Dr Caroline Leaf and the case of the killer reactions

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Stress! Believe the media and seemingly every disease known to man is in some way linked to it. Heart disease = stress. Cancer = stress. Flatulence = stress.

Dr Caroline Leaf, Communication Pathologist and self-titled cognitive neuroscientist, has been of a similar opinion for the last couple of decades. Dr Leaf must have been kind enough to read my book, because after teaching for the last fifteen years that stress is toxic, a subtle shifting under the weight of evidence has appeared.

In her 2009 book [1], Dr Leaf wrote,
“The result of toxic thinking translates into stress in your body.” (p15)
“Stress is a global term for the extreme strain on your body’s systems as a result of toxic thinking.” (p15)
“Stress is a direct result of toxic thinking.” (p29)
“These stages of stress are scientifically significant because they illustrate how a single toxic thought causes extreme reactions in so many of our systems.” (p39)

In 2013, her position on stress hadn’t really changed that much: “Even a little bit of these negative levels of stress from a little bit of toxic thinking has far-reaching consequences for mental and physical health”, and “The association between stress and disease is a colossal 85 percent.” [2: p36-37]

Again in her 2009 book [1], Dr Leaf devotes an entire chapter to the alleged effects of the toxic stress pathway on our body (chapter 4, p39-43).

Now in her latest social media update, tucked in amongst the gratuitous selfies and holiday snaps, comes something that’s actually about mental health: “Stress does not kill… is good for us! Its our negative reactions to stressful events that pushes into negative stress…and this is what kills! Sistas 2014 NZ”

The problem for Dr Leaf is that any stress, whether it’s caused by our “negative” reactions or not, doesn’t actually kill us.

There is a phrase used in science, “Correlation does not equal causation”. This simply means that just because two things occur together, one doesn’t necessarily cause the other. For example, do my red watery eyes cause my hives? They always appear together, but they don’t cause each other. The common element that causes both of them is actually the cat that I’ve just patted.

Just because stress is correlated with certain illnesses does not mean that stress causes or contributes to those illnesses. In fact, one of Dr Leafs own pivotal references, an article by Cohen and colleagues in the Journal of the American Medical Association in 2007, discussed the weakness of assuming that stress causes most diseases. As they say, “Although stressors are often associated with illness, the majority of individuals confronted with traumatic events and chronic serious problems remain disease-free.” [3]

Even if it were true that it how we react to stress contributes to the outcome of that stress, Dr Leaf’s statement about our killer reactions incorrectly presumes that both how we cope with stress, and the physical outcome of stress are the result of our choices.

Our levels of stress, and the way we cope with our stress, is mostly caused by our genetics. Some people will be naturally less stressed, and some people will be naturally better at coping with stress (see chapter 5 of my book [4] for a full discussion on the science of resilience). Just because you’re more prone to stress doesn’t mean that it’s all down to your bad choices. Assumptions like these only add to your already high levels of stress.

That’s not to say that we don’t have a way to improve our responses. For those of us at the stressed end of the spectrum, successful psychological therapies such as Acceptance and Commitment Therapy will help to improve our coping, and certainly have been shown to improve (not cure) mental illnesses like anxiety and depression, and other chronic conditions like chronic pain (see [5] for a review).

ACT and other modern psychological therapies recognise that trying to change our thoughts doesn’t make any difference to how we cope. So like I said before, it’s partly true that how we react to normal life experience will help us live full and productive lives, but it’s not about fighting or changing our thoughts. It’s about being mentally flexible enough to make room for our thoughts and fears and move forward towards meaningful action. I’m sure that the ladies at ‘Sistas 2014’ wouldn’t be hearing that from Dr Leaf.

Anyways, I’m glad that Dr Leaf is changing her tune on stress, but there’s still more room for change before she meets up with current scientific understanding.

For an in-depth review of the teachings of Dr Leaf, visit http://www.smashwords.com/books/view/466848 where you can download a free copy of “Hold That Thought: Reappraising the work of Dr Caroline Leaf.

