Each year for almost 2 decades I've asked this list's members 2
questions.  In November, between the Canadian and U.S. Thanksgiving, I
ask what you are especially thankful for this particular year.  And each
spring, usually in April, I ask what brings you joy this particular
year, what sustains you and brings renewal when work is grim.

This year, as every year, the responses are rich and varied: Colleagues
telling of special sources of joy and renewal that carry them through
tough times.

Here are some of this year's responses:

I am overjoyed to be alive! I was in the hospital for a week in November
and almost died! I'm grateful for every day!

I passed the EPPP!!!

Finally having conquered my own fear of what it would be like to swim in
a pool, after seriously damaging my leg in an auto accidenty, inside of
which I still carry a elongated plate, and necessitated a knee
replacement, I dared to join a Y and go swimming.  It ain't beautiful
but I can swim and do participate in working out in the pool.

Simply walking - 10 months ago I was in a wheelchair - 5 months ago I
completed a 5K walk for the Miami Transplant Institute - simple pleasures

What sustains me? Playing with my daughters, Emma and Lindsey, as much
as possible. For the past 6 months, Emma and I have been going ice
skating on Saturdays. When we are on the ice together, it's pretty close
to nirvana.

My husband, who always took charge of fixing things around the house,
died of cancer 10 years ago.  Afterwards, when something in the house
malfunctioned, I would fret and fret about what to do.  And then I would
hire someone.  One day, encouraged by my "You can do this, Mom"
daughter,  I decided to see if I could figure it out for myself.  And I
discovered that sometimes, I can!  And when I can, it brings me joy. 
And I can almost see my husband smiling.

My youngest son turns two next month. He has spent most of the past 23
months in and out of the hospital after being born prematurely, with
several respiratory complications. We've finally ruled out CF and
several other frightening issues and have stabilized him on medication.
We've heard over and over again if he makes it to two it's all things
he'll grow out of. That transition from "potentially deadly" to "chronic
but manageable" - never thought I'd be so glad to hear we'll be dealing
with this for the next few decades...

My wife continues her battles with cancer and Altzimer's. Some days show
great improvement although I know she will never recover to where she
was prior to her illnesses.  We live one day at a time and cherish each
and every moment we have.  We seem to have the strength to face each
issue and are able to smile with each other land renewed our wedding
vows in March.

Hearing my aged parents tell things about their past or about their
preesent feelings, since they did not do that in the past.

Stopping to look up at the stars every night when I come home from the office.

A lucid dream after my mom died in which she gave me a warm hug good-
bye....watching my husband dance with our daughter at her wedding a few
months later.a phone call from our son this winter sharing the news that
"we're pregnant", their first child and our first grandchild....sensing
my mom is somehow present through it all.

My thirty-one year old daughter's continuing determination to help
other's with their difficult medical conditions. She has developed deep
compassion for the suffering of others having lived with her own
intractable epilepsy.

Each week, several times, I go to a local barn early in the morning. I
groom the horse I ride while she snuffles my pockets for peppermints. I
saddle her up and we go for a walk, slowly feeling the day. My trainer
arrives and for the next 45 minutes we work on my riding. Some days are
very good, some days are not. I then take her back to the barn, remove
her tack, brush her dry, and now that its Spring, turn her out. As I
walk to my car I notice that I am always smiling, and at peace.

My terrific yoga class and group of women that practice with me

I find that doing doctoral research can be an isolating experience, but
when the veterans I interview thank me for bringing attention to their
needs on campus it really lifts me up and reinvigorates me.

My 95 year old mother who expresses love in her own special ways while
living with Alzheimers.

It's been a major source of relief to see my son actively working at a
job for well over a year, where he gets recognition, feels competent and
likes what he is doing; he is no longer as depressed as he had been, and
has gained considerable self-esteem. I can enjoy this progress mainly
because I know it is the result of the sustained effort by his siblings.
He is also aware of and appreciative of the special caring provided by
our family. My son, the late-bloomer, is gaining maturity thanks to our
group effort. Knowing that I am not alone has been an enormous source of 

Gardening and feeling a part of the earth.

