Just One of These a Day Can Keep Anxiety and Stress at Bay

We are often told that happiness comes from within but decades of research points us in a different direction. Accumulating evidence shows that happiness comes from “with” as much as it comes from within. A brand new study published in Communication Research highlights a specific way that connecting with others boosts everyday well-being: through quality conversations. The researchers found that just one good conversation with a friend during the day made people happier and less stressed by day’s end.

Living in a time when people talk past each other more than to each other and engage with their phone more than the person next to them, these findings are worth paying attention to.


1. Catching up

Filling a friend in on what has happened since you last spoke or recapping the day is a significant contributor to relational satisfaction and has been shown to reduce loneliness. “How have you been this week?” is a good place to start.

2. Meaningful talk

Engaging in substantive or valuable conversation boosts well-being due to its ability to increase feelings of relatedness and satisfying the basic human need to belong.

3. Joking around

Sharing a laugh with a loved one reinforces connection and enhances relationship satisfaction. Plus, humor enhances a good mood, facilitates reframing of negative emotions, and promotes bonding through play and responsiveness.

4. Showing care

Verbal and non-verbal supportive communication is linked to less loneliness and stress and decreases in blood pressure and depression. Showing care manifests in a variety of ways including unspoken gestures, acts of kindness, and simply being present.

5. Listening

Providing emotional support through listening boosts feelings of self-efficacy, coping, and overall well-being. Listening isn’t an exercise in silence—it entails asking questions, looking up from your device, giving feedback.

6. Valuing others and their opinions

Expressing appreciation is something many of us are reluctant to do. We assume the other person already knows how we feel that it might be awkward to say it aloud. Reality check: they don’t know and it won’t be ask awkward as you think. Plus, studies show that verbally sharing gratitude is associated with happiness, life satisfaction, and vitality.

7. Offering sincere compliments

Like expressing gratitude, giving a compliment to a close friend can seem a little cringy, especially if it’s not something we are in the habit of doing. Start with something simple. Fill in the blank. “I really admire X about you.”


Regardless of the type of conversation a participant was assigned to have with a friend, they all made a difference. The very act of intentionally reaching out to a friend in one of these ways enhanced connection and reduced stress. Just one conversation was enough to provide a boost but more was better. “The more that you listened to your friends, the more that you showed care, the more that you took time to value others’ opinions, the better you felt at the end of the day,” explained co-author and University of Kansas professor Jeffrey Hall. Not surprisingly, the study found high-quality face-to-face communication was more closely associated with well-being than electronic or social media contact.

Given how stressed out people are, taking the time to have a real conversation is a simple remedy worth trying.

Bottom Line: You have a buffet of options to choose from. Start talking.

 

“Ah, good conversation—there’s nothing like it, is there? The air of ideas is the only air worth breathing.”

— Edith Wharton

I wish you all the best,

Dr. Samantha Boardman

Five Steps to Transform Ill-Will into Good-Will

“Not forgiving is like drinking rat poison and then waiting for the rat to die.”

— Anne Lamott, Traveling Mercies: Some Thoughts on Faith

Last week I wrote about apologies and heard back from many of you about apologies you longed for but never received. Is it possible to forgive someone without one? Should we even try? A new study answers unequivocally “yes” to both questions and highlights how impactful letting grievances go can be for our mental health. For all the grudge holders out there (yes, me included—I still remember a time when a professor mocked a presentation I gave in medical school), this research is worth paying attention to.

The study found a statistically meaningful reduction in depression and anxiety in those who engaged in a forgiveness exercise. Dialing down resentment, anger, and suppression of negative thoughts likely contributes to this finding. There are no upsides to dwelling on past harms or allowing wrongs to fester. In the words of the great Don Henley in The Heart of the Matter, if “you keep carryin’ that anger, it’ll eat you up inside.” Think of forgiveness as an antidote for wound collecting, an interruptor of rumination, and a salve for brooding.

Merriam-Webster’s Dictionary defines the word “forgive” as “giving up resentment of, or claim of requital for.” The authors of the study describe it as replacing ill-will with good-will. They also provide a blueprint for how to do it. Participants in the active arm of the study completed a two-hour self-directed workbook over the course of two weeks.

The first step toward forgiveness is simply deciding to forgive. The next phase involves emotional forgiveness and entails five key steps based on the REACH method developed by psychologist Everett Worthington:


Recall the Hurt

We aren’t going to get anywhere if we keep telling the same story repeatedly. We need another, more objective (yet still true) story. So recall the event again, but this time as an observer—not as yourself.

