I recently interviewed my brother, Kurt Ashworth, who is an Audiologist in Ballarat, Australia. Here are his answers to some of the main questions I asked him:
1. What does an audiologist do?
Audiologists are communication experts. We specialise in testing and diagnosing hearing loss and can also specialise in testing balance function. Audiologists can help people of all ages experiencing hearing loss testing and diagnosing the type and degree of hearing loss and prescribing and programming hearing devices if appropriate, providing hearing rehabilitation and communication strategies and utilising other assistive technologies to improve their ability to hear and more effectively communicate.
2. What led to your interest in Audiology?
After an undergraduate degree in science with a major in psychology, that pathway did not interest me to pursue further, I stumbled across audiology and it seemed like a good mix of informational counselling and the utilisation of technology to improve peoples communication. The hearing devices and cochlear implants keep improving their capabilities to the point where they can now also work as Bluetooth headphones, an ai assistant in your ears and a fitness tracking device as well as improving the patients hearing.
3. How can Audiology help to improve someone’s quality of life?
As discussed, a lot of our patients can have long-standing hearing issues that have not been diagnosed or corrected. Hearing devices, assistive listening devices and cochlear implants and sometimes surgery to correct the hearing problem can give back peoples ability to communicate more effectively with their loved ones and when out socially which is very impactful on peoples quality of life. We also know there are links to higher risk of dementia, falls and loneliness with untreated hearing loss so the opposite exists if the hearing issue can addressed with hearing devices or surgery.
4. What are some of the most rewarding parts of the job?
I really enjoy the journey of seeing a patient through from start to finish, diagnosing the problem, coming up with a treatment plan with their individual goals and difficulties in mind. Then seeing how the technology has improved their hearing and they can then start to reintroduce things in their life they had previously cut out due to their hearing.
5. Do you have to do much counseling as part of working as an Audiologist?
I would say the most important part and the majority of my job is counselling and teaching. The technology is great but you can have the worlds best hearing aids but without buy in from the patient, they sit in the draw. We need to counsel about what to expect, how to manage the devices and help to get optimal outcomes. Majority of our adult patients have inner ear loss/damage so we’re also counselling about residual hearing issues even with technology due to the damage In their hearing pathways. The hearing devices can only do so much.
6. At what age does hearing loss usually begin?
At any age, all babies in Victoria are now testing in hospital after birth before they are discharged. If they do not pass their newborn hearing screen, they are seen by a diagnostic audiologist for electrophysiological testing while the baby is asleep and can diagnose with good accuracy the level of hearing loss in each ear and refer this baby on to Hearing Australia for aiding by 4 weeks of age and if cochlear implants are needed, can be implanted around 6 months of age. A lot of children have hearing issues in childhood due to middle ear blockages that can impact on speech and language development. Some adults experience progressive hearing loss or noise induced hearing loss, majority of adults in their latter years, 65+ experience differing degrees of age related hearing loss.
7. What difference can a good pair of hearing aids make?
The majority of the hearing aids available from the top manufacturers now have directional microphones to help people hear better from in front, noise reduction to help make hearing in background noise more comfortable.
The most important function of a hearing aid is the ability to make speech louder so the sounds in speech are audible for the user without loud sounds being too loud and uncomfortable.
The skill of the audiologist in optimising the hearing and providing appropriate counselling and guidance is often just as important as the technology in the device. If someone is not getting on well with their hearing aids, get them readjusted and if you’re still struggling it maybe worth a second opinion and adjustment before considering purchasing new technology again.
If you are quoted a lot of money for hearing aids, ring around for other quotes, base level hearing aids retail for about $1000 for 1 device up to about $4000 for top of the range with plenty of options in between.
9. What is Tinnitus and what causes it?
Tinnitus is a head noise that the patient can hear that is not present in the environment. It can be present all the time or intermittently, it can be in just one ear or both.
The exact mechanism of tinnitus is still up for debate but tinnitus often indicates a problem in the hearing pathway and can be seen more as a symptom of something else rather than the cause. Tinnitus can be brought on due to wax occlusion, middle ear dysfunction and or inner ear (cochlear) hearing loss.
10. Can anything help Tinnitus if someone has it?
The first thing needed is a hearing test, that way we can clear out wax if needed, test where the issue is and refer on to an ear nose and throat specialist if required. If all medical concerns have been ruled out, both amplification and or sound enrichment can assist with tinnitus. Referral to a psychologist for CBT can also be helpful in the more severe cases. Good news is most peoples tinnitus is loudest and most bothersome initially and often improves and reduces in intensity and concern overtime even if it doesn’t go away completely.
11. Have you heard of Misophonia/ hyperacousis and does anyone know what causes it?
Misophonia is reasonably rare, I have only come across it a couple times in my career. It’s a hatred of sounds and can be something as common as the sound of their partners chewing or a clock ticking, even when these sounds are not loud. It’s more about the emotional response to these sounds rather than pain but can be very debilitating in extreme cases. Sometimes people will wear earplugs to reduce the outside sounds but not enough to completely block off their hearing.
Hyperacousis is more common and is a physical discomfort to loud sounds and often goes hand in hand with more severe losses and often losses due to noise damage. Hearing aids can be programmed to improve the usable hearing but reduce the intensity of these loud sounds to more comfortable levels.
12. Can Audiologists help with Misophonia?
Yes, A clinic in Heidelberg – DWM specialises in treating hyperacousis and misophonia and we refer on for the more severe cases.
13. What if someone sleeps next to a partner who snores? Can Audiologists help at all?
Yes, we do a number of custom made earplugs that can help for reducing the volume of snoring, work related noise and music etc.
14. What are your hopes for the field of Audiology in the future?
My hope would be more accessible services and devices for all, while cochlear implants can be provided through a combination of state and federal funding free of charge in Victoria, patients between 26 and 65 really have very little support financially in the purchase of hearing aids from the governments. This leads to alot of patients without the means to access good devices which can lead to untreated hearing issues.
On a more positive note, we a seeing a lot of convergence in audiology, where hearing devices are now doing much more than just improving hearing. Some brands have heart rate monitors in their aids, can detect falls and notify significant others if this occurs and the patients current location. Others brands are tracking steps and levels of social engagement, they can even translate from one language to another in real time in the ear which feels very James Bond. My hope is with all these technological advances, hearing devices and the associated stigma is reducing so people are more willing to do something about their hearing earlier.
15. Is someone is concerned about their hearing at all, what can they do?
Find a local independent audiologist and get a hearing test. Even if the test is only to provide for baseline hearing levels, this allows for tracking of any deterioration going forward.
16. Where do you work, and how do people get in touch?
I work at an independent clinic in Ballarat, Ballarat Hearing Clinic. We provide hearing testing from birth to 16 on behalf of the Ballarat base hospital through their outpatients services. We also see adults for hearing testing, aid fitting and adjustment and cochlear implant assessment and programming. You can find us most easily by searching Ballarat hearing clinic on google and clicking on our website for contact details. You don’t need a medical referral to see an audiologist.
If you have tried my sleeping tips from the prior article and your sleep is still problematic, there are several things that you can do.
The safest option is to go and see your medical doctor or GP and get a referral to a Sleep Physician. They will be able to do a more comprehensive sleep study with you and see if you have any underlying sleep conditions impacting your sleep and feel. You may have to do a polysomnography (PSG) or sleep study to rule out conditions like sleep apnea, restless legs syndrome, periodic limb movement disorder, delayed sleep phase disorder, narcolepsy or idiopathic hypersomnia.
If it’s unlikely that you have any of the above sleep disorders, you may have insomnia. As many as 33% of people have sleep problems, and between six to ten percent have serious enough sleep concerns to warrant a diagnosis of chronic insomnia. Once you have had it for a few months, it may not get better on its own without treatment or applying the right strategies to your sleep.
Everyone will tell you what they think is the solution to sleep problems, from earplugs to eye masks, comfy pillows, new beds and weighted blankets. However, there are still only five strategies with enough evidence to be empirically supported insomnia strategies by the American Academy of Sleep Medicine (AASM). If you think you have insomnia and want to improve your sleep, please try one of these five strategies: Cognitive behavioural therapy for insomnia (CBT-I), sleep restriction, stimulus control, progressive muscle relaxation, and paradoxical intention.
STRATEGY 1: COGNITIVE BEHAVIOURAL THERAPY FOR INSOMNIA
CBT-I consists of four main components. Psychoeducation, sleep scheduling, relaxation techniques and cognitive techniques. Together, these four components target all three underlying sleep mechanisms. CBT-I has sleep scheduling to improve homeostatic pressure and circadian rhythms. It encourages people to get morning sunlight and remain off bright screens before bed to strengthen circadian rhythms. It also teaches relaxation strategies to help people learn how to relax and reduce their arousal levels. Finally, CBT-I teaches cognitive strategies to help people to challenge their unhelpful beliefs about sleep and further reduce their arousal levels.
If you want to try CBT-I, you can check out my Udemy course ‘Improve Your Sleep with CBT for Insomnia’. I’ve also seen the positive results published on other online CBT-I courses such as Sleepio or Somryst. CBT-I Coach tries to teach some of these strategies at no cost, including what times are best for you to go to bed and wake up if you do sleep restriction. If you’d prefer in-person CBT-I, you can search on the internet and see if there are any psychologists or behavioural sleep medicine specialists who specialise in CBT-I.
Sleep restriction is a strategy that increases homeostatic pressure by reducing your time in bed each night to only the amount of time you are sleeping. It also helps to strengthen your circadian rhythms by improving the regularity of when you go to bed at night and rise from bed in the morning, seven days a week. However, it is important that you set your sleep times at the right time for your body clock to be the most effective. Morning people would better choose earlier to bed and rise times, whereas evening people will need to stay up later and get up later.
Sleep restriction can increase distress and arousal levels initially. It can be especially difficult for people with chronic insomnia, who are already worried about not getting enough sleep and the consequences they will feel and face during the day. This can make it very hard for people to initially try and even harder to fall asleep or remain asleep at night. Once they sleep better, their arousal levels can drop significantly, as the individual can begin seeing how effective this strategy is.
Sleep restriction instructions are as follows:
Determine your average total sleep time over the past 1-2 weeks. If it is less than five hours per night, say it is five hours.
Add 30 minutes to this amount. The total is your new time in bed prescription. Only spend this time in bed every night for the next two weeks.
Figure out when you would like to wake up seven days a week. It is your rise time or time to get up each morning. Set the alarm to help you wake up at this time. When the alarm goes off, get out of bed and try not to sleep again until the next night.
Minus your time in bed allocation from your rise time to figure out your bedtime. For example, if you wake up at 6 am and are meant to be in bed for 6 hours and 30 minutes every night, aim to go to bed around 11:30 pm.
For sleep restriction to be maximally effective, bedtime should be approximate rather than absolute. For example, if it is 11:15 pm and you notice many sleepiness signs, go to bed rather than wait until 11:30 pm. On the other hand, if it is 11:30 pm and you are wide awake, wait up a little until you feel a bit sleepier. Then go to bed.
Once you have your bedtime, rise time and time in bed prescription, track your sleep for the next two weeks using a sleep diary or activity tracker. Then figure out your sleep efficiency, which is the percentage of your time in bed spent sleeping.
If your sleep efficiency for the next two weeks is under 85%, cut your bedtime by a further 15 minutes each night. If it is between 85-90%, keep your time in bed prescription as it is.
If it is above 90%, extend your time in bed by 15 minutes each night.
Keep tracking for another two weeks and repeat until your sleep efficiency is between 85-90% regularly.
