Sunday, October 7, 2018

ERNEST HEMINGWAY AND THE ART OF MINDFUL LIVING

Ernest Hemingway went out in style—with a double-barrelled shotgun. In saying that, I don’t wish to be seen to be making light of suicide. In my own family, I lost a grandmother, a great-aunt, and a great-grandfather, and possibly one or two others as well, to suicide. Those left behind after the suicide of a family member or close friend ordinarily struggle with a particularly difficult grief, yet I learned long ago that it is always wrong to pass any form of judgement on the deceased in relation to their decision to end their life.

In his final years Hemingway was beset with physical and psychological troubles and was not helped by an American government that incessantly trailed him with FBI agents, in both Cuba (where he lived in the 1940s and '50s) and the United States, and which in 1960 basically told him to denounce the Castro regime and leave Cuba or face the consequences, namely, being declared a traitor by Washington authorities.


Hemingway refused to denounce the Castro regime. He had declared his solidarity with Cuba in January 1959. He wrote that he believed completely in the 'historical necessity' [sic] of the Cuban Revolution. He knew that the Castro regime was far from perfect but he had also lived through the years when, for all intents and purposes, the American Mafia, in cahoots with the CIA, ran Cuba. At least Castro got rid of the Mafia from Cuba, even if they went elsewhere, and he gave the Cuban people universal health carea damn good thingand a decent education system. (No, dear reader, I am not a Commie. I simply believe in giving credit where credit is dueand putting the boot in as well when that is necessary.) 

Anyway, Hemingway and his fourth wife Mary left the Cuba they loved for good on July 25, 1960, leaving behind thousands of books, personal papers and memorabilia. Hemingway found his own solution to his troubles on July 2, 1961. Even on that last fateful day, the dreadful J Edgar Hoover’s agents were located just 150 metres from his house in Ketchum, Idaho.

Fidel Castro and Ernest Hemingway.
Havana, Cuba, May 1960.

Local fishermen erected this monument
in memory of Hemingway at Cojímar,
a town east of Havana.

My wife, youngest son and I were recently in Cuba for a holiday. It was a great trip and we travelled all over Cuba. I loved the people, the architecture of the buildings, the mountains and valleys, and the music. The hotels we stayed in were grand and we also stayed with some delightful Cuban families in their own homes. The people we met were happy for the most part, despite many problems, made much worse by the American embargo. That the latter continues to this day, after almost 60 years, is a disgrace. It does not speak well of the United States. 
The embargo, which has been condemned by the United Nations with overwhelming support every year since 1992, has been called a sustained act of genocide against the Cuban people—and it is. The accumulated cost of the embargo to Cuba over almost 60 years amounts to close to 934 billion United States dollars.

The Cuban people, especially in Havana, revere Ernest Hemingway, and while we were in Havana we went to Hemingway’s former home and farm Finca Vigía (now a museum), the Hotel Ambos Mundos, where he resided in 1939, the hotel La Terraza de Cojimar at Cojímar, the little port town 9.6 km east of Havana where Hemingway kept his fishing boat, the Pilar, which was the inspiration for the village Hemingway depicted in The Old Man and the Sea, and the restaurant-bars El Floridita and La Bodeguita del Medio, where Hemingway ate and drank (mostly the latter, its seems). In all these places, and many others, there are photos and other memorabilia recalling Hemingway’s presence in Cuba. Books or parts of his novels were written on the island. Copies of those books, as well as many biographies of the man and his life in Cuba, can be purchased in Havana book shops and elsewhere in Cuba.

Entrance to Finca Vigía

My wife and son outside Finca Vigía

Yours truly at the top of the tower at Finca Vigía

Hemingway’s writing style has been much written about and discussed. A former journalist and war correspondent, Hemingway is the master of the short, unadorned sentence, direct speech and simple dialogue. He uses no unnecessary words. His vocabulary is often tight but expressive and charged with meaning, even when reduced to only a few words. Sentences tend to be arranged in sequence rather than in a logical pattern. Take, for example, this exchange from chapter 10 of For Whom the Bell Tolls(Some of that novel, which arose out of Hemingway's own experience, was written in Cuba.)

‘What are you going to do with us?’ one asked him.
‘Shoot thee,’ Pablo said.
‘When?’ the man asked in the same gray voice.
‘Now,’ said Pablo.
‘Where?” asked the man.
‘Here,’ said Pablo. ‘Here. Now. Here and now.’
‘Have you anything to say?’
‘Nada,’ said the man. ‘Nothing. But it is an ugly thing.’

