WeAreLupus.org - The Social Support Network for People Living with Lupus & Fibromyalgia

maria

Not sure what's wrong tonight - text won't enter unless I type in.  I have a response about the first chapter and I'll try getting it tomorrow.  Hopefully, things will be working better.

Talk soon!  Chapters 2,3 and 4 by this Saturday the 10th.  I'll be posting on the 11th.  Remember to keep in mind how you manage your lupus as you're reading this book - it is about our intuition and the importance of utilizing this natural human process, and what better way to use it than to apply it to our own health?! 

28 months ago

maria

So this month’s book has to do with intuition – our “Gut Feelings”.  I chose this book mainly because I know how important my instincts are to me, especially when it comes to managing my lupus.  Actually, my intuition has been a strong influence in my life as a whole – who knows me better than myself?

 

I’ve questioned, though, my reliance on this sixth sense in making important decisions.  Where is that line where my judgment may NOT be as beneficial or benign as I think it is?  What if I’m working with some bad information, inaccurate perceptions or negative self-esteem?  How will I know?

 

At this point, I’ve read the first chapter and have decided that I like his writing – even though I did get bogged down with some of the details.  I suspect that could be because I was only half paying attention and trying to also carry on a conversation.

 

In this opening chapter, he offers up his definition or view of what gut feelings or intuition is (pg 16) – “...a judgment 1. that appears quickly in consciousness, 2. whose underlying reasons we are not fully aware of, and 3.  is strong enough to act upon.”  This ‘sense’ isn’t necessarily an impulsive action, but really does have some underlying reason.  In fact, it is his opinion that “more information, even more thinking, is not always better and less can be more.

 

As a person seeking to find some sense of control in her health and life, I tend to think things straight into the ground, placing them right next to where my bad mood is sitting after realizing I can’t really control anything.  Gigerenzer mentions the differences between “maximizers” (those who kill themselves to be the best, perfectionists) and “satisficers” (those who settle relatively quickly and are okay with ‘good enough’), which I can definitely identify with.  All my thinking, list making, blog hopping, researching, endless podcasts and awareness events...get me only to the next moment where I feel just as clueless as I was a minute ago.  At one point, I’m wondering if I’m practicing ‘intelligent’ and professional self-care as I breeze through a good day or ‘dysfunctional’ emotional self-flagellation when a flare finally occurs. The maximizers, as explained by the author are the ones who end up with more depression, regret and self-blame – as I do after a day at the computer searching.  Those who limit their searches for anything (here, it would be lupus info), choose an alternative and move forward report higher self-esteem and life satisfaction.  That’s so true for me -I get caught up into trying to know it all, do it all, and reap great benefits from it all...only to feel best when I have consulted myself and what I really think or feel is best.

 

He discusses how he thinks our “gut feelings” work – two components of “1) simple rules of thumb” (his example of the gaze heuristic and catching a fly ball was dead on for me in managing lupus) “, which take advantage of 2) evolved capacities of the brain ” (our human capabilities that become capacities through a great deal of practice).

 

How much do we ignore our own instincts when it comes to managing our lupus?  How many times have we heard doctors, friends and family give us advice as to what we should do to take care of ourselves – only to know deep down what we really feel we need?  Do we act on those feelings or instincts – or do we doubt them and their value? 

 

Just as logic has dominated Western thinking in general, so, too, has it been an obstacle for us all in the healthcare industry.  The use of holistic or alternative methods of managing our health has been ridiculed or ignored, only to discover some actual benefits in which the traditional medicine has been unable to fully answer.  Granted, all forms of treatment need to be weighed very carefully and all contributors or team members need to have a complete understanding of what the other is contributing.  However, the key in all treatments is our own understanding and faith in ourselves as being a full partner in our our own treatment plans.  That may include relying on information derived from those gut feelings of ours.

