Textured Breast Implants Recalled for Cancer Risk


July 24, 2019 — Pharmaceutical giant Allergan has ordered the recall of all of its BIOCELL textured breast implants after the FDA flagged a series of reports that the implants were causing cancer in hundreds of patients worldwide.

The FDA says the textured surface, unique to Allergan’s implants, are tied to 481 cases of breast implant-associated anaplastic large cell lymphoma (BIA-ALCL), a type of non-Hodgkin’s lymphoma. There have been 573 cases of BIA-ALCL worldwide, including 33 deaths. In 13 cases where a patient died and the manufacturer of the breast implant was known, 12 of them involved an Allergan breast implant.

Most cases of this particular cancer, which attacks the immune system, are not diagnosed for years after the original implantation.

Daniel Maman, MD, a board-certified plastic surgeon with 740 Park Plastic Surgery in New York City, says it remains unclear why these types of implants could cause cancer.

“But these rare cases are showing that the texture of the shell surrounding the implant can cause this lymphoma response in capsule tissue that surrounds the breast implant,” he says.

The FDA says anyone with an Allergan BIOCELL implant should not have it removed, unless symptoms are present. Those symptoms include persistent swelling or pain near the implant. Patients found to have BIA-ALCL would have the implants removed, along with surrounding scar tissue.

The FDA says in most cases, the cancer is limited to the scar tissue and fluid near the implant, but it can spread through the body. While the diagnosis is serious and can lead to death, the risk is considered to be low, the agency says. Some patients may need chemotherapy and/or radiation therapy.

The FDA says the risk of getting BIA-ALCL from an Allergan textured implant is roughly 6 times the risk compared to similar products from other manufacturers. Textured implants represent 10% of all breast implants sold in the United States.

“The popularity of the different types of implants is heavily dependent on the surgeon and what they prefer using, but there are pros and cons of each type of implant,” Maman says. “I personally have not put in a textured implant in over 5 years.”


The recalled products are:


Allergan Natrelle Saline-Filled Breast Implants (formerly McGhan RTV Saline-Filled Mammary Implant) approved under P990074. The following are the textured styles:

  • Style 163: BIOCELL Textured Shaped Full Height, Full Projection Saline Breast Implants
  • Style 168: BIOCELL Textured Round Moderate Profile Saline Breast Implants, also referred to as 168MP (168 Moderate Profile)
  • Style 363: BIOCELL Textured Shaped Moderate Height, Full Projection Saline Breast Implants, Allergan catalog includes 363LF, or 363 Low Height Full Projection
  • Style 468: BIOCELL Textured Shaped Full Height Moderate Projection Saline Breast Implants


Allergan Natrelle Silicone-Filled Textured Breast Implants (formerly Inamed Silicone-Filled Breast Implants) approved under P020056. The following are the textured styles:

  • Style 110: BIOCELL Textured Round Moderate Projection Gel Filled Breast Implants
  • Style 115: BIOCELL Textured Round Midrange Projection Gel Filled Breast Implants
  • Style 120: BIOCELL Textured Round High Projection Gel Filled Breast Implants
  • Style TRL: Natrelle Inspira BIOCELL Textured Responsive Silicone-Filled Breast Implants
  • Style TRLP: Natrelle Inspira BIOCELL Textured Responsive Silicone-Filled Breast Implants
  • Style TRM: Natrelle Inspira BIOCELL Textured Responsive Silicone-Filled Breast Implants
  • Style TRF: Natrelle Inspira BIOCELL Textured Responsive Silicone-Filled Breast Implants
  • Style TRX: Natrelle Inspira BIOCELL Textured Responsive Silicone-Filled Breast Implants
  • Style TCL: Natrelle Inspira BIOCELL Textured Cohesive Silicone-Filled Breast Implants
  • Style TCLP: Natrelle Inspira BIOCELL Textured Cohesive Silicone-Filled Breast Implants
  • Style TCM: Natrelle Inspira BIOCELL Textured Cohesive Silicone-Filled Breast Implants
  • Style TCF: Natrelle Inspira BIOCELL Textured Cohesive Silicone-Filled Breast Implants
  • Style TCX: Natrelle Inspira BIOCELL Textured Cohesive Silicone-Filled Breast Implants
  • Style TSL: Natrelle BIOCELL Textured Soft Touch Silicone-Filled Breast Implants
  • Style TSLP: Natrelle BIOCELL Textured Soft Touch Silicone-Filled Breast Implants
  • Style TSM: Natrelle BIOCELL Textured Soft Touch Silicone-Filled Breast Implants
  • Style TSF: Natrelle BIOCELL Textured Soft Touch Silicone-Filled Breast Implants
  • Style TSX: Natrelle BIOCELL Textured Soft Touch Silicone-Filled Breast Implants


Natrelle 410 Highly Cohesive Anatomically Shaped Silicone Filled Breast Implants approved under P040046. The following are the textured styles:

  • Style 410FM
  • Style 410FF
  • Style 410MM
  • Style 410 MF
  • Style 410 FL
  • Style 410 ML
  • Style 410 LL
  • Style 410 LM
  • Style 410 LF
  • Style 410 FX
  • Style 410 MX
  • Style 410 LX


Allergan tissue expanders for the breast that have BIOCELL texturing originally cleared as:

  • Natrelle 133 Plus Tissue Expander (K143354)
  • Natrelle 133 Tissue Expander with Suture Tabs (K102806)

Sources

FDA.gov: “The FDA Takes Action to Protect Patients from Risk of Certain Textured Breast Implants; Requests Allergan Voluntarily Recall Certain Breast Implants and Tissue Expanders from the Market: FDA Safety Communication.”

Daniel Maman, MD, board-certified plastic surgeon, 740 Park Plastic Surgery, New York City.



© 2019 WebMD, LLC. All rights reserved.





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Scientists Are Getting Better at Predicting Killer Heat Waves


The City of Lights could be the City of Lights Out tomorrow as temperatures approach a record of 107 degrees. And Paris isn’t the only place sweltering in this week’s heat. Cyclists in the Tour de France are wearing stretchy sacks of ice around their necks as they race toward the Alps, while commuters on the London Underground carry spare water bottles, and Spanish firefighters battle wildfires—all thanks to torrid air from the Sahara that got trapped between storm systems over the Atlantic Ocean and Eastern Europe, forming a “heat dome” over the entire continent. It’s similar to the extreme heat that lingered over the eastern United States for a 12-day stretch in July, breaking records and warming the Potomac River to 94 degrees.

