Oxytocin: There Is. No. Substitute.

Photo by Tobias Baumgaertner, Melbourne, 2020 https://www.bbc.com/news/in-pictures-55416365

“Tell me about your emotional support network,” I ask patients every year at their annual exam.

Our relationships kill us or save us, I am still convinced. 

How is your emotional support network? If you’re really honest: How secure are you in your relationships? How truly connected do you feel to the people in your life? In my mind, secure and connected relationships make up the core of our health and well-being. They are what give us deepest meaning and purpose, and what hold us up through any and all adversity.

This feeling of closeness, the ineffable sense of connection that inspires the most timeless and evocative poetry, that moves us to heroic acts, and that inexorably bonds lovers, friends, and especially mothers and children, is mediated in large part by oxytocin, the so-called love hormone. In the body it facilitates childbirth and lactation by contracting smooth muscle in the uterus and milk ducts. It plays a role in sexual arousal and orgasm. In the brain it promotes feelings of relaxation, trust, and belonging. It may even make us better at attuning to one another’s emotional cues. Levels rise when we connect with others, such as when hugging, dancing, and even reading or hearing stories. Interestingly, oxytocin also increases in times of stress, such as when we are separated from loved ones and feeling anxious. How fascinating and protective–I LOVE how nature works! The research seems new, but it may be that when cortisol rose under threat stress (of which social isolation is one of the most severe and dangerous), our ancestors whose oxytocin levels also rose survived better because it caused them to seek reconnection with the tribe, to stay close despite the drive to separate. Like so many things in nature and the body, the dynamic balance of opposing instincts gives us amazingly effective elasticity, flexibility, and adaptiveness–not only for survival but to really thrive.

Like other neurotransmitters, oxytocin’s presence in tissues is transient, stimulated and cleared in the course of normal cellular function. That said, the frequency, intensity, and consistency of tissue exposure to oxytocin has important consequences. More oxytocin correlates with improved mood, more secure attachment, and even increased pro-social behavior such as donating to charity and helping others in need. So how can we get more of this life-enhancing hormone in our systems? It’s about relationships, duh.

“She understood now. Treasure wasn’t something that could be picked up and carried off, that could be owned. Whatever happened here… could only happen here, and after it happened, it lived on inside you.”
The Conquering of Tate the Pious, Sierra Simone

Multitple times a week, I think my brain must be positively swimming in oxytocin. Ethos workouts with Jacob, Pam, Tim, Kasey, and now Andrew and Hailey stimulate it, for sure. I schedule regular meals and calls with close friends, and that always lifts me. These interpersonal contact highs defy verbal expression, truly. When I meet someone new I listen for their stories, engage my most sincere curiosity, and ask open ended questions to learn more about the very interesting person in front of me. We inevitably find something fascinating to share and expound on. I make these connections all the time, and the benefits last.

So therein lies the treasure. There simply is no substitute for the time and attention required to connect meaningfully in relationship with our fellow humans. Pictures in albums and shared on social media are great to commemorate, but they only matter because they bring back the feelings we had in communion–that warm and fuzzy, settled yet giddy, glad and joyous sense of true togetherness and connection. 

And it doesn’t necessarily need to be in person. Phone, video, letters–OMG letters! Read how The World Showed Up For Steven through www.moreloveletters.com, a website that allows people to request snail mail for their loved ones going through a hard time. Steven was widowed after 64 years of marriage and his daughter thought she could get maybe a dozen people to drop him a note. He received hundreds of letters, some that also included gifts of books, drawings, and invitations to Zoom meals. You are not alone. If that doesn’t raise someone’s oxytocin levels, I don’t know what does.