 

I’m hoping this book either helps me relax and more fully trust my intuition (that hasn’t yet let me down) - or gives me a better understanding about where it all stems from so that I can take a clearer look at it and confirm for myself (and others) that this process of sensing is a naturally human one with more behind it than it would seem.

 

Let’s get through to Chapter 4 by this Sunday (October 10^th).    Hope you guys will jump in with your own “a-ha!s” or “no-ways!) here –and in this case, less isn’t more.

27 months ago

maria

Today brought us through Chapter Four of Gigerenzer's book Gut Feelings.

 

In the second chapter, he covers how our memories have limitations on the amount of information we generally can store. This really rang a bell for me, as I have been trying to figure out whether my frustrations on not remembering things were lupus or simply age-related.

 

I had already known about our limitations, but it wasn't until I read this chapter did I put together the fact that it may not be simply my lack of focus or need to multi-task that causes me to forget half of what I set out to do (although I'm sure they both do factor into my mess).  When I wake up in the morning, I am already way beyond the seven to ten items that I listed to do that day.  I'm starting out my day climbing out of bed and immediately losing track of the items on my list with every step I take towards my first cup of coffee!

 

When I was younger, I know I had things to do and I had the energy to usually get them done.  Now that I'm older and have less energy, I am dealing with a list of to-do's that reflect my lack of accomplishing half my list from the day before, adding it all to a new list of things to do - and knowing that every new candle on my birthday cake signifies time is going by faster than ever.

 

This is where his discussion about the speed-accuracy trade off (pg. 33).  Up to this point, he has talked about the difficulties and complications we face when we have burdened ourselves with too many options, products, scenarios...and, in my own morning ritual, to-dos.  This trade off principle is about bringing up or doing something that occurs immediately in our thinking and going with it, rather than taking too much time and spending too much energy on weighing the options.  In his example, research showed that the novice golfers did do better by taking things more slowly and concentrating more on their technique, which led to better performances.  However, once the skill or techniques had become more developed - or the golfers were more at a more expert level in their game, the concentration and time caused poorer outcomes.  We develop skills that become more hidden and automatically get applied without us having to really think about it.  If we do concentrate or think too much about what we're doing, our 'performances' - or in my case, task accomplishments - our interfered with.

 

I'm late in putting this post up because I took this point perhaps a little too far tonight and allowed myself some distraction to occur.  I worked all day on other projects for clients and began to panic because I had forgotten what I had read earlier this week for this group.  When I finished those projects, I stepped away from the computer and busied myself with other things and noticed that the panicked feelings gave way to some of the reading material returning back.  The panic and searching did work against me in remembering, meanwhile the distraction allowed my brain to focus on reflecting on what had already been developed with much less effort.  He focuses on motor skills - physical actions that are developed through practicing so did my experience with my thinking really work in the same way?  I think it does, because even though I was doing things physically during my distraction, I was still focusing on what I was thinking - but it was different stuff and didn't compete with each other.  Thinking about all the things on my list to do or notes I took was too much information about the same thing...thinking about cooking dinner and what I read didn't compete.  At least, this is how I see it.

 

This can easily apply to how we work with our lupus, right?  We can research, focus on every symptom, obsess about nutrition, appointments or medications to the point of, perhaps, causing our own 'lupus managing performances' to go way down simply because we are overloading our capacities to process what is going on.  When first starting out, should we encourage newly diagnosed patients to take time, focus and think about technique as it may improve their daily 'performance' in adapting?  For us veterans, would it be more beneficial for us to spend less time concentrating on the techniques, lupus information or articles, medical terminology and other coping skills we've already developed in managing our lupus and allow a little more time in our days on experiencing distraction?  Are our flares that occur when we are really stressed out, then, be our body's way of letting us know that we've blocked our ability to simply do what we know - either physically, emotionally or cognitively - thereby leading to our poor health performance?

