestimate the role of positive emotions.

[00:48:47] These are sort of are lifeblood, and I’m not talking about sort of rainbows and unicorns, but actually genuine positive emotions, that sense of joy, those transcendent emotions of gratitude that one can feel or awe. You know, when you witness something, spectacular. But that, that when we can cognitively reappraise something in the context of CBT, we, we give ourselves the opportunity to have positive emotions and we can even have, we have this emo diversity.

[00:49:14] Even when we’ve looked at studies of caregivers or people, you know, dying with the terminal illness, those were able to say, Well, there was this funny moment when we looked out the window and saw this, You. Pigeon going to the bathroom on the, you know, on, on, on the, on the window or there was something funny.

[00:49:28] And being able to find even that sort of joy within the, the sadness and even that wellness within illness is something that we need to sort of remind ourselves to do. And again, that skill building of what’s good here, and not in a Pollyanna way, but actually in a very meaningful, impactful way.

[00:49:46] Duff Watkins: You mentioned toxic positivity, which I wrote down. So what? What is that? I think I got a pretty good idea, but I want to hear your view of it.

[00:49:54] Samantha Boardman: Just that idea of like, Oh, put a smile on your face. Everything’s going to be just fine. we have emotions about our emotions, you know, And so this pressure to be happy all the time.

[00:50:06] and that you sort of have pathologized some of the very normal reactions of, of feeling disappointed, feeling. Being down about something, or being stressed out. Even these are normal. And I think sometimes there is this pressure to sort of have that rainbows and unicorns life and just think everything’s going to be just great.

[00:50:25] And people are grieving sometimes and maybe. Psychiatrists are we jumping in there to sort of like, let me, help you through this. Where sometimes these are just natural processes that are occurring in natural emotions to, to be feeling and, and to allow for them? and to learn from them.

[00:50:41] Lesson 8: Build the habit of good enough

[00:50:41] Duff Watkins: Proceeding two lesson number. Eight, Build the habit of good enough. First of all, how do we build that?

[00:50:49] Samantha Boardman: This is idea. It’s around, I think being decisive. It is such a, also an important component of wisdom. It’s how, how can we decide to decide and not living in that sort of tumbleweed zone where we’re sort of feeling blown about by, by other people’s whims and other schedules and that kind of thing.

[00:51:08] And it, people who are, you can see what’s called maximizers or satisfiers. Maximizers are the ones. Do everything they can. They’re doing all the research. Should I order that hamburger, or should I order that tuna melt and what’s going to be better? And they’ll find, read reviews on online to see which one’s better.

[00:51:26] But the exhaustion that goes into that or the are just what’s good enough. And so kind approaching decisions with that in mind. And I think we, we have many occasions in our everyday life to practice satisfying. And so, you can just sort of help reduce your stress by. You know when you’re going to buy some salad dressing or some toothpaste just reaching for it blindly, just grab that one rather than sort of thinking, doing all the research.

[00:51:52] Should I get this one? Should I get that one? Because the problem with maximizing when we’re doing so much work, we’re pouring so much into these decisions, is we end up. With regret, and regret is a very complex emotion, but this idea should have, would’ve, could have, that we are sort of ruminating about, and we’re stuck swimming in that.

[00:52:13] And so it only makes us, it makes it impossible to joy to enjoy what we’ve chosen. And we’re also sort of living in this like liminal space of what, what we should have done otherwise. And so, I think being comfortable in with Satisficing, you know, it could be as much as what should I order for lunch? I think one of the, the best.

[00:52:30] treatments or antidotes for this also is gratitude what Dr. Jeste was talking about. It’s almost impossible when you’re practicing gratitude or thinking about what you’re grateful for to be regretful about something. And so just sort of being grateful that you even have an option and then choosing it and not looking back and thinking, Oh, I, you know, we’re looking at pictures of what you could have been doing or whatever.

[00:52:55] Samantha Boardman: Was the better choice to make. And I think being comfortable with that because, and understanding that even being disappointed is kind of a part of life and otherwise we can get stuck and ruminated it and then we can all get better at being satisfiers. a satisfier. How would you describe that to a person who’s never heard the term?

[00:53:12] Satisficing is a strategy of decision making where you’re, we are willing to make a good enough decision rather than striving for the very best decision because we, you know, put out a lot of energy and time and money, you know, sometimes looking to make the very best decision and we will. End up when we are, when we are maximizing, which is, you know, when we’re looking for the very best possible decision where we’re spending that time and money and energy and effort looking for that, we often end up disappointed, frustrated, and we idealize the alternative.

