Hooked on Our Smartphones

An enjoyable read most of us can relate to.
— Dr. Dale

From Hooked on Our Smartphones

The many men, women and children who spend their days glued to their smartphones and social media accounts might learn something from Lin-Manuel Miranda, creator of the groundbreaking megahit “Hamilton.” Asked in an interview with Delta Sky magazine when and where he finds time to be creative, Mr. Miranda, an avid reader of books and enthusiast for unfettered downtime, replied: “The good idea comes in the moment of rest. It comes in the shower. It comes when you’re doodling or playing trains with your son. ‘Hamilton’ forced me to double down on being awake to the inspirations of just living my life.”

Mr. Miranda’s observation bodes ill for the future, not just of creativity but also of healthy bodies, minds and relationships. No doubt you’ve seen the following scenarios, probably many times:

• Young couples out to dinner pull out their smartphones to check messages, emails and social networks even before scanning the menu, and check their phones repeatedly throughout the meal.

• Shoppers and commuters standing in line, people crossing busy streets, even cyclists and drivers whose eyes are on their phones instead of their surroundings.

• Toddlers in strollers playing with a digital device — a parent’s or perhaps even their own — instead of observing and learning from the world around them.

• People walking down the street with eyes on their phones, bumping into others, tripping over or crashing into obstacles.

Observations like these have prompted a New York psychotherapist to ask, “What really matters?” in life. In her enlightening new book, “The Power of Off,” Nancy Colier observes that “we are spending far too much of our time doing things that don’t really matter to us.” Both in and outside her practice, she has encountered many people who have become “disconnected from what really matters, from what makes us feel nourished and grounded as human beings.”

The near-universal access to digital technology, starting at ever younger ages, is transforming modern society in ways that can have negative effects on physical and mental health, neurological development and personal relationships, not to mention safety on our roads and sidewalks.

Don’t get me wrong. I’m no Luddite. I love technology. I love the convenience and assistance afforded by the myriad apps on my cellphone, a pocket-size information bank. I remember being amazed, as a Times reporter back in the early 1980s, when I started using word processing and realized how much faster I could write an article. Now computers save tons of time and effort and avert countless embarrassing errors because I can look up facts, figures, spelling, definitions and scholarly publications without leaving my ergonomic chair.

But I also love putting my computer in sleep mode and going for a walk with my dog, meeting and chatting with friends, acquaintances and strangers, some of whom have become friends.

As with so much else in life, moderation in our digital world should be the hallmark of a healthy relationship with technology. Too many of us have become slaves to the devices that were supposed to free us, giving us more time to experience life and the people we love. Instead, we’re constantly bombarded by bells, buzzes and chimes that alert us to messages we feel compelled to view and respond to immediately.

“Most people now check their smartphones 150 times per day, or every six minutes,” Ms. Colier wrote. “And young adults are now sending an average of 110 texts per day.” Furthermore, she added, “46 percent of smartphone users now say that their devices are something they ‘couldn’t live without.’”

In “The World Unplugged Project,” investigators at the University of Maryland reported that “a clear majority” of students in the 10 countries studied experienced distress when they tried to go without their devices for 24 hours. One in three people admitted they’d rather give up sex than their smartphones.

I fear we are turning into digital robots. Will future generations know how to converse with one another face to face? Will they notice the birds, trees, sunrise and the people with whom they share the planet?

Instead of visiting art galleries, attending concerts or walking on picturesque wooded paths, one woman I know who came to Woodstock, N.Y., last summer spent the weekend on her iPad communing with her many “friends” on Facebook. All I could think was “What a waste!”

Why, you may ask, is it so important to limit our digital lives? “Without open spaces and downtime, the nervous system never shuts down — it’s in constant fight-or-flight mode,” Ms. Colier said in an interview. “We’re wired and tired all the time. Even computers reboot, but we’re not doing it.”

She continued, “It’s connections to other human beings — real-life connections, not digital ones — that nourish us and make us feel like we count. Our presence, our full attention is the most important thing we can give each other. Digital communications don’t result in deeper connections, in feeling loved and supported.”

How often is your real work interrupted by signals from your smartphone that you find impossible to ignore? Have you ever avoided intimacy with your partner because you’re in the midst of iPhone Scrabble? Is endlessly snapping selfies and posting your every action and thought on social media creating an unhealthy self-centeredness?

