Connecting To Something Big: How It Improves Your Well-being ... And Why You Do Not Need To Be Religious For It

‘That is happiness; to be dissolved into something complete and great.’

                                                                                  Willa Cather (writer)

This week’s post is about a big topic – in the widest sense, it has to do with spirituality. As I am aware that, just as political beliefs, the topic of religion can be divisive and I would like to stress that the content of this post reflects what is known about this subject in the current relevant literature, rather than representing my own views.

Why we need something big

• Research has shown that our well-being is highly dependent on the ability to see ourselves as a part of a larger, interconnected whole.¹ By dissolving the boundaries between our physical self, other people, nature or an abstract concept, we become less self-focused and - as a result - we become happier.^1-5
• This process (also called self-transcendence) gives us a sense of meaning, a source of hope and provides a larger framework that we can set our life in.² The type of this larger framework may vary: It can be the belief in our family, our closer community or our nation, other sentient beings, a God or another larger value system (even science, for example), or simply nature or the universe.^1-5 This expansion of our identity and the feeling that we are part of something larger gives us the sense of interconnection. Linking ourselves to other people or larger systems/concepts is a requirement for a meaningful and purposeful life.¹
• Another way to look at self-transcendence and interconnection is to see it as a cohesive narrative:¹ We humans need to have the feeling that we understand who we are and what happens to us. We need to be able to tell the story of our own life and it is important that this story makes sense (at least to us!). And of course storytelling is never just about the central character: it is about how the main character relates to other people and the greater setting. In other words, telling our story is also about interlinking and forming connections. A cohesive narrative gives us security, self-esteem; it helps us to make sense of our lives and gives us orientation; and it provides the feeling of a continuation beyond the boundaries of time and distances.¹ For example, we may see ourselves as a continuation of all previous members of our family or larger community throughout history. Or we may see ourselves as part of a larger current world community (e.g. through our occupation or religion).

What about spirituality?

• Sometimes, the connection to another value system is called religion or spirituality. Particularly the term ‘spirituality’ means different things to different people. Usually it is used in the sense of a’ quality that involves deep feelings and beliefs of a religious nature rather than the physical parts of life.’⁷ However, spirituality can also be defined more broadly. For example, there has been a consensus of palliative healthcare providers in the US defining spirituality as follows:

‘Spirituality is the aspect of humanity that refers to the way individuals seek and express meaning and purpose and the way they experience their connectedness to the moment, to self, to others, to nature, and to the significant or sacred.’⁷

• For this post, I am using the term spirituality as defined in above consensus statement: It includes any form of (inter)connectedness and self-transcendence, which gives an individual meaning and purpose.
• Spirituality matters because it has been shown that positive spiritual beliefs improve physical illness and quality of life, whereas negative spiritual and religious beliefs can not only cause distress but also problems when dealing with physical illness.⁷ Furthermore a positive form of spirituality is significantly associated with a greater psychological well-being, lower level of mental illness, lower incidence of drug abuse, and more stable marriages.⁸ Spirituality is also associated with an increase in the positive emotions of love, gratitude and awe. Finally, when people feel emotionally connected to others, to society at large, nature or the universe, they are likely to behave more positively, and care for other people and the planet.^4,5
• It has been shown, that well-being can be increased by developing a greater self-awareness and working towards self-growth.⁹ This increased self-awareness and self-growth can be aimed at three areas: Self-directedness (e.g. responsibility, resourcefulness), cooperativeness (e.g. tolerance, helpfulness, compassion), and self-transcendence (e.g. wisdom, spirituality). People with a high level of well-being typically score high in all 3 areas. This means that intentional cultivation of spirituality, interconnectedness and self-transcendence is associated with a higher level of well-being.⁹ 

What happens when we lose sight of something big²

• Particularly in ‘Western’ societies, we have seen a significant erosion of some traditionally very stable value systems over the last centuries, including loosening of family ties (due to higher mobility and higher divorce rates) and a decline in the belief in God. As a result, there has been a shift towards a more individualistic society where individual freedom and the right to individual choice are highly valued.
• Interestingly, this increase in individualism and focus on the ‘self’ has co-incided with a significant increase in depression.
• It has been suggested that this association may be due to the fact that when we live a very individual life with little or no connection to a larger value system, it is more likely that we feel vulnerable and helpless when facing life’s inevitable failures and disappointments, many of which are outside our control. These personal failures may then seem more catastrophic, for example because we can see them as being our fault (rather than e.g. ‘God’s will’), and the resulting helplessness and hopelessness can manifest as depression.
• By being aware of the limits of individualism, we can open ourselves more to a greater value system, which provides us with hope, comfort and meaning.