Stimulus control is a strategy that ensures that your homeostatic pressure is high enough when you are going to sleep by encouraging you to get up at the same time every morning, seven days a week, no matter how well you have slept. By not napping during the day, your homeostatic pressure also remains high. Not going to bed until you feel sleepy means that you won’t go to bed until your brain and body are ready for sleep, which reduces how much time you spend in bed awake. Being out of bed whenever you can’t sleep for 20 minutes also means that you’ll never spend excessive time in bed awake each night.
Stimulus control also helps to strengthen your circadian rhythm with the regular rising time in the mornings and only going to bed when you feel sleepy. Stimulus control is better than sleep restriction if you strictly follow both of the rules as they are written. Stimulus control helps you to find out when your brain and body most want you to go to sleep, as opposed to going to sleep at the same time every night.
Like sleep restriction, stimulus control can also initially increase distress and arousal levels, especially for people with chronic insomnia. People with insomnia tend to already be worried about not getting enough sleep and the potential consequences they will feel and face during the day if they do not get enough sleep or have to be out of bed during their usual time in bed. This can make it very hard for people to initially try stimulus control and even harder for them to fall asleep or remain asleep at night.
Once you begin sleeping better through stimulus control, your arousal levels can drop significantly, as you can begin seeing how effective this strategy is. It also means that you will no longer have to get out of bed after 20 minutes of being awake if you fall asleep regularly within this time, which will likely reduce your worries further. The better you sleep at night and the less tired you feel during the day, the less you will feel the need to sleep in longer in the morning or nap during the day. So, the more effective stimulus control becomes as a strategy, the lower your arousal levels.
The stimulus control instructions are as follows:
Only go to bed when sleepy,
Wake up at the same time every day,
Only use the bed/bedroom for sleep and sex,
Avoid naps during the day, and
Sit up or get out of bed if you cannot fall asleep within about 20 minutes of retiring to bed.
If you have to get up at night, do something calming or relaxing until you feel sleepy again, and then lie back in bed for sleep. Ideally, this activity during the night should not involve bright light, rigorous exercise or be too cognitively demanding.
Paradoxical intention is probably the least used strategy that is effective for chronic insomnia. This is because it is quite counter-intuitive and, therefore, a hard sell to patients that are already struggling with less sleep than they would like. It also doesn’t target circadian rhythms or sleep pressure directly. Paradoxical intention instead indirectly targets both of these sleep mechanisms by helping patients to take off all the pressure they put on themselves to sleep.
As long as the individual follows the recommended paradoxical intention instructions, it can reduce sleep effort, performance anxiety and hyper-arousal levels. This allows homeostatic pressure and circadian rhythms to work better for the individual, as long as they have been up for long enough during the day and are going to bed at the right time for their internal body clock.
The instructions for paradoxical intention are as follows:
Go to bed at your usual bedtime.
Lie down in bed with the lights off.
Don’t read or look at your phone or anything else.
Try to see if you can stay awake for “just a little bit longer” without doing anything to force yourself to stay awake.
If you are still awake, congratulate yourself for successfully achieving your goal. Then, don’t look at the time on the clock and keep focusing on staying awake for “a little bit longer”.
Keep this up all night if you have to. But, whatever you do, do not try and force yourself to sleep and keep trying to stay awake “just a little bit longer”.
Progressive muscle relaxation is a sleep strategy that predominantly reduces how much physical tension someone feels before bed. Spending much of the day stressed or worried can lead to physical tension, especially around the neck, shoulders and upper back area.
Progressive muscle relaxation can also reduce cognitive arousal levels by helping individuals focus on different parts of their bodies and become more aware of their feelings. It is, therefore, a much better cognitive strategy than either suppression or worry.
Progressive muscle relaxation really doesn’t help with someone’s homeostatic pressure or circadian rhythms. It is an intervention that specifically targets someone’s hyper-arousal, particularly any physical tension they feel. It can help people feel more relaxed and calmer; therefore, the other two sleep components can work effectively and help them sleep enough at the right times.
PMR instructions are as follows:
Tense the muscles in your arms, bringing your hands towards your shoulders to feel your biceps tighten. Then take a deep breath through your nose and down into your stomach. Then relax your arms as you breathe out the air through your mouth. Next, let your hands hang down by your side and give them a shake. Then repeat one more time by tensing, breathing and relaxing your arms.
Then tense the muscles in your face, including the ones in your forehead, nose, jaw and around your eyes. Notice the tension. Then take in a deep breath through your nose and into your belly. Relax all the muscles in your face as you breathe all the air out through your mouth. Let your facial muscles droop as your jaw hangs loose. Then repeat one more time.
Tense the muscles in your neck by bringing your shoulders up to your head. Hold this pose tight for a few seconds. Then take a deep breath through your nose into your stomach. Pause for a second or two. Then breathe all the air out through your mouth as you relax your neck and let your shoulders drop. Next, move your head around slowly in a circular motion if this helps you to relax your neck. Then repeat once more.
Tense the muscles in your stomach and back, bringing your abdomen closer to your spine. Hold this for a second, then take a deep breath into your belly while keeping your stomach and back tense. It may make it a little harder to breathe in as deeply as with the other muscle groups. Then breathe all the air out of your mouth as you slump down and push your belly out. Repeat one more time.
Tense the muscles in your buttocks and thighs, squeezing them tightly. Take a deep breath, pause, and relax these muscles as you breathe all the air out. Shift back and forth from left to right in your seat, then repeat.
Lastly, stretch out your legs and tense your calves and feet, bringing your toes back towards your body. Breathe in, pause, breathe out and relax your calves and feet. Shake out your legs, and then repeat one last time.
Based on what I have written above, trying CBT-I is good if you think all three underlying sleep mechanisms are an issue. CBT-I is also the most recommended if you currently have some beliefs about sleep that are unhelpful for you.
If your sleep pressure is not high enough at night when going to bed, but your arousal levels are okay, try sleep restriction. Try stimulus control if your circadian rhythms impact your sleep or if you spend lots of time awake in bed each night. Stimulus control can help to recondition your bed by feeling calm and sleepy and sleeping well over time, so it can be a helpful strategy in several ways.
If elevated arousal levels are your main issue, but you are doing okay otherwise, give progressive muscle relaxation a proper go. If you find that you are putting in too much effort to try to sleep at night and your pre-sleep arousal is too high, I would recommend trying paradoxical intention first.
No matter what you try, try it every night for at least a week, ideally two, before deciding if it is the right or wrong strategy. Both stimulus control and sleep restriction are difficult and anxiety-provoking initially. Still, they can have some of the largest improvements for you and your sleep if you stick to the instructions over time. Even a year after people have completed a course of CBT-I treatment, the best predictor of who continues to sleep well is individuals who still follow the sleep restriction and stimulus control rules.
Alongside nutrition and sleep, exercise is one of the three pillars of our health. Before coming up with a realistic and sustainable plan, let’s see what types of exercise are most recommended and how much we should try to do each day or each week.
Walking – is there anything to the 10,000 steps recommendation?
Historically, humans walked a lot. Often as much as 10 or 12 miles a day when we lived a hunter-gather lifestyle, hunting for animals, foraging for berries, and finding different resting areas. One thing that often set us apart from other animals was not our speed but our endurance and capacity to keep walking. This would eventually lead to an animal becoming completely exhausted, breaking down, and needing to give up. However, once we finally caught up to them, all we had to do was begin preparing our next meal.
The Japanese were the first to come up with the idea of doing 10,000 steps a day. I don’t think it was based on any science. It was more to do with the fact that it was a nice round number with five digits to aim for on the “Manpo-Kei” pedometer or step counter by Yasama Clock in Japan in 1965. My Japanese is non-existent, but the internet says that “Manpo-Kei” translates to “10,000 steps meter”, which seems to have stuck as the daily step target for many pedometers and activity trackers since then.
Some research suggests that 10,000 steps a day can improve heart and mental health and lower your risk of diabetes. However, if you have tried to do this daily, you have probably realised just how long it can take. For me, it can be about 90 minutes or eight kilometres of walking. For others, it can take up to two hours a day, which might not make it so sustainable or easy to do consistently.
Other research from Harvard suggests that walking an average of only 4,400 steps a day can have positive health benefits or lower a woman’s risk of dying. The control group did 2,700 steps a day, so increasing your step count by 1,700 steps a day might make a significant difference in your health.
If you are already walking 7,500 steps daily, you may not need to increase it further. Another study found that increasing your steps to 7,500 a day reduced your risk of dying, but increasing it beyond that did not. So averaging 7,500 steps a day is going to be my new target. If I do more or less, that’s okay, as long as the average is around that.
If you wanted to have 7,500 steps a day as a target, too, you could aim to do the majority of it in one block. However, some evidence suggests that regular movement throughout the day and not remaining in one position for too long is even better.
For example, my Oura Ring gives me an activity score (out of 100) daily. If I don’t move every hour while I am awake, it penalises me that day for my overall activity score. It also recommends achieving a calorie goal in terms of energy used through activity, meeting my activity goals on most days of the week, and occasionally giving myself a rest day where I don’t overdo it and allow my body to recover.
Is sitting killing us, and can standing desks help?
I find the public discussion over the last five or so years about the dangers of sitting interesting. Such studies have said that sitting for too long can increase the risk of excess weight around the waist, high blood pressure, high blood sugar, high cholesterol, poor posture, muscle weakness, and even an increased risk of heart attack or stroke.
A review of thirteen studies found that people who sit more than eight hours a day and do no physical activity outside of this have a similar risk of death to people who are obese or smoke regularly. However, further analysis of the more than one million people showed that 60 to 75 minutes of moderately intense exercise cancelled out the harmful effects of sitting for long periods each day. So, if you need to sit long hours at work each day, try to make sure that you also incorporate some time, either before, during or after work, to get moving and work up a sweat. It may be even more critical for you than for people on their feet more during their workday.
Many opposing arguments for sitting are pushed by the makers of standing desks. These companies say that if sitting all day while at work is the problem, then standing all day is the answer.
Standing desks do seem to improve the productivity of some workers. Those in a call centre with standing desks were found to be 45% more productive than those with sitting-only desks. Sit-stand desks can reduce upper back and neck pain by 54% after 4 weeks. Using a standing desk can reduce stress and fatigue after only 7 weeks. Furthermore, 87% of those using standing desks said they had more energy and vigour throughout the day. These levels reverted back to how they used to be when they returned to their old sitting desks. Using standing desks after lunch can even prevent your blood sugar from spiking as much.
Standing all day may help you burn slightly more calories than sitting, but not much. One study in the Journal of Physical Activity and Health found that the average person burned 80 calories an hour while sitting at a desk or 88 calories an hour while standing. So about 60 extra calories a day if you stand all day. If you instead sat all day and then went for a walk during your lunch break, you would burn 70 more calories than standing all day. I know I’d prefer the sitting and lunchtime walk. It will probably come with less low back, leg or foot pain. What do you think?
The importance of regular movement and breaks
My sister’s husband, Dr James Gillard, Osteopath, says that the problem isn’t sitting or standing. It is more the issue of remaining sedentary in one posture for too long each day. So, try to change into different poses once you feel uncomfortable and want to change. If you have a standing desk, hopefully, it is adaptable, where you can spend some time sitting and standing rather than doing only one of them all day long. And please, take regular breaks during the work day if you can. Stand or walk while talking on the phone. Head outside, get some fresh air and go to the park or for a walk at lunchtime. Grab a coffee for morning tea around the corner if you need to. Have a walking meeting with a colleague sometimes rather than just sitting at your desk if you can. Regularly taking breaks and moving throughout the day is the key.
Running in a race with thousands of other people can be pretty fun. I’ve done several of them over the years, ranging from 5km runs when I was younger to a few 10km fun runs with my brother, to the run for the Kids 15km race with my cousin, and three half marathons by myself. Finishing the half marathon at the Melbourne Marathon festival was terrific. Entering the field of the MCG and completing a lap around the field before finishing the race in front of a few thousand people was a big rush and exhilarating.