The ability to predict the next heat wave is a big deal to meteorologists. That’s because more warning means extra time to prepare cooling centers and swimming pools, shore up the electric grid, and put supplies in place for heat-vulnerable populations and machines. As you might expect, climate change is making heat waves longer and more common. Scientists say that the number of heat waves in 50 major American cities has tripled since the 1960s. Last month was the hottest since record-keeping began 140 years ago.

Today, meteorologists are pretty good at giving us an accurate 10-day weather forecast, but now they’re peering farther into the future by examining an atmospheric phenomenon called the Madden-Julian Oscillation. The MJO erupts over the Indian Ocean every so often and moves eastward across the globe, spreading trouble through the tropics over the course of 30 to 60 days. The oscillation behaves like a high-altitude wave that either amplifies or squelches existing conditions closer to the ground. Think of it as El Niño at 18,000 feet.

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The WIRED Guide to Climate Change

According to a recent study in Advances in Atmospheric Sciences, the oscillation contributed to heat waves in California’s Central Valley from 1979 to 2010. “The MJO is an influencer rather than a creator,” says Richard Grotjahn, an author on the paper and a professor in UC Davis’ Department of Land, Air and Water Resources.

Using computer simulations and weather observations from ships, satellites, and roofs, scientists at the National Center for Atmospheric Research in Boulder are developing a short-term forecast model for extreme summertime heat. For now, they’re looking back in time, working to see how accurately their model captures heat waves globally and in the various seasons, and whether it accurately represents the high- and low-pressure systems created by the MJO.

In North America, says Julie Caron, an associate scientist at the center’s Climate and Global Dynamics Lab, the oscillation causes high-pressure systems that block the movement of cooler air from the Arctic or the Pacific Ocean. “It’s like a traffic jam where the weather systems are stalled out behind,” she says.

One question Caron and her colleagues are wrestling with is how exactly to define a heat wave. Not only do conditions vary from the tropics to the temperate zones, but average temperatures keep creeping upward as the planet warms under heat-trapping greenhouse gases. She is hoping that, by the end of the year, the model will be able to predict the likelihood of extreme heat three or four weeks in advance. But that’s just for research purposes, she cautions, not for local TV weather forecasts.

Officials at the National Weather Service have also been pushing forward their predictions of heat waves in recent years. They’re aiming for the same three- to four-week outlook, according to Jon Gottschalck, operational prediction chief at the NWS Climate Prediction Center in College Park, Maryland. “Right now, on average, we can do pretty well two weeks out,” Gottschalck says.



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How to “Hardwire Happiness,” with Dr. Rick Hanson


In this episode,we discuss:

  • Eastern wisdom traditions, psychology, and neuroscience
  • Hanson’s approach to happiness
  • How neuroplasticity works inside the brain
  • The negativity bias
  • The power of acceptance
  • The mind–body connection
  • Seven practices to awaken your consciousness

Show notes:

Hey, everybody, this is Chris Kresser. Welcome to another episode of Revolution Health Radio. This week, I’m really excited to welcome Dr. Rick Hanson as my guest on the podcast. He’s a psychologist, the senior fellow at the Greater Good Science Center, UC Berkeley and a New York Times best-selling author.

His books are available in 28 languages and include Resilient, Hardwiring Happiness, Buddha’s Brain, Just One Thing, and Mother Nurture. Dr. Hanson’s a summa cum laude graduate of UCLA and the founder of the Wellspring Institute for Neuroscience and Contemplative Wisdom. He’s been an invited speaker at Oxford, Stanford, Harvard, and other major universities and taught in meditation centers worldwide. In 2016, he gave the keynote address at the annual meeting of the American Psychological Association.

Dr. Hanson’s work focuses on helping people turn everyday experiences into lasting happiness, love, and inner peace hardwired into the brain. He really brings together neuroplasticity, mindfulness, meditation, and psychology in a unique approach that I’ve been really looking forward to talking with him about. I’m a huge fan of his books and his work, and if you’ve been listening to this podcast for any length of time, you know that I have a deep interest in neuroplasticity and mindfulness and psychology.

So this is a conversation that I am really excited about, and I hope you enjoy it as much as I have. Let’s dive in.

Chris Kresser:  Dr. Rick Hanson, thank you so much for joining us. I’ve really been looking forward to this.

Dr. Rick Hanson:  Well, Chris, it’s an honor and a privilege to be here. And please call me Rick.

Chris Kresser:  Okay, Rick. So how did you become interested in the intersection of Buddhist practice, psychology, and neuroplasticity? I’m really curious to hear a little bit more about your story.

Eastern Wisdom Traditions, Psychology, and Neuroscience

Dr. Rick Hanson:  Oh, thank you. Well, I think it happened in stages, like a lot of things in life. So, honestly, the beginning was this very poignant sense that I can see in my very earliest memories going back to age three and maybe two, this feeling, this knowing that I had as a kid that there was a lot of unnecessary unhappiness all around me.

Among the other kids, I would watch the grown-ups, I would see grown-ups with kids. I saw it in my family, which was a loving and decent family, and still, lots of unnecessary hassles, stress, fear, worry, shame, bickering, conflict.

Chris Kresser:  Yeah.

Dr. Rick Hanson:  As a little kid, even a little, little kid, you know things you can’t put into words, but they’re still true. So that was kind of the beginning of my journey of this poignant, wistful recognition of suffering and also a yearning to understand it and do something about it. And then kind of a second stage that happened for me was in my mid-teens. I was about 15 when this happened. I was so very unhappy and kind of twisted in my own mind. Really neurotic, socially anxious, contracted, awkward, very young for grade. I was a very young going through school kind of kid. And just was sort of despairing because it all just seemed hopeless.

And then I suddenly realized that no matter how bad it had been or no matter how bad it was in the moment, I could always grow a little bit from here. I could learn a little bit everyday about myself and other people. I could become a little more released from the bricks in my backpack. I could learn how to talk to girls. So, I could learn how to deal with my parents. It was very hopeful, the future, the so-called undiscovered country. I could learn and grow. And therefore, it was actually really important to learn how to learn. In other words, to get good at growing. And that really, really set me on my way. The notion of that growth itself is the superpower of superpowers because it is the one that grows the rest of it.