As for physical well-being, every hour spent on a device is likely to be an indoor, sedentary one. Screens are stealing time that children and adolescents should be spending on physical activity and sports, reading, or creating and engaging directly with other children, all of which are critical to healthy physical and social development.

“Children who overuse online media are at risk of problematic internet use, and heavy users of video games are at risk of internet gaming disorder” (translation: addiction), the American Academy of Pediatrics wrote in its latest policy statement on media use.

Ms. Colier, a licensed clinical social worker, said, “The only difference between digital addiction and other addictions is that this is a socially condoned behavior.” While her book contains a 30-day digital detox program, in our interview she offered three steps to help curb one’s digital dependence.

1. Start by recognizing how much digital use is really needed, say, for work or navigation or letting family members know you’re O.K., and what is merely a habit of responding, posting and self-distraction.

2. Make little changes. Refrain from using your device while eating or spending time with friends, and add one thing a day that’s done without the phone.

3. Become very conscious of what is important to you, what really nourishes you, and devote more time and attention to it.

Reflections: New Year's reminds us it's never too late to begin again

Never say never.
— Dr. Dale

From Reflections: New Year's reminds us it's never too late to begin again

Just one week into the new year, the resolutions we made in the light of Jan. 1 fireworks may already have lost their sparkle, too.

The books we vowed to read may still be on the shelf unopened, the rooms we resolved to de-clutter and tidy still a mess, the exercise routine we swore to undertake still in the planning. There’s something about that fresh, first page on the calendar that inspired us, but with the passage of each day, our resolve erodes, leaving us feeling more and more as though we missed the New Year’s boat and its opportunity to make a new start

Good news! The first of January is an arbitrary notion of when the year begins. It came to us by way of the Roman Empire, whose Julius Caesar decreed Jan. 1 to be the beginning of the new year in a political compromise, winning out over the winter solstice and the vernal equinox, the latter of which was his personal preference. Calendar reform under Pope Gregory tweaked the length of the year and leap days and was adopted in countries most influenced by the Roman (or western) Catholic Church; thus the eastern, or Orthodox tradition, still following the Julian calendar, often reflects Christmas and Easter dates different from ours.

This is but one of the culturally diverse notions of when the old year ends and the new one begins. The first full moon day in January (this year, Jan. 12) marks the celebration of the Mahayana Buddhist New Year, which, although more solemn, bears resemblance to our own in that it encourages reflection on one’s life and attention to important goals for improvement in the journey toward enlightenment. A fire ceremony sometimes invites individuals to write negative karma – the consequences of failures or poor choices – on papers, which are then burned to symbolize release.

With the new moon on Jan. 28, Chinese communities around the globe will welcome the New Year of the Rooster with celebrations ranging from three days to 15.

Homes are cleaned to sweep out any bad luck from the past year and make way for good. Families hold reunion feasts, honor deities and ancestors, and mark the event with fireworks and parades and parties and tokens of good health and fortune. So if 2017 no longer feels new, the lunar New Year offers a chance to begin again at the end of January.

Even though we’re likely still to be slogging through slush and snow, March brings another opportunity. The vernal equinox, the official start of spring when the length of daylight is equal to that of darkness, is on March 20. For Wiccan and other Pagan spiritual communities, it is Ostara, one of the eight great Sabbats that are sacred to mark the turning of the Wheel of the Year. For Baha’is and Zoroastrians, it is Naw Ruz or Norooz – New Year’s.

Among India’s 1.2 billion people, whose vast religious and cultural diversity places New Year’s celebrations from mid-February until late March and even into April, there are many rituals and traditions that help individuals, families, and communities to mark a new start.

For all of these and many more, there are seasonal and spiritual new beginnings when we celebrate what has been and what is yet to be, with new possibilities and the perennial emergence of new life.

If calendars are arbitrary, then New Year’s is in the mind and heart of the seeker. Any birthday, any new moon, new month, even any new week or new day can be a new beginning, another opportunity to begin that project, mend that relationship, get on the road to the degree or to health and wellness or just (just?!) being more the person that you long to be. It’s never too late to begin again, and every new beginning is a triumph over disappointment, defeat and despair, an opening, some of us would say, for grace, which makes all things possible.

As writer Anne Lamott puts it, “Grace is spiritual WD-40. It eases our way out of grippy, self-righteous stuckness,” and “We get to start a new, sillier, more self-forgiving day whenever we want to.

