Stop mislabelling labels.

The last time I looked through the supermarket, I bought some baked beans. How did I know the can I took off the shelf was full of baked beans and not freshly harvested sheep’s innards? Because the label on the can said so.

Labels aren’t perfect of course. Every now and then, a can of something has the wrong label applied in the factory. Usually it’s nothing too sinister – no accidental swaps of some goat entrails instead of your tinned salmon. Instead, it’s usually something similar – tuna gets labelled as salmon and vice versa, and the worst that happens is that the tuna mornay you’ve just made had an unexpected flavour.  Even these sorts of mild mix ups are rare. Overall, we trust that the labels are guides and the information they provide us helps us make an informed decision about what do to with that particular can and its contents.

It would be pretty silly for some random person to preach out the front of the supermarket, ranting about how all labels for a particular thing are all wrong.

“Uh, just because the occasional can of tuna was accidentally filled with cat food doesn’t mean to say that all labels are wrong. And just because one person had a bad experience with the wrong label, the supermarket shouldn’t stop using them … otherwise how else is anyone supposed to manage their cans effectively without labels? Honestly, stop looking like a fool by preaching about labels and let the rest of us finish our shopping.”

Dr Caroline Leaf, communication pathologist, self-titled cognitive neuroscientist, and a self-elected champion of irrelevant mental health advocacy, has come out all guns ablazin’ over ADHD labels again. She needs to give it a rest – she’s just like the crazy person standing in front of the supermarket.

“Labels for ADHD are bad”, she says. “Look at Avery Jackson, who was labeled ADHD but did not accept the label. He went on to earn multiple degrees and become one of the top neurosurgeons in the U.S!”  The underlying message – labelling a child with ADHD will lock then into a life of pathetic excuses and they won’t ever reach their full potential until they renounce the curse of their ADHD label.

For every scary anecdote about the evils of ADHD and the mental prison that everyone with such a label is supposed to find themselves in, there are ten more where the ADHD label helped them.  There are so many more people where the ADHD label helped them to finally understand their condition and receive the correct treatment, enabling them to reach their potential and improve their life in leaps and bounds.

Take, for example, one of my patients called Little Jimmy (not his real name). When Little Jimmy was in the early primary school grades, he was a bit of a fidgeter and couldn’t concentrate well enough at school or at home to complete his homework tasks. His mother took him to a naturopath who told him he had a disorder of “pyrolles disease”. Thankfully, mum brought him to see me, and after a careful history and a long chat, Little Jimmy went to see a specialist who diagnosed him with ADHD and commenced him on stimulant medications. Before his label, Little Jimmy’s reading levels were languishing at the bottom off his class after two years of stagnation.  He was more than a year behind in reading levels and going nowhere fast.  Two weeks after getting his label and the right medication, he went to the top three reading levels in the class.  His mother told me of the massive gains he made, and the flow-on effect this had to his self-esteem and confidence in other areas of his school work and school life. She cried as she recounted his story, and then I cried too.

So perhaps Avery Jackson became an orthopaedic surgeon because he chose to ignore his label of ADHD and worked hard anyway.  Good for him.  Little Jimmy got a label of ADHD and because of it, he learnt to read. Now he’s got the chance to follow in Avery Jackson’s footsteps, BECAUSE of his label.

Labels are important. Without them, we wouldn’t know how to know who needs which treatment. Labels can help people overcome some of the strongest barriers and connect with others for support.

And let’s face it, if someone really wanted to, they don’t need a label of ADHD to find excuses in life.

So labels are not a hinderance, but rather, they are a guide to help you know what’s going on so informed choices can be made. In Dr Leaf’s mind, those kids with ADHD are just naughty children, with bad parents, who are using the label of ADHD to cover their poor parenting and their bad behaviour. Clearly all they need to do is to stop their toxic thinking and they wouldn’t need their medications, but they would be cured.

Dr Leaf is wrong … she can stand and scream blue murder about labels and ADHD all she wants.  But just like the crazy random person screaming about labels in front of the supermarket, it means very little. It’s not helping her cause, and if anything, it’s sewing distrust in an system that, despite it’s flaws, works very well, and has helped thousands of children and adults alike to achieve their potential.

