An Old-Fashioned, Counter-Cultural Approach

Posted on Posted in Brain Science, Continuing Education, Elder Care, Homestudy, Psychology, Seminars

By Mary O’Brien, M.D.

Are you already worn out from holiday activities?  There is Thanksgiving travel, Black Friday, Cyber Monday, and reports of morning, noon, and night sales hitting record levels.  The cold and flu season is well underway, and millions of Americans are totally tuckered out.  They will, nonetheless, try to sustain this frenetic activity for another month.  There is an alternative, old-fashioned, counter-cultural approach.  It’s called Advent.

Long, long ago, before people had electronic devices surgically implanted into the palms of their hands, they observed a quiet, disciplined period of waiting for Christmas.  The word, “Advent,” is from the Latin word “adventus,” referring to the arrival of a significant person, time, or event.  Over the centuries, Christians developed the practice of spending the four weeks before Christmas in prayer, fasting, and giving alms to the poor.  It was a way to discipline themselves, physically and spiritually.

Many of our grandparents were very serious about this tradition.  They waited to put up a tree and decorate it until Christmas Eve.  The 12 days of Christmas were actually celebrated from Christmas Day to January 6th, the Epiphany, or arrival of the three Wisemen.  Today, Christmas-in-July sales have us in major shopping mode for half the year.  Many people are tired of Christmas long before it arrives.  By the time credit card bills arrive in late December, very few people are ready for any sort of Epiphany, spiritual, or otherwise.

There are some healthy, helpful things any of us can do in the spirit of Advent.  Most folks want to find meaning in their lives that extends beyond acquiring money, stuff, and titles.  Nonstop, frantic striving can only distract us for so long.

  • Before the holiday craziness consumes any more of your mental, physical, emotional, or spiritual energy, consider a slightly different approach to December: “Fast” from all electronics for one hour a day (while you’re actually awake).  This will reveal volumes about where you are in life.
  • Practice the old-fashioned discipline of giving up candy, sweets, desserts, etc. The first bite of your favorite holiday treat will taste heavenly.  Chances are good that you’ll drop a few pounds in the process.
  • Avoid spending money on fancy coffee, eating out, alcohol, and other little indulgences; give the money you save to help a family devastated by the recent natural disasters.
  • Do something nice for someone else — anonymously.
  • Do something nice for someone you really can’t stand.
  • Invest 15–25 minutes each day in prayer, meditation, contemplation, or spiritual reading to focus on what matters most to you.
  • Make a serious effort to replace cynicism and sarcasm with gratitude and gentleness.

If all of us did even half of these things for a few weeks, the ripple effect would be immense.  Advent.  It’s an old-fashioned, counter-cultural approach.

A Little Extra Thoughtfulness

Posted on Posted in Brain Science, Continuing Education, Homestudy, Psychology, Seminars, Webinars

By Mary O’Brien, M.D.

It’s coming.  The busiest travel time of the year is nearly here.  Thanksgiving is next week, and we’ll be bracing for impact.  Tens of millions of people will go somewhere they don’t really want to go and will do things they don’t really want to do — in some cases with people they may not even like.

Painful delays at airports, agonizing congestion on highways, bad weather, stress, and exhaustion will give a green light to viruses everywhere. Welcome to the cold and flu season.  It might be prudent to rethink a few things.

Despite a strong economy, this has been a very tough year for many people.  Historic flooding, catastrophic hurricanes, terrifying tornadoes, and hellish wildfires have inflicted untold suffering and loss.  Mass shootings, violent threats, angry mobs, and generally vicious behavior have overshadowed civility and decorum.  Many decent people across the country feel overwhelmed and demoralized.  I don’t think anyone needs more stress, certainly not at the Thanksgiving table.