However, running by myself, just for the sake of it, is never something I have particularly enjoyed. I struggled for years to get into a good routine with running. I loved listening to Haruki Murakami’s book What I Talk About When I Talk About Running and even hoped that one day I would feel the same way about it. I never did, though. After several years of trying and failing, I eventually stopped trying to run in 2017.
1.35 million Australians do run for fun and exercise. If you do it regularly, it can significantly improve your health and reduce your risk of death. It reduces the risk of obesity, high blood pressure, high cholesterol, type 2 diabetes, heart disease and cancer. It can also improve your balance, metabolism, heart function and aerobic endurance.
Even running for 50 minutes a week can give you all these benefits, with benefits not improving or decreasing if you run more than this. Which makes it great news if you don’t have heaps of time on your hands and want to incorporate it into your life. If you think you could enjoy running for 50 minutes a week, either in one go or across a few, please talk to your doctor to see if it is suitable for you to get started straight away or slowly build up to it. I’ve spoken to a few people who tried the Couch to 5km program and enjoyed the benefits of getting into a good routine and feeling fitter. I think I may need to reconsider my earlier running retirement.
There are some risks of injury or overuse with running, so try to avoid uneven or hard surfaces if you can, and wear appropriate and well-fitted footwear. Also, try not to suddenly increase the pace and duration of your running, like I did with attempting to run long races with little preparation. Instead, slowly build up your speed and distance over time, and don’t feel you need to run for more than 50 minutes a week. Running can be a healthy pastime that you can do consistently for many years.
If you’re like me and don’t love the idea of running alone, see if there are any running groups in your area. If you really hate it, see if there is another exciting sport you can do that can give you similar benefits and more enjoyment and rewards. The less your exercise routine seems like hard work, and the more it feels like fun, the more likely you are to stick to it.
What are the alternatives to running?
If you look at the complete list of sports worldwide, there are over 800. If you look at the list of international sports federations and recognised sports, there are over 200. It may be that your area has a lot less, but I wonder how much you have looked to see what is available to you. Your sports experience may be what you were exposed to in school. If you weren’t the most athletic, competitive or extroverted child, you might have bad memories of times that seemed to turn you off sport for life.
If you are in school, there are plenty of times when you have to participate in sports that, for whatever reason, are not your thing. Please do not let those negative experiences put you off all sports or exercise for life.
If you are not as active as you would like to be, having training or a game to turn up to at the same time each week is an excellent way to get fit. It may also be fun and introduce you to new friends.
If you are unsure but want to explore the idea further, please check out this list to see if there is anything that looks interesting to you and may be worth trying. Then see on the internet, Facebook, or Meetup if a group exists in your area. Or at your local sports stadium or university. Most of the time, there will be groups, teams, and classes that would love a newcomer to join them.
I currently have a pool in my apartment complex and want to get into a routine of swimming 1km, or about 30 minutes, once a week. Swimming has many benefits if you enjoy it or have a pool nearby that you can use when you need it.
Unlike running or walking, Swimming is more of a full-body workout. Swimming can lower your stress levels, reduce anxiety and depression, and improve your sleep patterns, even after a light swim. It can burn double the amount of calories as walking. Only 30 minutes a week can reduce the risk of heart disease, stroke and type 2 diabetes. It supports the body and requires much less pounding on the body than running on pavement. It can increase your energy levels and doesn’t leave you all sweaty at the end of the workout.
Cycling
I currently don’t own a car and use a bike to get to and from work four times a week. As it takes approximately 30 minutes each way, I am already getting enough exercise time each week through cycling. Anything I do outside of this with Running or Swimming is a bonus. I also find it much easier and faster to ride down to the local shops whenever I need anything from the supermarket.
Like Swimming and running, regular cycling has a lot of potential benefits. It can increase your cardiovascular fitness and reduce your risk of heart disease. It can increase muscle strength, flexibility and mobility, especially in your legs. It can decrease your stress levels. It can strengthen your bones and improve your posture and coordination. It can also reduce your body fat levels.
There are some risks of injury, especially if you are riding on roads or unstable trails or tracks. However, I’d still much prefer to ride than run. If I ride as part of my commute to and from work, it saves me money by not having to pay for public transport. It also saves me time, as it is much faster than walking and public transport. If I can be less stressed and healthier while also saving money and freeing up more time, that seems a pretty good deal.
HIIT
The one thing I am not adequately doing in terms of cardiovascular fitness, even though it is recommended frequently these days, is High-Intensity Interval Training (HIIT). I’ve done a two-week trial of F45 before and didn’t mind it. It was definitely a challenging workout. I’ve never tried Cross Fit, but I’ve heard similar things from the devoted fans who love it and go consistently.
To do HIIT properly, the aim is to do a repeated exercise at nearly your maximum for short intervals of about 20 to 30 seconds, followed by extended periods of rest, usually at a ratio of 2:1 or 3:1. So if you sprint for 20 seconds, rest for 40 or 60 seconds, and then sprint for 20 seconds again. Allowing your body to somewhat recover before beginning the next high-intensity interval is essential in HIIT. It will enable your body to get used to the two extremes and improve cardiovascular conditioning. I’ve done little bits of it before, but definitely not exactly like I described to you then. I think I will need to talk to an expert on exercise to see how useful it would be for me to include HIIT regularly in my life.
With HIIT, you can burn a lot of calories in a short period. It can raise your metabolism for hours after a HIIT workout. It can help you to lose body fat and waist circumference. You can gain muscle in the trunk and the legs. It can improve your oxygen consumption. It can reduce your blood pressure and heart rate. Some studies suggest that it improves your heart health more than other forms of cardiovascular exercise. It can lower your blood sugar. Finally, it can improve your anaerobic and aerobic performance, so you can move quickly and for extended periods, depending on your needs.
If you want to give HIIT a go, please speak to a doctor or exercise physiologist first, especially if you haven’t done much exercise lately.
Strength training
The last thing I want to do is utilise the gym in my apartment complex and have a weights workout 2 times a week, for about 30 minutes each time. Even though I am already doing enough cardiovascular training, I tend to view strength training as something that needs to be incorporated into a healthy lifestyle. Even though some of these activities, including Swimming and Cycling, can help maintain muscle mass.
For many reasons, going to the gym and improving or maintaining muscle mass is positive. One of the main ones males often focus on is wanting to be buff or ripped and look good. While it is true that having more muscle can look and feel better, many other health benefits are less superficial. Strength training can help prevent posture and movement issues and maintain your capacity to do the things you need to do in your life. Maintaining muscle mass can help prevent osteoporosis and broken bones by strengthening your bones. It can also increase your metabolism, even when you are not working out, which reduces your risk of fat and weight gain over time.
When an article in JAMA Psychiatry reviewed 33 clinical trials on strength training in over 1,800 people, they found that people who did strength training two or more days a week had significantly reduced depression severity. So even if you don’t get physically stronger, it can still give you mood benefits, so you don’t have to lift super heavy or hard.
If you want to gain muscle or get stronger, doing each set to fatigue is probably the best advice I have been given and one that seemed to have the best results for me. To do this, lift (or pull) the weight for as many repetitions as possible until you struggle to do the entire movement. Then try for one more repetition. If you cannot do it, you are too fatigued, and your muscles will likely grow over time. If you decide to lift this way, make sure you lift with a spotter or a personal trainer, who can assist you at the end of each set when you become fatigued. Otherwise, stopping before you get to this point is much safer.
A 2017 meta-analysis of 16 studies also found that resistance training can significantly improve anxiety in individuals with and without physical or mental illnesses. So, the mental health benefits of resistance training can be potentially even more prominent and faster than cardiovascular exercise.
If you want to give resistance training a go, please talk to your doctor first and see a gym instructor, personal trainer or exercise physiologist. All these experts could help if you need more guidance and support on how to establish a good weight routine, how often to go, and what you can do.
Unlike nutrition, I will not give a grade for each sport or type of exercise or tell you that you need to do these things. Instead, I have aimed to highlight that whatever movement and exercise you incorporate into your life will probably be better than none.
If you want to focus on walking, see if you can begin counting your steps. Most smartphones have a step counter built into them now. This isn’t too bad as long as you bring your phone on your walks.
I like listening to music, a podcast, or audiobook when walking. It is terrific to do this if you are unmotivated. Listening to something you want to do alongside walking can be considered temptation bundling, making it a little easier to go. For example, people who could only listen to a story when they were at the gym were more likely to go to the gym. If you give yourself a similar rule, you might begin looking forward to your walks or workouts rather than dreading them.
Once you count your steps for a week, if you are under 7,500 steps a week, see if you can increase your step count slowly each week until you get up to 7,500 steps a day. If you are already doing this, keep up the excellent work and don’t feel you need to do anything extra.
If you want to focus on sitting less, you could buy a sit-stand desk or take more regular breaks during a work day and ensure you get away from your desk and outside during your lunch break. Or exercise an hour a day if you have to sit for 8 hours.
If you want to see the benefits of running, aim for 50 minutes a week. If it’s Swimming, aim for 30 minutes a week. If it’s HIIT, try 30 minutes weekly to begin with. If it’s cycling, 30 minutes once a week would be an excellent start too. Finally, if you are going to do strength training, see if you can do two weekly sessions to see the full benefits.
If you want to lose weight, please remember that nutrition, and not exercise, is the best way to do this. The type, amount, and timing of when you eat and drink are more important for how much weight and fat you lose than how active you are.
Altogether, if you are doing 30 minutes of moderately intense exercise five times a week, you are likely to be reasonably healthy from an exercise point of view. In addition, you are probably also helping your mental health, stamina and mobility.
You don’t need to become addicted to the gym or your smartwatch to become healthier. Instead, move a little more, sit a little less, get your heart rate up a few times a week, and see if you notice any of its benefits.
I am definitely not a nutrition expert. Especially when you look at my behaviours or what I eat and drink daily.
I remember several years back when I tried to track my food and drink intake using My Fitness Pal’s phone application. They have a feature where you can share your diary with friends and family or make it available so they can see it too. I did this and had my cousin Shannyn see my diary. Let’s just say that she was slightly shocked at my diet. She was also not afraid to tell me this.
After this, I did not want to share my food and drink diary with anyone else.
I don’t believe my actions are based too highly on a lack of knowledge. By now, I have read a lot and have a general sense of what is considered healthy or unhealthy habits.
However, in terms of what specific actions I should take, I’m unsure exactly what to do. There are a lot of competing diets and rules out there. I don’t just want something to help me lose weight until my BMI is back in a healthy range of between 20 and 25 kg/m2. I want sensible and not too complicated or restrictive guidelines for how to eat to maintain a sustainable and healthy lifestyle.
The Healthy Eating Pyramid
Nutrition Australia first introduced their Healthy Eating Pyramid back in 1980. When I was in school, I remember it being in all of the school textbooks and on posters around the place. Of course, the pyramid has evolved over the years. The one I remember the most looked like this one from 1982:
My father was a physical education teacher and took on the food pyramid’s advice. So we would eat cereal and toast for breakfast, sandwiches for lunch, and often pasta or rice with dinner. However, some of the most recommended diets now, including the low carb, high fat (LCHF) diet, the slow carb diet, Atkins diet and the ketogenic diet, all recommend staying away from the things at the bottom of the pyramid (apart from vegetables), especially bread, cereals, rice and pasta.