Dreams of a new life in a new land (once my partner and I can
successfully sever all the old threads still attaching us to the current

I am sustained by my husband and daughter.  Even as life gets hard for
my circle of loved ones - cancer diagnoses, strokes, psychiatric
diagnoses, financial difficulties - I often step back and remind myself
that my little things, my things I take for granted, are really my BIG
things:  a loving relationship with a soulmate, a loving bond with a
great kid.  Our bonded band of three is a gift and a constant reminder
that life's journey is less about where you go or where you are going,
but who travels with you.  I am renewed each day by my traveling companions.

The fact that although my 94 year old mother passed recently, she did so
peacefully and without apparent pain

My wife receiving a development award from the New York Drama Guild for
her very first play. My oldest daughter getting her own internet radio
show. My youngest daughter in graduate school at Columbia and loving it.
My son in college and doing well.

My 102 year old father-in-law whose humor, grace and dignity still
shines through.

my first grandchild. watching him experience the small things in life
for the first time. learning babies are stereotyped as cry babies. i've
been watching babies laugh - a lot.

Opera, my cat, and my partner (in reverse order)

Our Son began his tenure as a Chaplain in the USA Air Force
Reserves...Riverside.  Good to see him mature in his faith and
leadership. Our Son in Law published his first book as a professor at
Biola University and our other Son In Law is advancing his missionary
teaching career in Germany and becoming a recognized artist/sketcher. 
we are proud of our three kids and their spouses, and our 8 grandkids.

In my case, it has been 18 months since a clearly declining haemoglobin
level stabilized just above the action level (biopsy, chemotherapy).  At
that point, I decided to work on my child development ideas and book. I
guess children keep you going one way or another.

The great joy for our family is to see our kids doing so well. Our
daughter was just accepted into her (1st choice) residency program and
son half way through his Fulbright Scholarship in Europe. The future of
the world rests with our the next generations - may we be good models
for them.

My wife's commitment to lovingly care for her father through thick and thin.

Petting and communicting with dogs.

What gives me joy? My childrens' faces, my friends' laughter, my work,
my students' enthusiasm and that magic quiet moment when I know
something I said is being fully processed, and rediscovering a piece of
music or poetry that moves me. (Recent re-find: Matthew Arnold's Dover
Beach.) And I love the list serve and the humanity and compassion that
goes into it! 

My son, his wife and their 2 little kids whose joy for life is contagious.

I have to share my delight this year about my new hearing device.  Quite
some years ago at Ken's suggestion I wrote this list about an
undiagnosed ear problem which led to off and on bouts of near-deafness--
a bit problematic for a clinical psychologist, as you might imagine.  I
got a number of kind, thoughtful responses and some very good ideas,
besides. Nevertheless, the problem remained undiagnosed for a while,
then there was a diagnosis, there were two surgeries...but little
improvement.  All in all, counting the first bout of deafness that
happened before I moved to NH, I've had serious hearing problems and
only semi-adequate relief for 10 years or more.

This year, actually December, I finally got my Baha (it is an acronym
but they don't use caps--Bone Activated Hearing Aid). There was a
surgery, minor compared to the others, to implant a titanium abutment
directly into the skull.  It acts like the bottom half of a metal snap
fastener.  The skull bone has to grow, close up around it, and that took
about 3 months.  Then right before Christmas I got my Baha, the hearing
device.  I snap it on (the Baha has the top half of the "snap"), push
the button, and sound rises around me as if it had been on a dimmer
switch! It is programmed for my hearing, it is brown (lighter than my
hair but it blends), and it is mostly concealed by my hair.  I snap it
on in the morning, snap it off at night, and in between I am hearing
about as normally as I did 10+ years ago (I've had hearing problems
since age 11, so that means "normal" for me). Sound vibrations are
conducted directly into the bone and to the acoustic nerve--quality is
good, better than aided air/bone conduction from a normal hearing aid.