That’s the power of labels, and Dr Leaf would do herself and all her followers a favour if she stopped mislabelling them.


Dr Caroline Leaf – Inside Out and Back-to-Front

Dr Caroline Leaf, communication pathologist and self-titled cognitive neuroscientist, put this up on her social media pages this morning:

“Never feel bad for being sad. Emotions should not be kept inside because that will only make things worse. Talk to someone, cry, scream… whatever helps you feel better. One of my favorite movies is Inside Out because it really highlights the importance of letting yourself feel sad as part of the healing process. I really encourage all of you to not keep emotions bottled up. Let it out!”

Inside Out is one of my favourite movies too.  It is a rich layering of some complex psychology, told through a wonderfully relatable narrative that is beautifully told.

Inside Out is about the emotions that live inside us. Riley, an 11-year-old girl, moves from Minnesota to San Francisco, and the movie tells the story of her emotions as they deal with all of the conflicts and chaos that comes with adapting to such a big change.

The main characters are Joy and Sadness, which share “headquarters” with Anger, Fear and Disgust.  Each character has its own role to play, which Joy, as the main narrator of the movie, explains:

“That’s Fear.  He’s really good at keeping Riley safe.”
“This is Disgust. She basically keeps Riley from being poisoned, physically and socially.”
“That’s Anger. He … cares very deeply about things being fair.”

And Sadness?  “And you’ve met Sadness.  She … well, she … I’m not actually sure what she does …”

Dr Leaf explained that Inside Out, “… really highlights the importance of letting yourself feel sad as part of the healing process.”

Well, that’s one way of putting it, but Inside Out is actually much much deeper.  The story of Inside Out demonstrates that all of our emotions are needed in order to be a healthy human being.

Joy thinks of herself as the primary emotion, and does her best to keep Sadness away from the control panel.  Over the arc of the story, Joy learns that Riley needs Sadness too – that some problems can’t be solved with distraction or a pop-psychology pep-talk and positive attitude.

By the end of the movie, Joy allows Sadness to take over, helping Riley to process all of the things she had been struggling with after the major life change of her move to San Francisco.

This is what Dr Leaf was referring to, I think.  Yes, sadness is part of healing from any major life change including grief.

What Dr Leaf didn’t discuss was the role of the other emotions in Riley’s life.  Yes, Joy and Sadness are important, but the movie demonstrated all the way through that Fear, Anger and Disgust were all just as important, and the end of the movie showed that Riley’s core memories, which each formed a different aspect of her personality, were various combinations of all of the emotions.

But that’s not what Dr Leaf teaches.  For decades, her teaching has been back-to-front, claiming that emotions like anger and fear are toxic, and that toxic emotions cause damage to your brain and damage to your health.  She tells her followers not to think toxic thoughts or to have toxic emotions, but to take control of your thought life.

“Toxic thoughts are thoughts that trigger negative and anxious emotions, which produce biochemicals that cause the body stress.” [1] (p19)

“Hostility and rage are at the top of the list of toxic emotions; they can produce real physiological reactions in the body and cause serious mental and physical illness.” [1] (p30)

“There are two groups of emotions that are polar opposites: positive, faith-based emotions and negative, fear-based emotions. Each has its own set of molecules and performs as spiritual forces with chemical and electrical representation in the body. Faith-based emotions are love, joy, peace, happiness, kindness, gentleness, self-control, forgiveness and patience.  These produce good attitudes and thoughts.  Fear-based emotions include hate, anxiety, anger, hostility, resentment, frustration, impatience and irritation. These produce toxic attitudes and create a chemical reaction in the body that can alter behavior.”

“When you think a toxic thought, or make a bad choice, or you hang on to anything that is negative—anger, bitterness, hurt, irritation, or frustration—it impacts the production of those chemicals.”
“Through an uncontrolled thought life, we create the conditions for illness; we make ourselves sick! Research shows that fear, all on its own, triggers more than 1,400 known physical and chemical responses and activates more than 30 different hormones. There are INTELLECTUAL and MEDICAL reasons to FORGIVE! Toxic waste generated by toxic thoughts causes the following illnesses: diabetes, cancer, asthma, skin problems and allergies to name just a few. Consciously control your thought life and start to detox your brain!”