Empathize with the One Who Hurt You

We have all experienced hurting others even with the best intentions, so we can understand that the person who hurt us might have not been aware of the consequences of their actions. Having a hypothetical conversation with the person who wronged you is one exercise the workbook recommends.

Give an Altruistic Gift of Forgiveness

Think about how you felt when you were forgiven and about how good it feels to simply do an altruistic act that a person does not deserve. Wouldn’t you like to forgive (emotionally) the person who hurt you?

Commit to Forgiveness

Experiencing emotional forgiveness is defined as the degree to which you actually feel that your emotions toward the person who offended or harmed you have become less negative and perhaps even more positive. Write about how much you emotionally forgave and how that feels.

Hold on to Forgiveness

Repeat REACH as necessary.


In addition to meaningful reductions in depression and anxiety, forgiveness is linked with lower mortality rateslower cholesterollower blood pressurelower cortisol (the stress chemical in our brains) and a lower likelihood of developing cardiovascular disease. Forgiveness may even support a healthier immune system. In addition to physical benefits, forgiveness is also associated with psychological benefits as well. Overall well-being is linked with forgiveness, as are higher quality marriages and committed romantic relationships. Forgiveness is even related to better sleep. There is evidence that children who learn how to forgive do better academically.

Here is what forgiveness is not:

  • Excusing
  • Forgetting
  • Reconciling
  • Forbearing
  • Invalidating your own feelings
  • Foregoing justice

Forgiveness doesn’t come on demand and can’t be forced. It’s not asking for an apology, creating excuses for the wrongdoer or being a pushover. There is no tolerance for the misdeed in forgiveness and it cannot come from a place of moral superiority. Contrary to the popular phrase, forgiveness does not require forgetting. Another important factor is time, forgiveness cannot be rushed.

In Spiritual Evolution, George Valliant, MD., professor of psychology at Harvard and pioneer of adult development, describes forgiveness as an end to a cycle of negativity that allows us to grow and heal. It can be a transformative experience: “Suddenly, the fight-or-flight response of vengeance is replaced by the calming green pastures and still waters of peace.”

Given all the animosity and unhappiness in the world, teaching and practicing forgiveness seems like a worthy public health intervention. Even if your emotional experience of forgiveness isn’t complete, the simple act of trying can make a difference.

As David Whyte says, “The great mercy is that the sincere act of trying to forgive, even if not entirely successful, is a form of blessing and forgiveness itself.”

I wish you all the best,

Dr. Samantha Boardman

How to Apologize and Why It Matters

“If it means so much to you, then … sorry.” Logan Roy’s apology to his children in episode 2 of the fourth season of Succession is a masterclass in How Not To Apologize. In Logan’s defense, apologies are hard. They often get stuck in our throat or come out the wrong way. Even well intended apologies don’t always land well. As Randy Pausch, author of The Last Lecture said: A good apology is like an antibiotic. A bad apology is like rubbing salt in the wound.

At risk of sounding like a junior version of Logan Roy, I vividly remember being 8 years old and being forced to apologize to another child in the playground. “I’m sorry I took the ball but you were being a ball hog.” Alas, amends were not made and my nanny took me home. An explanation or justification is unlikely to promote resolution, or as Benjamin Franklin cautioned, “never ruin an apology with an excuse.”

When it comes to issuing an apology, acknowledging wrongdoing is key. Saying a version of “I am sorry if you were offended” shirks responsibility and basically blames the other person for being overly sensitive. Similarly, “Oops, my bad” is unlikely to resolve a conflict. So is “You have to forgive me,” as Carrie pleaded to Aidan after cheating on him in Sex and the City.

While there isn’t a formula for a good apology, there are certain factors according to research that make one effective including:

  • Using the actual words “I am sorry” or “I apologize”
  • Naming the offense — i.e. saying specifically what you are sorry for
  • Taking responsibility and accepting fault
  • Empathizing with the other person
  • Conveying emotion such as regret or remorse
  • Expressing a desire and willingness to make things right

Sincerity is essential. Even if the words aren’t perfect, if given from the heart and with good intention, a genuine apology shows the person that you care about them and about making amends.

Cartoonist Lynn Johnston described an apology as “the superglue of life because it can repair almost anything.” While an apology cannot right a wrong, it can begin the process towards reconciliation. Perhaps Elmer’s glue and Scotch tape are better analogies than superglue. From a joke that was unintentionally hurtful to more serious situations, saying “I’m sorry” matters. Forty percent of patients say they would not have filed a lawsuit against their doctor if they had received a proper apology and yet we often choose to skip them.

Of course, there are many reasons people don’t apologize.