 

In Chapter Three, he goes into more detail of how our intuition is best when information is ignored.  Our gut feelings are based on things we pick up from cues in our environments that operate at levels we can sometimes find ourselves unaware of how we 'fill in the blanks'.(Figure 3-2 on page 43 is an excellent example of that).  This point about our environment is an important one when it comes to living both within our own personal environments (our bodies) and the environments we share with others like family, friends, employers and society,  in general.  His tit-for-tat example was a good one for me to read as I find myself trying to carry all of my past lupus 'episodes' into every new physical symptom.  Even though they aren't always lupus symptoms, the diagnostic 'flow-chart' I use when they occur goes much more smoothly if I don't get caught up into too much detail and just go with what I know.  Before I was diagnosed, I did the tit-for-two tat thing to the point of nearly losing everything.  I made excuses for people, weight loss/gain, doctor behaviors, and so forth thinking that it was all a fluke the first few occurrences.  What I should've done is to respond immediately to the situation, then let it go without carrying the fear of my situation into every single one that might be lupus-related. What I gain from every lupus flare or problem is 'in' me - I don't have to dwell on details because I now know them innately, without thinking too much about it.  When something isn't right, I will know it - no sense in trying to create it.

 

This knowing is what his fourth chapter discusses - and he even uses a familiar chronic illness analogy...a toolbox.  He describes the evolved capacities in his 'adaptive toolbox' just as we use the word 'adjustment' in living with lupus.  The "building blocks", which he states are the second element to be found in these toolboxes, are the 'coping skills' in our c.i. toolboxes.  Over time, we develop potential - in dealing with an alarm, in dealing with traffic, in dealing with an overflowing toilet, and in dealing with lupus.  All of these examples, and so many more, are stress inducers that require quick 'reflexes' to lead to the best possible result: stabilizing things.  With every experience in applying these building blocks creates a new rule of thumb (third element in the toolbox) to be used in gaging our steps, strengthening our applications and improving our potential -  all leading to better results over time.

 

So, learning more about how deeply-rooted our intuition, whether you're a female or male, can be leads me to wonder how many of you utilize yours?  Is your intuitive sense of your health accepted by others such as family or your medical practitioners?  Do you spend time analyzing and second guessing those thoughts?  Does reading this book about how limiting the over analysis can be in getting you the best possible results?

 

What are your thoughts on what we've read so far?  Is it too much information just getting through the chapter or are you picking up some things as you go that you can see may help you in your lupus management - even if you don't quite get the scientific detail?

 

If you're not reading the book, but following the discussion, what are your thoughts on the value, your reliance on or experiences with your own gut feelings?

27 months ago

maria

Well, Chapter Five was a blur for me and Chapter Six ended up bringing back some nightmares about my undergraduate logic classes that I bombed.

 

It didn’t help that math wasn’t my forte and then when that same method is applied to logic – just as it is described in this book– was just the thing to put me over the edge. I knew during those classes that logic wasn’t for me and I honestly felt very stupid. Now, after reading what he has to say about how gut feelings or “good intuition” take information and steps “beyond logic” in order to offer us much more, I feel better about those grades and my natural 'instinct' to want to trust my gut.

 

These two chapters finished up discussing how Gigerenzer defines intuition or gut feelings and the processes behind how they form. Reading through it – slowly - I couldn’t help but make parallels between my intuition and lupus. A friend of mine tells me I can get pretty abstract and, in this case, it may be true – please bear with me.

 

My immune system acts independent of my conscious thinking and seems to second guess or be unable to identify what is ‘host’ or ‘good’ and what is ‘foreign’ or a ‘threat’. My intuition operates the same way – I’ll get an ‘inkling’ and then spend way too much time second guessing myself or ignoring it. Ultimately, both my immune system and I seem to do more harm to myself when ‘things’ are ignored.

 

And, just as it is with learning about lupus or health management, Gigerenzer mentions that “...intelligence has to operate in an uncertain world...and needs to go beyond information given.” (Pg. 95) No matter how much information we take in or structure we give it all, this automatic processing of our self-created “rules of thumb”, perspectives and environments still mold our thoughts into a bigger picture with more to draw from than “just the facts, m’am”. The trick is to learn to take that gut instinct a little more seriously.