Chris Kresser:  Absolutely. Do you attribute that epiphany or realization to anything in particular? Or was it something that was just grace?

Dr. Rick Hanson:  I think a lot was coalescing, and part of it was that I was reading this science fiction novel Dune at that time, and I therefore mark, I was 15. Because Paul Muad’Dib, if you’ve read this classic fantastic novel …

Chris Kresser:  Yeah, several times.

Dr. Rick Hanson:  Personal training, personal training and a kind of old-school self-reliance really landed for me. And who knows what role grace has played? But that was there, very, very real for me, and it was so hopeful. And then to kind of third stage, it … in the last one, as I got into college in the late 60s, early 70s, I caught the wave of the human potential movement. Eastern wisdom traditions were coming strongly into the West at that time, as well as a lot of other countercultural and human potential and humanistic psychology things.

And it all sort of coalesced for me at the end of college, when I stumbled into meditation and the Eastern wisdom traditions. And then, click, it all just kind of came together for me that there were these three very, very deep, profound ways of understanding ourselves. Because that goes back to that early inquiry as a little kid. What’s causing this suffering and what can we do about it? So, the combination of Western psychology, the Eastern contemplative traditions, and the growing understanding, even then, in the mid-seventies of the brain and the nervous system and the body and how they all work together, just struck me as a very potent brew. If you imagine the intersection of those three circles—psychology, contemplative wisdom, and neuroscience—I think of what I do in a funny kind of way is applied neurodharma. Now that will not be a book title. That will sell nothing. But anyway, that’s a lot of what I do.

Chris Kresser:  Yeah.

Dr. Rick Hanson:  So that really sent me on my way. And then the rest was a lot of human potential activities, a lot of contemplative training, a lot of clinical psychology. I became a clinical psychologist, really a neuropsychologist, with my knowledge base at this point.

And then ended up as you know, after writing a book about mothers and couples after kids come along, which I think is a vastly important and underrated topic, then I wrote Buddha’s Brain, which came out in 2009, and whoosh! I’ve caught a good ride ever since.

Chris Kresser:  Yeah. So, did you go right from college into clinical psychology study at that point?

Dr. Rick Hanson:  No, I wandered in the wilderness for a while. Although there were a lot of great lessons there. I’ve delved deeply into wild and crazy human potential things. And I also actually spent a year working for a mathematician who was doing probabilistic risk analyses of things like nuclear power plants melting down, what are the odds or the likely cost of a huge construction project. And that actually taught me a lot about how to think about uncertainty, which is really central, as you know, to clinical practice.

Chris Kresser:  Absolutely.

Dr. Rick Hanson:  How do we weigh these different factors? Or yeah, yeah, exactly. And then optimize using base theorem or whatever. Update our priors about what would be the best possible course for a particular individual given what we know about the population in general.

H2 –  Dr. Hanson’s Approach to Happiness

Chris Kresser:  Fascinating. I’m always really interested to learn about people’s journey and how they arrived where they are now. And we’re going to talk about all of these topics in a lot more detail as we go through the show. But maybe just from a 30,000-foot view, you outline the triangle of contemplative practice in clinical psychology and neuroscience, and in particular neuroplasticity. Can you give the listeners just an overview of how each of these perspectives informs your approach to developing resilience and what you’ve called “hardwiring happiness”?

Dr. Rick Hanson:  Thank you. So, I worked backwards. I’m a methods guy, I’m a clinician like you. I’m in the trenches. I’m deeply interested in the science and even the philosophy of it all. But I’m really most focused on practical application. So, as a methods person, you see a problem, let’s say. As you know, there’s this fundamental model in healthcare and psychology too, the stress diathesis model, in which basically a person’s course, for better or worse, is a function of three factors:

  • Challenges,
  • Vulnerabilities, and
  • Resources.

And the greater the challenges and the greater the vulnerabilities that a person has, psychologically, physically, or environmentally, the more important it is to grow resources inside the body, out in the world, and in particular in my case, inside the mind. So, I’ve summarized a lot of stuff right there. So, I worked backwards from the problem—where does it hurt?—and then focus on what resources, especially psychological, mental resources, because I’m a psychologist, I’m a software guy. What psychological resources would be most useful to develop for this person, for this issue, at this time? And psychological resources like grit, gratitude, mindfulness, self-compassion, self-confidence, skillfulness of various kinds, motivation, etc., etc., those resources have a particular power because one, we can always be developing them. We can always be growing things inside our own minds, and second, we take the fruits of our efforts with us wherever we go.

Chris Kresser:  Right.

Dr. Rick Hanson:  So, resources, right? And then how do you grow those resources? You want to jump in here?

Chris Kresser:  Well, yeah, I might add that to me that’s a really useful framework because we have varying levels of control over each of those factors, right?

Dr. Rick Hanson:  Correct.

Chris Kresser:  We don’t always have control over what the challenges are. Especially the modern world. I find that … Sorry, that’s my seven-year-old. It’s the summer, so she’s banging around upstairs.

Dr. Rick Hanson:  Oh, great. I spent a lot of time working with kids, by the way.

Chris Kresser:  Yeah, this is a summertime podcast reality here in my home office. So, my listeners are used to it. Yeah, so I was saying with challenges being one of those three variables in the modern world, it seems to me that we have a growing number of challenges that are often outside of individual control. So, for example, if someone is living in an area with significant amounts of air pollution, they may not be able to directly influence that. Or if they move into a house with mold.

Dr. Rick Hanson:  Yes.

Chris Kresser:  Which is something you and I were both chatting about before we started recording, there is some level of control over that. But depending on someone’s socioeconomic circumstances and whether they’re renting or owning, there may not be full control over that. The influence of technology and maybe someone has a job where they’re forced to, not forced, but where they have to work with technology, and that impacts our brains, and then vulnerability.

People of varying, again, if someone’s living in poverty and they don’t have access to healthy food, that’s going to make them vulnerable to illness in a way that they can’t immediately change. So, I love that framework because it makes it even more clear how important it is. Like, developing resources is the one thing of those three variables that we have the most control over.