For starters, we are highly motivated to maintain a positive self-image. Apologizing requires acknowledging wrongdoing. It’s a whole lot easier to justify our actions and minimize the harm we caused than to take responsibility. Perhaps this explains why some people, like Logan Roy, just “don’t do apologies.” Another barrier to saying “I’m sorry” is that we underestimate the positive impact it will have on the other person and also on ourselves. It’s helpful to keep in mind that apologies are less about changing the past than helping shape a less angry and more connected future.

It might be hard to apologize but at the end of the day, we all long to be forgiven, even Logan Roy. A short story by Ernest Hemingway entitled “The Capital of the World” captures this human need. It’s about a father and his rebellious son, Paco. The two had become estranged and Paco was living on the streets of Madrid. In an effort to repair the rift, the father took out an ad in a local newspaper that said “Paco, meet me at the Hotel Montana at noon on Tuesday. All is forgiven!” On Tuesday, 800 young men named Paco showed up at the hotel, looking for forgiveness.

I heard that story in church one day and it reminded me of palliative care physician Ira Byock’s observation that at the end of life, the wish to be forgiven is the chief desire of almost every human being. If we ultimately hope to be forgiven, apologizing is a good place to start.

That said…

While apologizing does not come easily to some, it comes too easily for others. When someone steps on my foot, I am the first to say, “I’m sorry.” I apologize for the weather, for terrible traffic, the long line at CVS and dozens of other undesirable situations that I am not responsible for.

I am not the only one who is inflicted with “Sorry Syndrome.” Many of my patients, especially women, tell me they insert “Sorry” into any sentence that contains a request.

“Sorry, may I have a glass of water?”

“Sorry, can I ask a question?”

“Sorry, where is the bathroom?”

Knowing how to apologize for something you regret is one thing. Apologizing for basically existing is another. As columnist Jessica Bennett writes:

Sorry is a crutch — a tyrannical lady-crutch. It’s a space filler, a hedge, a way to politely ask for something without offending, to appear “soft” while making a demand.

So why do we insist on apologizing for no reason?

A Harvard Business School study provides a possible explanation. According to the research, superfluous apologies build trust. In the study, an actor approached strangers in a train station on a rainy day and requested to borrow their phone. Half of the time, the actor prefaced his request with “I’m sorry about the rain!” The other half of the time, the actor went straight to the point and asked, “Can I borrow your cell phone?” Apologizing for the rain made a big difference: forty-seven percent of strangers offered their phone if the actor apologized for the rain. Only nine percent did without the apology. As the authors conclude:

Superfluous apologies represent a powerful and easy-to-use tool for social influence. Even in the absence of culpability, individuals can increase trust and liking by saying ‘I’m sorry’ — even if they are merely ‘sorry’ about the rain.

Building trust is important but does not justify apologizing for every little thing. If you want to reduce the number of superfluous apologies that roll off your tongue, consider replacing “sorry” with “thank you.”

For example, instead of saying, “Sorry for rambling” you can say “Thank you for listening.” Instead of saying “Sorry” when you move past someone on a train, you can say “Thank you for making room.”

An article in The Atlantic highlights the benefits of replacing an apology with gratitude:

“Sorry you had to do that” is not only a rejection of their nice gesture, a lot of times, it makes it weird. “Thank you for doing that” is recognizing and accepting their kindness.

Bottom Line: Save your apologies for when you have hurt someone and thank you for reading this article.

I wish you all the best,

Dr. Samantha Boardman

The Secret to Waking up Alert and Refreshe

“Until I’m 6 feet under

Baby I don’t need a bed

Gonna live while I’m alive

I’ll sleep when I’m dead.”

— Jon Bon Jovi

With all due respect to the venerable Jon Bon Jovi, this is a terrible idea. Countless studies have shown that if we want to live long and well, we also need to sleep long and well. The reality is that most of us are not getting enough sleep and are in denial about how exhausted we are. Just because we are able to get through the day does not mean we are well rested. In fact, people claiming to need the least sleep are the ones who nod off the fastest if given the chance, explained sleep expert Elizabeth Klerman in an interview with The Harvard Gazette. Her rule of thumb: If you fall asleep the minute your head hits the pillow, it’s a wake-up call you’re not getting enough sleep.

Even if we try to trick ourselves with caffeine into not feeling sleepy, lack of sleep still takes a toll on the brain and body. From cardiovascular disease to depression to obesity, sleep deficiency puts our health at risk. Study after study shows that getting good sleep can add years to our lives and more life to our years.