Hemingway's study in Finca Vigía


Hemingway's study in Finca Vigía
Vestibule and room where Hemingway
received his family and friends at 
Finca Vigía

In Hemingway’s famous short story ‘The Killers’, the author makes effective use of tight, machine gun-like exchanges such as the following to create an atmosphere of impending doom:

‘What's he going to do?’
‘Nothing.’
‘They'll kill him.’
‘I guess they will.’
‘He must have got mixed up in something in Chicago.’
‘I guess so,’ said Nick.
‘It's a hell of a thing.’
‘It's an awful thing,’ Nick said.
They did not say anything. George reached down for a towel and wiped the counter.
‘I wonder what he did?’ Nick said.
‘Double-crossed somebody. That's what they kill them for.’
‘I'm going to get out of this town,’ Nick said.
‘Yes,’ said George. ‘That's a good thing to do.’
‘I can't stand to think about him waiting in the room and knowing he's going to get it. It's too damned awful.’
‘Well,’ said George, ‘you better not think about it.’

His themes and ideas arise from and out of the story and its imagery, as opposed to being thrust upon the reader as is the case with many writers. The emphasis is on action rather than introspection (although the latter is there as well). His aim, in his own words, is to record 'the way it was'. He is a master of mindfulness, recording what happens more-or-less as it happens or as it happened not that long ago. Even when one of his characters recalls something that has already happened, the remembrance of the event generally takes place in the context of the character remembering in the present moment what has already happened. That is the essence of mindfulness, along with remembering to stay present in the present moment, from one moment to the next, and remembering what is present.


Some of the 8,000 books in
Hemingway's library at Finca Vig
ía 

The 'Pilar' aFinca Vigía

Listen to these words from chapter 11 of For Whom the Bell Tolls. Hemingway contrasts the directness and immediacy of life itself, experienced mindfully, with an experience of life that falls short of that:

You only heard the statement of the loss. You did not see the father fall as Pilar made him see the fascists die in that story she had told by the stream. You knew the father died in some courtyard, or against some wall, or in some field or orchard, or at night, in the lights of a truck, beside some road. You had seen the lights of the car from down the hills and heard the shooting and afterwards you had come down to the road and found the bodies. You did not see the mother shot, nor the sister, nor the brother. You heard about it; you heard the shots; and you saw the bodies.

In chapter 13 of the novel, the combatant Robert Jordan, a young American fighting in the International Brigades in the Spanish Civil War, and Maria, a young woman who has been captured by the Fascists, have just made love in the heather. Shortly thereafter, we get these words from Hemingway, words that are more openly philosophical than is usual for him:

You have it now and that is all your whole life is; now. There is nothing else than now. There is neither yesterday, certainly, nor is there any tomorrow. How old must you be before you know that? There is only now, and if now is only two days, then two days is your life and everything in it will be in proportion. This is how you live a life in two days. And if you stop complaining and asking for what you will never get, you will have a good life.
 A good life is not measured by any biblical span.


My wife and son at La Terraza de Cojímar

Hemingway lives on at La Bodeguita del Medio

A life-size bronze statue of Hemingway
at the end of the bar in El Floridita

Each one of us is an inlet and an outlet of life's self-expression. Life is forever renewing itself, and expressing itself, as the present moment—from one moment to the next and ever onwards. Life is this moment and life is the reality of our very selves. We are the action of life that is always taking place. We live in the eternal now—the present moment forever renewing itself. The past? It exists only as a present memory. The future? It exists only as a hope. 

Life is endless movement—from one moment to the next. Any meaning we find must be found in the moment-to-moment experience of the eternal now, which is that ‘present’ which is forever renewing itself in and as each new moment. Eternity—the eternal now—is not the present time plus all the past and all the future, nor is it a postmortem experience. It is a present—indeed, ever-present—reality. In truth, there is no time after time after time. The eternal now transcends time altogether. There is a ‘present’ in the present as well as a ‘present’ beyond the ‘present’. Of course, in a very real sense the eternal now and the so-called temporal now are one and the same! Everything is—here now! Life is eternal, and we are alive in eternity—now! Well, at least we should be.

So, cherish this present moment. It is more than enough, even though it is so fleeting and ephemeral. Nevertheless, seize the moment—and live.









Saturday, September 15, 2018

MINDFULNESS FOR PAIN RELIEF


A study conducted at Wake Forest School of Medicine has shown that an individual's innate or natural level of mindfulness is associated with a greater tolerance for pain. In other words, they feel less pain than others.

