Professionally, I have acquired quite bit of experience in performing lifestyle inventories and helping people center themselves. During my years working at Mirasol (a holistic eating disorder facility, www.mirasol.net) and with a Native American tribe, I was given the valuable opportunity to help a large number of people reluctant to take psychotropic medication. I repeatedly observed how lifestyle changes can greatly impact wellness. I have seen people meeting full criteria for depression or anxiety disorders recover completely without medication. I have also seen lifestyle balancing diminish the amount and types of medications needed for symptom control in people with a psychiatric condition, like bipolar disorder or schizophrenia. Personally, I have even had the experience of giving my own lifestyle a total overhaul (see below). Lifestyle balancing is a powerful tool for recovery and usually involves much more than standard common sense advice, like “eat right, get plenty of sleep and stop smoking”, although that can be part of it.
How people prioritize their activities and allocate their internal resources, i.e. mental energy and creativity, can directly determine how they feel about their lives. Unbalanced lifestyles can develop slowly or quickly and in response to benign events or traumatic ones. In everyday life, lifestyles are set up based on goals and these goals can sometimes lose their meaning or change, while the lifestyle does not. Lifestyle and goal mismatch occurs commonly as people navigate through life transitions. People are busy and it may feel easier to stay on a set path, rather than to stop, take stock in their feelings and what comprises their day. Over time, people sometimes forget that how they live is actually a choice. Without mindfulness and correction, a person’s lifestyle can become increasingly skewed. Traumatic experiences can severely disrupt lifestyle balance and sometimes very quickly. Traumatized people will do almost anything to avoid situations resembling or reminding them of the traumatic event and in this attempt to stay safe, their life and activities shrink. People with childhood trauma or abuse may not develop aspects of a full life at all. Strong negative influences at vulnerable life stages can lead to dysfunctional beliefs which push a person away from balance.
Unbalanced lifestyles can become more entrenched the more unbalanced they become due to powerful maintaining factors: aspects of the lifestyle may be rewarding, perhaps in terms of a high degree of measurable success with recognition, money, or academic accomplishments or immediate gratification; fears of the unknown may develop as novel experiences diminish; identity and lifestyle become more intertwined as time goes on; relationships are built and maintained around a person’s lifestyle; support systems can slowly erode over time as maintaining them loses priority; unchallenged dysfunctional deep-seated beliefs may take stronger hold (e.g. “if I don’t work all of the time, I am lazy”, “if I go to school, everyone will see how stupid I am”). People with unbalanced lives can feel that everything is fine for years, but there tends to be less resiliency in the face of unforeseen negative events and a certain lack of joy, an emptiness. It can be like standing on one leg; an unexpected blow can be devastating. (See my story below for a good example of how this can happen).
Often the eventual path of an unbalanced life leads toward exhaustion, difficulties forming or maintaining relationships (marital troubles), a sapping of hope and inspiration and even other problems like emotional instability, depression, anxiety and eating disorders. Sometimes, unconscious attempts at rebalancing can develop, and seemingly “out of the blue” unwanted maladaptive habits or compulsions, like drinking too much or prescription pill overuse, binge-eating, compulsive exercise, porn, sex or love addiction, gambling or stealing can suddenly arise. With these behaviors, shame builds and this secret life can lead to further erosion of social supports.
An unbalanced lifestyle is often not recognized as the source of a person’s struggles, rather, people tend to blame their unhappiness on physical illness, depression or specific events, rather than considering that the life they have worked so hard to create has become toxic. Maladaptive habits/compulsions are often blamed on a personality flaw or weakness (contributing to low self esteem), stress or at times, another person or relationship. Sometimes it takes a major life-transforming event, like being diagnosed with a potentially terminal disease or exposure of the shameful, compulsive behaviors before a person realizes that changes must be made or help is sought.
My Story: Denial can be so strong that even a professional in mental health can rationalize and evade making (big enough) changes in her own life for years! I would like to share a bit about myself to help you understand what I am talking about. There are many types of unbalanced lifestyles; Mine fell into the all work and no play type. That was me-straight A’s, Ivy League college, 4 years after college spent performing medical research and taking science courses to be eligible for a 4 star medical school, four years of medical school, graduating cum laude followed by entrance into a 4 star combined internal medicine and psychiatry residency program. Working 36 hour shifts every two days providing medical care to very sick patients on the cancer floor, I started to lose some of my propulsion. I pushed myself harder and attempted to rebalance by moving back to Philadelphia, a place where I felt at home. After completing two 3 year residencies and becoming board certified in both specialties, I worked for 5 more years, putting in at least 60 hours per week (sometimes a lot more than that), all of my energy and effort being put into helping others feel better. In the middle of this, I moved to the desert with the hope that beautiful surroundings would provide enough inspiration to keep going. As I shared in my patient’s lives, hearing about holiday events, family happenings, hobbies, joys and sorrow, I started to compare the richness of their lives with my own and they didn’t compare. Because my work was so rewarding, I kept going.
Then a miserable home renovation, a serious accident, the death of very good friend, the death of a beloved pet and a series of physical illnesses with prolonged recovery (no doubt stress played a major role) walloped my ability to keep trucking. For years, I had been helping others with severe lifestyle issues find balance, and I had been in complete denial about my own vulnerabilities. I believed that if I was capable of doing something, I should be doing it. I loved my work because I felt so good when I was able to help my patients, but I didn’t feel well when I returned home to my empty life and with the pain and illness; it became increasingly difficult to muster the energy to get back and forth to work, although once I was there, I felt fine. I knew I had to do something!
My transition from that all work and no play lifestyle to my current, I think, balanced one, was excruciating. I employed all of the strategies I have used for years with my patients and just like them, I went through all of the stages-feeling that restructuring was not an option, terror, feeling like a quitter, wondering if I was going to lose everything, feeling lost, worrying about bills (I cut my work down to one satisfying job which allowed me to meet expenses), really feeling the toll all that stress took on my body as I became more mindful and stopped ignoring it (neck pain/back pain, fatigue), walking around in a fog as my mind struggled to find a new track to jump on to. I threw myself into one project after the next, at first with abandon. But then as I started to build a new chosen life, constructed of activities mindfully chosen and experienced, a major transformation started to occur. I was no longer just a doctor, but a horsewoman, a gardener, a chicken farmer, a home designer, a chef, a bicyclist and a beloved woman and my house was a home, full of activity, laughter, color, warmth and fun. The pain, worry and feelings of loss were replaced by purpose, clarity, joy and finally, vision for the future. Opening my own private practice is born out of that vision. The best part, though, is to be able to sit still, by myself, doing nothing and be to be at peace with pleasant thoughts, knowing that I have so many good things in my life that even a major loss would not be devastating.
(This sunset picture was taken from my patio on a day when I had the time to notice it and took the time to thoroughly enjoy it.)