Dr. Rick Hanson:  You are wonderfully accurate, and I would add even that inside the resources category, without speaking against the importance of growing resources out in the world, right? Everything from fixing a dripping faucet to getting your neighbor to control their dogs so they don’t keep barking all night and keeping you awake, let alone building a universal healthcare system, let’s say, in your country. And also, you need to build resources in your body, which I have enormous respect for the work you do, Chris.

Chris Kresser:  Thank you.

Dr. Rick Hanson:  And also, people in this territory, my wife included, frankly. And it’s really important to do what you can with the hardware, right? With the body. That said, it’s so often slow to grow resources out in the world, and the body takes a while. And then as you age, you just sort of slowly break down. I’m getting toward the last third or so of my life. But in your mind, you can always keep developing things there.

Chris Kresser:  Yes.

Dr. Rick Hanson:  In your own psyche. So yeah, so anyway, so I got very interested in resources in the mind as a key factor, as you say, not against any of those other things. It’s not either/or, put a field of opportunity. So, then the practical question is how you grow the good inside yourself of every kind.

Chris Kresser:  Yeah.

Dr. Rick Hanson:  Growing the good of healing and growing the good of cultivation and development. That takes us into a word you used earlier, neuroplasticity, as you know, the capacity of the nervous system to be changed by our experiences. And so, if we’re going to develop a resource like self-compassion or grit or, let’s say, happiness in the midst of our difficulties, fundamentally we need to change the body. Otherwise there’s no lasting shift from state to trait. And that’s been very much my focus.

How do you actually shift from experiences of one kind or another, which are impermanent and come and go, how do you help them leave lasting physical traces behind, endurable changes of neural structure and function? Thus, hardwired, as you said earlier, into your own body. How do you turn experiences of gratitude into trait gratitude? How do you turn experiences of self-worth in trait self-worth?

So that’s been very, very much my focus. And that has taken me into a deep dive and into how a neuroplastic change occurs in the nervous system and in particular, how our engagement with the experiences that we’re having as they’re occurring, how we protect them and sustain them and embody them and absorb them and focus on what’s rewarding about them and other factors in our relationships with the experiences that we’re having. How that can super turbocharge the growth process and really steep in your growth curve through life.

How Neuroplasticity Works inside the Brain

Chris Kresser:  I want to dive a little deeper into the science here. Not perhaps too deeply, because … I sometimes have to catch myself because I love to geek out on this stuff.

Dr. Rick Hanson:  Yeah.

Chris Kresser:  And I’m sure you do. But I think this is quite a revolutionary concept for some people who are not familiar with it. And I’ve talked quite a bit about neuroplasticity on the show, and I’ve had other guests on to discuss it. But to me it’s just a paradigm shift in our understanding of how we can cultivate happiness and relieve things like depression and anxiety. And this shift from believing that we have to control and change our circumstances to, as you put it, cultivating our inner resources so that we can maintain these states, not regardless of the circumstances.

It’s not like circumstances won’t affect us in some way. But that we’re not subject to the, completely to the whims of life and we have some ability to actually hardwire, to use your term, happiness into the brain. So just from a neuroscience perspective, can you tell us a little bit about how this actually works in the brain? How does neuroplasticity work and how is this different than our prior understanding of states like depression and the qualities like happiness?

Dr. Rick Hanson:  Right. Well I would say we’ve all experienced neuroplasticity from the inside out in the experiences we’ve had of healing, growing, learning, developing, changing for the better in any way. From crawling to walking. Walking to driving a car. Learning how to be more effective in business meetings. Learning how to be more patient.

Let’s say with your seven-year-old, or in my case, my 31- and 28-year-olds, that’s learning. That’s change. And if there’s any kind of psychological change, any kind of mental change, there must have also been some underlying physical change. Otherwise you’re left with magic. Now, I do believe in magic, and kind of outside the natural frame, the territory, the supernatural and the transcendental, but staying inside the natural frame, where I think most of the action is, at least, perhaps, all of the action. Inside the natural frame, the brain had to change for the kid to learn to walk instead of crawl or the adult to learn how to be more patient with in-laws over the holidays. What’s breaking news, though, is the vast number of mechanisms whereby those neuroplastic changes occur. And that’s where the paradigm shift, I think, is exactly right that you’re saying.

I think a wonderful summary phrase for this is given in the same from the work of the Canadian psychologist Donald Hebb, who did groundbreaking work in the 1940s and 1950s, “Neurons that fire together, wire together.” In other words, repeated and sustained patterns of neural mental activation co-occurring together leave lasting physical changes behind in neural structure and function. The mechanisms of this are very physical and they, to summarize a handful, include new connections forming between neurons.

Right now, people, listening inside your head, ballpark, are about 200 billion cells, roughly half of which are neurons. The other half are support cells. The neurons, let’s say, 85 to 100 billion or so on average, are making several thousand connections with each other, which gives us several hundred trillion synapses, those little microprocessors between each of the neurons inside our head right now. It’s an extraordinarily complex organ. And so, if you want to improve your psychological resources, that means changing the brain. So, one way that happens, as I said, is neurons start forming new connections with each other. Also, existing connections become weakened or strengthened.

There are also ebbs and flows of neurotransmitters like serotonin or dopamine or GABA or norepinephrine. And also, you have different coordinated activity between different regions of the brain that form functional connections more effectively together. For example, the prefrontal cortex right behind the forehead becomes more able to calm down or regulate the alarm bell of the brain, the amygdala. So, this process is really occurring. It’s biased negatively. That’s the negativity bias of the brain. I say gives us a brand like Velcro for bad experiences, but Teflon for good ones.

On the other hand, to finish, we can help the process occur of positive neuroplasticity, positive neuroplastic change, by helping our experiences when they’re beneficial to us. When they’re useful, authentic, useful, usually enjoyable experiences. We can help them leave more change behind in a variety of ways. One of the fundamental key ways to do it is to help them keep firing together rather than scurrying on to the next experience when something useful is occurring. Slow down for a breath or two, or longer, to help it really sink in.

The Negativity Bias

Chris Kresser:  I think this is, I’d love to talk a little bit more about the negativity bias. In my work, we look at things through the ancestral lens very often, whether we’re looking at what the right diet is for humans or sleep patterns or physical activity. And the negativity bias is another thing that we can look at through an ancestral lens. I think it’s really interesting when people first learn about this because on the surface, why would it make sense for us not to, to enjoy and cultivate positive experiences? Why do you have to work hard to do that? It seems sort of counterintuitive unless you understand this ancestral perspective, that the negativity bias actually served us in a natural environment. So, can you say more, a little bit about that and how it predisposes us to things like depression and anxiety?

