The Panacea is in the Practice

There may be no “gamechanger” and no “magic bullet” to reduce stress, improve wellness, or to otherwise make positive changes in life. The instant gratification from a quick fix is like a promissory note that can only be paid off through practice. When in search for a cure, for transformation, or for lasting change, the unsexy truth is that the panacea is in the practice. What often seems like drudgery, impractical, or otherwise impossible is actually one of the most fundamental imperatives of progress, success, and an inner sense of peace: consistent practice.

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We are collectively approaching a new year, 2021, and collectively we are leaving behind a year that will never be forgotten. The year 2020 has disrupted our lives with unceasing uncertainty. We have either adapted to it, been exhausted by it, or totally succumbed to it in terms of our collective health, mental health, and overall wellbeing and general functioning. The year 2020 has given us all an opportunity to practice things like living one day at a time, letting people we love know how much we love and appreciate them, or cultivating new relationships that may continue for a lifetime. In other words, in 2020 we practiced more of who we really are as humans. Many of us may not see it this way, or perhaps only see the worst parts of our humanity.

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Many would like to heed the call to evolve beyond the limitations we’ve been confronted with during this era of COVID. Maybe many will choose instead to get things “back to normal” as quickly as possible. Those who experienced 2020 as a catalyst for lasting change have likely already begun to put in place the kinds of daily practice that produces positive results. Each day is a day to begin anew, to refine old skills, develop new ones, and help move us all in the direction of progress. From the sculptor Elizabeth King, highlighted by Seth Godin in his recent book “The Practice” and discussed on a recent Tim Ferriss podcast, this is an excellent quote to ponder, a lot: “Process saves us from the poverty of our intentions”. I like to substitute practice for process because it is basically synonymous in this context. To elaborate even further, there is the notion that self-consistency may help save us from the erosion of self-trust.

The Flexibility Principle

To paraphrase a favorite quote: “I am a person of fixed and unbending principles, the first of which is to be flexible at all times.” (Everett Dirksen) Not only does such a quote point to the wisdom of paradox, it also highlights what may be considered a universal principle for health and well-being. We find countless examples of the significance of flexibility in nature, biology, science, spirituality, literature, philosophy, and psychology. As an exercise in creative thought, the Flexibility Principle holds that thoughts, feelings, beliefs and actions maintain a balanced and positive vibration in so far as the individual, partnership, or organization is able to easily be modified without breaking AND maintain an open willingness to change or compromise under all circumstances. Hence, thoughts, feelings, beliefs or actions should not be considered good or bad in-and-of themselves, but only in reference to their flexibility (i.e., ability to maintain balanced and positive vibrations). That’s it. That’s the blog for today. Hope it was enjoyable!

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Liking Versus Wanting

This is a difficult topic area to cover in a short, three paragraph blog as part of a 30-day blog-a-day challenge for December 2020. It has been chosen because it truly struck a cord when an article was forwarded along with the curiosity-inspiring title: “The science of addiction: Do you always like the things you want?” In a loosely associated way, it is reminiscent of the very popular Wired Magazine article from 2010 entitled: “Secret of AA: After 75 Years, We Don’t Know How It Works”. And what it all boils down to, in a word, is craving.

Craving Cues Us Down Pathways We Want But May Not Like

While craving, as a phenomenon, is written about and discussed a lot across various domains of human experiences, it remains an enigma to both the philosophically and scientifically inclined. The experience of craving, or wanting rather than liking, cuts across explanations of human functioning from behavioral conditioning, cognitive processing, spirituality/connection seeking, social modeling, and neurochemical signaling. The point of the aforementioned article which serves as the inspiration of this post is that, in addiction, “wanting becomes detached from liking”. That is, for people who go on to develop addiction, what started as a partnership between the experience of enjoyment or liking of the substance, behavior, or experience, eventually matured into a coupling of liking AND wanting, followed by the decoupling of liking and wanting. What is left is a living hell of chasing after a previous enjoyed experience driven entirely by craving or wanting, while often disguised as both liking and wanting.

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What is wanted may no longer be liked and the distinction between the two gets buried under layers and layers of conditioning, cognitions, connections, and a cacophony of confusing inconsistencies in daily life. The fact that Alcoholics Anonymous has been around since 1935 and deeply considers the primacy of craving as the main driver of self-destructive addictive behaviors is significant. While scientific progress continues to shed light on craving as it relates to human health, mental health, and addiction, the philosophical underpinnings of this uniquely human experience will also continue to provide insights and revelations for those who appreciate the more abstract and spiritual constructs that attempt to answer life’s most meaningful questions: Who Am I, Why Am I Here, and What Do I Do?