So it’s really interesting to see Dr Leaf discuss a movie that promotes the exact opposite of her teaching.  Perhaps she’s finally coming around to what real neuroscientists and researchers have been saying for ages, that “adaptive coping does not rely exclusively on positive emotions nor on constant dampening of an emotional reaction … Adaptive coping profits from flexible access to a range of genuine emotions as well as the ongoing cooperation of emotions with other components of the action system.” [2]

If Dr Leaf is finally coming around to real science, then that’s great, but she can’t have it both ways … she can’t promote expressing your emotions on one hand and then suppressing them on the other.  If she wants to come back to the fold of real science, then she’s going to have to renounce her previous teaching, and take it down from her website.  Otherwise it ends up being conflicting and hypocritical as well as being downright confusing.

So, Dr Leaf, you’re welcome to use movies like Inside Out to illustrate good psychological principles, but if you want credibility, you should work on some consistency.

[1]       Leaf CM. Switch On Your Brain : The Key to Peak Happiness, Thinking, and Health. Grand Rapids, Michigan: Baker Books, 2013.
[2]       Skinner EA, Zimmer-Gembeck MJ. The development of coping. Annual review of psychology 2007;58:119-44.

The lost art of joy – Something to look forward to


With only about eight hours left in 2017, I should be contemplating bigger things … the lessons learnt from the year gone by, what did I achieve, where did I fall down, what can I learn from those experiences.

Instead, I feel like bacon, so I’m cooking bacon.

Bacon is delectable. It’s one of those foods that proves God’s love. On it’s own, it’s special, but you can also add bacon to almost any other food and it will add to the gustatory experience of pleasure. The auditory and olfactory stimulation of bacon frying is distinctly pavlovian – I’m drooling just thinking about the culinary delights that await me.

As I was standing over the frypan, listening to the crackling and popping, smelling the juicy aroma and mopping up my hypersalivation, it also stimulated the rusty gears of my cognition.

Why do I drool when bacon is cooking? For all I know, the bacon could be rancid, or I could have cooked it wrong, or it could be too salty, or it could be pigeon meat in disguise.

But I have hope.

I can’t say, rationally and with certainty, that “the bacon will be good” because there are lots of reasons why it might be bad, but I have hope that the bacon will be delicious.

Hope. It is “the quintessential human delusion, simultaneously the source of your greatest strength, and your greatest weakness.
Hope is “being able to see that there is light, despite all of the darkness”. (Desmond Tutu)
Hope “smiles from the threshold of the year to come, whispering, ‘It will be happier.’” (Alfred Lord Tennyson)

Like we discussed yesterday, happiness is someone to love and something to do. Happiness is also something to look forward to.

Hope is like joy’s air. In order for joy to breathe, it has to be surrounded by hope. Without hope, joy can not survive.

Research bears this out. Numerous studies over the years have shown that those with higher levels of hope had higher academic and sports achievements. Lower levels of hope correlate to general maladjustment and thoughts of suicide. Hope is a crucial factor in dealing with major life stressors and traumas, such as cancer and old age. The impact of hope on depression and adjustment was studied in people with traumatic spinal cord injuries, and it was found that those with higher levels of hope had less depression and greater overall mental and social adjustment irrespective of how long it had been after the injury. In another study, lower levels of hope was related to higher levels of depressive symptoms in general.

Hope is applied optimism. Optimism is the general expectancy that good rather than bad will happen. Hope is “the belief that the future will be better than the present, along with the belief that you have the power to make it so.”  Hope is the ultimate fusion of acceptance, values and committed action – knowing which direction you want to go in, having a path leading in that direction and then going, not knowing what will happen but accepting that not everything will be perfect but believing that it will be better.

So what about 2018? I can’t say, rationally and with certainty, that “2018 will be a great year” because there are lots of reasons why it might be bad.

Still, I have hope that 2018 will be a great year.

Do you have hope? Do you believe 2018 will be a better year? Do you believe that you have the power to make it so? Over the last month, we’ve explored the lost art of joy; the ingredients of joy and how these can shape our lives; the things that can suffocate joy and the things that can help joy flourish. Do you believe that you can apply these principles to experience a life of greater joy, a richer life of deeper meaning and fulfilment? In all sincerity, I hope you can.