Cards, gestures, messages, collages, stories; hugging, laughing, crying, cuddling, making love–sharing love–that’s what it’s about, my friends. And it’s all kinds of love: romantic, platonic, fraternal, familial, collegial–Agape. Just the act of giving it heals us, even if we don’t necessarily get it back. *sigh*

I bet writing this post has elevated my oxytocin levels! As I think of my amazing friends, my loved ones, my patients, colleagues, and all of you readers–we are all connected! I feel it in my chest the most–full and calm–comforted the way a soft, heavy blanket feels on a cold night. If you want an oxytocin boost and blogging isn’t your thing, try these 12 suggestions. Or just do what the meme below says. Regardless, I hope you’re getting all the connection you need and want to live your best life, dear Reader. It’s what I wish for us all.

from Instagram

Walking the Talk: Leading Indicators

The most perfect gift from Donna. xo

Eureka! and YIKES. 

What is the nature of performance anxiety? Is that what I’m having? Or is it increasing resistance as a magnet approaches that which attracts it at one pole and repels it at the other, until it finally anneals and the magic happens? Truly, friends, this book project is kicking. my. butt.

I talk to patients about habit change every day. I have read the books, studied the methods. I’ve written about it ad nauseum. And there is still so much more to learn and practice! I get frustrated, sitting down yet again and analyzing today, judging my slow and intermittently frequently stagnating progress. 

And then I smile.
Because there is progress! 

I joined Ethos three seasons ago, consistently completing eight strength or conditioning classes per month since then. I had no specific outcome goals at the outset. I just knew I needed to get out of my basement, learn new movements, widen my repertoire. I knew I needed a community for accountability and connection. I trusted the folks at Ethos to meet those fundamental needs, and that my general outcome goals of getting stronger and more fit would be realized with time. And voila, it’s all true. Who knows how much I’ll eventually be able to bench press or dead lift? I’m doing more today than I ever have in 50 years of life, so who cares? All I have to do is keep showing up, bringing what I’ got, and whatever outcome I get will be valuable and worthy of the effort. I sense it already–how my clothes fit, the changing curves and definition, and how I feel–body, mind, and spirit. I also get feedback from others, which is gratifying. It all fuels me to keep going.

As of today, I have completed 14 consecutive days of Sunlight Before Screens, Morning Pages, and delayed caffeine. Thanks again, Shane! Here as well, specific outcomes/lagging indicators are not the goal (what would they even be?); rather it is the practice I’m after. Because I know that a more mindful and intentional start to my day is better for my health and well-being than a mindless and random one. Maybe similar to having my Ethos community for fitness, just knowing that my book hero and fellow fans endeavor, together, to establish and maintain this health practice holds me up? Just like going to the gym, I honestly, shockingly, look forward to getting up early every morning now and cracking open the journal, even if I go to bed late, just to see what may flow from the pen in that unfocused, creative state of my personal daily dawn. I’m only two weeks in, but I perceive significant benefit already: High energy and sense of purpose and confidence; increased attunement to hunger (or lack thereof); decreased craving for coffee (I’ve forgotten all about it a couple times). That last one floors me–I’ve had coffee every day since high school. Years ago when I abstained on non-patient days I noticed a heavy melancholy set in around mid-morning–fascinating, and a little alarming… 
But this morning I made a 70/30 regular/decaf blend to start using every day, and I have a strong intuition that it will be just fine; it’s all part of a concerted yet organic evolution. 
Everything is connected.

For whatever reason (12 days of cumulative creative opening?), this weekend felt portentious for book work. I posted on Instagram. I texted multiple friends requesting energy sent my way for perseverance and discipline. Whatever they did worked, because the ideas and ink bubble and flow with force. The EUREKA moment came yesterday when I realized that I don’t really know what my book will actually be in the end. That was also the YIKES moment–how do you start a project when you don’t actually know what you’re making? I feel an irresistable call to write something, and I have consistently answered that call for over eight years. I know I can write. I know I want a synthesis, an integrated whole of accumulated learnings, ideas, and original conclusions, in the form of a book. But the structure, organization, and specific content that I will publish is actually still somewhat unknown to me, a coy, elusive, and inviting mystery. 
What a strange relief! Because now I can approach it like fitness and mornings.