Here are two really cool recommended books on Craving – (Craving: Why We Can’t Seem to Get Enough by Omar Manejwala and The Craving Mind by Judson Brewer):

A Little “Relapsy”

A little relapsy? This came up in an addiction recovery-based support meeting recently and the significance of such a concept is worth exploring. What is a relapse, a lapse, a slip, harm reduction, “abstinence violation effect“, or “a little relapsy”? From an addiction context, relapse is variably defined and even more variably addressed. For example, “relapse is defined as the recurrence of behavioral or other substantive indicators of active disease after a period of remission” by the American Society of Addiction Medicine (ASAM). Put another way, relapse seems to be to continue to engage in self-defined and self-destructive patterns of addictive behaviors after setting the personal goal to abstain from such behaviors. One of the defining criteria in the Diagnostic and Statistical Manual of Mental Disorders (DSM) is: “wanting to cut down or stop using but not being able to”.

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“A little relapsy”, slipping or sliding, seems to suggest teetering on the edge of what some may call “a full-blown relapse” or perhaps a “binge” or in old-school language “to go on a spree“. Therefore, it is important to make the completely made-up distinction between being “a little relapsy” and being in “relapse mode”. The distinction can be quite simple and requires three main tools: a) honest self-appraisal, b) honest feedback from trusted others, and c) time, namely, staying present (see tools below). Two of the biggest drawbacks of the rabbit hole of relapse or a potential relapse are secrets and shame. Keeping secrets about one’s return to a self-defined self-destructive behavior and getting stuck in a vicious shame cycle about such a return to unhealthy behaviors are the real fuel for crashing and burning when it comes to relapse.

Dialectical Behavior Therapy Graphic

If someone is feeling “a little relapsy” or suspect that they are “headed for a relapse”, there is no need to despair (although the gift of desperation is totally underrated!). The single most important factor when wading in the waters of uncertainty, of whether or not one is on a path to healing or path to destruction, is the feeling of freedom. If those waters feel like bracing oneself for a wave of destruction, then feel free to walk back up on shore for a while and take in the breeze, the sound of the ocean, and the view of the great expanse. If the waters feel perhaps a little cool, a little choppy, and there are others around to lend a hand if it starts to get a little rough out there, it could be a feeling of freedom from addiction and a connection to the world around. There is so much more to “a little relapsy” or the “psychology of relapse” than is blogged about here. Hopefully, this provides “a little helpsy” for those finding their way in addiction recovery!

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In times of quiet contemplation, like a morning cup of coffee, there may arise from within, a calmness, or a sense of clarity or peace. During or after a morning meditation, in the shower, the commute to work, sitting on a park bench, looking out a window, or staring at a device without purpose, it is possible to connect to something within and around us as real and as invisible as air, particles of light, waves of sound, and the inner workings of millions of automatics processes occurring in our bodies every second. This momentary awareness could be called “re-ligio”. What does this mean?

Heart Center

Years ago I directed a program teaching medical residents in internal medicine, family medicine, pediatrics, and ob/gyn programs around New York City on alcohol and substance use disorders. The program consisted of 5 days of immersion in didactic and experiential teaching processes inclusive of lectures from leaders in the field of addiction medicine, psychology and spirituality as well as attendance in group therapy session, treatment programming and mutual aid support groups with patients undergoing residential and outpatient treatment. One of the lectures was on spirituality and addiction given by a priest from Columbia University College of Physicians and Surgeons. The lecture always started with breaking down the word ‘religion’, from the latin “re” or “again” and “ligare” bond or connect.

In recovery circles it is often said that religion is for those afraid to go to hell and spirituality is for those who’ve been there. In fact, many in AA go to some length, as did the co-founder Bill Wilson, to distinguish religion from spirituality. Perhaps the distinction is unnecessary when traced to the essence of religion. To bond again, to connect again, to oneself, to others, to the environment, to a higher power. Everything is connected. This is important to re-member.

If Gratitude Was a Drug

Two foundational concepts in basic pharmacology are pharmacokinetics and pharmacodynamics. Put simply, pharmacokinetics refers to the way in which the body acts on the drug and pharmacodynamics refers to the way the drug acts on the body. Let us consider the creative application of how the body acts on gratitude and how gratitude acts on the body.