References

  1. Leaf, C., Who Switched Off My Brain? Controlling toxic thoughts and emotions. 2nd ed. 2009, Inprov, Ltd, Southlake, TX, USA:
  2. Leaf, C.M., Switch On Your Brain : The Key to Peak Happiness, Thinking, and Health. 2013, Baker Books, Grand Rapids, Michigan:
  3. Cohen, S., et al., Psychological stress and disease. JAMA: the journal of the American Medical Association, 2007. 298(14): 1685-7
  4. Pitt, C.E., Hold That Thought: Reappraising the work of Dr Caroline Leaf, 2014 Pitt Medical Trust, Brisbane, Australia, URL http://www.smashwords.com/books/view/466848
  5. Harris, R., Embracing Your Demons: an Overview of Acceptance and Commitment Therapy. Psychotherapy In Australia, 2006. 12(6): 1-8 http://www.actmindfully.com.au/upimages/Dr_Russ_Harris_-_A_Non-technical_Overview_of_ACT.pdf

My patient, Kev

I meet a lot of people in my job. Some are not particularly memorable, and some I truly wish to forget. But every now and then, I meet a person who’s memorable for all the right reasons. Kev was one of those people.

Once upon a time, Kev was a business man, a corporate manager who started in the postal service in his late teens, but got more experience and moved into the Commonwealth Bank, where he quickly moved through their ranks and became a regional manager. Towards the end of his career, he moved industries to become the CEO of one of the smaller private hospitals in Brisbane in the 1980’s.

After he retired, his wife developed dementia, and he cared for her at home for many years, before he became too weak. They both moved into a nursing home, but his wife succumbed a couple of years later.

When I met Kev in early 2013, he was dying. His heart and his lungs were failing, and he couldn’t walk ten metres without gasping or needing oxygen. He was gaunt and frail, and extremely thin. I was worried that if he fell, he might snap.

But his intellect remained untouched by the disease ravaging the rest of his body. He was quick-witted, jovial, and always polite. He was the consummate professional – always showing respect, and earning it. I could see why he was so good as a businessman. He was a pleasure to be around – so much so that I spent extra time with him every week just chatting, when I should have been finishing off my work.

In the week before he died, the last time I saw him, as I sat in his room listening to some more of his stories, he looked me in the eye and said,

“Don’t sweat the small stuff. You don’t have to do everything. Let people flow in the things they can do. There are more important things in life.”

He smiled as he looked at the photos on his wall of his wife and kids.

I smiled and shook his hand. “I’ll see you later, Kev”, I said. I never did see him again.

I still remember him now, skinny and breathless, but with a big smile on his face and a sparkle in his eyes every time I entered his room. And I remember his advice on living a life driven by values.

New Years Day is a time to start afresh, a celebration of new beginnings, a focal point to take stock and refocus. But if we’ve learnt anything at all from our previous attempts at New Years resolutions, it is that they don’t work. Don’t be mislead by the occasional partial successes. I sometimes hit a golf ball straight, but that still doesn’t mean my golf swing is any good. New Years resolutions are the same – they are fundamentally flawed, in spite of the accidental successes that we sometimes have.

The truth is that etherial statements, or short term goals for self-improvement don’t help us. We don’t need New Years resolutions, we need New Years re-evaluations.

Values are different to goals. A goal is like a destination, where as a value is like a direction. Our individual values are like the direction of the breeze. It’s easier to sail with the breeze of our values than against it.

We often get goals and values confused. Goal orientation means that we move from place to place, sometimes travelling in the same direction as our values, but sometimes against them. When we live according to our values, the goals seem to set themselves as we live according to what we truly believe in, what truly motivates us.

A few things can acts as guides to help us learn what our values are. What are your passions or what makes you mad? Is it justice, or injustice? Is it relationships? Is it children, or family? The environment? What is it that gets your juices flowing?

Another way of understanding your values is to do the eulogy exercise. It’s a little morbid, perhaps. But simply, the eulogy exercise involves writing your own eulogy. What is it that you want others to remember you for? What do you want your epitaph to say?

The eulogy exercise helps us to plan our lives with the end in mind. When you’re on your death bed, will you regret not finishing that report, or will you regret whether you lived according to your values, your deepest desires. Putting your values into perspective makes it much easier to let things go that aren’t truly important. It’s a lesson I’m continually working at too.

May 2014, and the rest of your life, be about the important things. Don’t sweat the small stuff.

I hope you have a happy new year.

Cheers, Kev.