In addition to the overall health benefits of getting enough rest, here are some less obvious ways quality sleep impacts everyday life:

A study by UC Berkeley scientists shows how sleep loss dramatically reduced the desire to help others, triggered by a breakdown of the activity of key prosocial brain networks. (Credit: UC Berkeley)

If exhaustion is your default setting, take heart.

Scientists at the University of California, Berkeley, have discovered that it is possible to wake up each morning without feeling sluggish by paying attention to three key factors:

  1. Getting exercise the day before
  2. Sleeping longer or later than you typically do
  3. Eating a low sugar breakfast rich in complex carbohydrates, with a moderate amount of protein

The two week long study of 833 participants found that people felt more bright eyed and bushy tailed in the morning when they had done some physical activity the previous day, after sleeping longer than normal (ideally between 7 and 9 hours), and when they had eaten a breakfast high in carbohydrates and with limited sugar. Think nut butter on whole grain toast or banana oatmeal.

In addition to the three key behaviors mentioned above, here are some other data-driven ways to help you sleep better:

Lighten Up

Get 10 minutes of early morning sunlight. Going outside early in the day serves as a wake up signal, promotes focus, and prepares the body for sleep later that night by regulating the circadian clock, according to Dr. Andrew Huberman. Catch the sunset if you can or at least go outside for a few minutes in the afternoon as well. This also helps regulate the sleep/wake cycle.

Go Dark

The simple hack of wearing a sleep mask can boost how alert you feel the following day. Masks help sleepers spend more time in the deepest phase of sleep which is vital for processing new information and strengthening memory. The Sleep Code has a great selection.

If, like me, you have difficulty falling asleep or staying asleep consider this:

A typical recommendation for anyone having trouble sleeping is to get out of bed. The thinking is that trying to force oneself to fall asleep backfires and reinforces sleeplessness, both psychologically and physiologically. This advice has never sat well with me. Whenever I can’t sleep, the last thing I want to do is go to another room and play Sudoku.

I find the following unconventional methods to be tremendously helpful and they don’t require relocation. While I am a big believer in not sleeping with one’s phone nearby, I make an exception on sleepless nights so I can tune into these soothing modern lullabies. I think of them as Audible Ambien.

The BBC Shipping News Forecast

Listening to the weather reports for the seas around the British Isles is hypnotically soothing. The New York Times calls it “the secret for falling asleep so good it’s a national British treasure.” Even Dame Judi Dench is a fan. It’s wonderfully rhythmic and dull. It takes you to faraway places and describes weather patterns you can’t comprehend. That’s the point. Before you know it, you will be fast asleep.

Get Sleepy

This podcast is my cure for jet lag. I listen to the velvety-voiced Thomas Jones tell comforting bedtime stories to calm my unquiet mind. They are the equivalent of warm cookies and milk before bed. I queue up a few in a row but most of the time fall asleep within the first 15 minutes. Dreamy Views of Florence is one of my favorites.

One more thing to try…

Whatever you do, don’t fall asleep. If worrying about not sleeping is what keeps you up at night, try paradoxical intention. Paradoxical intention reduces performance anxiety about falling asleep by instructing patients to do the opposite — get into bed and stay awake. When we engage in our most feared behavior (i.e. staying awake), excessive stress about nodding off diminishes.

Sweet Dreams.

I wish you all the best,

Dr. Samantha Boardman

High Quality Comforting — 3 Ways to Support the Ones You Love

“In a relationship, each person should support the other; they should lift each other up,” says the ever-enlightened Taylor Swift. Of course, elevating and supporting each other is an essential ingredient of any healthy relationship. Sometimes our good intentions end up making the situation worse.

Wake Forest University communications professor Jennifer Priem’s research focuses on the connection between supportive actions and physiological signs of stress reduction. Her work sheds light on the specific behaviors that provide high quality comforting. When a person is stressed and in fight or flight mode, the stress hormone cortisol floods the system. Using saliva samples, Priem determines changes in stress by measuring the rise and fall of cortisol levels that follow an interaction with a loved one.

According to her findings, here are three features of communication that provide high quality comforting:


1. Validate their experience

Even if — actually, especially if — you think they are making a mountain out of a molehill, the person still needs to feel supported. Telling them that the situation is “no big deal” will likely be interpreted as indifference, not reassurance. Acknowledge that they are having a tough time. While well intended, telling the person to “chill out” or “not to worry” minimizes their experiences and definitely won’t dial down cortisol levels.

2. Provide “felt love”

Non-verbal forms of communication speak volumes. Give the person your full attention. Put your phone away. Make eye contact. Give them a hug. These little gestures are powerful cortisol reducers. As best-selling writer and psychologist Andrew Solomon observed, “Most of the people who get out of depression are the ones who know they are loved.”