The most recent pyramid in 2015 has shifted to accommodate the learning that has taken place worldwide since 1982. Unfortunately, over these 33 years, the average waistline has continued to expand, and the percentage of people that are overweight and obese has continued to climb:
Grains have shifted higher up the pyramid, and sugar has come out altogether. There are now some extra parts at the bottom about choosing water rather than any other drink, enjoying herbs and spices, and being active daily. The section at the bottom has also increased for vegetables and shrunk for fruit, indicating that we want to prioritise vegetables more in our nutrition than fruit. Finally, margarine is no longer mentioned at the top, but rather eating healthy fats. It doesn’t tell you what they are, but Nutrition Australia says that some fats are more nutritious than others. These unnamed fats are considered okay in small doses.
The Australian Guide to Healthy Eating
Similar to the food pyramid, but slightly different. The Australian Guide to Healthy Eating shows the recommended nutritious foods that the average Australian should eat. One of the most noticeable differences is putting the food in a circle rather than a pyramid. This makes it easier to think about how much of your plate should have the five recommended food groups:
It recommends a similar portion size of grains to vegetables, which is more in line with the older pyramid from 1982 than the latest one from 2015. It also shows specific oils that some people may consider unhealthy, including canola spray and margarine. It does recommend water as the main drink. Still, it is more realistic than the pyramid by showing that people sometimes eat and drink unhealthily, including alcohol, sugary, deep-fried, or fatty foods. Therefore, it recommends having these things occasionally and in small amounts. I’m not sure why chickpeas and red kidney beans have to be in two different food groups, but they are.
The Star System in Australian Supermarkets
The Health Star Rating System is an interesting intervention with the right intention. The aim is to help educate the Australian public about the healthiness of different foods in the supermarket so that consumers can make healthy choices for their shopping carts and homes. I’ve found myself looking at the star ratings for various products and being influenced by what is written when deciding what to buy.
With cereals, for example, there is a lot of variety. All-Bran Original tastes dull, but with a five-star health rating, it suddenly seems more appealing than the two-star Crunchy Nut Clusters or the 1.5-star Crispix cereal. More sugar and less fibre and protein generally mean fewer stars for the cereal, which makes sense and seems pretty straightforward.
A more contentious area is the oils and fats. From various things that I have read and heard, there is a big difference in how healthy or recommended certain oils are from others. For example, some experts and diets say that butter is healthy. In the Bulletproof Diet, people even add it to their morning coffee. Yet it obtains the worst star rating of 0.5/5 because it is high in saturated fat. Another oil that people have told me to cook before is coconut oil. It also receives a 0.5/5 health star rating. On the other hand, with all its chemicals, margarine gets a score of 4.5/5. I’ve even seen 5-star vegetable oils, even though some experts have told me to stay clear of these oils as much as possible.
Comparing the star rating between one type of food and another is also contentious. For example, Up-and-Go drinks receive 4.5 stars out of 5, even though they have 28.7 grams of carbs, 15.8 grams of added sugar, sunflower and canola oil. But, then, foods such as smoked salmon receive 2/5 stars, even though they only contain salmon and salt and have healthy omega-3 fats and zero sugar or carbs. However, because of the higher amount of saturated fat, salmon is penalised and considered a poorer health decision. This might lead to some people choosing the highly processed Up and Go instead of the smoked salmon.
Another problematic issue with the Health Star Rating System is that it is not compulsory. Because of this, star ratings are currently only posted on 31% of eligible foods in Australian supermarkets. Suppose people use this as a guide to what is healthy or unhealthy in determining their choices at the supermarket. In that case, they are left in the dark with 69% of the eligible products.
An even bigger issue is that big corporations are gaming the star system to trick the public into thinking that their products are healthier than they are. For example, if vegetable oils obtain a five-star rating, does this mean they are one of the most beneficial food options?
It shouldn’t mean this, but how is the consumer to know? The food pyramid says to avoid foods with added salt and sugar and only consume healthy fats in moderation. It’s debatable if vegetable oils and margarine are healthy fats. Still, the Health Star Rating System says nothing about this or how people should only eat them in moderation.
I’m guessing that if someone consumed all their food in deep-fried vegetable oil, they wouldn’t remain healthy for very long. So how does a use sparingly (or not at all) food obtain a five-star health rating? Is it helpful if the system doesn’t give better ratings to the foods that we’d be better to eat more often?
Other health books I have read advise steering clear of as many packaged foods as possible and trying to eat things without an ingredient list. So, vegetables, fruit, meat, unsalted nuts, and eggs. As soon as the product has items in the ingredients list where you aren’t sure what they are, maybe it’s not the healthiest choice.
Is it helpful to recommend that people count the calories they eat?
The average American is recommended to consume 2000 calories daily to maintain a healthy weight. On the back of all packaged foods in the USA, the Food and Drug Administration (FDA) requires a specific nutrition label. Here is an example of the latest nutrition label:
As you can see, 2,000 calories a day is used for general nutrition advice. Furthermore, in some countries and states, fast food and chain restaurants must state how many calories their products have in them. It is done to help educate people about how many calories their food has. By doing this, people hopefully do not go too far above the 2,000 calories a day recommendation.
A large Double Whopper with Cheese Meal from Burger King is 1,530 calories. After eating this, a person has only 470 calories they can consume for the rest of the day without going on their daily recommended limit. A large Cheese Lovers pizza from Pizza Hut in Australia contains 9909kj, well over the recommended 8700kj per day that the Australian Government recommends for people to consume daily. I don’t know about you, but I’ve definitely eaten a large pizza on a few occasions. I might think twice about doing this if I know it will put me over my recommended daily calorie intake. So, forcing fast-food restaurants to post the calorie content of their food might help some people not overindulge in one sitting and unknowingly gain weight over time.
All Calories Are Not Equal
A big issue with calorie counting is assuming that the only thing that matters to our overall health is how many calories we consume daily. It’s just not true. Drinks like Diet Coke and Pepsi Max have zero calories, but that doesn’t mean they are healthy. They contain several artificial ingredients, including colour (Caramel E150d), sweeteners (Aspartame, Acesulfame K), flavourings, acids (Phosphoric and Citric Acid), a preservative (Potassium Sorbate) and Phenylalanine. If you only look at the zero calories, then people should be able to drink as much of this each day as they want without it being an issue. But I’m not sure if a healthy person would want to knowingly ingest lots of these ingredients daily.
When it comes to being healthy, there are more important things than just how many calories we consume. A Diabetes Victoria website describes a deep-fried battered fish, two potato cakes, and twenty chips from a takeaway shop (1053 calories). They compare it to a skim latte for a snack, hummus and salad sandwich and a medium apple for lunch, a handful of almonds for an afternoon snack, and baked fish with sweet potato wedges for dinner. These snacks and meals equal 1075 calories, only 22 more than the fish and chips. They would also pack 24g less fat, 21g less saturated fat, 319mg less sodium, and 16g more fibre. The second option is more nutritious, with fewer things that could contribute to inflammation. Even though there are more carbohydrates across the two snacks and two meals than the one meal of fish and chips, they are spread out over more time, leading to less of a blood sugar spike and subsequent crash.
Calorie Density
A different way of thinking about food and calories is what the weight loss and healthy eating app Noom do. They still encourage recording all the foods, drinks and calories you consume daily. However, they also try to document how calorie-dense your food is. Your food or drink then receives a colour score based on its density.
Suppose you eat something low in density, such as vegetables or a salad without dressing; it receives a green score. With green foods, you can eat plenty of these and feel fuller for longer without worrying too much about going over your daily calorie goal.
Essentially, the more water a particular food has, the less calorie density it is likely to have. So, a grape is considered a green food, whereas a raisin, or dried grape, is a red food. Chicken breast and eggs are both medium or yellow foods with lots of nutrients. Still, a moderate number of calories compared to their weight. Many nuts, especially walnuts, are nutrient-rich but very high in calories. Therefore, they receive a red colour. There are no good or bad foods, but if you want to keep your calories low while also feeling satisfied and full, having more low-density or green foods in your meals and snacks is the way to go. Or at least that is what Noom says.
Intermittent fasting can help without cutting down on how many calories you consume daily
Some interesting recent studies have also begun to see the potential health and fat loss benefits of intermittent fasting. The book ‘Life in the Fasting Lane: How to Make Intermittent Fasting a Lifestyle—and Reap the Benefits of Weight Loss and Better Health’ by Dr Jason Fung, Eve Mayer, and Megan Ramos describes the potential health benefits. It also details how to practice it for those who want to learn more.
Intermittent fasting is another example of how there are other things to consider apart from how many calories we should consume every day. Eating and not eating at different times also affects our health and body composition. For example, healthy males, who frequented the gym, found that eight weeks of feeding (between 1pm and 9pm only) reduced fat mass but not overall muscle mass. The comparison group consumed the same calories but ate between 8am and 9pm (Moro et al., 2016).
A review article looking at intermittent fasting studies between 2000 and 2018 found similar results. Fat mass was significantly reduced in participants who underwent an intermittent fasting protocol (Ganesan, Habboush & Sultan, 2018). The review also found that some biochemical markers reduced significantly, whilst other changes were inconsistent. Therefore, intermittent fasting may be worth trying if you aim to reduce your overall fat mass without losing too much strength or weight.
Both low-fat and low-carbohydrate diets can produce positive short-term results
An interesting meta-analysis reviewed randomised controlled trials of diets in overweight and obese adults (BMJ, 2020). The reviewers found that both low-carbohydrate and low-fat diets produced similar benefits in weight loss and reduced blood pressure at six months. Compared to a usual diet, low-carbohydrate diets resulted in 4.63kg of weight loss at six months, and low-fat diets resulted in 4.37kg of weight loss. Atkins produced the most prominent weight loss of 5.5kg after six months of all the popular diets. Not surprisingly, dietary advice without substantial behavioural changes led to no weight loss after six months. Moderate macronutrient diets, such as DASH or Meditteranean, led to about 3kg weight loss and slightly improved blood pressure after six months. However, it was not as effective as either low-fat or low-carb diets.
Unfortunately, at 12 months, most weight loss benefits diminished across all diets, including low-carb, low-fat or moderate macronutrient diets (BMJ, 2020). Only the Meditteranean Diet maintained the cardiovascular benefits by 12 months, which puts it as the top eating plan if you want to improve your heart health in the long run.
If You Want to Lose Weight
At www.dietdoctor.com, they provide 18 tips that can help people lose weight. They also back up their recommendations with scientific evidence and rank them in importance. I don’t agree with all of their advice. Still, they tell you how strong the evidence they are using is. Below are my modified tips; based on their recommendations. You might find some of these tips helpful if you apply them to your life. However, please talk to a qualified Dietician before taking on any significant changes in your diet to see if they are right for you. If you have also suffered from any eating disorder-type behaviours, please seek assistance from a GP or psychologist who can support you on your health journey.
My top 7 weight loss tips
Avoid eating foods or drinking beverages high in sugar, and minimise your intake of highly processed or deep-fried carbohydrates.
Eat when hungry, and don’t feel that you need to eat if you are not feeling hungry.
Eat real food or foods without an ingredient list.
Eat as many vegetables or salads as you want to, assuming you go easy on the sauces and dressings.
Measure your progress wisely.
Be persistent by choosing a sustainable eating plan for yourself and stick to it as much as possible. If you have a meal where you do not, get back to the plan after that, not the next day or the following Monday.
Avoid beer and other alcohol as much as possible.
**Exercise is positive for your heart, health, mood and sleep. It is not a super effective weight-loss strategy, but it is beneficial in many other ways.
So many different rules and recommendation
If you can’t tell by now, knowing what to consume as part of a healthy and nutritious diet is tricky. Some organisations or Governments will recommend certain things. But, at the same time, other experts will tell you to avoid all that and suggest something different altogether.