[00:53:42] Samantha Boardman: Like, Oh, if only I had done that, if only I had. Chosen this one and we end up sort of full of regret. And so, making peace with the good enough. Uh, and it’s not, this isn’t compromising, I think, or settling, but I think making peace with that good enough option can help us and be sort of one of those, those strategies, it really does, um, help us to be more decisive.

[00:54:05] Another one I found to be super helpful is looking at pre-mortem decision making. when if you are faced with a decision, you know, and you can look, you’re sort of imagining yourself into the future and you’ve made that decision and thinking, you know, and everything actually worked out, it was the wrong decision to have made.

[00:54:21] Sort of tracing back those breadcrumbs, thinking, what led you to do that? And so just as a way to be a little bit more thoughtful because. It’s something that we don’t, as psychiatrists, I think take seriously enough, is the ability to be decisive and how that contributes to our wellbeing. Because feeling passive, feeling like you’re a tumbleweed, feeling that life is happening to you is really devitalizing in every way, and actually sort of feeling like you’re in charge and taking control and having that sense of agency is really like a contributor to flourishing.

[00:54:50] And I think obviously wisdom too.

[00:54:52] I think when we talk about decisiveness, sometimes people confuse that with making quick decisions that’s actually not the case. Some decisions need to be quick. There’s no question about that. For example, for soldiers in a war, you know, I mean, they have to make instantaneous decisions, but most decisions in life are not like that.

[00:55:15] And what one should remember is that perfect should not be the enemy of good, that we strive her perfection when it is not possible. I mean, just like ideal is ideal because it is not achievable. So, we shouldn’t try to do that,

[00:55:31] Samantha Boardman: Well, I think sometimes there’s this sort of even allergy to feeling those negative emotions and that we’re just so reactive to them. So, we, we feel anger, we feel hostility, you know, we feel rage in some way and then, we’ll, it’ll bubble up in our behaviors.

[00:55:46] But, so really what, what I’m asking people to do then is not to suppress them at all. I mean, I think that’s probably one of the worst things we can do for our, our blood pressure and our heart rate. And we know long term, that’s not a good strategy for anybody. But just to be able to sort of shine that flashlight and say, What can I learn from this?

[00:56:07] How can this help me even re-go right now I’m feeling a certain way, but this is data. This is data that I can take in. This is information that is being fed to me. I mean, think of it as like you’re looking at a spreadsheet so I can turn my back on it. I can ignore. Or even, you know, I can repeat the same mistake over and over again, or what can I learn from this?

[00:56:33] And I, I really think if you can take that as data and information of like, maybe I’m deeply offended by this. Maybe this reminds me of something where I felt totally useless in the past. Maybe I, you know, that you can kind of understand it a little bit more, and I think this way you’ll get off the merry go round of just having these knee jerk responses to things when you understand where these emotions, like these underlying emotions are coming from.

[00:56:56] if you, you have a hypothesis. We always are. We have a hypothesis like, this happened because that person’s awful. Or you know, I have to wear a mask because the world is crazy. Or, you know, this person voted for that candidate because that, you know, that this person must also be an awful person.

[00:57:11] Samantha Boardman: You know, these assumptions that we make about the world and about other people, and actually like one of, I think the most important things to learn, and it’s really contributed to wisdom, is the importance of being wrong. and actually, you know, sort of celebrating that and even seeing, I mean, I think I’ve never been more gratified when I’ve made assumptions about a patient that probably, you know, wouldn’t be able to recover maybe from substance abuse or, , I didn’t imagine having a certain trajectory and running into them in the street several years later, and just the ability to be wrong, to acknowledge you’re wrong and we wrong all the time. We need to celebrate that more.

[00:57:46] Duff Watkins: I have a colleague who said, and I, it is a phrase he used one time, and I’ve used it ever since.

[00:57:51] If I’m wrong, I’m happy because I’ve learned, you know, we learned a better way. And so, I, I say that to myself, personally, uh, and frequently, to Samantha’s point, making an effort trying to investigate your own thoughts and feelings, it will lead you somewhere to something, and then you simply flash that light on it, and something will move within you. Something will shift, maybe a little, maybe or lot, but worth a try.

[00:58:20] Lesson 10: Look up, Find your own spirituality

[00:58:20] Duff Watkins: All right, well then let us proceed to, tip number 10.

[00:58:25] Look up, Find your own spirituality.