There are 4 processes in pharmacokinetics: drug absorption, drug distribution, drug metabolism, and drug excretion. The acronym ADME is often used. In pharmacodynamics, there are three interactions that can influence the effect of a drug: drug-disease interactions, drug-drug interactions, and the drug and aging interactions. How can we apply these concepts as if Gratitude was a Drug?

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First, this is a fun exercise: to apply scientific concepts or processes to the value or virtue, principle or practice, experience or expression of gratitude. The kinetics of gratitude may be to observe how gratitude gets absorbed into one’s experience in the moment (absorption). This is followed by following the flow of gratitude throughout the mind, heart, body, and soul (distribution). Next up is how gratitude gets metabolized in the system, broken down into meaning, mindfulness, and perhaps even magnificence (metabolism). Finally, the act of how gratitude emerges from an individual, how it gets expressed, and experienced like an extemporary prayer (excretion). The ADME of gratitude may be an area of personal development that embodies the essence of mental, physical, emotional, and spiritual well-being.

The dynamics of gratitude are as exciting to play with as the kinetics. How does gratitude interact with a disease or disorder? What about the ways that gratitude interacts with other emotional or mental processes that are active in one’s moment experience? How does gratitude interact with a person’s socio-emotional development? It is fun to think about how gratitude neutralize diseases and disorders, how it may enhance positive emotions and experiences while eliminating negative ones, and how gratitude influences the quality of life over the years.

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If gratitude was a prayer rather than a drug then this famous quote comes to mind:

“If the only prayer one says in life is “Thank You”, that would suffice.” Meister Eckhart


We have all been invited to this event called life. Please respond. How have we responded? With delight or dread? With rejoice or resistance? With curiosity? Regardless, we were invited and we showed up to the event. Each day we can choose how we show up for life. Maya Angelou once said “If you don’t like something, change it. If you can’t change it, change your attitude.” Viktor Frankl said: “Everything can be taken from a human but one thing: the last of the human freedoms — to choose one’s attitude in any given set of circumstances, to choose one’s own way.” And William James stated “The greatest discovery of any generation is that a human can alter his life by altering his attitude.” Imagine that we can choose our thoughts at any moment of any given day. How do we operationalize this? Read on…

Power of Mind

We ruminate, worry, obsess. We get stuck, distracted and discouraged. In negative or anxious states of mind and body, it seems impossible to simple choose a new thought or change an attitude just like that. But we can. Often, the answer comes down to action – ACT I ON (I Act on myself). Move your body by breathing deeply 5 times. Reach both arms up to the sky several times. Get up and go for a walk around the block or the room. Drink some ice cold water. Do something. In the time that you are taking to move your body somehow, pay attention to your thoughts and quickly say to yourself “new thoughts, new thoughts, new thoughts”. Or, don’t say anything to yourself or out loud. Rather just notice and in the attempt notice, what happens is that the worry, confusion, repetitive negative thoughts stop in that instant. It’s true. It happens. However, that’s not all. We merely cannot keep moving all the time.

In that time of movement is a range of thoughts and emotions t\hat begin to get clarified. Experiential avoidance may get activated and become a barrier to a sustained change in mood, feelings, thoughts, and behaviors. The process is the practice and the practice is the process. Self-consistency and discipline in changing one’s thoughts, feelings, attitudes, beliefs and actions is the vital key. Finally, to quote William James again: “Seek out that particular mental attribute which makes you feel most deeply and vitally alive, along with which comes the inner voice which says, ‘This is the real me,’ and when you have found that attitude, follow it.”

New Neural Pathways

Surrender is Not a 4-Letter Word

Surrender is not a 4-Letter word. In a world smitten by self-reliance and strict self-determination, any association with the experience of surrender is quickly dismissed as a form of defeat, resignation, weakness, or powerlessness. Salty expressions of indignance at the concept of “giving up the battle to win the war” or that admitting weakness is a sign of strength, are a sad commentary on how we are conditioned to believe that the “Almighty Self” is the center of the universe.

From Polaris Insight Ketamine Training

A self-centered society is one aspect of how surrender is seen as sh*t. Another way in which surrender seems to be shunned is the tidal wave of trauma that has taken over our collective consciousness. As described in PTSD Nation, we now live in a world in which self-defeat and self-empowerment are mutually exclusive. Surrender and powerlessness have become synonymous with re-traumatization. Once a “self” has been shattered by trauma and then fought so hard to piece itself back together, any suggestion of letting go of this reclaimed sense of self is a terrible threat. In reality, true empowerment comes from surrendering our sense of self for the purpose of tapping into an expansive awareness of true power, for the individual and community, for country and cosmos. Does this sound too lofty? Listen again.