How to cultivate self-transcendence and interconnectedness

As a conclusion, evidence suggests that we will not find well-being through exaggerated individualism, selfish behaviour, self-preoccupation, or by pursuing superficial pleasures or bodily comforts. Rather, we need to find an appropriate balance between us as an individual and being ‘dissolved into something complete and great’.¹

There are several ways we can cultivate spirituality. Of course we can simply try to identify and practically engage with something big, which resonates with us (such as other people, value systems, nature etc.).^1-5,9 We can also identify connections in our day-to-day life, for example when eating we can think about where the food has come from, and how many people have been involved in the process for us to be able to eat.

Another way of increasing self-transcendence and interconnectedness is through contemplation and meditation. Particularly certain types of mindfulness meditations (for example the loving-kindness meditation) have been shown to increase our feeling of interconnectedness.⁴

…and what about religion and well-being?

Although I am not religious myself, I have some interest in the various religious concepts. And just in case that you have also often wondered if religious people have a higher level of well-being, here are some answers to the question:^4,5 

• Although it has been recognized that religious beliefs have motivated wars, genocide and intolerance, there are many aspects of religion, which can increase well-being. For example, all major religions capture important ideas about living a good life, promoting pro-social behaviour such as kindness, compassion, gratitude, forgiveness and hope, and they tend to discourage egoism, selfishness and self-centeredness. As regular blog followers will know by now, compassion, gratitude and forgiveness are all associated with a higher level of well-being.
• However, although many studies demonstrate that religious people are happier on average, the difference is often very small, and it does not apply across all communities, countries and cultures. For example, people who believe in the existence of hell (rather than just heaven alone) and in a hateful/revengeful God are less likely to be happy. Also, focusing on sin and hate makes people less happy.
• Factors which have been shown to specifically promote well-being in association with religion include:
• Offering comforting beliefs (particularly when dealing with death)
• If the religion or specific community provides social support within the congregation and offers this to people outside the closer religious community.
• Offering a way of self-transcendence, meaning and belonging: In line with the main topic of this post, joining a movement with a history, shared with many contemporary and historic people and with international connections promotes well-being as it provides membership to a cohesive group as well as a larger value system.
• Self-esteem and increased significance: Many religions teach that every individual life is important and precious but without encouraging outright individualism.
• Experience of rituals: sights, smells and sounds of specific religious practices can be experienced as fascinating, aesthetic and evoke feelings of awe.
• Prayers and some religious practices can have a meditative quality, even if they are not specifically considered to be meditations.
• As mentioned above, spirituality and religion can also directly evoke positive emotions
• Growing up religiously is associated with happiness even if the religious belief does not persist in adulthood. Possible causes include a sense of community, family unity and a foundation for moral reasoning/values. 

Preview: As discussed above, a cohesive narrative is very important for us. However, in order to tell a conclusive story about ourselves and what happened, we need reliable memories. But as you will find out next week, our memories can sometimes be tricky business. 

References and further reading:

1. Siegel D. Mindsight: Transform Your Brain with the New Science of Kindness. Oneworld Publications; Oxford, UK. 2011.

2. Seligman MEP. Learned Optimism: How to Change Your Mind and Your Life. Vintage Books; New York. 2006.

3. Lyubomirsky S. The Myths of Happiness: What should make you happy but doesn’t, what shouldn’t make you happy but does. Penguin Books; New York. 2013.

4. Kabat-Zinn J: Full Catastrophe Living: How To Cope With Stress, Pain and Illness Using Mindfulness Meditation. Piatkus. 2013

5. Diener E, Biswas-Diener R. Happiness: Unlocking the Mysteries of Psychological Wealth. Blackwell Publishing; Oxford, UK. 2008.

6. http://dictionary.cambridge.org/dictionary/english/spirituality

7. Puchalski CM, Vitillo R, Hull SK, Reller N. Improving the spiritual dimension of whole person care: reaching national and international consensus. Journal of Palliative Medicine. 2014;17(5):642-656.

8. Seligman MEP. Flourish: A New Understanding of Happiness and Well-Being- and How to Achieve Them. Nicholas Brealey Publishing; London, UK. 2011.

9. Cloninger CR. The science of well-being: an integrated approach to mental health and its disorders. World Psychiatry. 2006;5(2):71-76.