[00:58:28] Dilip Jeste: Yeah. So, so our original review of wisdom and the conference, uh, that we talked about did not include spirituality, mainly because this is somewhat controversial entity. So, after definitions of wisdom that have been used, If you look at the ancient definitions in the scriptures, of course all of them talk about not just spirituality, but religiosity belief in God organized religion.

[00:58:57] Spirituality is different from religiosity. You know, an atheist can be spiritual. So, to me, spirituality means feeling connected to something or someone that we don’t see hear or perceive. People may call it spirit or soul or consciousness or God, that doesn’t matter, whatever it is. But there are also, I find many people who actually strongly object to spirituality as a component of wisdom.

[00:59:25] My feeling is that part of that comes from the terminology, the word spirit is not really a good, good term. I mean, it is somewhat, uncertain, almost esoterical, and people have different conceptions of that. So, I wish we could replace that word spirit with something else. People will accept that because I do think that we all need to have a belief in something.

[00:59:49] That will not change in our own mind, not in reality, but in our own mind. We need that. We need that a source of comfort, no matter what the stress is at, that won’t happen with other human beings because human being, they have their own stresses, so they won’t always be able to support us. So, this concept behind is that having something or someone, whatever that you believe in.

[01:00:14] So when something goes wrong, instead of blaming yourself or I mean others, you said, that is, that was meant to happen. And actually, it is meant because it’ll lead to something good later on. So, I grew up in India. And in India there is belief in reincarnation and, Again, it’s not a question of whether it happens or not.

[01:00:33] I mean, not very likely it doesn’t, but that belief in reincarnation is actually very helpful because when people get old, when they get very sick, they’re about to die, they talk about what they will do in the next birth, and they talk about, We will, I hope that you are my spouse in my next birth. Or you’re not my spouse in my next birth, whatever, it’s

[01:00:58] So it gives you a feeling of continuity and that makes you feel good. There’s something you believe in. So instead of resorting to drugs or some other things that people do when they’re stressed out, what is wrong in believing in something that may or may not exist? People may not agree with that, but if that, for that person, that’s a sense of comfort.

[01:01:21] I don’t think there’s anything wrong with that. And actually, there are a number of empirical studies now coming out about not just spirituality, but religiosity that have clearly shown that objective majors show that religiosity. Is associated with better health, not just mental health, better physical health, cognitive function, and even longevity.

[01:01:43] And I think, I really think that that’s probably true. And the reason is not the specific religion or the specific belief it teaches. Having that source of comfort, belief, trust you have that cannot be changed for you. It is great to have that when you can go and approach that when you are stressed out.

[01:02:03] Samantha Boardman: And that, sense of, community that, you know, that that provides, but also the, those self-transcendent emotions that are so important to our wellbeing when, we’re not so self-absorbed or self-immersed when we are able to. transcend that. me, myself, and I sense of self, and I’ve always been fascinated by even those studies looking at atheists when you know something negative happens, there’s some negative life event that they too will often say, Well, you know, something happens for a reason.

[01:02:36] Like there is something, some kind of explanation that even somebody who unequivocally says, I don’t believe in any of this stuff. Does sort of seek some other explanation, something larger than oneself. And, and you know, we know that it’s actually helped people manage the pandemic that, to get through that.

[01:02:56] And it’s, been valued. And I guess it’s really the question comes down to how do we define spirituality or, or religion if it’s not in a formal way, but it’s, um, in a way somebody experiences, in their community and with self-transcendent experiences.

[01:03:12] Duff Watkins: Okay, I think we will finish there today. You’ve been listening to the podcast 10 lessons. It took me 50 years to learn. My name is Duff Watkins and our guest have been Dr. Dilip Jeste, neuropsych psychiatrist at the University of California, San Diego, and also Dr. Samantha Boardman from private practice at Manhattan.

[01:03:29] She is the author of the book. Everyday vitality, turning stress into strength. And Dr. Jeste, author of the book Wise, The Scientific Roots of Wisdom, You’ve heard from us. We’d like to hear from you. You can email us podcast@10lessonslearn.com

[01:03:45] and while you’re at it. Go ahead and get to subscribe button because this podcast is the one that makes the world a wiser place.

[01:03:51] Lesson by lesson.

 This episode is produced by Robert Hossary. Sponsored as always by Professional Development Forum, which office insights, community or discussions, podcasts, parties, anything you want here, but they’re unique and it’s all free online. You can find the www.professionaldevelopmentforum.org you’ve heard from us we’d like to hear from you. Email us it’s podcast@10lessonslearned.com. Remember, this is the podcast the only podcast. That’s makes the world wiser lesson by lesson.

 

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