But all is not lost.  Difficult situations bring out the worst in some people but the very best in many others.  Heroic acts of courage and compassion abound whenever disaster strikes.  Few of us will ever have to save someone from a raging flood or fire, but we can all be a bit more thoughtful and understanding.  This year, consider a few ideas that might make Thanksgiving less stressful and more pleasant for everyone:

  • Don’t put pressure on loved ones to travel. People only have so much time, energy, and money to spare.  Controlling relatives is not helpful here.
  • Include someone who might otherwise be alone.  Chances are good such folks are all around you.
  • Don’t be a perfectionist in the kitchen. Thanksgiving is not a competitive event.
  • Offer to help or bring a dish, but don’t force your brussels sprouts casserole on the host. Some people don’t know when to cease and desist.
  • Resist the temptation to talk politics. Now is not the time to upset people.
  • Put a ban on phones, television, and assorted other devices. Through your church, synagogue, or club, sponsor a Thanksgiving dinner for a family in need.
  • Show interest in other people at dinner. Good conversation starts with sincere questions about the other person and really listening to that person.
  • Don’t inflict yourself on others if you’re sick. Someone will almost certainly be happy to bring you some wonderful leftovers.
  • Be genuinely grateful for all the blessings you do have. Let people know that you appreciate them.

Thanksgiving is a lovely holiday with charming traditions.  With a little extra thoughtfulness, we can make it better than ever for everyone.

The Holidays: A Time for Comfort Food

Posted on Posted in Brain Science, Continuing Education, Homestudy, Nutrition, Seminars, Webinars

By Dr. Laura Pawlak

The term comfort food can be traced back to 1966, when the Palm Beach Post used the term in a story:  “Adults, when under severe emotional stress, turn to what could be called ‘comfort foods.’  These foods are associated with the security of childhood, the relief of stress, and euphoric feelings.”

Although the identification of particular items as comfort foods may be unique to an individual, patterns are detectable.  In a study of American food choices, males preferred warm, hearty, meal-related comfort foods, such as steak, casseroles, and soup.   Females consumed snacks as comfort foods, such as chocolate chip cookies and ice cream. Young or middle-age people, under 55 years of age, overwhelmingly chose snack-related, comfort foods.

As the holidays approach, families and friends gather to share an array of comfort foods that provide nostalgic or cultural value.  These foods are often characterized by their high caloric nature, rich in (1) carbohydrate and fat or (2) fat and salt.

Consuming energy-dense food awakens a group of brain structures wired together into a reward system.  This brain circuitry elicits emotions based on the sensory experience of the food.  Comfort foods trigger pleasurable feelings — moments of joy.

The chemicals responsible for feeling good are two-fold:  endorphins, nature’s opioids; and endocannabinoids, the feel-good chemicals found in marijuana.  Sugary foods activate the release of endorphins.  Pizza, cheese casseroles, and other fatty foods spur the production of endocannabinoids.

When fat and sugar are combined, as in desserts, an explosion of both endorphins and endocannabinoids floods the brain, causing elation beyond nature’s offerings.  The temptation to overeat may be overwhelming, especially when a fond memory is linked to the food.

Enjoying holiday celebrations, without consuming excessive amounts of comfort foods, requires forethought.  A plan is helpful!  For example, set aside the day before the event as a time to eat fewer calories.  Drink water, coffee, and/or tea. Have two light meals — perhaps a fruit salad and a green salad.

On the day of the celebration, eat a healthy breakfast and add a salad if you feel hungry before attending the festivity.  At the party, take a deep breath between bites of your favorite foods.  Notice the positive memories that surface as you eat slowly.

Lastly, don’t take goodies home.  Holiday gatherings are meaningful times with friends, not just food.  Savor the season!


Dr. Laura Pawlak (Ph.D., R.D. emerita) is a world-renown biochemist and dietitian emerita.  She is the author of many scientific publications and has written such best-selling books as “The Hungry Brain,” “Life Without Diets,” and “Stop Gaining Weight.”  On the subjects of nutrition and brain science, she gives talks internationally.

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Calm Down, Slow Down, and Live

Posted on Posted in Brain Science, Continuing Education, Pain, Seminars

By Mary O’Brien, M.D.

I witnessed a four-car accident this week.  Moments before it happened, I knew what was coming.  A driver wanting to turn left raced through a light turning red.

Another driver coming in the opposite direction jumped a light before it turned green. They collided.  Two cars following much too closely plowed into the mess.  Everyone was all right, but a major intersection was blocked and lots of people were ready to explode.

This scenario plays out all over the country every day. Impatient, rude, distracted drivers are increasingly problematic.  Drunk or sleep-deprived drivers cause a tremendous number of accidents, but 66 percent of traffic fatalities are caused by aggressive driving.

Nearly everyone is in a hurry today, even in a place like Myrtle Beach, South Carolina.  I suppose at 9 A.M. many people are still trying to get to work, but a traffic accident will really make you late.

