The Busier You Are, The More You Need Quiet Time

In a recent interview with Vox’s Ezra Klein, journalist and author Ta-Nehisi Coates argued that serious thinkers and writers should get off Twitter.

It wasn’t a critique of the 140-character medium or even the quality of the social media discourse in the age of fake news.

It was a call to get beyond the noise.

For Coates, generating good ideas and quality work products requires something all too rare in modern life: quiet.

He’s in good company. Author JK Rowling, biographer Walter Isaacson, and psychiatrist Carl Jung have all had disciplined practices for managing the information flow and cultivating periods of deep silence. Ray Dalio, Bill George, California Governor Jerry Brown, and Ohio Congressman Tim Ryan have also described structured periods of silence as important factors in their success.

Recent studies are showing that taking time for silence restores the nervous system, helps sustain energy, and conditions our minds to be more adaptive and responsive to the complex environments in which so many of us now live, work, and lead. Duke Medical School’s Imke Kirste recently found that silence is associated with the development of new cells in the hippocampus, the key brain region associated with learning and memory. Physician Luciano Bernardi found that two-minutes of silence inserted between musical pieces proved more stabilizing to cardiovascular and respiratory systems than even the music categorized as “relaxing.” And a 2013 study in the Journal of Environmental Psychology, based on a survey of 43,000 workers, concluded that the disadvantages of noise and distraction associated with open office plans outweighed anticipated, but still unproven, benefits like increasing morale and productivity boosts from unplanned interactions.

But cultivating silence isn’t just about getting respite from the distractions of office chatter or tweets. Real sustained silence, the kind that facilitates clear and creative thinking, quiets inner chatter as well as outer.

This kind of silence is about resting the mental reflexes that habitually protect a reputation or promote a point of view. It’s about taking a temporary break from one of life’s most basic responsibilities: Having to think of what to say.

Cultivating silence, as Hal Gregersen writes in a recent HBR article, “increase[s] your chances of encountering novel ideas and information and discerning weak signals.” When we’re constantly fixated on the verbal agenda—what to say next, what to write next, what to tweet next—it’s tough to make room for truly different perspectives or radically new ideas. It’s hard to drop into deeper modes of listening and attention. And it’s in those deeper modes of attention that truly novel ideas are found.

Even incredibly busy people can cultivate periods of sustained quiet time. Here are four practical ideas:

1) Punctuate meetings with five minutes of quiet time. If you’re able to close the office door, retreat to a park bench, or find another quiet hideaway, it’s possible to hit reset by engaging in a silent practice of meditation or reflection.

2) Take a silent afternoon in nature. You need not be a rugged outdoors type to ditch the phone and go for a simple two-or-three-hour jaunt in nature. In our own experience and those of many of our clients, immersion in nature can be the clearest option for improving creative thinking capacities. Henry David Thoreau went to the woods for a reason.

3) Go on a media fast. Turn off your email for several hours or even a full day, or try “fasting” from news and entertainment. While there may still be plenty of noise around—family, conversation, city sounds—you can enjoy real benefits by resting the parts of your mind associated with unending work obligations and tracking social media or current events.

4) Take the plunge and try a meditation retreat: Even a short retreat is arguably the most straightforward way to turn toward deeper listening and awaken intuition. The journalist Andrew Sullivan recently described his experience at a silent retreat as “the ultimate detox.” As he put it: “My breathing slowed. My brain settled…It was if my brain were moving away from the abstract and the distant toward the tangible and the near.”

The world is getting louder. But silence is still accessible—it just takes commitment and creativity to cultivate it.

This article originally appeared on Harvard Business Review & was written by Justin Talbot-Zorn.

The Great Ice vs. Heat Confusion Debacle

There is soooo much confusion about this issue. It’s a shame because therapeutic icing and heating — cryotherapy and thermotherapy — are rational, cheap, easy, safe self-treatment options for many common painful problems.

What ice and heat are for

Ice is for fresh injuries, and heat is for stiff, aching muscles. Roughly. But the devil is in the details, and there are a lot of them.

