REDUCING PREMATURE, PREVENTABLE DEATHS THROUGH EFFECTIVE LIFESTYLE CHANGES

 

 

 

 

A DISSERTATION

 

IN CANDIDACY FOR THE DEGREE OF

 

DOCTOR OF PHILOSOPHY**

 

 

 

 

BY

 

AL LOUIS RIPSKIS

 

 

 

 

Updated April 2008

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

TABLE OF CONTENTS

 

ABSTRACT .........................................………...........…….................................................... 1

 

Chapters

 

I. INTRODUCTION AND OVERVIEW.........…………………..................….....….............. 2

 

II. PROACTORS, REACTORS, VICTIMS AND PREDATORS.…………….......…...........….

 

III. BRAIN DISCOVERIES AND CHANGE..............................….....…………..…….............… 

 

IV. THE PLEASURE DEFICIT AND BRAIN’S REWARD PATHWAYS......……….............……

 

V. THE MODULAR BRAIN…………….........................................……………….............…….

 

VI. CORTICAL INTEGRATION ...............……….........................………………................……

 

VII. THE OVERWEIGHT EPIDEMIC AND THE FAILURE OF THE MEDICAL MODEL...…..…

 

Practical Instructions for the General Public

 

VIII. WEIGHT, FUN & FITNESS ……….......................................……………….............………..

 

IX. PLAY & FITNESS…………………...….................................……………….............………..

 

X. REPLACING THE NICOTINE ADDICTION..…...................……………….............………..

 

XI. THE DRINKING CONUNDRUM…………………………………………………………………

 

Appendices

 

A.  LIFESTYLE RESEARCH QUESTIONNAIRE.............……..........................................……

 

B. TW0 DOZEN PROACTOR CASE STUDIES ……...…….……...…..........................……….

 

Notes……………...........................……......................................................................………

 

 

 

 

 

 

 

 

Reducing Premature, Preventable Deaths Through Effective Lifestyle Changes

 

By Al Louis Ripskis

 

 

 

ABSTRACT

 

According to the World Health Organization:

o “Obesity has reached pandemic proportions globally, with more than 1 billion adults overweight -- at least 300 million of them clinically obese …”  resulting in 3 million deaths annually.

o “Physical inactivity is estimated to cause 2 million deaths worldwide annually.”

o “The tobacco epidemic is still expanding … Tobacco use kills 4.9 million each year…”

o  “Worldwide, alcohol causes 1.8 million deaths …”

 

The March 9, 2004 JAMA News Release proclaimed that “Poor Diet And Physical Inactivity May Soon Overtake Tobacco As Leading Cause Of Death In U.S.” The Centers for Disease Control and Prevention “found that the leading causes of death in 2000 were tobacco (435,000 deaths), poor diet and physical inactivity (400,000) and alcohol consumption (85,000).”

 

According to “Overweight and Obesity in Australia: the 1999–2000 Australian Diabetes, Obesity and Lifestyle Study (AusDiab) “approximately 60% of the population was overweight or obese.” And further “it is estimated that by 2010, 70% of Australians will be above their healthy weight range

 

As these worldwide pandemics explode, what do the health experts advocate? Use willpower to get more exercise, restrict calories and fat/cholesterol intake, and quit smoking and abusing alcohol.  These exhortations have been monumental failures, as every year the above casualty tolls mount.

 

A paradigm shift that will abandon the prevailing, antiquated Aristotelian model about how our minds function and replace it with the modular brain model that incorporates the breakthrough discoveries in neuroscience and psychology for dealing effectively with lifestyle changes, is long overdue.

 

Neuroscientists have discovered that our brains are modular, containing extremely powerful reward pathways which demand daily “quota of pleasure," or more precisely, stimulation via serotonin, dopamine and other neurotransmitters.

 

For the overweight, depressed, alcohol/tobacco-dependent, and others whose reward pathways don’t get sufficient, healthy stimulation -- food, tobacco and liquor become the major substitutes. Self-deprivation through willpower, diets, abstinence and “no-pain, no-gain” exercise regimens not only don’t work, but deplete the reward pathways even further and are counterproductive in the long run. Enriching lives and finding healthier sources of pleasure outside of food, tobacco and alcohol are the options of choice.

But that requires functioning from the existential position of a Proactor. Operating from the positions of Reactor or Victim deepen the sense of helplessness, perpetuating overweight, alcohol/tobacco dependencies and physical inactivity. For more precise overall picture of how this relates to overweight and obesity, see The Overweight Epidemic, chapter 7.

 

 

 

 

 

 

 

Chapter I

Introduction & Overview

 

 

Discovered early in the research process that the existential positions people operate from  -- Proactor, Reactor, Victim or Predator – were decisive as to what lifestyle changes they sought and whether those attempts would be successful.