Research has shown that aggressive, angry drivers have distorted depth perception. This is worrisome, since traffic congestion is not about to ease and most people drive much too close to the car ahead.  Add a little rain, fog, snow, or ice, and an accident is inevitable.

Halloween is on October 31, with Thanksgiving and Christmas travel soon to follow.  Since an ounce of prevention really is worth a pound of cure, there are a few tips we can all use to stay safe:

  • Get in touch with reality. Many people underestimate how long it takes to go anywhere.  Stress levels ease when you routinely leave an extra 15-20 minutes to reach your destination — more if you drive in a large city.
  • Leave more space between your car and the one ahead. The laws of physics work whether we like them or not.  Sooner or later someone will have to stop unexpectedly.
  • Don’t try to run a stoplight. At some point, it will not go well for you.
  • Don’t be rude on the road. Cutting off another driver, yelling, making vulgar gestures, or otherwise being aggressive will not help.
  • Stay focused on driving. Unless you’re driving across Wyoming or west Texas, you must have your wits about you at every moment.  Even talking on the phone or sipping coffee can be dangerous.  Texting is flat out foolish.  Don’t do it.
  • Be considerate of other drivers. We’ve all struggled to get in the correct lane on a congested highway.  Unless it’s simply unsafe, let another driver merge ahead of you and never fuss at someone for being gracious to others.

Every person today is dealing with stress, and most of us have made an occasional error on the road.  Perhaps we could all calm down, slow down, and live to enjoy the holidays.

A Circle of Prayer

Posted on Posted in Brain Science, Continuing Education, Elder Care, Homestudy, Psychology, Seminars, Webinars
Credit: National Review

They knelt in prayer and grief.  A dozen brave, dedicated, selfless firefighters and rescue personnel in Wilmington, NC were heartbroken on sight.  A mother and her 8-month old baby girl were killed when a tree crashed through their house during Hurricane Florence.  The father was severely injured and rushed to the hospital.  Upon completion of their agonizing task, the first responders were captured in a photo kneeling in a circle of prayer.  Within hours, the image went viral and millions felt their anguish.

Suffering and heartache are rampant here in the Carolinas now.  It will take many months and even years for people to recover from the devastation.  This part of the country has been my home for many years and my heartfelt thoughts and prayers go out to everyone in need.  I know that everyone at INR joins me in that circle of prayer.  To all our customers and colleagues who have worked with us for so long, we wish you Godspeed in your recovery.

To Whom Much Is Given

Posted on Posted in Brain Science, Continuing Education, Psychology, Seminars, Webinars

By Mary O’Brien, M.D.

Something is seriously wrong.  The unemployment rate is around 3.9 percent.  The most recent GDP (Gross Domestic Product) figure shows a 4.1 percent gain.  These are tremendous numbers, and yet, millions of people who should be building lives of their own are still clinging to mommy.  They don’t want to grow up, pay their own way, develop a career, make a commitment to another person, begin a family or household of their own, or accept responsibility for anything.  This is not good.  Maturity begins with the acceptance of responsibility.

Unfortunately, many of my fellow baby boomers have indulged their children to the point of pathology.  Feverish efforts to create a perpetual soft landing for kids have only enabled endless dependency.

In World War II, millions of young men in their teens and twenties signed up to defend the country.  No one who had stormed the beaches of Normandy or fought at Guadalcanal came home to sponge off mommy and daddy.

Even the relatively spoiled people of my generation would have chosen to live in their Volkswagens after college rather than go home to live with mom and dad.  Living with your parents after college was considered the ultimate sign of personal failure.

There are of course, millions of millennials working hard to develop their careers and raise young children.  But far too many still think that eternal adolescence is “cute.”  Arrested social development and “infantilization” of adults is not cute.  It’s medically, psychologically, socially, and even spiritually abnormal.  Our culture has gone off the rails attempting to normalize behavior that is clearly dysfunctional and disturbed.

Work is essential for a man to feel good about himself.  A woman needs a sense of accomplishment too, but a woman can also define herself through relationships and caregiving.  Depriving a young man of the satisfaction and fulfillment that comes with physical labor, challenge, and struggle is not in his best interest.  All too often part of the problem is a mother who desperately wants to feel “needed.”  Parents may complain about an adult child who won’t leave the nest, but as long as mom and dad pay the bills, little darling has no motivation to get off the couch.