Dr. Rick Hanson:  Oh, yeah. I think your framing is wonderfully correct, and I find myself, like, for example, right now I live in Northern California on the edge of open space. And I’m looking out into the open space on the other side of my backyard. And I know that 3,000 years ago native people were walking through this land. And it’s really useful to realize that our natural template, as you say, the ancestral template is a hunter–gatherer band.

Humans, anatomically modern, have lived for around 300,000 years. And then another two million or so years before that our ancestors, hominid ancestors, who could manufacture tools, they used tools to make tools, were also walking around in small bands, and their ancestors before that. So, to me, that’s really the frame of reference through which to look at the utterly artificial and constructed modern lives we have. Which have many wonderful features, including the capacity to have a podcast, right? Or I’m a fan of, let’s say, ESPN or refrigerators. I’m okay with all of that.

Chris Kresser:  Yeah.

Dr. Rick Hanson:  On the other hand, even though I love wilderness and I spend a lot of time there. So that’s the lens. So, to cut to the chase, if you imagine our ancestors, they basically had two missions, get carrots and avoid sticks. Carrots like food, sticks like predators and aggression inside their bands. Well, they both were important. But if you don’t get a carrot today, you’ll have a chance for one tomorrow. If you fail to avoid that stick today, no more carrots forever. So negative experiences from a survival standpoint over the 600-million-year evolution of the nervous system, have more urgency and impact typically than positive experiences do.

So today we have a brain—and I could go into the detail of it all—I’ll do it real fast here. You can watch your own mind doing this. It does five things automatically.

  • One, looks for bad news out in the world, in the body, in the mind.
  • Two, when it finds it, when it finds that one tile in the mosaic of reality flashing red, it overfocuses upon it.
  • Three, overreacts to it. Lots of evidence that people react more to pain than pleasure, more to loss than to gain.
  • Fourth, the whole package is fast-tracked into memory, especially somatic memory, emotional memory, body memory. The residues of lived experience sinking into us. Once burned, twice shy.
  • And then fifth, the stress hormone cortisol that’s released when we’re stressed or irritated, frazzled, pressured, lonely or blue, that goes up into the brain, crosses the blood–brain barrier and turbocharges the amygdala.

So now that alarm bell rings more readily, and cortisol weakens the nearby part of the brain, the hippocampus, that calms down the amygdala, puts things in context, and tells the hypothalamus to quit calling for stress hormones. This creates a vicious cycle. Stress today makes us just a little more vulnerable to stress tomorrow, which increases the stress tomorrow, which then makes us even more vulnerable for the day after that. That’s the negativity bias in a nutshell.

Chris Kresser:  Right. And the thing that’s always fun for me to think about is, like, if your ancestor didn’t have that bias, they probably didn’t survive to pass on their genes.

Dr. Rick Hanson:  Oh yeah.

Chris Kresser:  Yeah.

Dr. Rick Hanson:  The ones who were cranky and paranoid.

Chris Kresser:  Exactly, exactly.

Dr. Rick Hanson:  They had grandchildren.

Chris Kresser:  They’re our distant ancestors.

Dr. Rick Hanson:  That’s right.

Chris Kresser:  Because in a natural environment where things are trying to kill us, often having that kind of negativity bias and also, I talk about this in the context of technology addiction, a tendency for distractibility.

Dr. Rick Hanson:  Yep.

Chris Kresser:  Constantly scanning the periphery and being able to shift your attention quickly to something else, that would serve us in a natural, hostile, natural environment. But in our modern environment it’s a prescription for depression and anxiety and also technology addiction. Because our focus can be so easily hijacked, especially when you have technology companies that employ brain hackers that understand all of this and actually purposely design their technology to exploit those human vulnerabilities. But that’s another topic.

Dr. Rick Hanson:  But very important. So, can I say something practical about this?

Chris Kresser:  Please, please do.

The Power of Acceptance

Dr. Rick Hanson:  Okay, great. So, three things. First, there’s nothing in what we’re talking about here that’s about positive thinking or suppressing or resisting what’s painful and difficult. In other words, whether it’s driven by the negativity bias or not, when we’re feeling anxious or physical pain or hurt or sad, whatever it might be, the first and foremost thing is to be with it. Is to be with it mindfully, hopefully, stepping back from it a bit. Hopefully relating to it with self-compassion and acceptance. But most fundamentally we be with it.

That’s the foundational practice. But that’s not the only practice. And I think sometimes people get stuck in a kind of passive, receptive, be-with-it orientation to their own experience. And even sometimes think that that’s the only form of spiritual or contemplative or psychological practice. We also need to be able to let go. We need to be able to disengage from the “negative material” in our mind and not feed or follow it. Suzuki Roshi had this great line, said, “Yeah, well let the sadness, let the anger, let the thoughts come into your mind, but don’t offer them tea.”

Chris Kresser:  Yeah, I love that one.

Dr. Rick Hanson:  Tea and cookies, probably.

Chris Kresser:  Yeah.

Dr. Rick Hanson:  Yeah. So, don’t ruminate, as best you can. As soon as you watch your mind getting caught up in resentment or rehashing conversations, or in my case, writing emails in your mind at three in the morning, you know, pull out. Just don’t feed it or follow it. And then third, when you are having opportunities to experience something beneficial, that’s authentic and real, not chasing positive experiences, but appreciating beneficial ones when they occur, a moment of feeling strong inside, a moment of letting go, a moment of feeling cared about by other people, a moment, let’s say, of recognizing how to be more skillful with your partner or your kid or your boss. Whenever it might be, slowing it down to help your brain actually convert that passing experience, that momentary state, to some kind of lasting change in neural structure and function. And when you do this is you gradually fill yourself up and you grow what I called the unshakable core of resilient well-being, hardwired into your own body. As you do fill yourself up in these ways, craving diminishes. Because if you think about it, craving, probably defined, is a drive state based on an underlying felt sense of something missing and something longed.

But when you repeatedly internalize the felt sense of needs sufficiently met, enough safety or satisfaction or connection in the moment, and as you grow in a growing sense of peace, contentment, and love inside yourself, then you’re a lot harder to manipulate by advertisers and fearmongers and those who would try to breed us against them grievances and rivalries. And so, to me, that’s the essence of the process.