The biggest day-to-day change for me is that I don't have to "arrange to
hear."  I had found that over time I "arranged it" less and less.  I
used to have to put in or on a hearing device if I wanted to, for
example, click on a link for an interesting site, to watch TV, to listen
to music, to go out in public where someone might talk to me.  I
couldn't wear conventional hearing aids all day (prone to ear
infections), some of the devices were painful and I was glad to shed
them as I came through the door at night--but I'd have to go get the
blamed thing and put it on or in if I wanted to hear.  The sound quality
was not all that great, and there were still hearing problems even with
the best technology.  Going to a noisy restaurant was torture--couldn't
hear anyone talk, so why bother?  More and more there was a lot of "why
bother?" in my life.

So now I don't have to do that!  If I want to click a link, I just click
the link.  Music is back in my life.  Noisy restaurants can still be
problematic, but not as much a problem. I can hear in meetings.  And...I
can hear my clients.  I even have more energy than I have had because
I'm not expending it just to hear!  (I didn't realize how darned
*tiring* it was to be deaf.

Lots of exclamation points in the above, but I'm not taking them out.  I
can hear and I feel normal for the first time in more than 10 years. 
Now *that* is a delight, a joy, a wonder...and I'm sure there are plenty
of other words that qualify.

My wonderful grandchildren whom I am lucky enough to see almost every week.

I have found joy in mindfulness meditation and the technique of
"focusing." By meditating any amount each day, simply bringing my
attention back to the breath, I have reduced the reactivity and
agitation of my thinking, and therefore, my mental suffering, which
isn't to report any unusual amount of mental suffering, most likely the
typical amount that goes with being human. Focusing, developed by Eugene
Gendlin, is a wonderful practice of searching for the felt sense within
one's core and giving one's heart a voice. These practices give joy an
opportunity to come through. 

Joy has come from the love of my wife and family, including our four yr
old rescue dog, Penny, a mix of mini poodle and ???.  When I was pretty
sick recently, Penny barely left my side as I recuperated at home.

My 79 year old mother has Alzheimer's and my 82 year old father has
cardiac problems. Their aging shows more and more each day. My joy is
that I live within 90 minutes of their home and can visit them for day
trips. In addition, my mom and I email each other every day during the
week. We have had many talks about life, death, love and faith. It is
beautiful to see the depth of their love after 60 years of marriage. My
dad cries when he tells me that he prays every day that he outlives my
mom so that he can take care of her with her dementia. They kiss and hug
each other every night and my dad tells my mom, "I love you Theresa" and
my mom says "I love you less (Lester)"  :-). They have talked to me
about how they do/do not want to die; what they do/do not want done. We
have had many laughs about the "joys of aging" and we have shared how
much we love each other many times. I have seen my dad cry every time he
talks about the ship ride to Japan during the Korean war and when he
talks about the fact that his father (my grandfather) raised himself
after his parents died at the age of 10. I have heard my mom talk about
her life in poverty, about the need for humility, for being grateful for
what one has and the importance of giving back to others. It is
completely endearing that I have the opportunity to share this part of
their journey in such an intimate way. I am truly blessed.

I looked with an almost ineffable joy at my youngest son, who had a
learning disability as a child and who I thought would wind up in jail
or worse. Instead, he is very successful in his job, has two really
great kids (I mean REALLY GREAT!) a remarkably tolerant wife and lives
in a house with four acres of  carefully nurtured wetlands.  AND...he
has begun glass blowing instruction and is very talented!!!   My wife
smiles a lot at this.  Fate is not often this kind!!!

I am joyful I can keep my sanity (i.e., my ego intact) in the midst of a
topsy-turvy end of mid-life that has set me adrift into space. I am
joyful I can look on this time with mostly anticipation and mostly not panic.

Last year I was sustained by the work we do with the pre-doctoral
psychology interns that volunteer with our agency. Seeing them grow,
learn, and become the professionals I see in them was immensely
gratifying. It brought me joy and took away much of the sadness, and why
not say it, darkness, that enters when evaluating children in trouble
with the law and parents in the CWS system. This year, I experienced
another 'balance' between joy and sadness. 'Pebbles,' a pommeranian and
dachsund mix entered our lives after 'Mr. Dog' passed last November. 
After writing the above I realize that this is not a bad bargain; a
balance of sorts between the light and the dark in which I come out
feeling ahead.