If you found this information helpful, please consider supporting the campaign under Just Giving. Of course it is also great if you choose to support another charity or do a practical good deed, but it would be nice if you could let me know that you have done this because you felt inspired by this campaign. Please also feel free to share this post and let me know if you have any constructive feedback- good or bad!

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The Most Difficult Time- Coping With Illness And Death

“Everything that has a beginning has an ending. Make your peace with that and all will be well.”

                                                                                               Jack Kornfield (Buddhist teacher and author)

As I am about to discuss a very difficult and sensitive topic this week, I would just like to mention a couple of things in advance:

• If you are going through a difficult time yourself, please do not suffer in silence. Try to reach out to family, friends and colleagues and/or seek help elsewhere (e.g. in the UK you can contact the Samaritans under: phone- 116123 or email: jo@samaritans.org).
• All of us are going to be affected by a significant health problem, face our own death and that of a loved one at some point. I do not claim that I am particularly good at it myself and I do not want to underestimate or in any way belittle the anxiety and pain that such a situation causes. All I am attempting with this post is to summarize and present some of the available literature in order to get an understanding how we may cope with these situations a little bit better.

Although I do not feel qualified enough to discuss specific physical and mental illnesses in detail, I think that a blog about a Good Life would not be complete without discussing what happens when we are affected by severe and/or chronic illness or when life comes to an end. Modern high-tech medicine has for a long time treated the body (including the brain) as a distinct separate entity to the mind, but of course there is there is a strong, bi-directional mind-body interaction.^1,2 What is going on in our physical body and the brain has an effect on our mind and what is going on in our mind has an effect on our physical bodies including the brain. This concept is of course not new, as it is the essence of many traditional medical traditions, but what is new is that this idea is now being incorporated and validated in modern medicine.

This means that leading scientists and doctors on the ground increasingly recognize the importance of an integrative approach (considering the whole patient, not just the organ which appears to cause trouble at the given time), and this is also why discussing the effects of severe illness and death on our well-being is so important to me.

Facing mortality

Our brain has a great capacity anticipating and imagining negative events, and our own death probably represents the most terrifying negative event that we can think of. Death means the ultimate loss of control, the end to our connection with others, and to the many other things that matter to us.³ We go through our lives knowing that we (and every single one around us) will die, but we just don’t know exactly where, when and how this will happen, or what level of pain and suffering it will involve- and all this is very scary.

The fear of death has been scientifically examined, which has lead to development of the terror management theory. According to this theory, many human activities including the search for meaning and the need for self-esteem are an attempt to give ourselves a psychological sense of security, as a sort of ‘defence’ against the deep-rooted anxiety caused by our awareness of mortality.

One of the consequences of our fear of death is that we tend to avoid anything to do with it. We try not to think about death and live our life as if it would last forever. Numerous experiments have shown that even the subtlest reminder of death can significantly change our behaviour without our conscious realization.^3,4 It not only makes us become uneasy and look away when seeing severe injury and suffering, but it also has an influence on our worldviews and makes us have stricter moral judgments.

The problem of course becomes more acute when we can no longer look away and pretend all is fine: if we are personally involved in a serious accident or affected by a severe and/or chronic illness, or if this happens to someone close to us.

So how can we manage the terror?

This is of course a deeply personal issue, but here are a few suggestions, which have been shown to help people to come to terms with mortality and/or debilitating illness. Both, death and serious diseases cause the feeling of a loss of control, dignity and threatens to break our connection to others. This also applies to illnesses, which are not directly life-threatening but which significantly affect the quality of life, such as chronic pain, some physical disabilities or mental diseases. In all these circumstances, everything that increases our sense of security and certainty, self-esteem, normality, continuity and feeling of connection is likely to provide us with comfort:

• Meaning: As explained above under the terror management theory, meaning is one of the central concepts, which can help us cope with the fact of mortality.^3,4,7 Meaning provides comfort because it can give us a goal, a sense of belonging and security; it broadens our perspective and focuses our attention outside ourselves (self-transcendence).^1,3 This can give us the strength to carry on day after day even under the most difficult circumstances. Importantly, meaning does not need to be anything grand. It is a fluent process and we need to form, find and claim meaning ourselves,^3,6,7 rather than passively waiting for meaning to present itself to us. Meaning can be found in various ways, including taking an active part in family life, caring or helping others. For example, some patients with locked-in syndrome (a condition in which the patient is fully conscious but has usually lost the control of all muscles except for those of the eye) report that despite all challenges by their severe disability, they still feel active and make contributions to their families.¹ The role of meaning can also be seen as a ‘positive personal legacy’ which will outlive us, for example by influencing the lives of other people in a positive way.⁷ For more information about meaning see also What Do You Live For- About Finding Meaning.