You can see a lot more about it on my website. I have tons of freely offered meditations, scientific papers, slide sets, talks, all kinds of good stuff there. But the essence is really simple. Have it, enjoy it. When you have the beneficial experience, don’t waste it on your brain. Stay with it for a breath or longer. Feel it in your body and focus on what’s rewarding about it. And in that way, bit by bit, synapse by synapse, you’ll be growing the good inside yourself.

Chris Kresser:  This is such fertile ground, and I can, my own experience with chronic illness, and then having a teacher, Darlene Cohen, who we were chatting about a little before the show, who had severe chronic illness for most of her life, and a lot of her practice was oriented around how to be with that. How to be with challenge and pain and difficulty and how to transform that into happiness and joy. And for me, I really love the framework that you introduced there because what I learned in my own experience with chronic illness and my practice with Darlene is that acceptance is not the same as submission.

Dr. Rick Hanson:  Right.

Chris Kresser:  People often confuse, we have a tendency to confuse those two things. Like, acceptance is giving up. If I accept something, it means that I can never change it and I’m just stuck with it. But really, acceptance is the necessary precondition to responding in an appropriate way. So, for me, it was like really coming to terms with, “Okay, this is happening. I don’t like it. I’m in my mid-20s. I would prefer not to have this severe chronic illness. I would prefer to be living my life as I thought it would unfold. But this is actually happening now. And I’m accepting that it’s happening.” And fully letting that in was the first step for me in being able to actually start moving to that second stage that you outlined.

Dr. Rick Hanson:  Right.

Chris Kresser:  And making the changes that were necessary to be able to be with it in a more productive way and to start making those shifts in my brain and in my body. And then in my practice with Darlene, her really major focus of her practice was being fully sinking into those moments of pleasure, even of the very small pleasures in life that she was able to have, because she was in so much pain for so much of the time. Just feeling the sun on your arm as it rests on the open window of the car as you’re driving. Or feeling that feeling of the wind against your skin as you sit outside. Or having the tea in the morning, that first sip, and really fully experiencing those things was like, really for her because of the extent of her pain, it was a lifesaving and life-enhancing approach.

And so, what’s interesting to me about this is that that’s all amplified in a situation like Darlene’s, where she was in so much pain and so much difficulty, but we all have pain. It may not be to that extent, but we all spend so much time trying to avoid the pain that we have and then skipping over those moments of joy and happiness because of this negativity bias. So, it’s so profound and I’m so grateful for the work you’re doing in this area, because it’s really, for me, has been the thing that has transformed my life more than anything, everything that we’re talking about today.

Dr. Rick Hanson:  That’s really beautiful, and I would, if I could just say two things quickly about related to what you’re saying. First, it’s so ironic isn’t it, that our ostensibly hedonistic culture, pleasure-seeking Western cultures, is more like the hell realm of the hungry ghosts.

Chris Kresser:  Yeah.

Dr. Rick Hanson: Yeah, you see people. They’re chasing pleasure and yet they’re actually not experiencing it when it lands. First point. And second point, I want to really emphasize that when we’re talking about growing mental resources to deal with our challenges and vulnerabilities, a small fraction of that is smelling the roses along the way. That’s an important part.

Feeling the pleasure, let’s say of the sun on your arm as you’re sitting in the car. That’s crucially important and it’s especially important if we’re in chronic pain, because positive emotions and wholesome pleasures are analgesic, including the feeling of being loved and supported by other people. Very, very important. But most of what I think the opportunity is in terms of growing psychological resources is to experience a resource like understanding how to be more skillful with your wife. I’m speaking to myself personally here.

Or learning how to disengage from outrage about politics and find that sweet spot where you’re strong about what’s going on, but you don’t feel overwhelmed and preoccupied and burdened.

Chris Kresser:  Yeah.

Dr. Rick Hanson:  Or yeah, or maybe in the subtle way you’re meditating, and you realize, “Oh, I can open even one step further in the letting go in impermanence, and it’s all right.” Whatever it might be. Those are really, really, really lots of the opportunities for growing resources inside ourselves. Not just ones that are flagged by kind of the ordinary pleasures of life. Not that there’s anything wrong with those.

Chris Kresser:  Yeah. And again, returning to the evolutionary perspective, so much of this for me comes down to a mismatch. We have hardware and software that was designed for a particular environment. And now that environment has changed pretty much beyond recognition. If you took one of our hunter–gatherer ancestors and dropped them into the San Francisco Bay area here in 2019, it would just be, they would feel like they had been transported to another planet.

Dr. Rick Hanson:  I’ve got to say that my kind of science-fiction mind thinks about transporting a Neanderthal shaman into the passenger seat of my car.

Chris Kresser:  Right.

Dr. Rick Hanson:  So suddenly, let’s say it’s a man. That guy has shifted from, let’s say, 40,000 years ago in southern France, whoosh into my car.

Chris Kresser:  Your car.

Dr. Rick Hanson:  Oh yeah, it would be almost …

Chris Kresser:  Or the top of the new Salesforce Tower in San Francisco or something. I mean what the heck. Like, it’s so bizarre, and I think we’re like the frogs in the boiling water. This is the only reality that we’ve known. And it’s the body and the mind that we have, so we don’t recognize how significant that mismatch is. And in the case of, for example, our negativity bias, I think it’s really easy for us to just assume that the negative thoughts that we have or the negative perceptions that we have or the bad things that happen are more real than the good things.

Dr. Rick Hanson:  Yeah.

Chris Kresser:  Because they feel that way to us and we don’t recognize that that feeling is actually something very biological. It’s hardwired and it’s part of our evolutionary programming. And for me, like, learning that and really understanding the biomechanics makes it less personal and takes it out of the realm of “This is an individual weakness or failing” to, “Wow, this is some hardwired biological programming that I actually have to work to overcome in order to feel the way I want to feel and accomplish the goals that I have.”

Dr. Rick Hanson:  Yeah.

Chris Kresser:  It’s a really big shift.

Dr. Rick Hanson:  It is really, and I like the teaching that it’s not our fault, but it is our responsibility to deal with.

Chris Kresser:  Right. “Response, ability.” That word, when you break it down, it really makes it clear. Like we have the ability to respond here. That’s all that that means.