Dr Fadel Zeidan
The researchers analysed data obtained from a study published in 2015 that compared mindfulness meditation to placebo analgesia. In this follow-up study, the study's lead author, Dr Fadel Zeidan, assistant professor of neurobiology and anatomy at the medical school, part of Wake Forest Baptist Medical Center, sought to determine if dispositional mindfulness—that is, an individual's innate or natural level of mindfulness—was associated with lower pain sensitivity, and to identify what brain mechanisms were involved.

In the study, 76 healthy volunteers who had never meditated first completed the Freiburg Mindfulness Inventory, a reliable clinical measurement of mindfulness, to determine their baseline levels. Then, while undergoing functional magnetic resonance imaging, they were administered painful heat stimulation (120°F).

Whole brain analyses revealed that higher dispositional mindfulness during painful heat was associated with greater deactivation of a brain region called the posterior cingulate cortex, a central neural node of the default mode network. Further, in those that reported higher pain, there was greater activation of this critically important brain region.

The default mode network extends from the posterior cingulate cortex to the medial prefrontal cortex of the brain. These two brain regions continuously feed information back and forth. This network is associated with processing feelings of self and mind wandering.

‘As soon as you start performing a task, the connection between these two brain regions in the default mode network disengages and the brain allocates information and processes to other neural areas,’ Zeidan said.

‘Default mode deactivates whenever you are performing any kind of task, such as reading or writing. Default mode network is reactivated whenever the individual stops performing a task and reverts to self-related thoughts, feelings and emotions. The results from our study showed that mindful individuals are seemingly less caught up in the experience of pain, which was associated with lower pain reports.’

The study provided novel neurobiological information that showed people with higher mindfulness ratings had less activation in the central nodes (posterior cingulate cortex) of the default network and experienced less pain. Those with lower mindfulness ratings had greater activation of this part of the brain and also felt more pain, Zeidan said.

‘Now we have some new ammunition to target this brain region in the development of effective pain therapies. Importantly this work shows that we should consider one's level of mindfulness when calculating why and how one feels less or more pain,’ Zeidan said. ‘Based on our earlier research, we know we can increase mindfulness through relatively short periods of mindfulness meditation training, so this may prove to be an effective way to provide pain relief for the millions of people suffering from chronic pain.’

Journal reference:

Zeidan F et al. ‘Neural Mechanisms Supporting the Relationship between Dispositional Mindfulness and Pain.’ PAIN, 2018; 1 DOI: 10.1097/j.pain.0000000000001344


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MINDFULNESS AND POST-OPERATIVE PAIN RELIEF



IMPORTANT NOTICE: See the Terms of Use and Disclaimer. The information provided on this blog is not a substitute for professional medical advice, diagnosis or treatment. Never delay or disregard seeking professional medical advice from your medical practitioner or other qualified health provider because of something you have read on this blog.

Monday, August 13, 2018

MINDFULNESS AND RESPONSES TO EMOTIONAL STIMULI

How well can you control your emotions?

The essence of mindfulness is acceptance and non-reactivity. It’s like the old-fashioned tape recorder or the modern-day video surveillance camera; the equipment records but does not react to what it hears or sees. So it is with mindfulness.

Ordinarily, whenever there is an activating experience, there follows an emotional response on our part. The emotional response may be positive, negative or neutral. In between the activating experience and the emotional response is the interpolation of some belief or misbelief (eg ‘This is pleasant’, ‘This is unpleasant’, and so on) about the activating experience which causes us to pass judgment on, and then react emotionally to, the experience.

A recent study, involving more than 150 adults, evaluated the impact of long and short-term mindfulness meditation training on the amygdala response to emotional pictures in a healthy, non-clinical population of adults using blood-oxygen level dependent functional magnetic resonance imaging.

Now, the amygdala, at the end of the hippocampus, is part of the limbic system of our brain and is responsible for the processing of memory, decision-making and emotional responses, especially fear, anxiety and aggression. Mindfulness meditation and other forms of meditation can quieten the activity of the amygdala.


 Photo credit: National Institute of Mental Health.


Long-term meditators had 9081 hours of lifetime practice on average, primarily in mindfulness meditation. Short-term training consisted of an eight-week mindfulness-based stress reduction (MBSR) course. The control group, made up of people with no meditation experience, was randomly assigned to a ‘health enhancement program’ over the same time period that included well-being practices, but not meditation specifically.