• Acceptance and courage can help us to deal with the uncertainties of death and illness.^1,5 They help us to calm our urge for absolute control but also give us a clear vision for changing the things we may be able to change. I have only recently stumbled across a beautiful quote by psychiatrist Carl Jung who has said: ‘We cannot change anything until we accept it. Condemnation does not liberate, it oppresses.’ Acceptance means acknowledging that illness and death are affecting our life, and this act is liberating because it allows us to change our attitude and/or behaviour in order to cope better. Although we cannot change the reality of death, we can accept the fact that it is a normal part of everybody’s life cycle and in this way death loses some of its oppressing power. Similarly, we cannot change that we (or someone else) are affected by illness, but we may be able to change many aspects of the situations, to make it easier to bear. Acceptance and courage can be specifically cultivated – for more information see also Making Your Peace With How Things Are- About Acceptance and Courage- Overcoming Your Fears.

• Self-transcendence and interconnectedness: Having the sense of being part of something bigger than we are is associated with a higher level of wellbeing in our daily lives,^1,6,7 but when dealing with death this concept obviously gains a new significance. Dissolving our own boundaries and expanding our physical, small ‘I’ into a larger, bigger ‘we’ or having the feeling that we a part of a larger value system, an integral part of nature or the world as a whole gives us a feeling of connection and reassurance.^1,2 Importantly, we do not need to be religious, believe in God or some other divine force in order to feel self-transcendence and interconnectedness, as this experience can also be reached in other ways, for example by contemplative practices.^1,2,6

• Keep in control where possible: When dealing with a serious illness and facing mortality, the loss of dignity and control is experienced as one of the most difficult aspects.^2,5 Although we cannot control everything, there are still a lot of things which can be influenced. It is important that we feel in control over decisions, which are made about us regarding the management of our condition.² For this, we need a clear vision of our values, our hopes, fears, and goals.⁵ We may also need to get more detailed information about our illness and available treatment options for the disease and/or associated pain. We may need to ask for second opinions and we may have to speak up if we feel that our wishes are not taken on board when treatment is planned.

• Keep connected, seek help/advice/support: Stressful situations including severe illness tend to make us want to withdraw from others, but it is very important to avoid isolation, as other people are an important source of comfort and strength.^1,6 Other people can also give us advice and guidance in situations when we have to make difficult decisions, or encourage us to continue taking an active part in life.

• Look at what is right with you: It is frustrating if we can no longer do things, which we have previously regarded as normal. Everybody who has had even just a temporary, limiting injury can attest this. However, focusing on our limitations and what we can no longer do means that we are letting our illness define us, and this often makes us limit ourselves even further.² Jon Kabat-Zinn, founder of the Mindfulness Stress Reduction Program, which has shown great effectiveness in improving the quality of life of people with chronic and/or terminal illness said: ‘from our point of view, as long as you are breathing, there is more right with you than wrong with you, no matter what is wrong with you.^’ Looking at the things which are still right with us and finding areas, where we can actively participate in life gives us a greater sense of freedom, self-esteem and self-determination.^1,3

• Making the most of your time: ’Adding life to days and not days to life’ is the motto of the hospice movement, which has made looking after terminally ill patients its priority, with a particular focus on maintaining quality of life, patient dignity and control.⁵ Whether we are facing death or a chronic illness, following things may help to make the most of our time:
• Focusing the attention on the present moment by trying to be mindful and open to your experiences. Mindfulness practices and meditations have been shown to be greatly effective in the management of chronic illness and pain,² see also Staying in the Moment: Mindfulness and Conscious Appreciation.
• Even in the most difficult times und under the most harrowing circumstances, there are still opportunities to experience positive emotions.^2,5,7,8 Interestingly, it appears that it is the frequency and not the intensity which makes the biggest difference.^7,8 In other words, make sure that you notice and appreciate all the small positive moments of joy, gratitude, serenity, interest, hope, pride (in your achievements as small as they may be), amusement, inspiration, awe, love and kindness.
• Prioritize: Make more time for what makes you genuinely feel good.⁸
• 
  