Thank you for coming on my journey with me. On the 1st of December when I had the bright idea of writing a blog post a day for a whole month, I thought it would be easy. When I got to the 5th of December, I thought I was going to run out of ideas and I should have thought twice before committing to such a huge project. Now, on the 31st of December, I’m glad I made that ill-considered commitment. It has challenged me for sure. It’s helped me to clarify concepts, to grow in knowledge and make me that little bit more proficient as a writer.

My hope is that my 31-day challenge will not just help me, but help others who are struggling to see the light and to experience the warmth of joy in their souls. “These things have I spoken unto you, that my joy might remain in you, and that your joy might be full.

Happy New Year! May you all have a safe, prosperous, and joyous 2018.

Oh, and by the way, the bacon was delicious.

The lost art of joy – Someone to love

In 1939, a doctor at Harvard University initiated a research study into long term health and happiness. He recruited 268 physically and mentally healthy young men who were all in their second year of study at Harvard University, including one John F. Kennedy, who went on to become US President. As the story goes, as part of the recruitment process, “the men who were chosen for the study had what the team considered a ‘masculine body build’: significant muscle mass, narrow hips and broad shoulders. The study participants were asked about masturbation and their thoughts on premarital sex. They were also measured for brow ridge, moles, penis function and the hanging length of their scrotum.”

As it turns out, the hanging length of one’s scrotum isn’t a significant factor in one’s long term health and happiness.

What is important is love.

Over the last eight decades, the study has grown to include a number of control groups, wives and children. The longer the trial has gone on, the stronger the conclusions, that “Close relationships, more than money or fame, are what keep people happy throughout their lives, the study revealed. Those ties protect people from life’s discontents, help to delay mental and physical decline, and are better predictors of long and happy lives than social class, IQ, or even genes.”

The short and intense forms of love are very strongly associated with happiness. Remember the study we discussed in earlier posts from George MacKerron, who mapped the correlation of happiness to activity and location of the users of his specifically designed mobile phone app? With hundreds of thousands of data points, he was able to show that people were happy when they were exercising, when they were at the theatre, ballet, or a concert; when they were at a museum or an art exhibit; and while doing an artistic activity (like painting etc.). Though at the top of his list, the greatest number of people were at their greatest level of happiness during “sexually intimate moments” (on a date, kissing, or having sex).

Of course, love is more than just a good snog, but it demonstrates that intimate connection with another person you love, and who loves you, is an intense and intoxicating source of joy.

Other research into the relationship between love and joy shows the same thing as the Harvard Study of Adult Development. The “Very Happy People” study showed that there was a 0.7 correlation between social support and happiness, which is higher than the connection between smoking and cancer. People with one or more close friendships are more likely to be happier, and those with few social connections are more likely to be depressed than those who have more social connections. People with strong and healthy relationships are less likely to feel stressed by challenging situations. Supportive marriage is a cause of happiness.

We always need to be careful in interpreting these sorts of conclusions, remembering that correlation does not equal causation – people don’t get depressed because they have no friends. Often times there are underlying factors contributing to both a persons depression and difficulty in forming solid friendships.

What we can safely say is that happiness and love are intimately connected. The deeper the social bond, the more likely there is to be happiness.

It’s also important to remember that it’s not quantity of the social connections that’s important, but the quality of the social connections. A hundred loose associates, or deep but unequal, unreciprocated relationships are not associated with happiness. Joy comes from sincere, committed love that gives as much as it receives.

Do those themes sound familiar? They are the same sort of themes that we have discussed on other blogs in this series, the same sort of things that are common to our personal search for joy – kindness, giving, honesty and acceptance, committed action to a deeper value. When you apply the same things that bring individual joy to a relationship, they also bring joy, but to more than just yourself.

And what else better sums up love, but sharing the best things in life with another person.

If you want to foster happiness, invest in quality connections with other people by sharing those same things that bring individual joy. Be thankful, be kind, be generous and be committed and there will be more than enough joy to go around.

The lost art of joy – Music

With only five days to go before Christmas, most people are rushing into the shops to purchase those last minute items.