Ice is for injuries — calming down damaged superficial tissues that are inflamed, red, hot and swollen. The inflammatory process is a healthy, normal, natural process … that also happens to be incredibly painful and more biologically stubborn than it needs to be. Icing is mostly just a mild, drugless way of dulling the pain of inflammation… we hope. Examples: a freshly pulled muscle or a new case of IT band syndrome (which is more likely to respond than the other kind of runner’s knee, patellofemoral pain, because ITBS is superficial and PFPS is often a problem with deeper tissues).

Heat is for muscles, chronic pain, and stress — taking the edge off symptoms like muscle aching and stiffness, which have many unclear causes, but trigger points are probably one of the usual suspects. Chronic pain often involves lots of tension, anxiety, hypervigilance, and sensitization, and comfortable heat can soothe a jangled mind and nervous system. Stress and fear are major factors in many painful problems, of course.

What ice and heat are not for

Both ice and heat have the potential to do some minor, temporary harm when used poorly. Heat can make inflammation significantly worse. Ice can aggravate symptoms of tightness and stiffness; it can also just make any pain worse when it’s unwanted.

Both ice and heat are pointless or worse when unwanted: icing when you’re already shivering, or heating when you’re already sweating. The brain may interpret an excess of either one as a threat, but icing is more threatening — and when brains think there’s a threat, they may also amp up the pain. Ice seems to be feel more threatening to most people.

Be especially wary of icing muscle pain — and it may not be obvious. You may think your back is injured, for instance, but it may “just” be muscle pain. Trigger points (painfully sensitive spots) can be surprisingly intense and easily mistaken for “iceable” injury and inflammation. But if you ice trigger points, they may burn and ache even more acutely. This mistake is made particularly often with low back pain and neck pain — the very conditions people often try to treat with ice.

Heat and inflammation are the other particularly bad combination. If you add heat to a fresh injury, watch out: it’s going to get worse! A physician once told my father to heat a freshly injured knee, and wow — it swelled up like a balloon, three times bigger than it had been before. And three times more painful.

What about injured muscle? Muscle strains?

If you’re supposed to ice injuries, but not muscle pain, then what do you with injured muscles (a muscle tear or muscle strain)? That can be a tough call, but ice usually wins — but only for the first few days at most, and only if it really is a true muscle injury. A true muscle injury usually involves obvious trauma during intense effort, causing severe pain suddenly. If the muscle is truly torn, then use ice to take the edge off the inflammation at first. Once the worst is over, switch to heat.

Is ice better than heat? Is heat better than ice?

Ideal uses of ice and heat are roughly equal in potency — which isn’t very potent. Neither is strong medicine. Some experiments have shown that both have only mild benefits, and those benefits are roughly equal in treating back pain. The reason to use them is not that they are highly effective treatments — they rarely are — but because they are so cheap, easy, and mostly safe, especially compared to many other popular treatments.

The bottom line

The bottom line is: use whatever feels best to you! Your own preference is the tie-breaker and probably the most important consideration. For instance, heat cannot help if you already feel unpleasantly flushed and don’t want to be heated. And ice is unlikely to be effective if you have a chill and hate the idea of being iced!

If you start to use one and you don’t like the feel of it … just switch to the other.

This article originally appeared on Pain Science & written by Paul Ingraham.

Acupuncture to Treat Anxiety Disorders

According to the National Institute of Health, “Anxiety disorders are the most common mental illness in the U.S., affecting 40 million adults in the United States age 18 and older.” In addition, according to the same source, women are 60% more likely to experience anxiety and the average onset of an anxiety disorder is age 11. However, only 42.2% of those with anxiety seek any kind of treatment, and of that only 33.8% are receiving minimally adequate treatment. The take away is that anxiety is something we all experience at some level and we are not doing enough to treat it.