 

That is what intuition is actually trying to do – it’s putting together a bunch of tidbits that form into a more valuable option for action or understanding, and we need to recognize that it all comes from a source we need to learn to trust...ourselves. Not to say that the bits of information are always accurate, healthy or logical, but to ignore the contribution completely may actually do us more harm than simply considering it.

 

What has impressed me most about this first part of the book is how easily intuition can work under my 'surface' and without too much additional effort on my part, if I would just let it. Trying to be logical about something like health or life sounds like an exercise in futility because, as we all know but still deny, those are things we just can’t control. No matter how much logic we apply to lupus management, it is not enough. No matter how much information we take in, we still have lupus and it is still unpredictable.

 

Both intuition and lupus are automatic forces in my life and very much a part of who I am. I can learn as much as I want about them, though, and it is still how they are put into action that perhaps matters more in how I get through my day. Since I am pretty problem-focused in my coping, I look forward to reading the rest of the book where the focus will be on gut feelings in action.

 

Has Gigerenzer given you any insights into where you are emotionally when your gut tells you something? Open, closed off or skeptical? Do you second guess or ignore that little nagging thought or voice prompting you about something? How much does intuition play in your days? In your lupus management? Do you feel any differently about what these gut feelings are telling you?

 

Sorry for the late post this week – let’s read Chapters 7-9 for Saturday and I’ll be back by Sunday evening, the 25th.

27 months ago

maria

I chose this book to explore intuition and gut feelings because I feel like managing my health in general (lupus specifically) is more up to me than my doctor.  Not because I don’t trust my docs – I am actually blessed with an awesome nephrologist and a ‘cooperative’ rheumatologist. It’s really because they have a strict regimen of how long they can see me and what they can really do for me – which is very little, really.

 

With no new meds for Lupus in over 50 years (although some promising ones on the horizon) and still little practical knowledge of what causes lupus or how to best treat it – what can they do?  You get your five minutes of them reviewing lab work that tells them only crisis information, they run through their flow chart including pain, medications and symptoms – then, unless you’re on death’s door, you leave.

 

That whole ‘routine’ aggravates me and can keep me from going to follow up appointments as often as they would prefer.  More so than ever, I rely on my personal experience of over ten years with kidney-involved lupus, whatever  information/tips I pick up from the internet and written media, and a great deal of, what I consider to be, my gut instincts to know when something really needs medical attention.  I do this because I have no medical insurance.  I don’t recommend this way of managing your lupus – if you have options and medical insurance, then, by all means, take advantage of them.

 

So, this book was a source of information for me to learn a little more about what this ‘relying on my gut’ is all about.  Is it habit?  Is it instinctual?  Is it possible that I have some social or psychological hurdles I need to address?

 

I think the first part of this book was good in how it helped me see just how much is going on without me ‘purposely’ thinking about it.  However, I did look forward to reading more about it in action and feeling a little more like I am in the driver’s seat.

 

In Chapter 7, Gigerenzer distinguishes between the recall and recognition memory functions, which eased my concerns about how much I tend to forget these days.  Even though it is easy to blame it on lupus fog, I knew it was more than that.  What I didn’t know is just how important it is not to just memorize things that will be called forth later.   Placing some type of personal relevance onto the subject will help me ‘recognize’ what I want to remember...even if it isn’t consciously.  This recognition is strongest when we’re younger and older – therefore, in my case, learning some tools to help me enter into these ‘golden’ years will help me keep them ‘golden’.