Sometimes real love is difficult and even disruptive.  The fundamental responsibility of any parent is to provide and protect the child when he or she is young.  The job is not complete, however, until a child has been taught the skills necessary to become a capable, honorable adult who gives more than he or she takes.

“To whom much is given, much will be required.” Some people think that sounds harsh.  Actually, it’s one of the secrets to a happy, fulfilling life.

The Wise Whisper of Prudence

Posted on Posted in Brain Science, Continuing Education, Psychology, Seminars, Webinars

By Mary O’Brien, M.D

They had second thoughts about it.  Twelve boys and their soccer coach had heard heavy rains were coming, but they went on their excursion anyway.  Tourists looking forward to an outing on a lake in Missouri never imagined how dangerous a storm could be.  The duckboat operators chose to ignore a forecast for thunderstorms.  They thought it would be alright.  Life jackets were considered unnecessary.  After all, they’re such a nuisance.  Two groups of people failed to heed the quiet whisper of prudence.  The first group survived, but only with the immense efforts of over a thousand people and the loss of a brave Thai diver.  The second group suffered catastrophic consequences with 17 deaths including nine members of one family and seven seriously injured.

Prudence would have prevented both disasters.  It’s not a word we hear much today.  In fact, it almost seems arcane.  Prudence sounds like the name of a fussy old maid in an eighteenth century novel.  The New Oxford Dictionary defines prudence as “acting with or showing care and thought for the future.”  Its origins can be traced to the Old French and Latin word “provident,” meaning “foreseeing or attending to.”  Could any reasonable person doubt the need for more prudence at every level of society?  Foreseeing or attending to the future is a tremendously useful virtue.

Many of us have fallen into the trap of wanting too much and, naturally, we want it now.  A flight delayed or cancelled due to bad weather leaves nearly everyone frustrated and upset.  It’s better to cope with temporary disappointment and stay alive.

Every year, people die in cars swept away by raging flood waters.  Thousands die or sustain serious injuries in accidents related to severe storms, blizzards, hurricanes, and tornadoes.  Prudence would have dictated staying off the roads in the first place.  Numerous other situations confirm this vital lesson.  Swimmers, surfers, golfers, hikers, campers, skiers, mountain climbers, and others have ignored prudent warnings and suffered terrible consequences.

Prudence does not shout.  It announces its presence with a whisper.  The next time you feel an uneasy, nagging sense of caution about something, pay attention.  It may just be the wise whisper of prudence.

Pearls of Wisdom

Posted on Posted in Brain Science, Continuing Education, Homestudy, Psychology, Seminars, Webinars

By Mary O’Brien, M.D.

He was a disciplined thinker, a real-life Mr. Spock, in a world where so many worship emotion.  Dr. Charles Krauthammer died on June 21, 2018, after a battle with cancer and 46 years of paralysis from a diving accident.  He finished medical school at Harvard and trained as a psychiatrist before turning to political journalism.  Early in his career he won a Pulitzer Prize.  The rest is history.

Dr. Krauthammer was an intellectual force of nature.  Facts, reality, logic, and truth served as his compass.  He had an unusually inquisitive mind and was open-minded enough to allow his thinking to evolve.  This stood in stark contrast to so many in the media who idolize notions and emotions.

Always patient and respectful in debate, Dr. Krauthammer was kind, thoughtful, gracious, and dignified.  But those qualities never suppressed a laser-like wit and genuine sense of fun.  He knew what there was to know about baseball and chess. People loved being around him because they always learned something and had a good laugh.  Being confined to a wheelchair did not prevent him from enjoying life.

Most people will remember Dr. Krauthammer for his political analysis and writing.  But as a physician who struggles with multiple illnesses, I have a slightly different focus.  Here are just a few pearls of wisdom I learned from his remarkable example:

  • Resist the temptation to feel sorry for yourself. Bitterness and victimhood will not solve anything.
  • Think about death every day. This is not morbid.  Charles Krauthammer was a wonderfully cheerful, funny man.  Confronting death allows one to appreciate life fully.
  • Keep your focus on others. We live in an age of malignant narcissism.  Krauthammer rarely talked about himself and kept his focus on the needs, problems, hopes, and dreams of other people.
  • Be courageous enough to say what you think but always be measured and civil. Hatred and nastiness abound today. There’s nothing constructive or healthy about it.  Civility, patience, gentleness, and humility will always be the mark of true wisdom.