• …but allow yourself to feel the pain: As much as it is still possible to feel positive emotions when facing illness and death, it is of course also a time of sadness, stress, fear/anxiety and sometimes anger and despair. It is very important not to try and suppress negative feelings. It is not possible to selectively numb negative emotions- if we do this, we concurrently reduce our ability to feel positive emotions (one of the reasons why depression is such a debilitating condition). So we need to allow ourselves to experience and work through the negative feelings before we can start coping with the situation constructively.^7,8

• Basic self-care: Facing serious illness and death can be very stressful. In order to deal with stress and associated negative feelings most effectively, it is absolutely essential to get enough sleep, enough rest, good quality food and enough exercise.^9,10 Sleep is particularly essential as a lack of sleep directly results in a further increase in anxiety and stress.¹⁰ More information on basic self-care can be found in Don't Forget The Basics. Self-care also means supporting your body in other ways, such as taking medication regularly, performing specific exercises as required for the particular illness, and avoiding things, which may be harmful.

Helpful books on the topic:

Several friends and colleagues have recommended these remarkable books on the topic, which are not only informative but also profoundly inspiring despite the seriousness of the topic:

Atul Gawande is a surgeon who has written many interesting books, but Being Mortal: Illness, Medicine and What Matters in the End is certainly special. In the book he explores what ageing, illness and mortality mean to us now, and what has changed throughout history and across cultures. It is a very sensitively written book with many stories of patients and Dr Gawande’s own family. The book shows the importance of opening ourselves to the reality of death in order to make the right decisions when the time comes.

When Breath Becomes Air is the personal account of neurosurgeon Paul Kalanithi, who was diagnosed with terminal cancer at the age of 36, and who died before he could fully complete the book. Paul Kalanithi takes the reader through his transition from a doctor to a patient, writes about how to make difficult decisions and considers the importance of a meaningful life.

Preview: As discussed above, the sense of self-transcendence and interconnectedness can help us to deal with times of uncertainty. Next week, we are going to focus on this topic a bit more and find out in which ways taking the larger perspective can make us happier.

References and further reading:

1. Siegel D. Mindsight: Transform Your Brain with the New Science of Kindness. Oneworld Publications; Oxford, UK. 2011.

2. Kabat-Zinn J: Full Catastrophe Living: How To Cope With Stress, Pain and Illness Using Mindfulness Meditation. Piatkus. 2013.

3. Dias D: The Ten Types of Human: A New Understanding of Who We Are and Who We Can Be. William Heinemann; London, UK. 2017.

4. Burke BL, Martens A, Faucher EH. Two decades of terror management theory: A meta-analysis of mortality salience research. Personality and Social Psychology Review. 2010;14(2):155-195. 

5. Gawande A. Being Mortal: Illness, Medicine, and What Matters in the End. Profile Books; London. 2014.

6. Graham L. Bouncing Back: Rewiring Your Brain for Maximum Resilience and Well-Being. New World Library; Novato. 2013.

7. Lyubomirsky S, Tucker KL. Implications of individual differences in subjective happiness for perceiving, interpreting, and thinking about life events. Motivation and Emotion. 1998;22(2):155-186.

8. Fredrickson B. Positivity: Groundbreaking Research to Release Your Inner Optimist and Thrive. Oneworld Publications; Oxford, England. 2010.

9. Seppälä E. The Happiness Track: How to Apply the Science of Happiness to Accelerate Your Success. Piatkus; London, UK. 2016.

10. Pittman CM, Karle EM. Rewire Your Anxious Brain: How to use the neuroscience of fear to end anxiety, panic & worry. New Harbinger Publications; Oakland. 2015.

If you found this information helpful, please consider supporting the campaign under Just Giving. Of course it is also great if you choose to support another charity or do a practical good deed, but it would be nice if you could let me know that you have done this because you felt inspired by this campaign. Please also feel free to share this post and let me know if you have any constructive feedback- good or bad!