 

Scope of Research

 

I started the research in 1985 while counselor with the Washington, D.C. Crisis Hotline where we received three major type of calls.

 

Category 1: calls from people who had experienced some acute, traumatic or distressful incidents or events such as marital infidelities/divorces (troubled/broken relationships), loss of jobs, rapes or attempted rapes, assaults, accidents, arrests for driving under the influence of alcohol or other drugs, recipients of eviction notices…

 

Category 2: calls from individuals who were dissatisfied with themselves (their intelligence, appearance or habits) or their lifestyles. The intensity of their dissatisfaction varied from mild to severe, such as suicide ideation, threats and attempts; unsatisfactory relationships (ranging from boredom, unsatisfactory sex lives to repeated child and spousal violence and psychological abuse); undesirably habits/addictions such as overeating, anorexia, bulimia, smoking, alcohol and other drug abuse; and economic insecurity, job/career dissatisfaction.

 

Category 3: calls from lonely, isolated, withdrawn people with limited social skills, who had not developed their own network of friends and acquaintances and relied on the D.C. Hotline for social and emotional support.

 

New counselors to the Hotline were trained and were prepared to provide callers with empathy; understanding; help to clarify, defuse and put into perspective hot, emotional issues; and assistance in anticipating and forestalling future recurrences of similar distressful situations.

 

Only the Proactors were prepared to accept and make use of this broad range of help. Predominantly these callers were flexible, optimistic and persevering. They tended to interpret the negative events that prompted them to call the Hotline as aberrant, isolated incidents rather than their normal life patterns. They usually wanted to deal promptly with the adverse occurrences and move on with their lives.  Mostly they were Category 1 callers.

 

On the other side of the existential spectrum were the callers whom I identified as Victims, who were primarily Category 2 and 3 callers. Instead of acute events they tended to repeatedly report chronic situations and histories of incidents they apparently had never gotten over. These callers preferred to keep recounting the traumatic event and complaints about their unsatisfactory lifestyles rather than focusing their energies on resolving the unsatisfactory situations and bringing about more favorable, future outcomes.  For them victimization was the norm not the exception. “Why does this always happen to me? ” was more of a Transactional Analysis game they were playing, rather than a serious question for finding a way out of their predicaments. For the TA Victim profile see The Karpman Drama Triangle.

 

The callers that occupied the Reactor existential position were, as the term suggest, predominantly reacting to outside circumstances and events, without any clear goals or systematic life plans. A couple of them volunteered, almost poetically: “I’m like a piece of driftwood in a vast ocean of life.” The other: “I am being bounced around by circumstances beyond my control like a billiard ball.” They followed the path of least resistance and did what was socially expected, rather than acting from personal convictions. In the broader context Reactors are the “other-directed” people – the social character that David Riesman, et al described in The Lonely Crowd. Being entertained and finding fun things to do are what Reactors’ lives are about. They were predominantly Category 2 callers.

 

Criminals and psychopaths made up the fourth existential position, that of Predators. They were not interested in changing themselves internally or their lifestyles. They called primarily because they found themselves in a “down position” and wanted to regain control so they could exploit better the people or situations they were in.  Finally, the mentally ill, who were Category 3 callers.

 

Expanded Scope of Research and Methodology

 

After my research at the D.C. Hotline pinpointed the critical importance of people’s existential position for achieving successfully desired lifestyle changes, I widened the universe and investigated other indispensable elements essential for achieving lifestyle changes effectively.

I formed Impact Consultants, a private counseling and consulting practice, which also served as a laboratory for experimenting, evaluating, testing and refining the most effective ways for making lifestyle changes.

I designed a comprehensive Lifestyle Research Questionnaire (Appendix A) which I either mailed or completed myself in telephone or face-to-face interviews, locally as well my travels in the U.S. and other parts of the world.

The research revealed that being a Proactor was one of three indispensable factors for bringing about lifestyle changes effectively. Having a basic knowledge of human brain functioning and knowing the most effective combination of factors for changing the particular habit/condition were equally important.


**A PERSONAL NOTE: In view of the millions of lifestyle-related deaths reported each year by the World Health Organization, as author of this dissertation I felt as sense of urgency to get my research findings published as soon as possible, in the interest of saving some of these lives. Unfortunately my dissertation advisor felt that I should delay the release of the dissertation for another semester so I could finish up on couple of course requirements. Thus I had two choices: One, sit on my discoveries for another semester as millions are dying from lifestyle-related causes. Or publish my findings and kiss my Ph D program good-by. I choose the latter course.

Copyright © 2008 Al Louis Ripskis