3. Listen deeply

Before offering any words of wisdom, hear them out. Resist the urge to interrupt, cheer them up, or to tell them they are overreacting (see #1 above). Hold off on giving advice unless they specifically ask for it. Instead of assuming you know what’s best or have all the answers, follow their lead.


Alas, wanting to be supportive does not always translate into good support. Good support is only good if the person on the receiving end perceives it to be good. Try not to take anything too personally in these moments—when people are stressed, they may not be at their best. So be flexible and forgiving.

Poet David Whyte explains what it really means to show up for another:

But no matter the medicinal virtues of being a true friend or sustaining a long close relationship with another, the ultimate touchstone of friendship is not improvement, neither of the other nor the self, the ultimate touchstone is witness, the privilege of having been seen by someone and the equal privilege of being granted the sight of the essence of another, to have walked with them and to have believed in them, and sometimes just to have accompanied them for however brief a span, on a journey impossible to accomplish alone.

While it’s nice to be a rainbow in someone’s cloud, bearing witness and letting them know they are not alone are the essence of high quality comforting.

I wish you all the best,

Dr. Samantha Boardman

Is Decentering the Key for Feeling Centered?

When I meet a patient for the first time, I always ask about what they hope to achieve in therapy. Of course, therapy is a process, not an outcome, and as the process unspools, goals sometimes shift or morph into something else entirely. “My hope is to salvage my relationship with my partner,” might become “My hope is for our relationship to end with mutual respect and dignity.”

While some goals evolve, a persistent and enduring wish, in my experience, is the longing to feel centered. Feeling centered conjures confidence, calmness, and a sense of control over one’s emotions. It is the opposite of feeling “adrift,” or “un-moored” or “frantic” or any other experience that conjures a lack of equanamity.

While one might assume that the most reliable way to get centered is to focus on oneself, think again. Counterintuitively, research shows that decentering—separating one’s thoughts from one’s feelings—is the key. Decentering entails stepping outside of one’s immediate experience and shifting perspective. Rather than seeing one aspect of a situation, decentering expands our point of view and allows us to see multiple points of view.

The paradox of decentering is not self-focus but finding ways to get out of your own head. Here are five data-driven decentering strategies.


1. Be a Fly on the Wall

In the heat of the moment one of the worst things to do is what comes naturally to many of us. We immerse ourselves in our emotions and fixate on what’s bothering us. This response is like putting gasoline on a fire. It fuels the flame by keeping upsetting thoughts front and center. Research offers a simple strategy to cool these hot emotions. When someone upsets you, pretend you are a fly on the wall, viewing the situation from a distance. The process of mentally stepping back from an experience and seeing it as separate from itself and through the eyes of an outside objective observer will protect you from feeling emotionally askew.

2. Separate Yourself From Your Negative Thoughts

Use your words to create some distance between you and your critical self. For instance, if the thought is “I’m useless,” add the phrase, “I’m having the thought that I’m useless.” To create even more distance, take another mental step back with the phrase “I notice I’m having the thought that … I’m useless.” The goal is to see these negative thoughts as what they are—just thoughts—and as a result, lessen their power over you.

3. Zoom Out

Think of yourself and your situation, then zoom out and see it from the sky—see your house and the street you live on. Then zoom out further and see the city and the country underneath the clouds. Then zoom our further and see the Earth spinning round. Then zoom out further and see the solar system, and then the whole galaxy of the Milky Way, and then thousands and thousands of galaxies, containing billions and billions of stars and planets. Look around you, at the expanse of the universe, glittering with light and energy. This view from above, adapted from Philosophy For Life, helps keep perspective on the ground.

4. Fast Forward

Imagining what your future self might think about a current stressful situation reduces the emotional toll of the present. For example, as upsetting as an interaction with a difficult coworker might be today, imagine how you will think about it six months from now. When viewed through the lens of a future self, emotional challenges feel less permanent and less personal. Plus, recognizing the transitory nature of our thoughts lessens the distress they cause.

5. Be Your Own BFF

When you’re feeling off-balance, consider how you would advise a friend who was in the same predicament. Research shows that this technique promotes clearer thinking about one’s own issues. It is also linked with cultivating greater humility and awareness of one’s own shortcomings, and with feeling greater appreciation for another person’s point of view.


Self-immersion might seem like the most logical path for feeling centered but the opposite turns out to be true. People who decenter more frequently are less likely to get stuck in distressing emotional experiences and their negative thoughts don’t linger as long as they do for those who don’t.

Bottom Line: We all get self-centered at times. The key is to find ways to decenter.

I wish you all the best,

Dr. Samantha Boardman