Anxiety can be caused by many factors. From a specific event like an upcoming test, to an uncomfortable conformation with a loved one, to a more serious trauma, anxiety has many roots. Although the roots of the anxiety vary from person to person and must be identified and treated, the anxiety one experiences needs to be managed. Below are some of the bodily responses of anxiety:

•Physical symptoms such as an irregular heartbeat.
•Cognitive symptoms, which can cause negative thoughts.
•Behavioral symptoms, which may include uncharacteristic aggression or restlessness.
•Emotional symptoms, such as fear.

Acupuncture can be a good way to treat anxiety. According to Psychology Central, “In a comprehensive literature review appearing in a recent edition of CNS Neuroscience and Therapeutics, it was proved that acupuncture is comparable to cognitive-behavioral therapy (CBT), which psychologists commonly use to treat anxiety (Errington-Evans, 2011). Another study published in the Journal of Endocrinology in March 2013 discovered stress hormones were lower in rats after receiving electric acupuncture (Eshkevari, Permaul and Mulroney, 2013).” Science clearly agrees that acupuncture is a more than adequate way to help manage anxiety.

To understand how acupuncture helps relieve anxiety is to understand the thoughts behind Traditional Chinese Medicine (TCM). TCM believes in a force called QI that regulates the body’s overall health. QI, like blood, moves through the body via pathways called meridians. When factors like stress or changes in environment disrupt the flow of QI, health issues follow, according to the University of Miami Health System. When an acupuncturist inserts needles at a specific point in the body, balance is restored to the QI and the body’s overall health, the University of Chicago Medicine states. This might seem hard to grasp, but if you consider that QI is just another way of describing chemical reactions taking place in the body, it makes more sense.

Acupuncture needles can affect the body’s chemicals reactions. For example, needles placed in the correct acupuncture point can cause the nervous system to produce painkilling chemicals. It can also jump start the body’s natural healing process or stimulate the part of the brain that controls emotions, including anxiety, according to Dr. Daniel Hsu, a Doctor of Acupuncture and Eastern Medicine. Specifically referring to how acupuncture helps with anxiety, researchers at Georgetown University led by Eshkevari used lab studies to demonstrate that acupuncture slows the body’s production of stress hormones.

One study, published online in the Journal of Acupuncture and Meridian Studies showed that participants who underwent acupuncture for anxiety saw improvements after just one 20-minute session. This means that after just one session, patients could feel relief from their anxiety, and because acupuncture changes the chemical balance in the brain, which makes the patient feel better, it may mean less medication is needed. As the chemicals in the brain are altered, medication, which does the same thing, may no longer have a role to play.

It is important to note that any acupuncture session comes with general, normal side effects. They include minor bruising and dizziness, both of which are minimal as opposed to psychotherapy drugs, which can have more serious side effects. In this sense, acupuncture is much safer for treating anxiety. Plus, unlike drugs that can lead to dependency, acupuncture is not likely to have the same addictive effect.

When it comes to trying acupuncture for anxiety, you have nothing to lose. With a licensed acupuncturist, the risks are almost non-existent and are outweighed by the potential benefits. After just a few sessions, you may even find yourself sleeping better and enjoying other health benefits. If already on treatment for anxiety, acupuncture can make a good addition to your regimen. If it works, you can speak to your doctor about limiting or reducing medication. It is a win-win situation for your health. Even just trying a treatment will make you feel better because you are taking action to alleviate the anxiety instead of worrying and increasing your anxiety level.

Like many medical diagnoses, there is not always a one-size fits all solution. Depending on the person and the individual diagnosis, treatment may vary. For some people, acupuncture alone may work. For others, a combination of therapy, medication, and acupuncture may be best. Consult with your doctor before starting any treatment and discuss a treatment plan that will work for you.

This article originally appeared on Above & Beyond Acupuncture.

Does Acupuncture Work by Re-Mapping The Brain?

Acupuncture is a form of traditional medical therapy that originated in China several thousand years ago. It was developed at a time bereft of tools such as genetic testing or even a modern understanding of anatomy, so medical philosophers did the best they could with what was available – herbs, animal products and rudimentary needles. In the process, perhaps, they stumbled on an effective medical approach.