 

Losing our ‘recall’ capacities as we age seems to naturally ease our abilities to make good judgments.  Gigerenzer explains that the less people know about a particular subject, the better and more accurate their judgments are when in situations requiring a decision.  He uses the example of a Russian mnemonist named Shereshevsky, whose memory was so amazing that he became burdened by all the information his brain took in, hampering his ability to make daily living judgments and decisions.  Basically, it appears that the more we know, the better it is for us to forget things in order to manage dealing with the big picture.  Whew – I feel better.

 

 

The recognition heuristic (again, a heuristic is simply another word for rule of thumb) guides our intuitive judgments and requires: 1) recognition and 2) evaluation.  In Chapter 8, the author goes into some of the other ways that this recognition occurs through the use of sequential decisions – both in humans and in the animal world – leading to a flow chart “way” of understanding this process.  This is where I started to get uneasy.

 

I think I’ve already confessed to living in the gray area – multiple choice answers restricting my need to expand and explain.  He seemed to be building up to the idea that the less we know about a lupus patient’s situation, the easier it is to treat their immediate concerns.  Did any of you feel that way when you read this?

 

Lo and behold, Chapter 9:  “Fast and Frugal Tree”.  He does address the legal concerns and limitations physicians have when treating patients - concerns that are deeply embedded into our current healthcare system.  What he presents is that in trying to make the best decisions for a patient in need, it is more accurate when the possibilities are more focused and limited to a few rules of thumb, rather than confusing their decision process with an elaborate, time-consuming flow chart of possibilities.  Research backs up what he is proposing, but it is research dealing with more concrete issues (in his case, cardiac patients) than an illness that is flaring one minute and maybe not the next.  An illness that may show symptoms in the lungs one week and in the kidneys the next.  Granted, he is talking about quick decisions and not long-range treatment plans, but I am considering the appointments I go to now where this same time-limited foray into my current health status plays out within a meager five minutes and see them as similar situations.

 

What do you think about his summation as it pertains to our relationships and experiences with our doctors when we meet with them about our lupus?:

 

“ ...physicians intuitions can be improved not only by complex procedures that are in danger of being misunderstood and avoided, but by simple and empirically informed rules.” (pg. 177)

 

How do your appointments go?  Are you invited to offer more than ‘just the facts” or does it feel like there are boundaries and time limits to your conversation?  Do you ever offer up your gut feelings about what is happening?  Has your doctor ever offered anything that resembles a less ‘empirical’ and more ‘personally-derived’ impression of what is going on or what you both might do regarding treatment/medication/tests?

 

Do you feel more assured with a doctor who sticks with strict parameters than one who seems to think outside the box?  Does looking at their white coat automatically lead you to follow their judgment over what you know or intuitively recognize as a better choice?

 

Next Saturday is the completion of the book – only two more chapters to go-moral behavior and social instincts.

27 months ago

maria

Today is the final posting for our October book.  We finished with the chapters on Moral Behavior and Social Instincts. 

 

The moral chapter, I have to admit, didn’t really catch my attention.  Not sure what to think of that fact, but it didn’t fit into what I was looking for —more answers.  Bringing morality into it just muddied the waters even more for me when I was trying to get clear about when I should rely on my gut rather than my head.

 

Chapter Eleven's "Social Instincts" does address the fragility of gut instincts and how easily they can be used for manipulation or get things more carried away than intended. 

In this chapter, he identifies two basic social instincts—Family and Community—which he distinguishes as the former being a more biological (primal) instinct, and the latter as very “human”.

 

Relating it to our health, many of us who cope with lupus by using ‘relationship–focused’ strategies more often tend to ‘protect’ our families from our illnesses.  We prioritize taking “care of our kin” (pg. 209) much more often than taking care of ourselves, either physically or emotionally.  We generally believe that 'blood is thicker than water.'  Of course, depending on your ‘family’, this could be a positive or a negative.

 

Community instincts, however, are focused more on our “identifying” with, working together with and a willingness to “defend” group members. This basic instinct is more human because it can be applied to large numbers of people and is not limited to kin or those were are genetically linked to.  In fact, we often seek other groups to belong to outside of our families to develop and benefit from the conformity and loyalty we socially need.  Yet, Gigerenzer states that community instincts don't kick in unless there are other groups to compete with (otherwise, there would be little need for loyalty) and that they are based on reciprocity ("tit for tat".)