After a long seeming arduous struggle to complete the Winter this year
it gives me joy to see the sharp shadows and the sunshine.  The picture
of daffodils pushing their way through the sod to open once again
resonates with me and gives a new energy.  As I look around others
appear to have a little quicker step, topics on the tongue, and a look
into the next few months. Hearing their experiences encourages a deeper
joy for the season and refreshing look to see what they see.  At 65 the
preparation for retirement can be put off yet a little while and the
burdens seem less weighty.  Who knows maybe my son who received lots to
complete his advanced degree will be grateful this year?

Talking with old friends.

My granddaughter is graduating with her bachelor's in chemistry and
applying for pre-med. I am in my dissertation stage of my doctoral
degree. My daughter and family have survived the changes in the economy
well. My best friend and her family have survived without losing their
home when her husband lost his job and made it to her husband's
retirement. So many things have made this past year one of gratitude and joy.

A constant and reliable source of joy is seeing how my family,
especially my children, share and take responsibility in helping me cope
with one of their siblings, an adult (middle-aged) child who has
struggled to find his place in the community. My daughter and older son
went on a campaign of regular and continuous intervention, and
successfully weaned their brother away from turning only to me each time
he confronted a problem regarding his young son, his son's mother, or
work. They have also successfully coached me to accept the realities of
his limitations, and to assure me that they will "be there" for him
after I am gone. My son is now inclined to turn to either of them when
he needs help with parenting issues, child custody matters, and job
concerns, and fill me in after handling the problem.

Professionally, what has brought me joy is supervising other therapists
who want to get into my specialty.  Discovering what I know and being
able to pass that along to others has always brought me pleasure,
starting from when I taught elementary school.  Personally, it has been
seeing my daughter, now a sophomore in college, coming into full
adulthood.  She is just the coolest person!

When you ask this question again next year, I expect that my answer will
center on the great joy of finally seeing the 6th edition of Jay's book
in print - it will mark the fruition of an 8 year undertaking, with many
thanks to Oxford University Press for their unwavering support. Too bad
Jay is not around to see it for himself.

What brings me joy and what I am thankful for are closely related. This
is a long-ish story but here goes.

One of the graduates of my master's program was travelling in northern
Uganda when he met Ayuru Beatrice Byaruhanga. Beatrice started the Lira
Integrated School and was recently honored with the United Nations 2010
Empretec Women in Business Award, Geneva, Switzerland.

Beatrice came and spoke at my college in October and visited my family
and home, attending the High School JV soccer game in the suburbs,
eating dinner with the kids and grad students, trying new and exotic
American foods such as cheese. Beatrice talked with us at dinner about
what it was like to grow up in a polygamous family and also her dreams
of starting a University (she already has created a nursery, elementary,
and secondary school). She talked about how there is not time to waste
in starting the university because she is already 39 years old which is
the average life expectancy in her country.

A group of colleagues and students and others at Springfield College
where I work decided that we could lend a hand. What Beatrice wanted was
a team of us to come to Uganda and fund and build the basketball courts
needed for the students (sport has proven to be a way to reach some
children badly affected by their war experiences that can't be reached
in other ways).

It brings me joy to meet incredible people such as Beatrice and I am
thankful that I can lend a hand with this project. I received donations
of books for the library and a brick from the building that basketball
was invented in and first played to bring to the new university and
court. With fund raising and organization, we plan to travel to Uganda
in January of 2012.

It is a strange contradiction that when work seems grim and draining
that adding more work (planning a project on another continent) can
bring so much joy.

My good friends, always there to share life with.

What has sustained me as a psychologist that is newly licensed are the
kind caring people that own the practice where i work. Their guidance
and concern about my professional growth is a special gift, since
insurance makes it so difficult to begin and develop a private practice,
when one is newly licensed.

My greatest joy this year has come from my young adult sons (both in
their 20s) who have graduated from university and found meaningful work
in their areas of interest and who are both independently self-
supporting, well-connected to friends and family, and happy with their
lives. I feel, in turn, that I have succeeded in the most important role
of MY life.

My wonderful golden retriever dog who is perpetually joyful

Here, now, in 2011, I simply don't know.  Nature has been especially
unkind to Homo sapiens, the hubris of supply side economics is
increasingly evident, and, whatever one's political bent, the leadership
has failed the outlook.  Even so, I do feel the joy of self-fulfillment
daily.  Perhaps our evolutionary biology can lead to good affect when
one's own vantage point is not immediately threatened.