The average shopping centre in the pre-Christmas week is an auditory and visual cacophony. Not only are there people EVERYWHERE, there are fairy lights, baubles, and tinsel everywhere! Then there are those Christmas carols, the auditory froth of tinny Christmas melody bubbling incessantly in the background. It’s all enough to make you want to shop on-line.

It’s such a shame the way Christmas carols have been subjugated and exploited for commercial gain. So many of the old Christmas carols are euphonious in their own right, with a lyrical profundity that encapsulates the deeper meaning of Christmas in just a few words.

In fact, music in general is fundamental to us as a language of emotion. The linguist Steven Pinker once said that music was “auditory cheesecake,” a purposeless byproduct of language development. But music is deeper than language. Neuroscience suggests that we’re hardwired to interpret and react emotionally to music from before we’re able to crawl, and well and truly before we develop language. Music activates most of our brain, from our frontal lobe and temporal lobe to process the sounds across both sides of the brain. Music also activates our visual cortex, our motor cortex, our memory centres and, not surprisingly, our deep emotional brain centres. It’s only if the song has lyrics that our language processing areas are activated.

Music has been shown to affect our physical bodies and our minds. Music helped to reduce blood pressure, heart rate and anxiety in heart disease patients, while upbeat music can have a very positive effect on our emotional wellbeing, so long as the music was happy and upbeat. Music that we expect to be happy also results in an increase of dopamine, the neurotransmitter of pleasure.

So the emotional connection that music carries is very important for our overall joy.

Listening to music can increase our joy. While the research supports the improvement in mood that comes from listening to happy, upbeat music, there’s a place for ‘sad’ or ‘angry’ songs too, which can connect directly to our souls and provide a type of catharsis that goes beyond trying to express our emotions through the clunky limitation of speech.

Music can help to scaffold memories, especially emotional memories. Remember the music playing when you had your first kiss? Or the song that they played at a friends funeral? Playing those songs related to happy times in your life can help you to recall and re-experience those uplifting emotions if you’re feeling down.

Music creates opportunities for healing. Hospitalised children were happier during music therapy (in which all the children were involved and could play with simple musical instruments like maracas and bells while a leader played the guitar) than they were in standard play therapy when their options puzzles and toys.

But more than anything, music increases joy through the power of human connection. Music is emotionally deeper than language and the social bond that music can create between people is much stronger than any intellectual or verbal connection. There have been numerous studies that demonstrate this – people who go to concerts and who go dancing report higher levels of subjective wellbeing than those people who listen to music on their own. People who create music together have higher levels of happiness and find other activities more pleasurable overall, an effect which has been demonstrated in groups of both adults and school children.

So if you want to increase your joy, engage with music, and use music to engage with other people … even if it is singing Christmas carols.

The lost art of joy – Learning

Solomon wrote: “Of the making of many books there is no end, and much study is a weariness unto the flesh”.

I loved that verse when I was at school. It was utilised more than once when my teachers wanted to give us more homework – “But, sir, the Bible says that too much homework is bad for you.” Not that my teachers cared, they just gave me more homework anyway.

Much study may be a weariness unto the flesh, but some study is actually very beneficial. Learning helps to promote joy, and joy helps to promote learning.

It’s been shown that learning is much easier when there’s joy involved. Co-founder of the NeuroLeadership Institute, Dr David Rock said,

“Engagement is a state of being willing to do difficult things, to take risks, to think deeply about issues and develop new solutions … Interest, happiness, joy, and desire are approach emotions. This state is one of increased dopamine levels, important for interest and learning.”


“There is a large and growing body of research which indicates that people experiencing positive emotions perceive more options when trying to solve problems, solve more non-linear problems that require insight, [and they] collaborate better and generally perform better overall.”

This makes sense. According to the classical psychology principle of the Yerkes-Dodson law, optimal task performance occurs at an intermediate level of arousal, with relatively poorer performance at both lower and higher arousal levels. Too much stress (anxiety) or not enough stress (boredom) results in reduced performance. When someone is happy and engaged, their learning is at its optimum level.

But while it’s true that happiness and engagement create the optimal conditions for learning, it’s also true that learning created a sense of joy.