Heart Center

When we align what we think of as our “self” with others, with the world around us, with a sense of a higher self, or some might say a “higher power”, we discover power, connection, energy, movement, stillness, and growth. The “self” at the center of ‘our’ universe merges with “something else” (like spirit) at the center of ‘the’ Universe. Still sound too out there? Try this: Surrender Guided Meditation by Sarah Blondin. Another good listen is this podcast by Tara Brach on Surrender. Forgiving, giving up, and giving in all involve giving. When we give ourselves over or give of our selves, we gain, get, and grow immeasurably. Holding on to pain, resistance, suffering, and hurt may be necessary for a time while also constraining and imprisoning us. It is often in total surrender that we find true peace. Ego deflation, dissolution, deconstruction allows for the discovery of true power within and around us and allows us to rebuild on a new kind of foundation. This is discussed in 12 step recovery from addictions, research with MDMA and trauma, Acceptance and Commitment Therapy, and research on psilocybin and anxiety around death and dying, among others.

“Forgiveness is giving up the hope that the past could have been any different.” Oprah

“We don’t heal in isolation, but in community.” S. Kelley Harrell

“Unlike other forms of psychological disorders, the core issue in trauma is reality.” BVDK

The Shaken Soul

When the soul shakes, it is as though energy has been awakened that beckons the attention of all parts of our being. Whether we are shaken into new awareness or shattered into pieces, or both, what is unleashed within us is overwhelming. Marcus Aurelius is quoted as saying “unrest of spirit is a mark of life”. At the same time, Marcus Aurelius also stated: “The mind maintains its own tranquillity by retiring into itself, and the ruling faculty is not made worse. But the parts that are harmed by pain, let them, if they can, give their opinion about it.” In other words a shaken soul or a restless spirit must express itself without judgment, without fear, and without negativity.


Allowing negative thoughts, feelings, beliefs and behaviors take control of our lives that extends beyond their adaptive usefulness must be prevented. This process involves heightened self-awareness and a commitment to move from avoidance to acceptance or from barriers to breakthroughs. There are many ways to develop and reinforce this commitment. Here are three: physical, mental, and emotional. Sound too simple? It is.


Our brains, beliefs, and behaviors respond to repetition and reward. Integrating rituals into a daily practice will enhance self-awareness and prevent negative habits, feelings, and thoughts from cementing themselves into lived experience. Choose one small physical thing to be practiced or accomplished each day: walk, meditate, eat a piece of whole food. Choose one small thing to be mentally focused upon each day: a mantra, a poem, a sudoku or crossword puzzle. Choose a set time each day to focus exclusively on a pleasant memory that evokes a positive emotion like humor, love, peace, compassion, or gratitude.

Rumi Quote

Stuck in Rut? Don’t Furnish It

“If you’re stuck in a rut, don’t furnish it.” I heard someone say this at a drug and alcohol treatment program years ago. And it stuck. That is, it left an impression. People, things, experiences, memories gets stuck all the time. We all get stuck in various kinds of ruts. Examples include: depression in terms of rumination, anxiety in terms of intrusive worrisome thoughts, addictive behaviors, traumatic memories, resentment, shame, procrastination, being unable to forgive oneself and others to name a few. But what does “Don’t Furnish It” mean?

Don’t furnish the rut you’re in means more than holding on to resentments, being overwhelmed with worry, being unable to let go of traumatic events, or finding oneself trapped in a cycle of addiction. Not furnishing the ruts we find ourselves in means raising our awareness of the way we add stuff to the thoughts, feelings, behaviors, beliefs, and memories we experience. It means cluttering ourselves with miscellaneous add-ons we think are helping “tie the room together” (The Big Lebowski reference) to the point where we can’t even move. Resentment literally means “to feel again”. And to reference the same classic (one of my all-time favorites) movie again “we are talking about unchecked aggression here”…towards oneself, others, and the world.

The solution seems all to simple: unfurnish the rut. This means clean house, declutter, let go, give up and get out, surrender, ask for help, and pursue a new path. Yes, this is easier said than done but it may not require a psychic shift, a bottoming out, or an earth-shattering event. For so many people, getting unstuck comes in the form of a “pivotal mental state“, an “Aha! experience“, and or sudden gains in psychotherapy. The goal of this brief blog is to offer hope. The human experience is so difficult for so many. Getting unstuck seems like an impossibility, a distant dream, or unthinkable when we are deep in the struggle of life. Be kind to yourself. Pause. Breathe. Things will change.