I am thankful for the health of my husband, family, friends, those whom
I serve, and those who wish to help another make their way in the world;
my creativity, passion and especially, my desire to be of service.

This has been a dismal year internationally and nationally, so for joy I
will have to turn to local events. My co-authored book HAUNTED BY
COMBAT: UNDERSTANDING PTSD IN WAR VETERANS came out in paperback and got
a positive review from the New England Journal of Medicine. This won me
an invitation to be an "honored guest" at the G.I. Film Festival in
Washington D.C. and here is where the joy comes in.  I was able to bring
my teenage grandson with me, and this was the first opportunity we have
ever had to spend several days together without other family members
around. He enjoyed seeing the films and meeting the celebrities, and I
enjoyed his company and giving him some unique experiences.

Wonderful mind-body training I received recently

Erupting blooms of flowers and trees in springtime and splashes of
sunshine after a dark, gloomy, cold winter

Family and friends

After several years of grueling challenges, including three years of
stalking and harassment by neighbors who fit the definition of
"resentful stalkers" and have damaged my property, assaulted a child in
my care, conducted electronic and photographic surveillance of me in my
home, and, in response to which the police and district attorney refused
to intervene; as well as seven deaths of people close to me, including
two suicides and three murders....what has given me enormous joy this
year has been renting a friend's old farmhouse in rural Vermont.  This
past winter has brought the heaviest snowfall in years. But I have
welcomed the snow and ice with joy.  I have skied outside the house in
the woods, and become an expert at handling ice dams with a wooden
rolling pin.  I have renewed my wood-fire-building skills from
childhood.  Being in a space imbued with the loving spirits of my friend
and her late husband, who, with his twin sister, were born in this,
their family's, farmhouse, has brought me joy & balance, and renewed me
physically, spiritually, emotionally, creatively, and intellectually.  I
have been able to do my public interest legal work here, and have a harp
and piano to do my musical work as well.  All in peace and surrounded by
nature's splendor and majesty.  Whether under sun or clouds, snow, or
rain, these old mountains have breathed new life into me.  As I write
this, I am watching spring's first robin hunting for worms outside the
window as snow has finally melted giving way to mud.  Amid this serenity
and magnificence of majestic creation and renewal, after several years
clouded by human darkness, I feel Light and Joy once again.  The light
shining in the darkness has once again become clearly visible to me.

I delight watching Kuroi, a feral cat that I adopted, slowly come to a
place of less fear of other people.  Showing absolutely no fear of Nori,
another adopted cat, who plays the role of a mama cat to Kuroi.  The joy
of watching both play together bringing me much laughter as well.

Ken Pope


Cyclists’ Descent Anxiety – Interview w. Andrew Jacobs

Posted: March 23, 2011 in Uncategorized

I had the pleasure of interviewing Dr. Andrew Jacobs – the “Good Doctor” about cycling and downhill anxiety occurrences in cyclists.

Dr. Jacobs was the sport psychologist at the 1983 Worlds in cycling, where the winner of the event was Greg Lemond.  Dr. Jacobs has witnessed many crashes in his time.

He believes that this is a FEAR issue more than an Anxiety issue.

Here are some of the ways that he suggested work for helping cyclists’ overcome their fears of downhill riding:

  • Desensitization
  • Visualization
  • Positive visualizations
  • Relaxation
    Visualization training

In a properly sequenced intervention, it is best to first:

Identify the Issue and Set Goals .  Define the fear and decide how to deal with it.

Need to find ways to eliminate negative thinking and alleviate fears.

More to follow…

Came across these two sites: Cat and Dop Help and Ken Pope’s site of special needs animals at his office: Ken Pope’s Special Needs Pets

Even terminally ill pets need good homes. Here is what to do if you find one or find that yours is beyond your care.

Thanks for loving and caring for animals on this Earth!

Fund Raising for CAF

Posted: February 17, 2011 in Uncategorized

Racing and fundraising for Challenged Athletes Foundation! For more information on how to help:

I’ll be training for a triathlon in October to help raise funds for the Challenged  Athletes foundation.