I could potentially test out all the different variables and see which one is the best fit for me. Fortunately, US News & World Report have released their Best Diets Overall 2022, which ranks 40 popular diets for me. They look at which eating plans are the healthiest, which ones are easiest to follow, which ones lead to the fastest weight loss, which ones are the best for long-term weight loss, and which eating plans are the best overall:
Best Diets for Healthy Eating in 2022
Mediterranean Diet = 4.8/5
DASH Diet = 4.7/5
The Flexitarian Diet = 4.7/5
MIND Diet = 4.6/5
TLC Diet = 4.4/5
Easiest Diets to Follow in 2022
Mediterranean Diet = 3.7/5
The Flexitarian Diet = 3.4/5
The Fertility Diet = 3.3/5
MIND Diet = 3.3/5
WW (weight watchers) Diet = 3.3/5
Best Fast Weight-Loss Diets in 2022
Atkins Diet = 3.9/5
HMR Program = 3.8/5
OPTAVIA = 3.8/5
Biggest Loser Diet = 3.7/5
Keto Diet = 3.7/5
Best Long-term Weight-Loss Diets in 2022
The Flexitarian Diet = 3.5/5
Volumetrics Diet = 3.5/5
WW (weight-watchers) Diet = 3.5/5
Vegan Diet = 3.4/5
Mayo Clinic Diet = 3.2/5
The Best Diets Overall in 2022
Mediterranean Diet = 4.2/5
DASH Diet = 4.0/5
The Flexitarian Diet = 4.0/5
MIND Diet = 3.8/5
Mayo Clinic Diet = 3.7/5
TLC Diet = 3.7/5
Volumetrics Diet = 3.7/5
WW (weight watchers) Diet = 3.7/5
Vegetarian Diet = 3.6/5
Ornish Diet = 3.5/5
I want a sustainable diet to help me lose weight initially and keep my body mass index in the healthy range for the rest of my life. The Flexitarian Diet, therefore, seems like the best option for me. However, with the best overall diet score of 4.2/5, the Meditteranean Diet also seems like a good choice.
If I wanted to lose weight as fast as possible, I might choose The Atkins Diet. However, The Flexitarian Diet achieves a better long-term weight loss score than the Atkins Diet. The Atkins Diet’s overall score is also 2.2/5, which is 34th out of 40. Much worse than the 4.0/5 score and 2nd overall for the Flexitarian Diet.
Interestingly, the things I have been hearing the most about regarding eating plans are not at the top of the list. For example, the Ketogenic Diet comes in 5th for best fast weight loss but is nowhere near the top-recommended diets (37th best eating plan out of 40). Neither is the Paleo Diet (30th best eating plan overall) or Intermittent Fasting (27th best eating plan). Jordan Peterson’s diet of only eating meat doesn’t even rank. Still, the AIP Diet, which also claims to target autoimmune diseases, is the 35th best-ranked eating plan overall.
Which nutritional recommendations do you think will work best for you and be possible for you to stick to long-term?
What guidelines work best for you to change your nutrition and eating habits? Are they any of the diets listed in the US News & World Report rankings? Or the 2015 food pyramid? Or the Australian Guide to Healthy Eating? Or the Health Star Rating System? Or Calorie Counting or using the data provided on Nutritional Labels? Or whatever the expert you see suggests is best for you? I’d love to hear how people try to approach their nutrition in a healthy, effective and sustainable way.
My stepdaughter is now in year 7 and at a new school this year. We’ve all moved across to Melbourne, Australia, after being in Port Vila, Vanuatu, since 2018. Her new school seems to be going well for her. They have asked all parents of year 7’s to write a letter to their children for their time capsule, which will be opened in year 12 in 2027. As we will likely be back living in Vanuatu in 2027, she is unlikely to read what I have written. I have therefore decided to share what I have written here also. I doubt she will read it until then, but it was an interesting exercise. Below is my letter:
Dear M,
I am writing this letter to you as you are about to finish your secondary schooling. How cool is that? What’s the year 2027 like? Is it like the Fifth Element, where there are flying cars everywhere? Or like Minority Report, where everyone is getting locked up in jail for crimes they have thought about doing but haven’t committed yet? Or like Blade Runner, where it’s hard to tell who a robot and a human is?
Probably not, but I thought I’d ask. Does it seem like the world is getting better still? Or is everyone worried about the world and its people even though progress has been made? Hopefully, there hasn’t been another pandemic that has shut things down again, and even though we still worry about Russia and China, we haven’t had a nuclear war or World War III.
I don’t even know if you will get this letter. I guess you will return to Vanuatu and attend the international school again. Hopefully, they manage to get it to you in some way.
Either way, I am super proud of you. It’s been so cool to see how you have adjusted to life here in Melbourne and Australia in 2022. Your mum was more scared of how you would do with coming to Melbourne than how she would do. Not that it is a competition, but you are doing way better so far. I hope it continues that way for you and that you enjoy your time here in Melbourne and at your new school.
I’m proud of you for being unapologetically yourself and doing whatever you want, regardless of what others do. I wish I had the same courage to do that in high school when I was your age. I do it these days, but it took me a long time to get to that point.
I’m happy that you are such a voracious reader at your age and that you are so curious too. You described yourself as curious in the video questions I asked you this year, which is super cool. I hope you continue to love reading, learning, and being curious about everything for the rest of your life. There’s this weird term called polymath, a person of vast knowledge or wisdom. I think it’s a pretty cool thing to be, and if you can do that, it means that the world is your oyster, and you can apply yourself to learn about and do whatever it is that you want.
Your school is telling me to discuss my hopes and wishes for you next. Essentially, I just want you to feel okay with who you are and for you to be able to enjoy some things. I hope for life to not feel too difficult for you, for you to have some connections and relationships that mean a lot to you with people you feel close to. I also hope you are doing what you want to do in your life. Finally, I hope you know that we will always have your back and will never try to keep you from doing the things you want.
You don’t need to be super successful in a societal sense with lots of money, cars and houses. I just want you to feel loved by your mum and me and know that you are living the life that you want to be and not be held back by your fears too much. Life can be scary, but the more we choose to move towards the life we want rather than be held back by our fears, the better life we can have. Or at least that is how I think about it.
My feeling at this moment is complete gratitude. I am grateful that you are in my life. I want to be a positive male role model in your life that is 100% happy when you can be the best version of yourself. I don’t really want anything else.
Some of my best memories of you are when we first met. Doing things together. Playing games at my house initially. Then, you wanted to move in with your mum and me. Us living in our new place near your school and grandparents together. Us going on trips overseas together. You teaching me to be as honest as I can be. Us talking over video and the phone while I was in Australia by myself for 17 months. When I felt like I wanted to get better for you and your mum after I had a stroke. When I felt like we are a family together. Helping you with your math or any other homework when you are stuck. Doing new things with you, like going on bike rides, swimming together, rock climbing, or anything else you enjoy.
I’m then meant to give you advice as your graduate high school. I hope you have enjoyed as much time as possible between years 7 and 12. If you remain curious and interested in what you are learning, I’m sure you will do well. I hope that you have some options for whatever it is that you would like to do next. Try to enjoy it where you can, be grateful for the positive things you have, and don’t feel like you need to have all the answers straight away. I definitely didn’t have everything figured out when I was your age, and I doubt that I do even now.
Life is about asking the right questions and trying to live your life in a way that will help you figure out the answers you seek. If you need some time off or a gap year, take it. Just make sure you spend your time in the ways you would like. Someone on the couch all day who wishes they could be doing something else is not happy. Someone who chooses to be on the couch all day and does it can be. So do whatever it is that you feel that you need to be doing at the moment. If you do this unapologetically, you will hopefully get out of it what you need so that you feel like you have correctly done this. Once you get tired of this or all the benefits you want, move on. Then get everything that you can out of that.
Life isn’t always easy, and our brains will never be 100% satisfied. This doesn’t have to be a problem. Seeking and searching for new and better things is not a sign that something is wrong. It is just how the brain works. Try to enjoy whatever you can, be grateful for what you have, and put your energy towards creating the things you want for yourself and others. If you do this, you will live the best possible life.
The more you can enjoy the effort you put in towards something, whatever it is, the more you will be willing to do hard things. If you can do this, you can have a good life by doing what you want. Your brain will probably always strive for more, which is normal and natural. Just go out there, experience all the things you want to, and try not to be held back by fear when it is about doing what you want to that is likely to be safe. Try to keep being the person you want to be. If you ever need anything, whether it is a shoulder to cry on, a hug, a break from everything, or some guidance, know that I will be there to try to help you. I can’t guarantee that I will always help you the way you want, but I will always try my best.
“The saddest aspect of life right now is that science gathers knowledge faster than society gathers wisdom.” — Isaac Asimov
The Longevity Project
Over 1,500 of the most promising and brightest boys and girls were recruited in 1921 by Lewis Terman. Unfortunately, he died in 1956, but the study continued for decades afterwards. All participants were born around 1910 and studied for 80 years or until they died. It was then possible to figure out who lived the longest and why.
Although each child was potentially gifted, not all lived long and happy lives. Fortunately, analysis of this extensive data has taken place for over twenty years at The University of California in Riverside.
The study’s significant findings are summarised in the 2011 book “The Longevity Project: Surprising Discoveries for Health and Long-Life from the Landmark Eight-Decade Study” by Howard Friedman and Leslie Martin. I listened to this audiobook recently and was quite surprised with some of its key results:
1. Living honestly is essential.
“A key part of one of the healthy paths is called ‘The High Road.’ Such an individual has good friends, meaningful work and a happy, responsible marriage. The thoughtful planning and perseverance that such people invest in their careers and relationships promote long life naturally and automatically, even when challenges arise.”
2. Please do NOT send your children to school earlier than their peers.
“Starting formal schooling at a very early age was not a great idea for most. Children need unstructured playtime, and they need to get along with their peers; starting young seemed to alienate them.”
3. Illness is NOT random.
“Those that live longer are often healthier throughout their years and (managed to) avoid serious ailments altogether.”
“Those who are healthier tend to be happier, and those who are happier tend to be healthier.”
“It’s never too late to choose a healthier path. The first step is to throw away the lists and stop worrying about worrying.”
“Thinking of making changes as taking ‘steps’ is a grand strategy. You can’t change major things about yourself overnight. But making small changes, and repeating those steps, can eventually create that path to a longer life.”
4. Good marriages lead to better health, especially for men.
“Marriage is only health-promoting for men who are well-suited to marriage and have a good marriage. For others, it is more complicated.”
“Women who stayed single, were widowed or got divorced often thrived more than women who were married to troublesome husbands.”
“Men who stayed divorced were at high risk for premature mortality.”
5. Divorce during childhood predicts early death in adulthood.
“The strongest social predictor is parental divorce, as it often pushes the child into many unhealthy directions, including heavier drinking and smoking, less education, lower career achievements and a greater risk of later divorce themselves.”
6. Follow the long-term recommendations that are right for you.
“The long-lived did not find the secret to health in broccoli, medical tests, vitamins or jogging. Rather they were individuals with certain constellations of habits and patterns of living. Their personalities, career trajectories and social lives proved highly relevant to their long-term health, often in ways we did not expect.”
“You need to make changes that will be sustainable in the long term. We say, if you don’t like jogging, don’t jog! Instead, begin doing things that you enjoy and can keep up, like a walk at lunchtime with a friend or vigorous gardening.”
“The usual piecemeal suggestions of relax, eat vegetables, lose weight and get married are lifesaving for some, but neither effective nor economical for many.”
“Some of the minutiae of what people think will help us lead long, healthy lives, such as worrying about the ratio of omega-6 to omega-3 fatty acids in the foods we eat, actually are red herrings, distracting us from the major pathways. When we recognise our long-term healthy and unhealthy patterns, we can begin to maximise the healthy patterns.”
