LIVING SMALLER

(Published in the May 2008 East Bay Psychiatric Newsletter)


Have you noticed that the size of people, houses and cars has increased greatly over the past decade or two? My architect son, who thinks in spatial terms, commented that he sees Americans existing on a scale of 1.2:1 relative to Europeans. But now the recent economic downturn in our country has some pundits talking about a 20% chance of a depression, and others predicting the loss of value of the dollar so great that the U.S. economy will eventually resemble an emerging market country. Maybe it’s time we all started living smaller.

This economic downturn, with the certainty of less buying power for most people, got me thinking about the things that are important in life that money can’t buy. Many of my patients who are under emotional stress can benefit from clarification of their values so that they don’t simply expend all their time on the treadmill of earning money and spending money, with no chance to actually find meaning, purpose, and pleasure in their lives.

How one manages money seems to correlate with stress. One patient of mine who was earning $300,000 a year between himself and his wife, complained, “we can’t make ends meet.” I asked him what kind of car he owned, and he answered, “A Lexus SUV.” I then asked him how often he drove his SUV off road, and he answered, “Why would I take it off road?” I proceeded to point out that he had purchased a $45,000 car that was engineered for off road driving, when he could have bought a car for half that amount to accomplish what he wanted from a vehicle. Regardless of how much money you earn, if you spend beyond your means, you can feel poor.

In an attempt at clarity, I have made a partial list of things that I suggest are important toward fulfillment and satisfaction, followed by a list of things not so essential. When measuring the importance of these, it is helpful to distinguish between what would bring you happiness (a long-term emotional state), versus what simply is fun (a short term emotional state). Some are expensive and need to be budgeted for, others are free of cost.

Important:

1) A lot of laughter
2) Freedom
3) A support system of family, colleagues, and friends
4) Accessibility to the natural world for pleasure, exercise, and spiritual awareness
5) Reasonable quality food, clothing, and shelter
6) An intellectual life, including access to good books
7) A cultural life, including access to good music and the arts
8) A recreational life including exercise
9) A spiritual life
10) Adequate leisure time to reflect, read, and relax
11) Some travel and entertainment
12) Meaningful, satisfying work
13) Good health with access to quality medical care
14) A safe, quiet neighborhood to live in
15) Access to information and knowledge

Not so important:

1) A luxury car
2) An elaborate house
3) Fancy furniture
4) Gourmet food and wine
5) Expensive jewelry
6) An expensive wardrobe of brand name clothes
7) Electrical appliances of all sorts
8) Technological gadgetry
9) Recreational vehicles

A financial counselor, when asked by his client whether he could afford to retire yet, said: “It depends on what you want to do when you retire. If you want to play golf every day you will need more money than if you want to play bridge every day.”

It seems important to go through some clarification of values from time to time. Overworked, heavily indebted people encounter more emotional problems, more marital conflict, more problems with their children who may feel neglected, and a greater sense of frustration and dissatisfaction that can lead to problems with physical health.

One definition of being rich is to feel satisfied with what you have. This may be one of the most important keys to happiness. If you have your values clear and your “head straight’ in this regard, you probably have all the money you need, regardless of what happens to the larger economy as the future unfurls.

SCIENCE, FAITH, OR GOOD FORTUNE?

Published in the March 2008 edition of the East Bay Psychiatric Newsletter


I take a bunch of pills every day—ten to be exact. But despite my scientific training and “prove it” attitude when it comes to most things, seven of these ten pills are non-proven, over-the-counter nutritional supplements that I take mostly as a matter of faith. You won’t find me acting this way in other areas of my life, so why do I behave this way is this particular area?

The simple answer is that when it comes to my health, I’ll do just about anything to improve my odds of remaining well and lengthening my life. Scientific evidence seems less important when non-toxic supplements like a high potency multivitamin, glucosamine, folic acid, vitamin C, selenium, omega-3 fatty acids, and vitamin E are concerned. And I haven’t even mentioned the Echinacea tea and other herbal teas I drink routinely to “boost one’s immune system and add anti-oxidants to prevent aging of cells.” I have fallen prey to the poorly documented claims that if I take these remedies I will delay the onset of Alzheimer’s disease, ward off colds, keep my knees and varicose veins from worsening, improve my cardiovascular status, and maybe even live longer.

There is some documentation for these claims from the multi-billion dollar nutritional supplement industry, but for the most part it is anecdotal and has not been subjected to the rigorous double blind studies that I would normally demand. Studies that would definitively demonstrate value or lack thereof for some of these substances could take decades to complete. They may even be too costly or cumbersome to undertake at all. At age 64, I do not have 20 years to learn that it might have been helpful to take some of these supplements for the prior 20 years. By then it will be too late for me, so I have to proceed now on sparse evidence and hope.

I am not looking for the fountain of youth. My hope is an ordinary one--to live to a ripe old age without being afflicted by the physical infirmities or serious decline in cognitive functioning that so many people suffer from in their last years. One of my patients recently told me that her 96-year-old father simply “stopped.” He went to bed one night saying he felt over-tired, woke up the next day not feeling well, held his 94 year old wife’s hand during breakfast, and then died right there sitting at the kitchen table. He had experienced no serious physical decline, no major illness, and no loss of mental acuity. I asked my patient if I could sign up for the same end-of-life contract her father had arranged for himself, and she and I smiled, knowing it doesn’t get any better than that.