If I don’t know the outcome, but I have clarity on the process, then I’m free to steward the work with openness, curiosity, humility, generosity, and joy! I can achieve my goal of having a pitch and proposal to present by April 18. I just don’t know, and don’t necessarily need to know, exactly what it will be. Very likely, it will not be what I imagine today. But if I sit BUTT IN CHAIR (BIC) and do today’s work each day, with disclipline and lightness, then I can let go expectations of any particular product. I can trust the process, that whatever turns out will be fine and good, because it will be the result of honest, authentic, deeply committed effort. It will be me, because I showed up every day to create it. How motivating!

I wrote my post on Meaningful Metrics about a year ago now. I think I have shared it with patients almost every week since then. Weight and cholesterol are lagging indicators. Habits are the leading indicators, the concrete, real time metrics that can be monitored, adjusted and maintained, and that have much higher predictive value. I can’t tell you how much you’ll weigh a year from now if you start doing the 7 minute workout. But if you do 7 minutes, three times a week, for 52 weeks, I can tell you that you’ll feel differently, likely better, in your body. And there will also likely be downstream benefits in other domains of your life and health. Focus on the practices; the outcomes will take care of themselves. Trust the process; get help when needed, assess and adjust regularly, and establish effective accountability. 

So if I sit down, get centered, and show up for my book each day, it will show up and emerge for me. I set a concrete product goal for April, tied to relevant things that make the deadline meaningful. But if I focus on April today, I get in my own way. Today is for today’s work. I have interim goals to benchmark, to keep me aware. I can continue leashing the gremlins–the ones telling me I ‘should’ have figured this all out long ago, the voices of perfectionism and un-compassion. Thank you, now go sit in the corner. I have work to do. 
I’ got this.

What are you working on this year? What leading indicators guide you, keep you on track? What else helps? Who’s on your team?
ONWARD, my friends. The world needs our contributions. 

Bit Post: Dementia

Posted on Facebook, in rapid response to my friend’s share of an Alzheimer’s Awareness Week message:

More and more of my patients seem to live in fear of dementia, and rightly so. I see it as my job to hold that fear, validate it, and also monitor for its immediate effects. Constant fear that looms over us like a black cloud is threat stress, and that has significant negative health consequences in itself, both immediate and long term.

How can we get to peace with our inevitable end, however it may occur? I was just thinking about it this morning, as I have written about it often the past 8+ years on the blog. Today I believe that if I were to die tomorrow, and I had five minutes at the end to relfect, I could be at peace. But who TF knows? I could be a thrashing rage case at the end of my life, depending on the circumstances. But I realized this morning that this may be an excellent example of a Useful Delusion. Because I feel, however irrationally, at peace with my own death today, I can live more peacefully now, freed from that particular fear. Maybe. That’s the story I tell.

Of note: None of us can actually control our future health and death. But we have so much agency to influence risk and likelihood. Thankfully, all of the behaviors that help prevent heart disease also lower the risk of everything else: cancer, diabetes, obesity, and dementia. None of us can be perfect in all of our health habits; some are easier than others for each of us. But if we focus more on goals and trade offs, acting intentionally and mindfully as much as possible, assessing and adjusting often, I think we will have less to regret at the the end, no matter what happens.

—————

Someone once said when you love someone with Dementia you lose them more and more everyday. When they are diagnosed, when they go through different stages, when they need treatment and when they die. This is called “Ambigua Loss.”

I wouldn’t wish Dementia on anyone. As the brain slowly dies, it changes physically and eventually forgets who their loved ones are. They can end up lying in bed not moving and not eating or drinking.

There will be people who will scroll by this post because Dementia has not touched them. They may not know what it’s like to have a loved one who battled or is fighting Dementia.

To Raise Awareness of this Cruel Disease, I’d like my Friends to Put this on their Page Today.

Hold Finger on Post to Copy and Paste to Your Timeline.

A Special Thank You to All Willing to Post This On their Timeline for Alzheimer’s Awareness Week 💜💜