7. Conscientiousness is the most critical personality factor for longevity.
“Conscientiousness is very important. Unconscientious boys, even bright ones, are more likely to grow up to have poor marriages, smoke more, drink more, achieve less education, be relatively unsuccessful at work, and die younger.”
“Conscientious people stay healthier and live longer for three reasons:
First, they do more things to protect their health.
Secondly, they are biologically predisposed to be healthier, and
Lastly, they end up in more beneficial situations and relationships.”
8. Working hard can be helpful for you.
“Those who worked the hardest often lived the longest…especially if they were involved in meaningful careers and were dedicated to things and people beyond themselves.”
“It was clear that working hard to overcome adversity or biting off more than you can chew — and then chewing it — does not generally pose a health risk. Striving to accomplish your goals, setting new aims when milestones are reached, and staying engaged and productive is what those heading to a long life tend to do. The long-lived didn’t shy away from hard work; the opposite seemed true.”
9. Resilience is protective for health.
“Depending on the circumstances, a traumatic event such as parental divorce could contribute to a longer life if the child learned to be resilient.”
“Resilience is important, and can be achieved via a sense of personal accomplishment, the strength of character and maturity.”
“Combat veterans are less likely to live long lives, but surprisingly the psychological stress of war itself is not necessarily a major health threat. Rather, it is a cascade of unhealthy patterns that sometimes follows. Those who find meaning in a traumatic experience and can reestablish a sense of security about the world usually return to a healthy pathway.”
10. Human connection is essential.
“Having pets can improve well-being, but they do not help people live longer and are not a substitute for friends.”
“People who feel loved and cared for report a better sense of well-being.”
“The clearest health benefit of social relationships comes from being involved with and helping others.”
“It is important to be well-integrated into your community.”
“Connecting with and helping others is more important than obsessing over a rigorous exercise program.”
“The groups you associate with often determine the type of person you become — healthy or unhealthy.”
The Harvard Study of Adult Development began in 1938. It is sometimes also called ‘The Grant Study’.
This longitudinal prospective study aimed to identify predictors of healthy ageing in real-time.
For 79 years, it has examined the lives of 268 physically and mentally healthy Harvard college sophomores from 1939–1944 until their death, including eventual US President John F. Kennedy. It has also incorporated many of their offspring and 456 disadvantaged inner-city youths who grew up in Boston between 1940 to 1945.
Earlier this year, I listened to the 2012 audiobook by George Vaillant, titled “Triumphs of Experience.” He was the previous director of the study.
The primary research findings include:
1. “Alcoholism is a disorder of great destructive power.”
Alcoholism precedes marital difficulties and is the leading cause of divorce, with 57% of divorces traced to alcoholism.
Alcoholism can also lead to the later development of depression and neurosis.
Alcoholism is the most significant predictor of early death alongside cigarette smoking.
2. “Above a certain level, intelligence doesn’t matter.”
There is no significant difference in income earned by men with an IQ of 110–115 compared to men with an IQ higher than 150.
3. “Ageing liberals have more sex.”
While political ideology has no significant impact on life satisfaction overall, most liberal men continue to have an active sex life into their 80s. In contrast, conservative men are likelier to cease having sex by 68.
4. “For good or ill, the effects of childhood last.”
A warm childhood relationship with the mother predicts greater financial earnings later in life ($87,000 more than males who had uncaring mothers), greater effectiveness at work later in life, and a three times lower risk of dementia in old age.
A warm childhood relationship with the father predicts lower rates of anxiety and pessimism during adulthood, increased life satisfaction later in life, reduced difficulties in letting others get close and greater enjoyment of vacations throughout life.
5. “It is not one thing for good or ill — social advantage, abusive parents, physical weakness — that determines how children adapt to life, but the quality of their total experience.”
It means that what goes right during childhood matters much more than what goes wrong.
If bad things happen, as long as they are outweighed by the good, you are likely to still turn out okay.
“Bleak childhoods were not always associated with bleak marriages.”
“Restorative marriages and maturing [psychological] defences” are “the soil out of which resilience and post-traumatic growth emerge.”
6. “People really can change, and people really can grow. So childhood need be neither destiny nor doom.”
7. “Even the death of a parent was relatively unimportant by the time the men were fifty. By age eighty, men who had lost parents when young were as mentally and physically healthy as men whose parents had lovingly watched them graduate from high school.”
8. “Prudence, forethought, willpower, and perseverance in junior high school were the best predictors of vocational success at age fifty.”
9. “All fifty-five Best Outcomes had gotten married relatively early and stayed married for most of their adult lives. Proportionately three times as many of the Best Adjusted men enjoyed lifelong happy marriages as the Worst.”
The effect of marriage was even starker for the inner-city men of the Glueck Study: “two-thirds of the never-married were in the bottom fifth in overall social relations, 57% were in the bottom fifth in income, and the study raters classified 71% as mentally ill.”
“It turned out that happy marriages after eighty were not associated either with warm childhoods or mature defences in early adulthood — that is, you don’t have to start ‘all grown up’ to end up solidly married.”
10. “It was the capacity for intimate relationships that predicted flourishing in all aspects of these men’s lives.” In other words, “Happiness is love. Full stop.”
Spouses’ mutual dependence on each other was associated with happy and healthy marriages. For example, 76% of the men still alive at age eighty-five said their marriages were happy.
“Most of the men who flourished found love before thirty, and that was why they flourished.”
See the latest director of the study Robert Waldinger talk about the key findings from the Harvard Study of Adult Development for more information. His TED talk has millions of views:
I hope you find these highly significant findings as fascinating as I do.
They also give us scientifically supported indicators of what to do if you want to live a happy, healthy, and long life.
It is possible to understand who you are and what you want in only three steps.
STEP ONE: Who am I?
To know what we want, we first need to figure out who we are (or, more accurately, what we see ourselves to be).
STEP TWO: What do I care about?
Once we know who we are, we must figure out what is important or meaningful to us (and what isn’t).
STEP THREE: How do I show that I care about these things?
We then need to figure out what actions to take and what systems or habits we can develop to help us live consistently by these values.
STEP ONE: Who Am I?
Our identity, or who we see ourselves as consists of many things.
It may include our name, family, nationality, ethnicity, or racial background. It could also have our culture, our class, our friends, our relationship status, our sexuality, our gender, or our religious beliefs. Finally, it could have where we live, work, what we do for work, our interests and hobbies, and what we like to do for fun or relaxation. Most people can answer these descriptive questions about themselves quickly.
Different factors can shape the overall identity of one person much more than they do for others. For example, a cisgender straight white male may not consider that his gender, race, sexuality or culture play a significant role in his identity. However, these factors could be huge for someone who is non-gender conforming or sexually fluid. It could also be substantial for people from a minority cultural or religious group in their country who have suffered stigma or discrimination.
1a. Write down a descriptive answer to the question “Who am I?”
What is your name? ________________________________________________________
How many siblings do you have? ____________________________________________
Are they older or younger than you? __________________________________________
Are your parents still together or married? _____________________________________
What did they do for work? __________________________________________________
Has anyone important to you died? __________________________________________
Where were you born? _____________________________________________________
What country are you a citizen of? ____________________________________________
What is your ethnicity? _____________________________________________________
Where do you live? ________________________________________________________
What do you do for work? ___________________________________________________
What is your sexuality? _____________________________________________________
Are you in an intimate relationship? __________________________________________
Do you have any children? __________________________________________________
Are you religious? __________________________________________________________
What are your hobbies? ____________________________________________________
What do you like to do in your leisure time? ____________________________________
MY DESCRIPTIVE PROFILE:
I’m Damon Ashworth. I’m the middle child in my family, with an older brother and a younger sister. My parents are still happily married, and we all get along well. I am a dual citizen of Australia and the United States of America. Still, I have spent most of my life in Melbourne, Australia. I am of Caucasian descent. My parents were both teachers, making me from the middle class. My friends are predominantly from Melbourne, but I’ve made some friends in the US when I went to school there for two years and some good friends since moving to Vanuatu. I am currently volunteering in Vanuatu as a Clinical Psychologist with the Ministry of Health and at the Vila Central Hospital. I identify as a straight male and am in a happy monogamous relationship with my partner. She has a fantastic daughter. I have been baptized as a Christian but do not attend religious services. I love reading non-fiction books, listening to podcasts, playing fantasy basketball and watching NBA, and writing and making music and movies. I love hip-hop and laid-back music, horror and comedy movies, and watching live theatre shows and stand-up comedy. I also love to be active, get outside, visit new places on holidays, and travel and snow ski when I can afford it.
1b. Take a personality test to help answer the question “Who am I?”
No matter what is essential to you, everyone needs to construct a cohesive narrative or story about who they are. If you are getting stuck in describing your personality, many tests can help you. I believe the five-factor personality model is probably the best personality test for the average person to understand themselves better. You can complete either the short-form 120-question IPIP-NEO or the long-form 300-question version for free online.
An individual’s scores on Extroversion, Agreeableness, Conscientiousness, Neuroticism and Openness to Experience are reasonably consistent across their lives. So, knowing where you sit on the spectrum of each of these facets helps you get to know yourself better. It can also help you work with who you are rather than against yourself when designing your Deliberately Better Health plan.
Take the IPIP-NEO. Then write down your percentile scores for each of the five factors.
What are your different personality factor scores?
Scores above the 60th percentile indicate that you are more extroverted than introverted. It means you are above average in friendliness, cheerfulness, excitement seeking and activity level. In addition, you are above average in speaking up when needed and enjoy being in large groups and crowds. Extroverts love being around other people and expressing their feelings and whatever is on their minds. They also tend to feel more energized when socializing and enjoy living a fast-paced life.
Scores between the 40th and the 60th percentile indicate that you are an ambivert. That means you identify more with extroverts with some of your traits and more with introverts with other characteristics.
Scores below the 40th percentile indicate that you are more introverted than extroverted. Introverts prefer to spend more time doing quiet or solitary activities and recharge their energy more when alone than with others. When they are in a group, they may talk less and listen more.
Scores above the 60th percentile indicate that you are more agreeable than disagreeable. In addition, you are likely higher than average on trust, straightforwardness, cooperation, altruism, modesty and sympathy.
Scores between the 40th and the 60th percentile indicate that your agreeableness is average. You might identify more with highly agreeable people in some ways and with disagreeable people in others.
Scores below the 40th percentile indicate that you are more disagreeable than agreeable. You are probably higher than average on distrusting people and keeping your cards close to your chest in discussions with others. On the other hand, you are less likely than average to comply with other people’s wishes, feel bad for those less fortunate, enjoy helping others and be humble in discussions with others.
Scores above the 60th percentile indicate that you are high in conscientiousness and are efficient and organized. You believe in yourself, like to have things in order, and stick to your promises. You try your best to achieve something, are self-disciplined, and think through the consequences of your actions before deciding what to do.
Scores between the 40th and the 60th percentile indicate that your conscientiousness is average. You might identify more with highly conscientious people in some ways and with people low in conscientiousness in others.
Scores below the 40th percentile indicate that you are low in conscientiousness and may be extravagant and careless or lack direction in your tasks or life. You are more likely to struggle with your belief in your ability to achieve things, follow through on your obligations or promises, and keep things neat and organized. You are also unlikely to strive towards attaining things or have the discipline to follow through on the tasks that you want to do. Lastly, you tend not to deliberate on things too much before acting and may be careless.
Scores above the 60th percentile indicate you are high in neuroticism. You experience more negative emotions than the average person, including depression, anxiety, and anger. You are more likely to feel self-conscious, struggle to moderate your behaviours, and feel vulnerable when overwhelmed.
Scores between the 40th and the 60th percentile indicate that your neuroticism is average. You might experience some negative emotions intensely while experiencing other negative emotions less often or less intensely.