The “San Diego Triathlon Challenge (SDTC)” consists of a 1 mile swim, 44 mile bike and 10 mile run on one of the most breathtaking courses in the country – in La Jolla, California.

This one-of-a-kind event will change your life as athletes compete side by side with Ironman® champions, world-class challenged athletes, celebrities and other enthusiasts while raising important funds for the Challenged Athletes Foundation®(CAF). Money raised will help CAF provide individuals with physical challenges with the tools necessary to find success in sports — and in life.

SDTC is an event unlike any other in the world. Inspiration, perspiration and determination are the words of the day, as more than 125 of the world’s top physically challenged athletes take on this gruelling yet rewarding course alongside 550 able-bodied triathletes (yes, one of those will be me!!), celebrities & pros.

So I’ve started training now and fundraising.  Again, here is the link to donate and be a sponsor of my efforts.  Your donation will be put to good use for CAF!!

New Top Performance Consulting page on Facebook!!

Posted: February 15, 2011 in Uncategorized

Top Performance Consulting

This morning’s *Los Angeles Times* includes an article: “Strength
training does more than bulk up muscles” by Jeannine Stein.

Here are some excerpts:

[begin excerpts]

A growing body of research shows that working out with weights has
health benefits beyond simply bulking up one’s muscles and strengthening

Studies are finding that more lean muscle mass may allow kidney dialysis
patients to live longer, give older people better cognitive function,
reduce depression, boost good cholesterol, lessen the swelling and
discomfort of lymphedema after breast cancer and help lower the risk of

“Muscle is our largest metabolically active organ, and that’s the
backdrop that people usually forget,” said Kent Adams, director of the
exercise physiology lab at Cal State Monterey Bay.

Strengthening the muscles “has a ripple effect throughout the body on
things like metabolic syndrome and obesity.”

When we hit middle age, muscle mass gradually diminishes by up to about
1% a year in a process called sarcopenia.

Women also are in danger of losing bone mass as they age, especially
after the onset of menopause.

Some studies have shown that moderate to intense strength training not
only builds skeletal muscle but increases bone density as well.

Strength training often takes a back seat to cardiovascular training,
but it can benefit the heart in ways that its more popular cousin can’t.

During cardio exercise, the heart loads up with blood and pumps it out
to the rest of the body: As a result, Potteiger said, “the heart gets
better and more efficient at pumping.”

But during resistance training, muscles generate more force than they do
during endurance exercises, and the heart is no exception, Potteiger said.

During a strength workout, the heart’s muscle tissue contracts
forcefully to push the blood out.

Like all muscles, stress causes small tears in the muscle fibers.

When the body repairs those tears, muscles grow.

The result is a stronger heart, not just one that’s more efficient at pumping.

Another big advantage of working out with weights is improving glucose
metabolism, which can reduce the risk of diabetes.

Strength training boosts the number of proteins that take glucose out of
the blood and transport it into the skeletal muscle, giving the muscles
more energy and lowering overall blood-glucose levels.

The benefits don’t end there.

A 2010 study in the Clinical Journal of the American Society of
Nephrology suggested that people on dialysis can benefit from building
muscle. Researchers found that kidney dialysis patients who had the most
lean muscle mass — a measurement derived from the circumference of the
mid-arm muscle — were 37% less likely to die than the patients who had
the least.

“This is something that has an impact on survival,” said Dr. Kamyar
Kalantar-Zadeh, a principal researcher at the Los Angeles Biomedical
Research Institute and coauthor of the study.

“It’s not just about having more muscle and looking better — we’re
talking about life and death.”

Even people who already have chronic kidney disease could benefit from
strength workouts.

Germany began to incorporate modified exercise equipment into dialysis
treatment centers in 1995, and a 2004 study in the American Journal of
Kidney Diseases examining that policy found that exercise may improve
the efficiency of dialysis by increasing blood flow through the muscle
and improving phosphate removal.

The brain may get a boost from the body’s extra muscle as well.

A 2010 study in Archives of Internal Medicine found that women ages 65
to 75 who did resistance training sessions once or twice a week over the
course of a year improved their cognitive performance, while those who
focused on balance and tone training declined slightly.