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Quick Update and Two Quotes for the Week

Dear blog followers, 

One of my greatest pleasures during the adventure of becoming a blogger are all the interesting conversations and discussions which arise as a result of the blog, and the great messages, quotes and tips that I get from you.  So I thought I send you another short 'extra edition' to share some of these with all of you: 

• We have been discussing the topic of personal heroes and courage recently, and another great way of being inspired by other people is by simply listening to them. There are many great radio programs and podcasts, and one blog follower has made me aware of a particularly interesting one: http://www.oneyoufeed.net. The One You Feed features is about people who have gone through difficult times in life and also about sharing new scientific insights, tips and tricks on how to increase resilience and lead a full life. 
• If you are more specifically interested in the topic of courage, you may want to have a look at the following books: 
• Daring Greatly: How the Courage to be Vulnerable Transforms the Way We Liver, Love, Parent, and Lead by Brené Brown
• The Courage Quotient: How Science Can Make You Braver by Robert Biswas-Diener
• Another thing which is fascinating is that you can find inspiring messages pretty much everywhere. I have been discussing 'Thought for the Day' on radio BBC 4 with another blog follower; as it turned out we both like this program but I had missed a good episode on gratitude, where Professor Tina Beattie shared the quote by Hyman Schachtel that: 'Happiness is not having what you want, but wanting what you have.' 
• And I have been sent another great quote by a lovely colleague: 

'Some of your hurts you have cured, 

And the sharpest you've even survived, 

But what torments of grief you've endured, 

From evils which never arrived.'

Ralph Waldo Emerson

Emerson's quote captures that pain and suffering are an inevitable part of life, but that we sometimes increase the pain and suffering ourselves by our worries and negative anticipations (as a result of the inherent negativity bias of our brains). As Emerson says, many evils never arrive but later this week we are going to discuss a topic which will sooner or later affect all of us: Illness and mortality. As a good life lived also includes dealing with with the inevitable end, I thought that it was an important topic to include. 

Finally, as the blog community continues growing, I just wanted to remind everybody that previous topics can be searched by keywords (labels) on the right hand side of the website, but that this option is only available on the web version (not mobile version) of the blog.

I hope that you all have a good week until Friday,
Petra 

Courage- Overcoming Your Fears And Boundaries

‘Courage is what it takes to stand up and speak; courage is also what it takes to sit down and listen.’

                                                                                                                                  Winston Churchill

We have touched on the importance of courage before in the posts about personal heroes, dealing with difficult people and On A Personal Note, but as it has a very central role for our well-being I thought that it may be helpful to dedicate a special post to courage and how we may cultivate and increase this quality in our own life.

What is courage and what do we need it for?

Courage is often misunderstood: We tend to associate it mainly with heroic, daring or adventurous behaviour when dealing with challenges in the outside world, and often overlook the importance of courage in the more ordinary everyday situations and when dealing with ourselves.

The origin of the English word ‘courage’ comes from the Latin word ‘cor’, meaning ‘heart’, and courage was originally used in the sense of ‘speaking one’s mind by telling all one’s heart’.¹ This original meaning of courage reminds us that it can also have more subtle and quieter qualities: Not the type of courage we need in exceptional moments when doing heroic deeds, but the type of courage that permeates all aspects of our everyday lives and that enables us to be honest and open with ourselves (and others) about our feelings and experiences.^1,2

The reason why I like the above quote by Winston Churchill so much is because it shows that courage may be indeed required for any sort of behaviour: Sometimes we need it to actively do something but sometimes we require courage to stay deliberately inactive; we need courage to trust others, and at other times we need courage to challenge other people and stand up for our values; we also need courage to change our habits and behaviour, and we need it to be patient and persist in what we are already doing.

Another way in which courage is often misunderstood is that it is synonymous with fearlessness. However, it has been recognized that courage is in fact somewhat independent from fear; it is about doing (or purposely not doing) something despite your fears.^3-5 As Nelson Mandela put it: ‘I learned that courage was not the absence of fear, but the triumph over it. The brave man is not he who does not feel afraid, but he who conquers that fear.’

And if there is one truth about courage and fears then it is that everybody has both, courage and fear, and that they are a normal part of our lives. In fact, fear is an adaptive and helpful negative emotion, a result of many thousands of years of evolution, which makes us stay cautious in order to avoid harm and injury.⁴ And there are many things we may fear: There is fear of spiders and snakes, fear of flying or heights, fear of failure, fear of loneliness/rejection/loss of social status, fear of losing control, fear of change, fear of ageing/illness/death to name just a few. We may also simply be a habitual worrier, someone who just needs to always have one worry on the go.

Of course we may not all share the same fears and we may feel them to a variable degree. The personality trait of ‘neuroticism’ and traumatic life experiences shape us to a large degree, and can make us more prone to anxieties.^4,6 However, as courage is the triumph over fear, people who feel fear more intensely but overcome this fear may, in a way, be more courageous than ones who did not feel fearful in the first place. We may even learn to see situations in which we experience fear as an opportunity for personal growth.⁷

When fears and anxiety become a problem

As mentioned above, experiencing fear is a normal human experience. However, fears and anxieties become problematic when they limit our quality of life, and/or if they limit the way we respond to other people or life’s inevitable challenges.