After an eight-week period, participants viewed and labelled photos as either emotionally positive, negative or neutral while undergoing a brain scan by functional magnetic resonance imaging.

Meditation training was associated with less amygdala reactivity to positive pictures relative to controls, but there were no group differences in response to negative pictures. Reductions in reactivity to negative stimuli may require more practice experience or concentrated practice, as hours of retreat practice in long-term meditators was associated with lower amygdala reactivity to negative pictures, although the researchers did not see this relationship for practice time with MBSR.

Short-term training, compared to the control intervention, also led to increased functional connectivity between the amygdala and a region implicated in emotion regulation (in particular, the processing of risk and fear), namely, the ventromedial prefrontal cortex (VMPFC), during affective pictures. Thus, meditation training may improve affective responding through reduced amygdala reactivity, and heightened amygdala–VMPFC connectivity during affective stimuli may reflect a potential mechanism by which MBSR exerts salutary effects on emotion regulation ability.


Study
: Krak T R A et al. ‘Impact of short- and long-term mindfulness meditation training on amygdala reactivity to emotional stimuli.’ NeuroImage vol 181, 1 November 2018, 301-313.

Thursday, July 26, 2018

THE MAJOR CAUSE OF BAD POSTURE—AND EVEN WORSE THINGS THAN THAT!

Good posture occurs when the muscles of the body support the skeleton in an alignment that is stable as well as efficient, both in stillness and in movement.

Bad posture is the result of a number of things including bad habits developed over time as the body seeks ways to accommodate muscle spasm, weakness, tension or imbalance between muscle groups. Causes of bad posture include but are not limited to injury and muscle guarding, muscle tension and muscle weakness, and the incorrect use of technology. Genetics and hereditary can also play a role. However, there is one cause of bad posture that, in my experience, tops the list—shallow breathing.

Most people have heard of the diaphragm. Sadly, most people hardly use their diaphragm when breathing. They are shallow breathers. They utilise only a small part of their lung capacity. So, what exactly is the diaphragm? Well, it is a great, strong dome of flattish muscle located in the lower rib cage, that is, at the base of the lungs or, more exactly, at the bottom of the chest between the lungs and the stomach. The diaphragm, which is shaped like a parachute, separates the chest cavity and the abdominal cavities. The floor of the chest cavity which contains the lungs and the heart is made up of the diaphragm. The abdominal cavities contain the digestive, reproductive and excretory organs.


The diaphragm works like a pump. It has the capacity to move upwards and downwardsand inwards and outwards—thereby changing the volume of both the chest cavity and its passive occupants (specifically, the lungs). When we breathe with our diaphragm, air is drawn into the lower lung spaces. The diaphragm and the intercostal muscles—the muscles between the ribs—should be used to take the in-breath to the middle and lower parts of the lungs. During inhalation, the diaphragm contracts and flattens. That causes our upper abdominal muscles to relax and extend slightly. Our abdomen thus moves forward, and the lower 'floating' ribs flare or expand slightly outward to the side. In addition, the diaphragm is the principal muscle used for exhaling. When we exhale, the diaphragm—in an upward movement—relaxes and returns to its ‘normal’ dome-shaped position. What happens here is the upper abdominal muscles contract, and air (in the form of carbon dioxide) is expelled - in fact, forced out - from the lungs.

How the diaphragm works.

Now, what happens when we fail to use, or hardly use, our diaphragm when breathing? Terrible things!
Most people are 'chest breathers'. Chest breathers are shallow breathers. They use only the top portion of their lungs. They don't fill up the bottom part. Chest breathing is a very 'shallow' and ordinarily haphazard and non-rhythmic form of breathing, with almost all the outward movement being confined to the upper chest. One of the results of chest breathing is that the lungs are never filled completely, so the body rarely, if ever, receives sufficient oxygen. That is not good. There is a lung condition known as atelectasis, which is the collapse or closure of a lung resulting in reduced or absent gas exchange. It may affect part or all of a lung. There are several causes of atelectasis, but one of them is—you guessed it—shallow chest breathing. What we don’t use, we lose. If we don’t use all of our lungs, we end up with part of our lung collapsing or closing. Not nice at all. When we breathe correctly—that is, breathing deeply using our diaphragm—we use the bottom of our lungs as well as the top.



Atelectasis of the right lower lobe seen on chest X-ray.
(Source: Hellerhoff. Wikipedia.)

