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Defeating Performance Anxiety, One Revolution at a Time

by mweiss24 0 Comments

Start, Tour de Palm Springs, 2015

Last weekend, I rode in the annual Tour de Palm Springs around the Coachella Valley. I joined several thousand people who challenged the high-80s heat, distance, and themselves.

I’ve been cycling my entire life. In my young-adult-no-kids-and-few-obligations years, a 50-mile ride was routine. But last weekend felt anything but routine. Lately I haven’t been riding as much as I’d like, so the lack of miles in my legs meant 50 miles was a stretch. I was quite anxious as the ride approached, and far from confident that I could ride that far.

Preparation limits anxiety

Despite my anxiety (and lack of fitness), I managed to complete the ride. It was even fun, and I’m proud of the accomplishment. I also was reminded how to manage anxiety when approaching a big, scary venture. First: Preparation reduces anxiety, and a lack of preparation creates anxiety. When I committed to the ride many months ago, I created a careful training plan, which I proceeded to ignore, leaving me with insufficient fitness. Had I been disciplined enough to stick with it, I would have lined up at the start line feeling confident rather than anxious.

So does planning

Second: My biggest challenge was that lack of confidence. My anxiety kept telling me that I couldn’t ride 50 miles, so I had to develop a strategy to keep my anxiety in check and keep my legs moving. My solution: ignore the overwhelming overall goal and instead break the ride into a series of shorter targets. There were three rest stops scattered roughly 10 miles apart around the course, so I told myself I just had to get to the next one. Four short rides (including the final leg to the finish), each of a distance I knew I could do, felt much more do-able than one long ride. Result: more confidence, less anxiety.

Third: I wouldn’t have finished had I been riding alone. I rode with a partner, which meant I was accountable to someone else. He wanted to finish, so I’d be letting him down if I quit. I had added incentive to challenge my anxiety, not allow it to “win,” and complete the ride.

In other words, discipline creates confidence, which counters anxiety. Confidence is strengthened by breaking large goals into smaller, attainable targets. And accountability helps keep us on track.

Of course, a little sweat helps, too.

tdps2015survivor

After the ride

 

What is “Sobriety,” Anyway?

by mweiss24 0 Comments

Over on HuffPost, @jasoncherkis has written a brilliant and provocative look at the state of opioid addiction treatment here in the U.S. It’s long, but well worth your time, especially if someone you care about is struggling with addiction and sobriety. The article outlines the inadequacies of our current approach to treating addiction, and hammers home the point that the consequence of failed treatment is often death. It asks whether our moralistic thinking about addiction gives a punitive cast to our treatment choices. And it cites modern medical science to suggest that addiction is at least in part the result of a malfunctioning brain (in the same way diabetes results from a malfunctioning pancreas), and wonders what’s wrong with using medication to repair that malfunction.

But for me, the most interesting question this article raises is: What does it mean to be sober? Surprisingly, a quick Google search, including a visit to the Big Book, reveals that there does not appear to be any agreed-upon definition of “sobriety” among 12-step and other recovery programs! (Here’s a definition that, paradoxically, emphasizes the many possible definitions.) Given that sobriety is the central focus, indeed the goal, of these programs, this seems odd. Some of the definitions my search uncovered include:

  • Being free of all intoxicants (which, as you’ll know if you’ve ever attended a 12-step meeting, apparently don’t include coffee and cigarettes).
  • “Not being intoxicated,” which is not the same as not consuming intoxicants.
  • Living a certain kind of life: responsible, ethical, and with healthy strategies for coping with stress.

I’m sure there are more. The definition is important: how you think of sobriety dictates how you achieve it. This becomes obvious when you consider buprenorphine: the article cites several instances in which people are excluded from treatment because their use of buprenorphine means they aren’t sober. But buprenorphine is designed to suppress cravings and prevent withdrawal symptoms without providing the intoxicating effects of heroin; in other words, when used correctly, it is not an intoxicant. So how is using it breaking sobriety, unless you define sobriety as being free of all psychoactive substances, even life-saving, prescribed medications like antidepressants or anti-psychotics?

This discussion isn’t abstract, but goes directly to the question of how we help people who are suffering from addiction be healthy, happy and productive. Cherkis’ story details over and over again that our current model of addiction recovery works well as long as you are in a controlled setting like a sober living center. But the story makes a strong case that hard-won sobriety often cannot survive in the outside world. Indeed, often the addict cannot survive in the outside world. There’s something worrisome about using a model that insists on limiting itself to using self-discipline, introspection, social support, and spiritual appeals, when so often that model fails, and at times catastrophically. Sure, it’s better when addicts are able to be sober without relying on medications. But it seems misguided to pursue that ideal when the price for failure can literally be death, and there’s an alternative that, while less “pure,” preserves life.

Psychedelics and Mental Health

by mweiss24 0 Comments

This New Yorker article is a long and fascinating exploration of recent experiments in the use of psychedelics to treat various mental illnesses and conditions, including addiction, depression, obsessive-compulsive disorder, anxiety, and even existential dread and despair. It raises more questions than it answers (your psychiatrist or doctor isn’t likely to be prescribing you a psilocybin trip anytime soon) but it reinforces the idea that the human mind is astonishingly complex and our understanding of how it works remarkably thin. What we don’t know dwarfs what we do know, and that includes how to treat mental disorders. For me, the key message of this article is this: Psychedelics may not become a standard treatment tool anytime soon, but in the struggle to reduce human suffering, we shouldn’t rule anything out.