One reason for the improvement, researchers believe, may be that
strength training triggers the production of a protein beneficial for
brain growth.

This study was triggered by another that looked at resistance training
as a way to reduce the risk of falls in older people, said coauthor
Teresa Liu-Ambrose, a researcher at the University of British Columbia’s
Centre for Hip Health and Mobility in Vancouver.

As the study progressed, she said she noticed that participants “were
able to take on new tasks, like taking the bus by themselves. They were
able to prepare and plan for things and execute them.”

[end excerpts]

The article is online at:

Next month’s issue of the *Swiss Journal of Psychology* (vol 70, #1,
March) includes an article: “FIT — Do Something Different: A New
Behavioral Program for Sustained Weight Loss.”

The authors are Ben Fletcher , Jill Hanson, Nadine Page, & Karen Pine.

Here’s how the article begins:

[begin excerpt]

Even as more and more diets become available, obesity rates continue to
rise, which has led some to conclude that “there is little support for
the notion that diets lead to lasting weight loss” (Mann et al., 2007,
p. 220). Repeated dieting has also been shown to have a negative impact
on immunocompetence (Shade et al., 2004) and mortality (Sorensen,
Rissanen, Korkeila, & Kaprio, 2005) and to produce cognitive impairments
(D’Anci, Watts, Kanarek, & Taylor, 2009).

Many researchers have shifted the focus from dieting to emphasizing
lifestyle or behavioral modification as a viable, more effective, and
safer approach to weight loss (Dansinger & Schaefer, 2006; Wardle,
2005). The challenge, however, has been to identify which aspects of
behavior to target since current behavioral programs seem to produce
modest results at best, even when well conceived and well resourced. For
example, the large-scale TAAG study targeted schools and community
agencies and 8,727 participating adolescent girls and was informed by
the best available models and previous practice and social marketing
over a 2-year intervention. The intervention produced no reduction in
BMI or associated markers, with only a 1.6 minute/day difference in
activity levels on one of the cohort-control comparisons (in which it
seemed the control group had an unusually low score compared to the
other controls) (Webber et al., 2008).

To be effective in weight reduction, behavioral approaches must tackle
the causal characteristics that are amenable to change. Willpower or
intention is a likely candidate, yet people have limited willpower, and
this is known to weaken the more it is called upon (Baumeister,
Heatherton, & Tice, 1994), probably because it relies on glucose as a
limited energy source (Gailliot et al., 2007). Equally, the link between
weight control intentions and food choice is very weak (Wardle,
Griffith, Johnson, & Rapoport, 2000), and good intentions are not in
themselves sufficient to bring about behavioral change (Webb & Sheeran,
2006). Behavioral programs that rely too heavily on participants’
willpower and active intention are therefore likely to fail in the
longer term. Diet and exercise regimes are maintained for a short time
at best, but people simply do not have the willpower to make every day a
diet day. For sustained success, it is argued, the answer may lie in a
behavioral approach that avoids overreliance on willpower (Dansinger &
Schaefer, 2006). Recent research highlighting the role of genetic
factors in weight regulation and obesity (e.g., Blakemore & Froguel,
2008; Hofker & Wijmenga, 2009) and in food intake (Wardle, Llewellyn,
Sanderson, & Plomin, 2009) further amplify the need to target core
psychological mechanisms to deal with the growing obesity problem.

A key finding from our previous research is that overweight people have
low behavioral flexibility (Fletcher, Hanson, & Jones, 2004; Hanson,
2008). In other words, their range of behaviors across situations is
limited. Behavioral flexibility can be reliably measured using FIT tools
(Fletcher & Stead, 2000) and has been found to correlate negatively with
BMI in a sample of over 1,000 people. In essence, heavier people are
more habitual and constrained in the way they behave. A recent study of
obese schoolboys also reported an association between BMI and clinical
tests of cognitive flexibility (Cserjesi, Molnar, Luminet, & Lenart,
2007): Boys with higher BMI were more likely to persist with ineffective
strategies when solving problems.