M
outh breathers are invariably chest breathers, but chest breathers aren't confined to mouth breathers. When we breathe with our chest, the neck, shoulders and upper rib muscles are all 'engaged' as our chest 'elevates' toward our chin when breathing inwards. The result? Chronic neck and shoulder tension which, of course, lead to pain. Worse, over time there can be noticeable postural changes in the body such as a forward shift in the head and a rounding of the shoulders. When the head is pulled forward, the additional pressure on the neck, shoulders and back rises dramatically. The result? Well, there are several, but one of the nastiest is tissue damage ... and more 
painEvery 2.5 cm (inch) that the head is thrust forward from its natural position adds another 4.5 kg (10 lbs) of stress and pressure on the neck, shoulders, back and spine. More bad stuff. 


The answer to all this is not to throw back your shoulders. Silly but well-intentioned advice, that. No, the answer is to learn to breathe correctly—that is, deeply, using the diaphragm, drawing air into the lower lung spaces, and exhaling fully. When we do that properly, rhythmically and habitually, our posture will improve dramatically. The shoulders will go back where they should be, there will be less rounding of the shoulders, and the forward tilt of the head will be corrected as well. The result? Not only good posture but a much better state of fitness and overall health.

So, when we breath, we should fill our entire lungs with air. It helps immeasurably if you can breathe through the nose. (Sorry, mouth breathers.) Practise ensuring that your out-breath is longer than your in-breath. That will also assist with posture. It also relaxes both the body and the mind. In addition, the regular up-and-down movement of the diaphragm massages the abdominal organs.

One of the best things you can do for yourself is to learn to breathe correctly. It is never too late to start.


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Tuesday, July 10, 2018

MINDFULNESS MAY EASE TINNITUS SYMPTOMS

Dr Laurence McKenna
New research led by Dr Laurence McKenna, pictured, from University College London Hospitals NHS Foundation Trust (UCLH) and Dr Liz Marks from the Department of Psychology at the University of Bath has found that a mindfulness-based approach to tinnitus can make the symptoms of the condition less severe, less intrusive and less troublesome.

Tinnitus is a physical condition experienced as noises or ringing in the ears or head when no such external physical noise is present. The condition, which can result from a wide range of underlying causes, is usually caused by a fault in the hearing system itself, and is a symptom, not a disease in itself. At present there is no actual 'cure' for tinnitus. However, many of the causes of tinnitus are treatable.

It is an extremely distressing, even disabling, condition in and of itself. Worse, the condition is associated with many other problems such as emotional stress, insomnia, auditory perceptual problems and concentration problems. Tinnitus afflicts a significant percentage of the population—about ten to twenty per cent of the population. Some people are more at risk for the condition—musicians, military personnel, people who otherwise work in loud environments, and seniors.

Regrettably, there is at present no treatment to stop the noise of tinnitus. That’s where mindfulness comes in. The essence of mindfulness is—acceptance and non-reaction. It’s like the old-fashioned tape recorder or the modern-day video surveillance camera; the equipment records but does not react to what it hears or sees. So it is with mindfulness.

The research team found that mindfulness-based cognitive therapy (MBCT) helps to significantly reduce the severity of tinnitus compared to relaxation-based treatments, an approach recommended by many tinnitus clinics.


For the study, which has been published in the journal Ear and Hearing, seventy-five patients took part in a trial at UCLH’s Royal National Throat, Nose and Ear Hospital, receiving either MBCT or relaxation therapy. The research team found that both treatments led to a reduction in tinnitus severity, psychological distress, anxiety and depression, but the MBCT treatment led to significantly greater reductions in tinnitus severity than the relaxation treatment, and this improvement lasted for longer.

‘MBCT turns traditional tinnitus treatment on its head — so rather than trying to avoid or mask the noise, it teaches people to stop the battle with tinnitus,’ Dr Marks said. 

In other words, people learn how to 'allow' and 'accept' tinnitus rather than fighting it or trying to push it away. This is the practice of non-resistance: what you resist, persists. How true that is!


Study: McKenna L, Marks E, & Vogt F. (2018) ‘Mindfulness based cognitive therapy for chronic tinnitus: evaluation of benefits in a large sample of patients attending a tinnitus clinic.’ Ear and Hearing, 39(2), 359 - 366. DOI: 10.1097/AUD.0000000000000491


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IMPORTANT NOTICE: See the Terms of Use and Disclaimer. The information provided on this blog is not a substitute for professional medical advice, diagnosis or treatment. Never delay or disregard seeking professional medical advice from your medical practitioner or other qualified health provider because of something you have read on this blog.