In the past century, some modernisation has taken place. For instance, acupuncture has been paired with electrical currents, allowing for stimulation to be more continuous and to penetrate deeper into the body. This approach was termed electro-acupuncture and represents a convergence between the ancient practice of acupuncture therapy and modern forays into targeted electrostimulation delivered to the skin or nerves. Such approaches have attracted the attention of the pharmaceutical industry and are part of a growing class of neuromodulatory therapies.

So why all the rancour against acupuncture from some corners of the internet (and academia)? Shouldn’t we apply our modern research methods to see which classical acupuncture techniques have solid physiological backing?

It’s not as easy as it seems. Let’s look at the clinical research. A recent landmark meta-analysis threw together data from thousands of chronic-pain patients enrolled in prior clinical trials, finding that acupuncture might be just marginally better than sham acupuncture (in which non-inserted needles are used as a placebo control). The differences were statistically significant, but lack of a larger difference could be due to the clinical outcome measure that the researchers studied. Symptoms such as pain (along with fatigue, nausea and itch) are notoriously difficult for different people to rate in a consistent manner. Conventional wisdom says that these kinds of symptoms are improved by placebo, but what about improvements in the body’s physiology? For instance, in a recent study that assigned an albuterol inhaler for asthma to some patients and sham acupuncture to others, patients reported both as effective. But objective physiological measures demonstrated significant improvement only for albuterol. It’s clear that in evaluations of acupuncture, research should explicitly hunt for potential physiological improvements, in addition to patient reports.

While most chronic-pain disorders lack such established, objective outcomes of disease, this is not true for carpal tunnel syndrome (CTS), a neuropathic pain disorder that can be validated by measuring electrical conduction across the median nerve, which passes through the wrist. Interestingly, the slowing of nerve conduction at the wrist does not occur in isolation – it’s not just the nerve in the wrist that’s affected in CTS. My own department’s research and others’ has clearly demonstrated that the brain, and particularly a part of the brain called the primary somatosensory cortex (S1), is re-mapped by CTS. Specifically, in functional magnetic resonance imaging (fMRI) brain scans, the representation of fingers innervated by the median nerve are blurred in S1. We then showed that both real and placebo acupuncture improved CTS symptoms. Does this mean that acupuncture is a placebo? Maybe not. While symptom relief was the same immediately following therapy, real acupuncture was linked to long-term improvement while sham acupuncture was not. And better S1 re-mapping immediately following therapy was linked with better long-term symptom reduction. Thus, sham acupuncture might work through an alternative route, by modulating known placebo circuitry in the brain, while real acupuncture rewires brain regions such as S1, along with modulating local blood flow to the median nerve in the wrist.

Where you stick the needle might matter as well. While site-specificity is one of the key features of acupuncture therapy, it has been controversial. Interestingly, in the S1 region of the brain, different body areas are represented in different spatial areas – this is how we localise the mosquito that’s biting us, and swat it. Different S1 areas might also pass along information to a diverse set of other areas that affect different bodily systems such as the immune, autonomic and other internal motor systems. As far as acupuncture is concerned, the body-specific map in S1 could serve as the basis for a crude form of point specificity. In our study, we compared patients receiving real acupuncture locally to the wrist with patients receiving real acupuncture far from the wrist, in the opposite ankle. Our results suggested that both local and distal acupuncture improved median nerve function at the wrist. This suggests that the brain changes resulting from acupuncture might not just be a reflection of changes at the wrist, but could also drive the improved median nerve function directly by linking to autonomic brain regions that control blood vessel diameter and blood flow to the median nerve.

This new research clearly demonstrates that bodily response is not the only means by which acupuncture works; response within the brain might be the most critical part. Once we better understand how acupuncture works to relieve pain, we can optimise this therapy to provide effective, non-pharmacological care for many more chronic-pain patients.

This article originally appeared on Aeon & written by Vitaly Napadow.