Scores below the 40th percentile indicate that you have high emotional stability. You experience low anxiety, anger, depression, self-consciousness, immoderation, and vulnerability.
Openness to experience: ____________________________________________________
Scores above the 60th percentile indicate that you are highly open to experience. You are more likely to be higher than the average person in imagination, artistic interest, liberalism and intellect. You are aware of your emotions and others and enjoy being adventurous.
Scores between the 40th and the 60th percentile indicate that your openness to experience is average. You might identify more with highly open people in some ways and with less open people in others.
Scores below the 40th percentile indicate that your openness to experience is low. For example, you are less likely than the average person to escape to fantasy, be interested in art, or be aware of your emotions and others. You are also less likely to enjoy discussing abstract ideas and concepts, and more likely to support conservative and traditional views. Lastly, your desire for adventure is lower than average.
MY PERSONALITY FACTOR SCORES:
Openness to Experience:95th percentile
Agreeableness:90th percentile
Extroversion:74th percentile
Conscientiousness:74th percentile
Neuroticism:13th percentile
What are your top personality facets?
Are there any facets in which you are very high (90th to 99th percentile)? These facets likely represent your personality, regardless of your overall factor scores.
Try putting all of this together to make up a personality profile about yourself, based on your factor scores and your top facets. I have done this for myself below.
Your personality profile: ____________________________________________________________________________________________________________________________________________________________________________
MY PERSONALITY PROFILE:
I am highly open to various experiences, including cultural, intellectual, emotional, and physical. I am highly agreeable and tend to do whatever it takes to have positive relationships with others. I will always try to co-operate with others if I can. I like to challenge convention and try to help bring about progressive change. I prefer a lot of variety and want to go on adventures. I am highly attuned to my emotions and the emotions of others around me and try to remain open to whatever I am feeling. I enjoy helping others when they need it. I trust others easily and believe that most people are generally good and do not harm others. I have lived a pretty fast-paced life and care about being efficient and effective. I love to have in-depth discussions with others and enjoy playing with ideas and reflecting on essential aspects of life through meditative practices and my writing.
STEP TWO: What Do I Care About?
Finding out what you care about is through the process of clarifying your values. Values are guiding principles in life that we cannot achieve like a goal but choose to live by each day. For example, someone who values honesty does not live consistently with what matters to them when they tell a lie but is consistent as soon as they return to telling the truth. By clarifying which values are most important, we can know when we have gone off track and what to do to get back on.
2a. Engage in thought experiments to elucidate what values are most important to you
An interesting experiential method to help patients identify their top value is writing the epitaph they want on their gravestone. For this, they would write what they hoped would be said about them if they were to die after a long and good life.
What would your epitaph say?
Here lies __________________________________________________________________
MY EPITAPH:Here lies Damon. He tried his best.
It tells me that one of my core values is applying myself to be the best I can be. Of course, not the best person overall, as this is an outcome I can’t control. But, I want to know that I have applied myself and put in the effort required to give me the best chance that I can have for success.
If writing your epitaph seems too dark or morbid, try to imagine your birthday party at least 20 years later (I choose my 70th birthday). All of your closest friends and family are there. An important person in your life gets up and makes a speech about the type of person you have been from today until then (over the past 20+ years).
It can be a powerful exercise that helps people realize the type of person they most want to be, both to themselves and others.
WHAT I WISH MY PARTNER’S DAUGHTER WOULD SAY ON MY 70TH BIRTHDAY:
I wasn’t so sold on Damon when I first met him. He seemed tall, friendly, pleasant, and good at sport. However, I also really enjoyed it being mum and me for the six years before we met. But the more I got to know him, the more I realized he wasn’t so bad and that there could be a few positives for me about having him around. Firstly, he helped to calm down mum when she was upset about something. He also seemed to care about her and me, making mum happy. He also tried to help me understand what I was going through whenever I was upset and made me feel loved and appreciated for who I was. He didn’t seem to want anything from me except for what I thought would be in my best interest in the long term. We also had fun doing things together, including daily walks with our dog Serahfina, playing games, rock climbing, watching movies and swimming as a family. I also loved the fantastic trips that we went on as a family.
2b. Take a strengths survey to identify your key strengths or values that you put into action
If none of the above activities interests you or help to highlight your core values, the Values in Action (VIA) Character Strengths Survey can. It ranks your strengths from 24th to 1st and is quite valuable for elucidating what you may want your guiding principles in life to be. You can complete it for free online at www.characterstrengths.org.
Based on my 2018 findings, my top five strengths were as follows:
Love of learning
Curiosity and interest in the world
Kindness and generosity
Humour and playfulness
Judgment, critical thinking, and open-mindedness
If you want to explore the results further, you can see which virtues are the highest for you. For me, wisdom was my highest virtue, with an average score of 6.2 for these items. The next highest was humanity, with an average score for these items of 8.33. Justice and transcendence were not virtues that were strengths of mine, with average scores of over 13.
You can answer the following question by combining your strengths and virtues. My response to this question is also provided as an example below.
I care about not jumping to conclusions and looking at the evidence from multiple perspectives before deciding the best thing to do. I care about being able to say that I am sorry and that I was wrong or being open to changing my mind if there is enough evidence about something. I care about being playful, having fun, laughing, or smiling with others. I care about being generous and kind to others and giving them my time, help, and undivided attention if possible. I care about learning new things and developing my knowledge and skills in various subjects and topics. I care about maintaining my curiosity and awe,growing as a person and gaining wisdom. Finally, I like to use what I have learned to help humanity where possible—both individually and on a larger scale.
STEP THREE: How do I show that I care about these things?
Finally, we must assess if we live consistently with our core values or key strengths. In other words, how much are you currently being the person you want to be, and what changes can you make to move in the right direction from now on?
3a. Do the Bullseye Exercise to assess where you are at and what is most important to you
The Bullseye exercise, first created by Swedish ACT Therapist Tobias Lundgren, is the best way to determine if you live consistently with your values. It helps you specify this in four critical areas of your life:
school or work,
leisure or recreation,
personal growth or health, and
relationships (including an intimate relationship if you have one as well as with your friends and family).
First, determine which areas you prioritize in your life at the moment. Is work most important? Or your health? Or your relationships? Or how you spend your spare time? Once you know how you would rank them, from first to fourth, write them down.
Keep your core values or key strengths in mind. Then, from 0 to 100%, say how consistently you have lived by your values in each area of your life. Place an X in the circle or a percentage for where you think you have been over the last month. 100% = a bullseye and 0% = outside the last circle. You can download a complete worksheet for free online if you want to complete it. You can also write down the percentages below.
How consistent have you been living with your values in this area of your life?
Consistency with your personal growth and health values: _____________________________
Consistency with your values in your most important relationships: ____________________
Consistency with your leisure and recreation values: ___________________________________
Consistency with your values in work and education: __________________________________
CONSISTENCY WITH MY VALUES IN EACH AREA OF MY LIFE:
Personal growth and health = 60%
Relationships = 75%
Leisure and recreation = 70%
School and work = 80%
Unfortunately, I am living more consistently with how I want to be when it comes to my work than in all other areas of my life. At the moment, I want to prioritize my health the most, and yet it feels like I am not living my life as healthily as I would like to. I want to exercise more, eat more fresh and less processed food, and maintain daily healthy habits.
Health was my top priority, yet my lowest score on the bullseye. It highlights how living more consistently with my health values could help me improve my overall well-being and life satisfaction.
What about you? What did your bullseye reveal that you were previously unaware of? Is improving your health the number one priority in your life, or are there other things you would prefer to put time and effort into improving?
3b. Set up sustainable systems or goals to help you live more consistently with your core values and strengths in each vital area of your life.
Once you have identified where you stand on each quadrant of the bullseye, ask yourself what you can do over the next 1–2 weeks (short-term), following 1–3 months (medium-term) or next 6–18 months (long-term). You want goals that help you live more consistently with your core values or key strengths. It could be new targets for studying, working, eating, relaxing, socializing, exercising, or sleeping.
Setting Your Targets
It helps to rank the aspects of your life that you most want to improve. Write down your top 5 targets for improvement. Place this list somewhere easily accessible and where you are unlikely to lose or forget about it. If you only have two or three aspects you want to improve, you don’t need to write down five. The less you have, the easier it will be to assess, track and improve when you start trying to develop and implement a plan.
MY TOP FIVE HEALTH TARGETS THAT I WOULD LIKE TO IMPROVE:
My stamina and being able to have enough energy to live the life I want
Healthy muscle mass and body fat percentages in comparison to my overall weight
A more nutritious diet with less processed and junk food
Better work/life balance
Increased relationship satisfaction with my partner, her daughter, my friends and my family
As you achieve your goals or implement your systems, you show yourself and others that you know who you are and what is important to you. As a result, you will begin to feel that you are heading in the right direction towards a healthier, more personally meaningful and satisfying life.
“Watch your thoughts; they become words. Watch your words; they become actions. Watch your actions; they become habits. Watch your habits; they become character. Watch your character; it becomes your destiny.”
– Lao Tzu
I love the above quote by Lao Tzu. It highlights that all of the little choices in life are important, especially in the long run. Not a single option or action unless it is unusually severe or unforgivable. I’m talking about the little things we do regularly, which accumulate over time and define who we are and how others see us.
It may be something like choosing to make your bed every morning or getting up to go to the gym before work. Or having a veggie smoothie rather than a jam-filled doughnut and caramel macchiato for your 3 pm work snack. Taking the easy or not-so-healthy option may not seem like such a big deal if it’s just the once, but what if this becomes a habit over time?
Without realising it, you may wake up one day and recognise that you have severe sugar, nicotine, alcohol or smartphone dependency. But, unfortunately, it’s no longer as easy to stop this behaviour as you may have believed. Especially once it becomes an ingrained habit.
Neuropsychologist Donald Hebb famously said in 1949:
“Neurons that fire together, wire together.”
– Donald Hebb
It means that the more we do a particular action, the more these pathways become ingrained or more substantial in our brain. So the first time we do something, it might be a little path. But if we do it enough, it can become a superhighway, where our brain finds it much easier to repeat that behaviour than do anything else.
Most obese, unfit or unhealthy individuals probably didn’t expect they would be where they are. But it didn’t just happen overnight either. They started with an initial thought, felt something, experienced an urge or craving, and chose to act in a certain way. The more they repeated this action in similar situations, the more the brain learnt that this is just what they needed and that this is the correct behaviour whenever they think or feel this way. Eventually, the action no longer feels like a choice but a compulsion. People may not even realise what they are doing until it is too late. Let alone be able to change it going forward.
William James said something similar but offered a solution to this trap:
“Thoughts become perception; perception becomes reality. Alter your thoughts; alter your reality.”
– William James
I’m not sure if I agree with William James completely. In my experience, it is often easier to act ourselves into new ways of thinking rather than think ourselves into new ways of acting. While how we think and feel about things is vital, it is tough to make any positive long-term change if we don’t challenge and change our behaviour.
Suppose we instead change our behaviours first regardless of our thinking. In that case, we will have more and more evidence contrary to the unhelpful thoughts or beliefs that we hold. In time, shifting these negative thoughts and perceptions becomes more comfortable. By doing this, you can shape your reality.
Why Bother Trying to Change?
Someone once asked me: “will you ever just be satisfied with how you are and stop using questionnaires and other measures to keep tracking and changing your life?” It seemed like a weird question, but it is consistent with how my father views life. He knows what makes him happy and does it. He’s not too worried about changing or growing. Instead, he focuses on enjoying each day, even if it’s the same as yesterday.