Yes, maybe we eat a tiny, tiny bit more candy than is ideal. Then? We start over again, and again, and again. Starting now. Ready, set, go!”

Irritable Bowel Syndrome (IBS) Food Triggers

For my patients who need more information on IBS.
— Dr. Dale

From Irritable Bowel Syndrome (IBS) Food Triggers 

Irritable bowel syndrome (IBS) is a chronic digestive condition which is associated with cramping stomach pains, bloating of the stomach, and alternating diarrhea and constipation.

This condition is thought to affect up to one in five people at some point in their life, and it usually first develops when a person is between 20 and 30 years of age.

Different people have different symptoms, of varying severity. Even in the same person, symptoms wax and wane, lasting for a few days or months. Flare-ups occur during periods of stress, or in response to specific trigger foods.

The prevalence of IBS is about 20%, overall. Typically, it starts between the age of 20 and 30 years, and is twice as common in women as in men. Though it lasts a long time, significant remission may occur as time goes on.

Causes

IBS is due to some unknown pathology which causes the digestive tract mucosa to become hypersensitive to ordinary food.

The resulting mucosal changes lead to indigestion and bacterial proliferation, with the production of several toxins which further aggravate the symptoms.

The pathophysiology of IBS includes:

  • Slowing of gut movements and an increase in mucosal permeability. This allows toxins to cross the mucosa, affecting gut integrity.
  • Changes in the gut flora accompany altered interactions between the gut and the brain.
  • Food triggers are increasingly being identified, with 84% of patients finding that symptoms start or become worse after a meal.
  • Bloating due to bacterial fermentation of undigested food produces pain. Delayed or rapid passage of food through the gut may also occur, depending on the exact processes that are occurring. Stress also plays a role in altering normal gut metabolism.

Food triggers

It is observed that some foods may worsen the symptoms of IBS. These may include:

  • Fatty foods which produce bloating, nausea and pain: patients with IBS have a lower pain threshold in the intestine for normal stretching in response to food. Fat molecules may slow bowel transit, leading to the accumulation of gas which accounts for the symptoms.

Again, the motility of the colon is stimulated by the gastrocolic reflex which is more active in these patients, causing diarrhea after each meal.

IBS patients are primarily either constipated or diarrheal, and the same lipid meal can cause different reactions, of rectal pain and rectal urgency respectively.

  • Lactose-containing foods, possibly because of lactase deficiency. The sugar then passes unabsorbed into the large bowel, and is fermented to produce gas and short-chain fatty acids, which cause further symptoms as discussed above.
  • Alcoholic or caffeinated beverages which can irritate the gut mucosa, worsening diarrhea.
  • Artificial sweeteners in significant amounts.
  • Foods which ferment readily such as cabbage or beans.

How to identify food triggers

People with IBS can try to pinpoint which foods cause their symptoms by keeping a food diary. This will contain:

  • What foods are eaten at what time
  • What symptoms are experienced, and the time

After a few days, these entries can be discussed with the health care provider to help formulate a list of foods which should be avoided.

IBS dietary guidelines

People with IBS may consider going on a diet which greatly reduces or avoids foods such as starches and other carbohydrates that cannot be easily digested.

This is called a low FODMAP diet, the letters standing for Fermentable Oligosaccharides, Disaccharides, Monosaccharides, and Polyols.

This describes the types of sugars found in the following foods, which are not quickly digested and absorbed.
As a result, bacteria in the gut feed on them, releasing gases which cause bloating and cramping.

These foods are avoided over the first 1.5 to 2 months. They are then carefully reintroduced one at the time, to test how they are tolerated.
During this period, developing a food plan is important to avoid deficiency diseases.

Some foods that should not be eaten include:

  • Fruits or fruit juice, including apples, apricots, mangos, watermelons, as well as canned fruit which contain a lot of natural fruit juice
  • Vegetables such as artichokes, asparagus, broccoli, cabbage, cauliflower, garlic-containing spices, onions, mushrooms, lentils and other legumes
  • Milk and milk products
  • Foods containing wheat and rye which contain little absorbed, short-chain carbohydrates that are ideal for bacterial fermentation; these not only hold water but also produce gas, leading to stretching of the gut which is interpreted as pain because of the known hypersensitivity of the gut in these patients
  • Sweeteners such as honey or high-fructose corn syrup, as well as products containing sweeteners such as sorbitol, mannitol, or xylitol