If behavioral and cognitive flexibility is negatively related to weight,
then we propose a novel hypothesis: increasing it should lead to a
reduction in weight. An intervention designed to increase flexibility is
the FIT-Do Something Different (FIT-DSD) program. By doing something
different on a daily basis individuals are challenged to break existing
habits and increase their behavioral flexibility. This may help to break
distal habits that other behavioral approaches do not target, yet that
nevertheless play a key role in maintaining unhealthy behaviors. It is
known, for example, that changing the context of behavior can help break
habits (Wood, Tam, & Guerrero Witt, 2005). Recent neuroscience research
has also shown that doing something new over a period of several weeks
can result in marked gray matter growth and white matter architecture
changes in the adult brain (Draganski et al., 2004; Scholz, Klein,
Behrens, & Johansen-Berg, 2009). Doing something different may have the
potential to lay down new learning pathways as well as disrupting
negative habitual ones.

This approach also avoids the need for sustained willpower and may
provide the impetus for positive change by altering the daily habits
that trigger overeating and the broader changes needed for positive
health engagement generally. There is some evidence that positive, habit-
based approaches can lead to weight loss in the longer term if they
target the proximal habits related to eating and exercise (Lally,
Chipperfield, & Wardle, 2008), although no research has so far looked at
the effects of tackling more distal habits. Therefore, this research
evaluates the efficacy of the FIT-DSD program as a tool for purposeful
sustained weight loss. Study 1 is a pilot study comparing two behavioral
interventions, the FIT-DSD program and a narrative control group whose
daily task did not target behavioral habits. Based on the hypothesized
relationship between behavioral flexibility and BMI, participants
following the FIT-DSD program were expected to lose weight during the
intervention period and to continue to lose weight post-
postintervention. No specific predictions were made regarding the weight
losses of narrative control group participants, although all wanted to
lose weight. The purpose of this control was to establish whether the
active ingredient of the FIT-DSD intervention was the hypothesized
expansion in behavioral flexibility. This would be supported by a weight
loss advantage in the FIT-DSD group over the narrative control group. If
both groups show weight loss to the same degree (and both were wanting
to lose weight), this would be more easily attributed to other, more
general demand characteristics present in both conditions. Behavioral
flexibility is important in many life contexts, and the studies may also
help to examine whether this novel approach could have broader
applications for well-being generally.

[end excerpt]

Another excerpt: “In Study 1, the FIT-DSD program was compared with a
control condition where participants engaged in daily tasks not expected
to influence behavioral flexibility. Study 2 used an active or
quasicontrol group in which half the participants were also on food
diets. Measures in both studies were taken pre-, post-, and post-
postintervention. In Study 1, FIT-DSD participants showed greater weight
loss that continued post-postintervention. In Study 2, all participants
on the FIT-DSD program lost weight, weight loss continued post-
postintervention, and participants who were also dieting lost no
additional weight. A dose relationship was observed between increases in
behavioral flexibility scores and weight loss, and this relationship was
mediated by calorie intake. Corresponding reductions in BMI were also

Another excerpt: “Why should changing comparatively small behaviors help
people lose weight when other multimodal programs fail? We suggest that
the FIT-DSD program acts on mechanisms different than those that are
usually the focus of weight loss and weight maintenance programs. First,
by doing something different on a daily basis, the participants expanded
their behavioral repertoire and modified some of their usual habits.
Habits do not exist in isolation; they form an interconnected web (Neal,
Wood, & Quinn, 2006). The FIT-DSD program may have weakened the web of
habits so that participants’ daily pattern of behavior was less likely
to contain triggers that led them to overeat. The behaviors that
participants modified on a daily basis (e.g., interacting differently
with a person, having a no-TV day, taking an alternative route to work)
required little sustained willpower and led to a measurably greater
sense of well-being. Because their attention was directed toward their
behavior rather than toward their food intake, they did not fall victim
to the food cravings previous work has shown dieters experience
(Fletcher, Pine, Woodbridge, & Nash, 2007). Nor are they likely to
suffer from the behavioral rebound that can occur as a result of trying
to suppress thoughts about food (Erskine, 2008).”

The author note provides the following contact information:
Ben Fletcher
School of Psychology
University of Hertfordshire
College Lane, Hatfield
Hertfordshire, AL10 9AB