One problem is also that we may not always be aware of our fears. While some types of fears or anxiety disorders will be very obvious to us (e.g. arachnophobia- the fear of spiders), others may be more subtle and concealed. As mentioned on previous occasions, we have two types of memory: the explicit memory, which stores the conscious memory of our personal life and other factual knowledge and the implicit memory, which (amongst other things) stores our emotional associations with certain situations, our vulnerabilities and emotional deficits.^7,8 As the implicit memory is negatively biased (which means that it stores negative experiences more readily than positive ones), our decision-making may be lead by fear without even being fully aware for the reasons of our decisions,^7,8 which may make us behave in a way which is not helpful in the long run.

Another issue is that strong negative emotions like fear can reduce our capacity for rational thinking and may lead to a reactive mindset, in which we are not able to choose our response flexibly but in which we tend to be defensive or have a ‘knee jerk’ reaction.^7,8

How to cultivate courage

Whatever our starting point, here is some further information and a few tips on how we may all increase the much needed quality of courage in our lives:

• As courage has to do with challenging our fears it can be helpful to be aware of the two principal pathways in our brain which are associated with fear and anxiety, as the two different types of fear need to managed in slightly different ways:^4,7,8

o   The conscious thinking part of our brain (cerebral cortex) can create anxiety through negative or worrying thoughts. Another part of the brain, the amygdala, is responsible for the more instantaneous stress (or fight-or-flight) response. The amygdala is also involved with the formation of our implicit memory.

o   The reason why this differentiation is important is because cortex- or thought-based fears can be overcome more easily by challenging our negative or exaggerated worrying thoughts and by adopting a more optimistic and self-supportive mindset.

o   Amygdala-based anxiety (for example arachnophobia or negative implicit memories) is less approachable for self-soothing thoughts as the cortex has only a weak influence on the amygdala. Telling yourself to calm down may therefore be of limited value. Once a full-blown amygdala stress response is initiated, the most effective ways of managing the resulting fear are deep breathing, muscle relaxation and/or vigorous physical exercise.

o   For the long-term management of amygdala-based fears, it is necessary to re-experience the trigger (object or situation) without a negative experience or emotion in order for the brain to form new (neutral or positive) associations. For example, therapy for arachnophobia may include a carefully staged, step-by-step exposure to spiders. It is also possible to strengthen the normally weak influence of the cortex over the amygdala (fear modulation) by certain exercises, see also below under mindfulness.

o   For more information see also the previous posts Why Things Often Seem So Bad And What To Do About It and Dealing With The Darker Days- Emergency Measures And Emotional Intelligence.

• Practice self-acceptance: According to Brené Brown, a social scientist who has researched this topic extensively, courage is associated with vulnerability. More precisely, if we dare to be vulnerable, if we accept ourselves as we are, and if we allow others to see who we are then we can arrive at a new sense of courage.⁵ From this follows, that our courage may be increased by cultivating self-acceptance and self-compassion.
• Be mindful: Mindfulness practices and meditations have been shown to improve emotion regulation including fear modulation.^7,9 This means that we can strengthen the otherwise weak influence of the cortex onto the amygdala, which can help to control our fear response. Furthermore, mindfulness can be defined as the willingness to see and experience things as they are moment by moment. By training ourselves to be mindful we therefore increase our potential for courage. There is also a specific type of meditation, which can increase our capacity for acceptance and self-acceptance called loving-kindness meditation. Additionally, there are also special meditations on courage.
• Increase your confidence by self-efficacy: Believing in your ability to cope with stressful situations and a having a sense of control are important when you are fearful. Self-efficacy can be increased with achieving success (mastery experience), physical activity, observing other people (social modeling, see also below under cultivating courage in everyday life), and by being supported and convinced by other people that we are able to do something (verbal persuasion).¹⁰
• Cultivating courage in everyday life: In order to cultivate courage we may be able to learn from our own day-to-day experiences, or have role models or personal heroes who embody courage and who we can learn from.⁷ We can then make a conscious effort to remember all the little occasions when we have shown brave behaviour and slowly build up our courage. As mentioned in the previous post about personal heroes, we can also imagine ourselves in situations, which require courage and in this way prepare our brains for situations in which courage is needed.

