Three A’s of Positive Aging: Awareness, Attitude, and Adaptation Donna Amaral PMHCNS- BC

Centenarian Study Find Your Tribe Seek a Purpose Move It Eat Smart Who you hang out with is more important than anything else Seek a Purpose Move It Eat Smart

Positive Aging = Quality of Living Bio-psycho-social-spiritual life-long process that facilitates a feeling of well-being Possess wisdom and the ability to problem solve and manage uncertainty Feeling that you are thriving and not just surviving Feeling empowered to create your own happiness (RICH) Growing gracefully into gravity. Feeling fulfilled and able to integrate and accept life experiences.

“Life is Difficult” or “Life is a daring adventure” or “Life is like a box of chocolates” Life is complex Stress is a part of life There are many challenges of aging Experiences through the lifespan influence current behavior Life gives opportunities to grow, or fail, or both Perception will influence the aging process Locus of Control will influence behavior and ability to adapt to challenges

Some Challenges to Positive Aging Stress Loss History of Trauma History of Abuse Addiction Health Issues Pain Family Problems Knowledge Gap Missing Skills Lack of Resources Fear Shame Depression Isolation Loneliness Negative Relationships Cognitive Changes Perception Resentment Chronic State of Anger Attitude

Stress Physical, emotional, mental strain or tension Part of being human Can help motivate to act and to change There are external and internal factors that can trigger stress If not managed can cause physical, emotional, cognitive, behavioral, and relationship problems Prolonged and chronic stress causes aging

Stress and the brain Continuous stress changes brain size, structure, and function During stress the Hypothalamus Pituitary Adrenal Axis (HPA) is activated Cortisol increases getting you ready for action (Fight, Flight, or Freeze) High levels of Cortisol over long periods of time impact activity in the Amygdala (the emotion center) and increases Fear This signals the Hippocampus where memory and learning occur Stress control deteriorates which inhibits the HPA axis which further weakens ability to control stress and cope

Stress and the brain Cortisol can cause your brain to shrink in size There is loss of synaptic connections between neurons This can cause shrinkage of the Prefrontal Cortex which regulates concentration, decision-making, judgment, and social interaction. (Executive functioning) This makes it harder to learn things and remember May lead to more serious Mental Health problems like Depression and Dementia “ The mind can change the brain to change the mind.” Rick Hanson Ph.D. http://greatergood.berkeley.edu

Think about your thinking Attitude effects stress Catastrophizing Personalization Overgeneralization Jumping to conclusions/mind reading Disqualifying the positive Mental Filtering Negative self talk The worrier Promotes anxiety The critic Promotes low self esteem The victim Promotes depression The perfectionist Promotes stress

Adaptation Strategies To achieve mental and behavioral balance between your needs and the demands of life Finding ways to cope and adjust to aging Change your thinking as a way to cope and adapt to challenges of aging Use of The Wellness Triad model Behavioral Activation Psychotherapy Support Groups Self Compassion

Self Compassion Being compassionate to oneself is associated with emotional well-being and is a robust resilience factor Being aware of one’s painful experiences in a balanced way without self-judgment Self criticism is a risk factor for diverse forms of psychopathology (depression, anxiety, PTSD, interpersonal problems) Are you your own worst enemy, or your own Best Friend? http://self-compassion.org

Research Self Compassion (S-Co) can be a protective factor for PTSD and depression Combat veterans with higher S-Co showed lower level of psychopathology, better functioning, and fewer symptoms of PTSD S-Co lower in GAD patients compared with healthy controls experiencing stress S-Co is associated with less body dissatisfaction, body preoccupation, and less disordered eating In a study of heterosexual couples S-Co partners described as being more emotionally connected, accepting, and supportive than those lacking S-Co S-Co associated with intrinsic motivation, goals based on mastery rather than performance, and less fear of failure

Research Self Criticism(SC) predicts depression and anxiety SC in med students predicted depression 2 years later and in male med students 10 years later in their careers SC associated with social phobia SC predicted greater severity in PTSD in male veterans Holocaust survivors with PTSD scored higher on SC than survivors without PTSD Sc also distinguished between male and female domestic violence victims with and without PTSD In eating disorders SC associated with over-evaluation of shape and weight and body dissatisfaction independently of self-esteem and depression SC associated with loneliness, rejection, and lack of intimacy

“Self-compassionate responses to aging” Batts-Allen, A.,& Leary, M.R., The Gerontologist, April 2014 Research of 121 older adults ( mean age 76.2 years) Measured self compassion and self esteem Randomly assigned to write about positive, negative, or neutral age related event and their reactions Coded for self compassionate themes and emotional tone Self compassion predicted positive responses to aging and coping with age-related events Participants with high self compassion thought about events in ways that predicted positive outcomes Encouraging older adults to be more self compassionate may improve well-being in old age

“Self-Criticism and self compassion: Risk and Resilience” Warren,R., Smeets,E., and Neff, K., Current Psychiatry, December 2016 Study of college students Self Criticism was associated with less progress toward goals, rumination, and procrastination. Self Compassion is associated with successful goal pursuit and resilience when goals are not met. S-Co strongly linked to mental health, lower levels of depression and anxiety Benefits of S-Co come partly from a greater ability to cope with negative emotions. S-Co enhances positive mind states such as happiness, wisdom, curiosity, and personal initiative and is a powerful way to cope with life challenges

Self Compassion Interventions Write a compassionate letter to yourself daily for one week ( study showing decreased depression) 3 weeks of self compassion meditation training improved body dissatisfaction, body shame, and body appreciation among women with body image concerns, and greater mindfulness, optimism, and self efficacy in female college students Mindful Self Compassion (MSC) an 8 week group designed to teach S-Co through meditation and daily life practices. The study reported significantly greater self compassion, compassion for others, mindfulness, and life satisfaction, and greater decrease in depression, anxiety, and stress.

Self Compassion therapy S-Co therapy can trigger a grief response or increase anxiety Explores perceived advantages and disadvantages of self criticism Presents self compassion as a way to get perceived advantages of self criticism without the disadvantages Explores what it means to be compassionate to others and what it would be like if they treated self the same way

Wellness triad Balance Between Relationships Self Care Work

Self Care How do you nurture your Mind Body S Spirit = love, joy, awe, connection, peace, gratitude