The Mind–Body Connection

Dr. Rick Hanson:  You must deal with this, Chris, in your own work. I’m just thinking that. I see this. People who have at bottom physiological issue inside their bodies, let’s say an immune system issue or something, or something, let’s say, in their G.I. system. And the body goes into understandable alarm about it.

Chris Kresser:  Yeah.

Dr. Rick Hanson:  Here are all these systems in the body that are monitoring states and then shifting into alarm when they go out of range and equilibriums shift into a place that’s not good.

Chris Kresser:  Yeah.

Dr. Rick Hanson:  So bubbling up, basically, from bottom up, these alarm signals that are really about the body come into the mind, and then people start looking for something outside themselves for an explanation as to why they feel anxious or their mood has slumped or they feel irritable. But really the fundamental source of that is physiological inside their own body.

Chris Kresser:  Right. And then it becomes also, there’s the vicious cycle of the chicken and egg, because that alarm response can then tend to produce more physiological symptoms or exacerbate the ones that started it in the first place. And, I mean, that’s where my interest has gone recently. I had, I’m not sure if you’re familiar with DNRS, or the dynamic neural retraining system.

Dr. Rick Hanson:  Yeah.

Chris Kresser:  Annie Hopper, I had her on the show recently, and I’m fascinated by that approach because it’s using the techniques that we’ve been talking about today of neuroplasticity to rewire the brain and change gene expression, which then in turn can actually shift those physiological patterns, even if the trigger of those patterns in the body was not initially something going on in the mind. And that’s where it gets really interesting because we can use these techniques not only to change our mind and our mental state, but actually to physically change our body.

Dr. Rick Hanson:  Oh yeah. The flows of causality really go in both directions. In a sense, the example I was giving—and I’ve seen this with a lot of people—is that they overinterpret their body sensations, understandably, and they look outside themselves, or they blame themselves for the slump in mood or the sense of alarm or uneasiness or contraction.

Chris Kresser:  Right.

Dr. Rick Hanson:  And it’s really useful to kind of look at it, as you were saying, in a much more impersonal way. It is a body. It’s not me. I’ve got to deal with it, but it doesn’t mean necessarily that, let’s say, my partner is a jerk, just because I’m irritable. I’m irritable because my body is irritated by something, for example.

Chris Kresser:  Yeah.

Dr. Rick Hanson:  That was really helpful. And in the same way, to realize that you have the power to rest your state of being repeatedly and authentically over the day in ways that are calming and soothing psychologically and happy psychologically. And because we’re so social, such profoundly social primates, mammals feeling loving and loved.

As we rest there, that really does, as you know, affect gene expression, and it really does exert regulatory influence over our internal physiological systems in ways that are really, really, really far reaching. And I find for myself that there’s a lot of old-school appreciation here for self-reliance.

Chris Kresser:  Yeah.

Dr. Rick Hanson:  For doing what you can every day and taking responsibility for doing what you can inside your own mind every day, which will then feed into your body and help it as well.

Chris Kresser:  Yeah. This is really where my attention has been over the past year, I would say, is in this cyclical and circular relationship between these rather artificial categories that we’ve come up with, of body and mind. Even to, I think we struggle with our language, even to talk about this because we talk about there is the body, as if there is a body that’s apart from the mind.

Dr. Rick Hanson:  Yes.

Chris Kresser:  And a mind as if there’s a mind apart from the body, which of course there isn’t. And if you look at traditional medicine, like Chinese medicine, which I studied, Ayurveda, they didn’t really even have in their medical terminology a way of talking about the body and the mind separately. But we often do that today. And you mentioned that the symptoms in the body can cause changes in mental state. And I certainly see that all the time.

I mean, using gastrointestinal problems as an example, it’s not unusual for us to treat someone for SIBO, bacterial overgrowth in the small intestine, or a parasite or something like that, and then they’ll come back and say, “Well, my gut’s a lot better, but also my anxiety is gone.”

Dr. Rick Hanson:  Yes.

Chris Kresser:  “I had no idea that this was connected, and I for years was thinking that there was, I was just an anxious person. And now I realize that had nothing to do with me as a person. It had to do with this parasite or whatever else.” And the flipside of that is, as you pointed out, if you spend more time in the parasympathetic state, which is the state that you’re likely to enter into when you’re more relaxed and at ease and you’re more present and you’re more accepting of what’s happening, then that causes a whole cascade of changes in the gut.

It creates a more hospitable environment for healthy bacteria, it improves peristalsis, the cleansing action wave of the gut. It helps release stomach acid and enzymes. There’s such a large body of research on how different nervous system states affect the gut because the gut is just one big nervous system, essentially. And all of that can actually promote a self-healing response that can lead, could potentially lead to the resolution of SIBO, and even a parasite infection. So that’s what’s really fascinating to me is we can choose these levers that lead to healing, even if those levers are not the source, or the same lever, that caused the problem in the first place.

Dr. Rick Hanson:  I think you’re exactly right, and how I kind of loosely think of it is that there are physical issues and mental issues. There are physical factors and mental factors that make things better. And the key takeaway here is that just because the issue is physical doesn’t mean only physical interventions could help it. Flipped the other way, just because something is mental, like anxiety or depression, an experience that a person is having, doesn’t mean that only mental factors can address it. And that goes to what you said in the very beginning, which is that, which I thought was so important that we have little influence over many things.

So, it’s really important to be able to look around for where we could have influence and then go to work there. Like, for example, frankly pragmatically I see people in therapy sometimes who they’re just not going to work with their mind very much, but you know, they’ll do something, they’ll start taking probiotics because that’s something concrete and physical they can do. And then, whoa, just like you said, lo and behold, they’re less anxious and cranky a few weeks later.

Chris Kresser:  Yeah, yeah.

Dr. Rick Hanson:  Fine. Then there are other people, I would love it if they would do a serious Functional Medicine protocol like you talk about, and they just don’t do it. On the other hand, they will do a gratitude practice every night before they go to sleep, where they’ll focus on three blessings, let’s say, that they had over the day. That’s their form of intervention.

Chris Kresser:  Yeah.

Dr. Rick Hanson:  And I love that fact that there’s so many different places where we can kind of pull the levers or push the buttons that can make things better.

Chris Kresser:  Yeah, there’s no right or wrong way. It’s according to your inclination. Many paths to the top of the mountain, right?