Further information on the web:

• Just in case that you have not seen it yet, you may want to have a look at one of the most popular TED talks of all times, where Brené Brown explains the association between vulnerability and courage: https://www.ted.com/talks/brene_brown_on_vulnerability
• The great Mindful Awareness Research Centre of the University of California offers free mindfulness meditations, including a meditation on courage: http://marc.ucla.edu/mpeg/Hammer031215.mp3

Truly amazing people- What can we learn from…:

Because courage comes in so many different forms I have included several people in this week’s post as representatives of the different categories:

Jan Karski was a young Polish reserve army officer and junior diplomat with a promising future when World War II changed his life in an unexpected direction. After narrowly escaping death at the Katyn Forest by Soviet troops Jan Karski became a courier for the Polish underground resistance. He survived torture and a suicide attempt in German captivity from which he managed to recover. After his escape, he took up missions to the Warsaw Jewish Ghetto and the Izbica concentration camp at great risk to his own life. Following these assignments he presented his eye witness accounts to the Western Allies, urging them to intervene in the Holocaust but tragically his appeals had only little effect. Jan Karski stands for all the truly outstanding people who embody active courage and integrity, overcoming their greatest fears and putting their own lives at risk for a greater cause. You can find out more about his remarkable life at http://www.jankarski.net/en.

Rosa Parks was an American civil rights activist who is best known for her courageous choice of inaction. When travelling on a bus in 1955, she was asked to give up her seat in the ‘coloured’ section for a white person, as all seats in the ‘white’ section on the bus were already taken. When Rosa Parks refused to give up her seat she was arrested. This in turn led to a boycott of the bus line, which took over a year and during which Martin Luther King Jr became known as a national figure and spokesman for the civil rights movement. To find out more about the life of Rosa Parks go to http://www.rosaparks.org/biography/.

Boxers like Frank Bruno are usually associated with the action-type of courage needed to face physical challenge and competition. However, the probably biggest challenge he had to face was when he was sectioned under the mental health act due to bipolar disease. Following this, Frank Bruno showed great courage by facing his vulnerabilities and speaking openly about his mental health. He created the Frank Bruno Foundation, a charity offering non-contact boxing training for children, young people and adults affected by mental health issues. More information go to www.thefrankbrunofoundation.co.uk and www.theguardian.com/FrankBruno.

And finally, the lead singer of the heavy metal band Metallica James Hetfield, shows how the behaviour of every one of us may be somehow affected and influenced by fears. In James Hetfield’s case it is the fear of responsibility. In this short video he talks about his fear, about learning to overcome it and how being a role model means showing vulnerability: http://metallife.com/metallicas-james-hetfield-on-overcoming-fear-being-a-role-model/.

Preview: As described above we need courage for many different situations in our lives, but there are times when we particularly need this quality. One of them is when we are dealing with severe or chronic illness and/or if we are facing our own mortality or the death of somebody we love. This difficult topic is going to be the focus of next week’s post.

References and further reading:

1. Brown B. Courage is a heart word. 2011. Retrieved from: http://brenebrown.com/2011/08/09/201188courage-is-a-heart-word-html/

2. Milton M. From Hogwarts to the boxing ring: courage, creativity and psychological well-being. Counselling Psychology Review. 2012;27(3):101-112.

3. Norton PJ, Weiss BJ. The role of courage on behavioural approach in fear-eliciting situations: A proof-of-concept pilot study. Journal of Anxiety Disorders. 2009;23(2):212-217.

4. Pittman CM, Karle EM: Rewire Your Anxious Brain: How to use the neuroscience of fear to end anxiety, panic & worry. New Harbinger Publications;­­ Oakland. 2015.

5. Brown B. Daring Greatly: How the Courage to Be Vulnerable Transforms the Way We Live, Love, Parent, and Lead. Penguin Books Ltd; London. 2012.

6. Nettle D. Personality: What makes you the way you are. Oxford University Press; New York. 2007.

7. Graham L. Bouncing Back: Rewiring Your Brain for Maximum Resilience and Well-Being. New World Library; Novato. 2013.

8. Hanson R: Hardwiring Happiness: How to reshape your brain and your life. Rider Ebury Publishing, Random House, UK. 2013. 

9. Siegel D. Mindsight: Transform Your Brain with the New Science of Kindness. Oneworld Publications; Oxford, UK. 2011.

10. Wiens KJ. Leading Through Burnout: The Influence Of Emotional Intelligence On The Ability Of Executive Level Physician Leaders To Cope With Occupational Stress And Burnout [Dissertation]. University of Pennsylvania. 2016.

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