 

Both of these basic instincts involve trusting others.  Since family or kin are relatively smaller groups and closer to us, it is easier to feel as though we know them well and don't have to actually 'trust' them as much as a big group of 'outsiders'.  Gigerenzer states:  "The more you are able to control and predict the behavior of others, the less need you have for trust." (pg. 214)

 

This statement made me stop and think about how I relate to family members and, maybe more importantly, how they relate to or trust me.  I think this is where my gut feelings tend to 'flare' up the most.  I try to feel like I have some sense of control or predict how I will be from one day to the next healthwise.  That addresses more of my 'physical' community involving my immune system, my organs and general biology.  I also tend to look at those around me in the same way.  I do know my family and they know me.  However, the shift from health to living with lupus has changed me.  How can we believe we can predict things about each other when we are all dealing with a situation that is new to all of us and with so few answers?   Even though my kinship is a small enough group where trusting should be easy, it isn't something that comes easy to me.  With others such as my medical providers, bloggers, or any other groups of people I invest into, the trust is especially limited.  After several years, I still resist seeing myself as 'ill' and becoming a member of a community that is invisible, unknown to many and still is a fog on the medical world's horizon.  This holding back or, what Gigerenzer refers to as 'mystique' creates obstacles in maintaining my place in that group by questioning my loyalty and visa versa. 

 

Just as we have the ability to choose to use our gut instincts as unconscious information power sources in our decision making, sometimes it is these same instincts that can guide us to some less-than-beneficial directions of mistrust, assumptions and manipulation.  Although Gigerenzer doesn't offer any sure fire methods of knowing when to rely on our intuition and when not to, he does offer a look at just how readily available this personal resource is for us whenever we want.  Just as these feelings are automatically created in our days as our lupus is, our gut feelings (and our health) are only as good as our mind's ability in putting together information without any conscious help from us (inferences like perception); the strength of our brain's evolved capacities (e.g. language, recognition, memory), and our ability to quickly apply rules of thumb based on these capacities, while also considering their effectiveness when we use them within our environments.

 

Gigerenzer suggests that gut feelings or intuition are so deeply imbedded into our lives that we aren't able to function without them and benefit greatly because of them.  His book leaves us with a glimpse of our personal, unconscious sources of guidance that aren't merely fleeting sparks of emotional intervention. Gut feelings are amazing opportunities for all of us to reconsider what we already know and trust that knowledge as a part of who we truly are.

 

Do you see any comparisons between lupus and these gut feelings?  How do you feel about learning how much our biology plays a part in our gut feelings?   How does the discussion on community instincts apply to your 'membership' in the lupus community?

 

This was a thick theory book and I know not everyone enjoys a good dose of theory like I do.  I'll try to keep these at a minimum, promise.

27 months ago

maria

A follow up to this book discussion~

I heard from an associate of Dr. Gigerenzer regarding a question about how the Fast and Frugal Tree approach (mentioned in his book here) in diagnosing acute illnesses doesn't seem to appropriately apply to diagnosing chronic conditions (such as lupus), even though a flow chart/diagnostic tree-type process is often used at the initial medical appointments.  To this day, we still don't have an official diagnostic tool to accurately target whether we do or do not have lupus.  His associate's email (which included references for me to explore further) pointed out that there is little research in the area of diagnosing chronic conditions (not just lupus) using tools like this tree format that is designed for short-term exploration rather than long-term observations of symptoms and test results.

I have always felt that seeking a lupus cure is a goal to be sure, but I would rather focus on developing more reliable, consistent and individually-approrpiate diagnostic tools as a means of providing earlier disease management options.  The earlier we know what we're dealing with, the better our outcomes can be.

 

25 months ago