That’s great for my father, and on some level, it would be nice, but I can’t do things that way. Maybe it was because I was an often stressed out, anxious and unhappy child. Or perhaps I have seen how much I’ve been able to improve my life and my relationships with others through learning, monitoring, and challenging myself over time.
A quote by Charles Bukowski probably sums it up better than I ever could:
“People are strange. They are constantly angered by trivial things, but on a major matter like totally wasting their lives, they hardly seem to notice.”
– Charles Bukowski
Some Worrying Statistics
According to the Centre for Disease Control and Prevention, people should do at least 4 hours of moderately vigorous physical activity each week. Yet, researchers have found that the average American adult only does 17 minutes each day.
According to the 2017 OECD findings, more than 50% of adults and nearly one in six children are overweight or obese. This figure is likely to increase further by 2030.
In addition, the World Health Organisation says that 3 million people died worldwide in 2016 due to harmful alcohol use. Fortunately, alcohol drinking has continued to decrease in Australia since its peak in 1974–1975. However, regular teen alcohol consumption is still the most significant risk factor for problematic alcohol drinking in adulthood.
In 2014 in the US, 6.2 million people suffered from an illicit substance use disorder. Furthermore, over 115 people die every day from opioid abuse or misuse. Moreover, social isolation and loneliness are becoming more severe problems these days. One-quarter of Americans reported that they have no one to discuss important matters with or call in case of an emergency. Too much social isolation and loneliness can increase the risk of people dying. Perhaps even more than cigarette smoking.
The average American household watched 8 hours and 55 minutes of TV daily in 2009–2010 (the peak). In 2018, it dropped to 7 hours and 50 minutes per household, which is still extremely high. From 1950 to 2010, viewing time per household increased every decade. It became what Americans did for leisure, as documented in Robert Putnam’s sociological book ‘Bowling Alone’.
59% of all Americans and (48% of Europeans) now play video games, including 97% of teenagers in the USA. However, a 2016 study found that 6% of gamers worldwide could be considered addicted. Another study found that 7% were problematic gamers who played at least 30 hours weekly.
Lastly, smartphone usage continues to increase worldwide. Excessive social media and smartphone usage can result in adverse mental health outcomes. Australia is now fourth in the world regarding smartphone usage. The average for all Australian mobile phone users is 2.5 hours a day, which adds up to 38 days per year. We check something on our phones 30 times daily, and 45% of Australians now say they couldn’t live without their phones.
It is Possible to Choose to Change
It’s pretty easy to see the long-term consequences of our brains wanting to conserve energy, take the easy option, or avoid pain. However, these seemingly insignificant moments can happen hundreds of times per day. In each moment, as long as we pay attention, we have a choice. We can stay on autopilot and do what is easy. Or, we can tune into our core values, ask ourselves what type of person we would like to become in the long run, and then act consistently with this vision.
It may feel strange, different, or even uncomfortable when you start making more challenging choices and living by your values. However, that doesn’t make it wrong. For example, going to the gym will always hurt the first time you go, but the 20-minute walk you choose to do today is better than the 10km run you put off until next week.
Likewise, it may be tempting to say that you’ll start a new diet on Monday, but why put off making a healthy decision in the here-and-now if you don’t have to? These moments will eventually define who you become. You can begin to make a positive long-term change today.
But What Do We Do if We Want to Change?
Let me ask you the following three questions:
1. Is there anything you wish you could do more in your life?
2. Is there anything in your life you want to do less?
3. Finally, what is stopping you from making these changes?
If you answered YES to question 1 or 2 and don’t know the answer to number 3, it is worth exploring deeper.
Just the other day, I was having a debate with a client about isolation versus loneliness.
He believed that social contact with others was a more significant predictor of well-being, whereas I thought how close we felt was more important for long-term health and happiness.
In other words, he thought that the number of interactions with others was more important than the quality of the relationships. I was solidly on team quality over quantity when it came to the type of relations that we wanted in our lives.
Because I wasn’t sure whose position was more supported by research, I further explored the issue.
My aim in writing this post is to define the difference between isolation and loneliness clearly. I will then highlight what the scientific evidence suggests.
Isolation
The Merriam-Webster dictionary for English language learners defines isolation as:
“The state of being in a place or situation that is separate from others: the condition of being isolated”
Notice with this definition that there is no emotion connected to it. It merely indicates being isolated or separate from others.
Someone could choose to live a solitary life in isolation, and they may be happy with their choice. Alexandra de Steiguer, a shy individual who spent a lot of time alone when she was a child, chooses to isolate herself each winter as the sole ‘caretaker’ of the Oceanic Hotel on an island in New Hampshire. For the past 19 winters, she has spent months on the island without any guests.
de Steiguer states:
“it’s the thing I look forward to every year… When I come out here it’s like a homecoming. All those details of mainland life just fall away.”
She later says:
“Being alone (has) it’s advantages. It’s peaceful, and I can use my imagination…It makes me feel connected to life (and the natural world) in a way that I don’t normally feel.”
I don’t think I could do what she does, especially after watching ‘The Shining’, but each to their own.
Henry David Thoreau also glorified isolation and solitude in his famous book ‘Walden; or Life in the Woods’, stating:
“I find it wholesome to be alone the greater part of the time. To be in company, even with the best, is soon wearisome and dissipating. I love to be alone. I never found the companion that was so companionable as solitude.”
To write the book, Thoreau built a cabin near a pond in 1845 and lived there for the next two years.
He also highly valued simplifying life and reconnecting with nature:
“I went to the woods because I wished to live deliberately, to front only the essential facts of life, and see if I could not learn what it had to teach, and not, when I came to die, discover that I had not lived.”
Before you think about selling up everything in Emile Hirsch’s ‘Into the Wild’ style and moving to the wilderness by yourself, it is important to highlight two things first:
Thoreau walked into the nearby town of Concord, Massachusetts, almost daily and received visitors regularly.
In ‘Into the Wild’, Hirsch’s character Christopher McCandless (**spoiler alert**) dies after eating a poisonous plant and concludes, “Happiness only real when shared.”
When solitude doesn’t involve nature and someone forces it upon you, it is often considered a devastating form of punishment. For this reason, various prisons use solitary confinement all over the world. However, prisons often violate human rights with solitary confinement. For example, the UN’s Mandela Rules state that humans must not be “without meaningful human contact for more than 15 consecutive days” (Martin, 2016).
People would rather be out in the prison yard where they could be stabbed or beaten up instead of in isolation, making me realise that humans are social creatures. Too much time in isolation can lead to active psychosis or acute suicidality in approximately one-third of the prisoners exposed to solitary confinement (Rodriguez, 2016). It can also lead to crippling social anxiety for prisoners once released into society (Breslow, 2014).
Consequently, I can’t help but feel that except for a few individual cases or people who are very introverted, too much isolation does more harm than good.
Loneliness
The Merriam-Webster dictionary defines loneliness as:
“Sad feelings that come from being apart from other people”
Notice the focus of the definition is on the feelings of sadness. Unlike isolation, loneliness suggests a deficit and a longing for companionship and a genuine connection that is not there.
As JD in ‘Scrubs’ suggests, it is also possible to feel lonely in a crowded space, even though you could not be considered isolated:
So what is more damaging — being separate from others, or feeling apart from others?
The Village Effect
Our brains light up during human interactions, primarily in-person face-to-face contact. Online communication and passively watching videos don’t have the same effect.
In her 2017 TED talk, Susan Pinker looks at different reasons why people live longer, including the role that relationships play:
As you can see in the graph above, minimising isolation and loneliness was more critical for staying alive than someone’s BMI, activity level, smoking and drinking behaviours, or even their heart health and blood pressure. While these factors are still relevant, having constant and close relationships is almost essential for our long-term health and longevity. Quantity, or level of integration, is seen as slightly more important than the closeness of relationships or quality — one point for my client.
Either way, in her book ‘The Village Effect’, Pinker suggests that we would all benefit from the type of interconnectedness that a small village lifestyle provides.
Pinker also believes that we would benefit more by increasing our in-person face-to-face contact and cutting back our use of technology to better connect with others.
Alone Together
Another fascinating book that I read in 2017 was ‘Alone Together’ by Sherry Turkle.
Turkle’s 2011 book also highlights the difference between how often we interact with other people and how sad, disconnected or alone we feel.
Her 2012 TED talk nicely summarises the negative aspects of technology and how it is leading to a greater sense of loneliness, even though it is easier than ever to remain in contact in some way or another:
As Turkle says:
“we use conversation with each other to learn how to have conversation with ourselves. A flight from conversation can really matter, because it can compromise our capacity for self reflection. For kids growing up, that skill is a bedrock for development.”
Turkle concludes:
“we’re lonely, but we’re afraid of intimacy. (We want) the illusion of companionship, without the demands of friendship.” (As a result, we) expect more from technology, and less from each other. (We imagine, that with technology), we’ll never have to be alone.”
It’s pretty scary stuff when you think about it. However, Turkle’s findings indicate that loneliness is more damaging than isolation, so one point for me.
Other Research
Social isolation is associated with:
an increased risk of depression (Hari, 2018),
more heart disease (Barth, Schneider, & von Känel, 2010),
a more significant risk of infectious illness (Cohen et al., 1997),
a higher risk of major depressive disorder (Hari, 2018),
increased blood pressure (Hawkley et al., 2010)
heightened cortisol (Cacioppo et al., 2000)
elevated inflammation (Steptoe et al., 2004), and
increased risk of heart disease, functional decline and early death (Patterson & Veenstra, 2010; Perissinotto, Stijacic Cenzer & Covinsky, 2012).
A 2013 study titled “Social Isolation, Loneliness and All-Cause Mortality in Older Men and Women” looked at 6,500 men and women over 51 from the English Longitudinal Study of Ageing between 2004 and March 2012. After taking demographics and health at baseline into account, social isolation significantly predicted later mortality, but loneliness did not (Steptoe, Shankar, Demakakos & Wardle, 2013).
Both loneliness and social isolation were associated with an increased risk of mortality. Still, reducing isolation was considered more critical in reducing the risk of premature death than loneliness. Furthermore, loneliness did not add to the risk of early death for already socially isolated people (Steptoe et al., 2013).
Final Outcome and Recommendations
THE VERDICT: SOCIAL ISOLATION IS MORE DANGEROUS THAN LONELINESS!
I am surprised to be wrong, but I am glad to have a bias pointed out whenever it occurs. I have never felt socially isolated, but I have felt lonely, so my own experience must have influenced my opinion to some degree.
Social isolation is more hazardous to our long-term health than the subjective feeling of loneliness. However, both of these states are potentially damaging, and you should take steps if you are experiencing them regularly.
Lifeline recommends the following strategies for overcoming social isolation and loneliness:
“Connect or reconnect with friends and family — staying in contact with loved ones can prevent loneliness and isolation. If your family don’t live nearby, technology can help you keep in touch.
Get out and about — regular outings for social functions, exercise, visiting friends, doing shopping, or simply going to public places can help.
Get involved in your community — Try a new (or old) hobby, join a club, enrol in a study, or learn a new skill. Try looking online at your local TAFE/Community College, library or community centre for things in your area that might be interesting to you.
Volunteer — helping others is a great way to help yourself feel more connected.
Consider getting a pet –pets are wonderful companions and can provide comfort and support during times of stress, ill-health or isolation.
Get support — If loneliness and social isolation are causing you distress, you should discuss your concerns with a GP, counsellor or a trusted person.”
Engaging in treatment with a clinical psychologist could help if social anxiety or other mental health difficulties contribute to your isolation or loneliness. If not, the meetup website is an excellent resource for getting out there, trying some new things, and meeting some new people.
As George Valliant says:
“Joy is connection… the more areas in your life you can make connection, the better.”
Damon Ashworth Psychology 
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