Dr. Charles Krauthammer could have given up on everything at the bottom of that swimming pool when he was 22 years old.  He chose to fight back, and I’m one of millions who is grateful that he did.

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Note to Self

Posted on Posted in Brain Science, Continuing Education, Elder Care, Psychology, Seminars, Webinars

By Mary O’Brien, M.D.

Anthony Bourdain. Kate Spade. Robin Williams. They had what most people dream of having: massive success; fame; money; and a fabulous lifestyle. And yet, on the most profound and intimate level, they were utterly miserable. They couldn’t find a way to love themselves enough to keep living.

They are not alone. Millions of people, known only to a few folks around them, suffer the torment of suicidal thinking. We’ve known for decades that most suicide victims see some sort of health care professional shortly before they die. There is no shortage of studies, articles, committee meetings, and conferences on the subject. But somehow very little seems to change.

Two days ago I heard an “expert” on TV insist we should ask every patient about his or her personal life, marriage, relationships, family and financial problems, and work stress. I’ve been quite ill in recent years, and I’ve seen multiple physicians. No one has ever asked me about any of these matters. Perhaps, since I’m a physician, they feel too uncomfortable to ask. I suspect, however, that the larger issue is our obsession with time and money. Herd ‘em in, herd ‘em out, generate more revenue. A discussion about personal problems can become lengthy and emotionally charged. It’s difficult to get a tearful, distraught patient out of the office. In far too many cases, we’d really rather not know about it. Besides, when someone is crying, it’s tough to stay focused on your computer.

We live in an ever more detached, isolated, dissociated, overstimulated, and under-loved culture. All the “fans,” “likes,” and “followers” in the world cannot take the place of one sincere, sympathetic listener who actually cares.

Morals, Manners and Mindsets

Posted on Posted in Brain Science, Continuing Education, Elder Care, Homestudy, Psychology, Seminars, Webinars

By Mary O’Brien, M.D.

Our culture appears to be in free fall.  Movie moguls assault young women.  Campus doctors exploit and molest patients.  Gymnastics coaches and doctors engage in appalling sexual crimes.  The abuse of women and children has occurred for millennia. However, as individuals and as a civilization, we’re supposed to be advancing.

The human person, the human body, must be treated with dignity and respect at all times, at every stage of life.  The notion that we can do whatever we want, whenever we want is wrong.  It always has been, it always will be.

Professional stature is non-existent without self-restraint and honor.  And those in leadership positions who merely look the other way bear just as much guilt as the perpetrators.  It’s shocking to realize how much disgraceful behavior is tolerated out of ineptitude, laziness, greed, or complacency.  Virtually every sector of our society is at fault here.  Until we reach a critical mass of people willing to challenge this horrid behavior, nothing will change.

In our professional realm, there are a few things we can do to restore respectfulness:

  • Call patients or clients by their proper names: , Mrs., Mr., Dr., Reverend, Judge, etc. are all appropriate until someone invites familiarity.  Using first names with a new patient is not “friendly” as we have been led to believe.  It merely signals a sloppy level of unearned familiarity and unprofessional demeanor.  A medical or dental office is not a nail salon.
  • Male professionals should not be alone in an examination room with a female patient. The “expense,” “inefficiency,” or “inconvenience” of having a nurse or assistant present is an unacceptable excuse for this breach of protocol.
  • Manners matter. “Old school” nurses and doctors were taught to ask the patient’s permission before we touched him or her.  “May I listen to your heart?”, “May I examine your abdomen?”  No doubt some youngsters in health care would roll their eyes at this.  But we should never make assumptions about touching anyone (apart from emergencies), and yet it happens routinely today.
  • It’s good to remind ourselves, our colleagues, and our students that decorum and propriety are not old-fashioned and unnecessary. On the contrary, they are critically important, and their absence is palpable.

Morals, manners, and mindsets do not exist in a vacuum.  When someone is disrespectful or unethical in one domain, that vice will eventually metastasize.  Regardless of our age, culture, or profession, we should always try to treat others the way we’d like to be treated.  It’s not corny.  It’s not outdated.  It’s our only path forward.