Learning new things is stimulating. Exposure to new information makes the brain work harder. We are very predictive creatures, and our brain has adapted to be predictive because it’s the most efficient way of processing the vast amount of information that we come across each day. After a while of being exposed to the same stimuli, our brains get a bit lazy. There’s no need to grow new branches and our brains become a bit stagnant. There’s no stimulation, so there’s no dopamine rush. We just get into our rut. But being exposed to new experiences, to new stimuli, is invigorating. Our brain can not longer rely on the same old predictive pathways, and new parts of the brain need to be engaged to process all of the different things we’re being exposed to. The dopamine cloud that comes from all of the novel stimuli is quite euphoric.

Learning something new helps our brain to stay supple. The brain is like a muscle – the only way to keep it flexible and strong is to exercise it. By constantly providing stimulation, our brain can better cope when unexpected events occur, because we’re already used to novel challenges. It helps us stay resilient by improving our psychological flexibility.

Learning something new can also give us a sense of accomplishment which is always good for our self-esteem and self-confidence.

There are many ways to learn new things – read new books, or if you’re not the reading type, find some interesting, factual documentaries. A great way of stimulating your brain is to learn a second language, which also gives you a great excuse to do the other thing that helps to grow your brain and your joy, which is to travel to a different country. Trying to speak a new language in a foreign country will really give your brain a workout, which may seem very daunting at first, but will help you grow immensely. You can also learn a new skill like craft, or a musical instrument. Your learning doesn’t just have to be about yourself – learn to juggle or make balloon animals, and use those skills to entertain people, or put a smile on a child’s face. That way the joy is shared through learning and giving.

Just remember your values when deciding what you would like to learn so that your learning is in step with your authentic self and enriches your life. And make sure you keep your work and life in balance as you carve out time to learn something new, all that study doesn’t become a weariness unto the flesh.

The lost art of joy – Laughter

(and part 2 –

I was lectured by Patch Adams once. He took his pants off.

When I was in medical school in the early 1990’s at the University of Queensland, Patch Adams gave a guest lecture. He was originally booked on a speaking tour and sadly, his other engagements cancelled, but he was extremely generous with his time, and visited our humble university anyway, to share his life story and his less-than-conventional views on practicing medicine. This was before the movie based his life was released (it came out in 1998), where he was portrayed by none other than the great Robin Williams.

It took a little while for the audience of young, idealistic, somewhat naive medical students to warm up, and in order to engage us, Patch took off his pants.

Everybody laughed!

It had the desired effect. He had everyone’s attention and it broke down the pretence and barriers. He later put on a pair of clown pants and continued to use humour to communicate his message of laughter, advocacy and social justice.

For the record, I have never taken my pants off to enable better communication with my patients, just so you (and anyone from the medical board who’s reading this) knows. It was the first and only time in my whole seven years of medical school that anyone ever delivered a lecture in their boxer shorts, and it’s not a customary way of engaging with one’s audience. Still, he made us laugh, and it was once of the most memorable lectures I have ever been to.

Laughter connects us. It certainly helped Patch Adams engage with people from all walks of life. Laughter equalises, because it is one of the most ubiquitous and natural of all human emotions.

And laughter is the best medicine, as the saying goes. According to the Mayo Clinic, laughter can lighten your load mentally and induce physical changes in your body. Laughing increases your intake of oxygen-rich air and stimulates your heart, lungs and other muscles. Laughter increases the endorphins that are released by your brain.

A good belly-laugh can also stimulate circulation and aid muscle relaxation which can help reduce physical symptoms of stress. Over the longer term, laughter can improve your immune system. Humour can actually release neuropeptides that help fight stress and potentially more-serious illnesses.

Laughter may even help to relieve pain by stimulating the body’s production of endorphins. Laughter can also make it easier to cope with difficult situations – like the saying goes, you either laugh or you cry. Laughter is also thought to lessen depression and anxiety.

Laughter is even thought to improve your cognitive function. As cognitive neuroscientist, Dr Scott Weems says, “Comedy is like mental exercise, and just as physical exercise strengthens the body, comedy pumps up the mind.”

It sort of goes without saying that laughter increases our joy levels. But it’s worth mentioning, because sometimes in the serious business of adulting, we can start taking things too seriously, and sometimes we just need a good laugh.

As always, it comes down to balance. There are times when we need to be serious, but we can’t be serious all the time. There are times when we just need to (metaphorically) take our pants off.