Dr. Rick Hanson:  Yeah, that’s right. There’s humility in it for me where first you have that kind of horrifying recognition that you’re really utterly dependent on so many processes. So many processes in your body, so many processes that extend out into nature. You’re so affected by biological evolution, even affected by culture and other people.

It’s almost alarming to realize how vulnerable we are interdependently to all these causes. But then in the next stage, you kind of accept that and you release into it, which itself relieves a lot of suffering because then you’re not really struggling against reality. You drop into, “Yeah, it is really like this.” And then after that, you start seeing that life as a field full of opportunity. Because much as we are interdependently affected by all these factors negatively, because of that fact, there are all these factors we can intervene in to help our lives be better.

Chris Kresser:  Yeah, yeah. We’re remarkably resilient as well as vulnerable.

Dr. Rick Hanson:  Yeah.

Seven Practices to Awaken Your Consciousness

Chris Kresser:  And I love that focus of your work. And tell us a little bit more. You mentioned resources before. I’ve read and loved Hardwiring Happiness and Resilient, your two most recent books. And then you have another book, I understand, that’s coming out. Tell us a little bit more about that, and then where can people go to learn more about this? You have some wonderful online classes and resources. I’d love to hear more about those.

Dr. Rick Hanson:  Well, the best place to find out about this is simply to go to my website, RickHanson.net. And you’re right, we’ve now developed a lot of online programs because that’s a wonderful way to reach a lot of people who can then engage these programs at their own pace and very affordably. So, I love online things. I mean for me, I think about, I don’t know. Honestly, the way I think about it is that someone in any part of the world in the middle of the night has an argument with their partner or is dealing with something and then can click a few links and boom, suddenly get access to a wealth of resources.

So, I have these great online programs of different kinds. People can check them out. One of the foundational ones is called The Foundations of Well-Being, and also most recently, going back to this neurodharma territory, if you will, I’ve pulled together the material for my next book, The Seven Fundamental Steps of Awakening that Are Grounded in the Body, that I taught in a retreat a year ago that we’ve now turned into an online program that we’re starting to offer. It’s called Neurodharma, The Deepest Roots of the Highest Happiness. And that material itself is fantastic, and it’s the basis for the next book I’m doing, which is coming out in May next year, and I’m thoroughly stoked about it.

My working title is Growth and Grace, A Neuropsychology of Awakening. And it pulls together seven of the most profound qualities of awakened consciousness that we can also find deep inside ourselves. I’ll just name them, actually, if I could. And that’s what the book’s about, including the underlying neuropsychology of this and how to use that information to turbocharge your own growth process. So, the seven practices are, and people can do them in their own lives right now. It’s just so amazing:

  1. Steady your mind
  2. Warm your heart
  3. Rest in fullness
  4. Be wholeness
  5. Receive nowness
  6. Open into allness
  7. Find timelessness

So, the book’s about that, the online program that we’re now offering, the Neurodharma, Deepest Roots of the Highest Happiness program, is about that. And I love the fact that on the foundation of the first three, steadiness of mind, warmth, lovingness of heart and equanimity and well-being together in resting and fullness, then you go out into the deep end of the pool: being wholeness, accepting yourself fully, being mindness of whole, really coming into the present moment, the front edge of now. Receiving nowness. Then opening out into everything with allness. And then the transcendental. The unconditioned. Finding timelessness. That’s really where a lot of grace is. Anyway, that’s the—

Chris Kresser:  Beautiful, we look forward to it.

Dr. Rick Hanson:  Yeah.

Chris Kresser:  And Dr. Rick Hanson, thank you so much for this conversation. It was a real pleasure, and I know my listeners are going to get a lot out of it. And definitely go check out Rick’s work. RickHanson.net, is that right?

Dr. Rick Hanson:  That’s right.

Chris Kresser:  Right. And I highly recommend his books and his online courses, and thank you again for doing the work that you’re doing. It’s so important and transformative.

Dr. Rick Hanson:  Well, Chris, really back at you. Your work is exemplary. I really mean that. And it’s an honor to be here. And I wish everyone listening the best.

Chris Kresser:  Thanks, Rick, take care.

What’s your approach to happiness, and what have you discovered during your journey to find it? Comment below and share your wisdom.





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Watch Live: SpaceX’s Dragon Set for Wednesday Resupply Mission


spacex dragon cargo
A SpaceX Dragon cargo craft on a resupply mission to the ISS. (Credit: NASA)

Just days after the three newest crew members arrived on the
International Space Station (ISS), SpaceX’s Dragon cargo capsule is set to launch
on a resupply mission.

At about 6:24 p.m. EDT on July 24, a Falcon 9 rocket with
the attached Dragon capsule are scheduled to blast off from the Space Launch
Complex at Cape Canaveral Air Force Base. Dragon is supposed to reach the ISS
for docking on Friday.

On this mission, Dragon will be delivering supplies, science investigations and the new International Docking Adapter. With this new docking adapter, other spacecraft created by Boeing and SpaceX, along with international spacecraft, will be able to dock at the ISS easier. This will be an asset in the future as the Commercial Crew Program starts coming into focus for the ISS.

As of right now, the conditions are only 30 percent
favorable for a launch on Wednesday, with possible lightning in the forecast,
according to NASA. The supply mission was originally planned to blast off on July
21 but was moved back over the weekend.

The last Dragon cargo mission docked at the ISS back in May. This particular capsule will be making its third trip, a first in private spaceflight, as the spacecraft already reached orbit in 2015 and 2017. SpaceX is aiming to launch a crewed version of Dragon by the end of 2019.

This next launch is also happening on the 50th anniversary of Apollo 11’s splashdown.

NASA TV will broadcast the launch beginning with a press conference at 10 a.m. EDT.



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Home Remedies for Hives — Dr. Group’s Natural Recommendations


Hives are never an easy condition to deal with. It’s a rash that can appear anywhere on your body and is usually triggered by an allergic reaction from a number of things like stress, foods, and even medications. Regardless of your situation, hives are a huge inconvenience.

To complicate the situation, the number one remedy for hives is identifying the root cause of your allergic reaction, but the potential causes seem endless. Not to mention, there are home remedies and you start to wonder which natural approach is the most effective?

Watch below or read on to learn some of the top causes and remedies we recommend for your hives.