Follow along with the transcript below for episode: Living With Intention With Dr. Greg Hammer
[INTRODUCTION]
[00:00:02] PF: Thank you for joining us for Episode 423 of Live Happy Now. By now we're all aware that the mind and body are connected. But how do we use that knowledge to create our best life?
I'm your host, Paula Felps, and this week, I'm talking with Dr. Greg Hammer, a professor at Stanford University School of Medicine, physician, and a mindfulness expert, who developed the four-step gain method of mindfulness. As he explains in his book, Gain Without Pain, this is an acronym for gratitude, acceptance, intention, and non-judgment. He teaches this method to reduce stress and increase wellbeing. Today, he's going to talk about how you can create a more intentional and happier life. Let's welcome Dr. Greg Hammer.
[INTERVIEW]
[00:00:50] PF: I'm so excited to talk to you. You have a lot to tell us about the power of intention. But before we get to that, I want you to tell our listeners a little bit about yourself, because you've been so instrumental in showing us how our mental state affects our physical wellbeing. Explain to us how you became so attuned with that and why it's so important to you?
[00:01:12] GH: I have been a lifelong fitness enthusiast in every sense of the word, mental, spiritual, physical. About 10 years ago, I joined a directive at Stanford called Well MD, that was convened in order to address the growing prevalence of burnout among physicians, which has only probably gotten worse since then. But in any case, I joined Well MD, and then I was asked to give a talk on burnout and wellness at a national meeting, and then another talk, another other talk, and then I had some sabbatical time, and I decided to write the book. The first book that I wrote.
In the meantime, I've been – went to medical school because of my interest in in the human body and the miracle of how all the parts are interrelated, I found that I really had an affinity for people that work with children. They don't seem to take themselves quite as seriously as some of the people in adult medicine and that comported with my personality. So, I did a residency in pediatrics and loved Intensive Care Medicine. So, I did a residency in anesthesiology, and then fellowships in pediatric anesthesia and critical care. I've been working in both arenas, the pediatric intensive care unit and cardiac anesthesia for over 30 years. I have a research lab at Stanford where we study developmental pharmacology from babies up to adults.
Again, my interest in in wellness has further intensified, I would say. I've been a student rather of Advaita, or non-duality for 12 years or so. That has certainly influenced my ways of thinking. So, everything I talk about with you, probably for the rest of this session is going to have something to do with all of that.
[00:03:05] PF: Are you seeing more of that in the medical community where they're not just treating the body, but they are looking at things like mindfulness. You're huge on mindfulness and you're a trailblazer in that way, because I know in my own life, just having a physician that sees things that way, has been a challenge. Do you see that changing?
[00:03:24] GH: I do. I think that just like our medical system as a whole has really focused on disease more than preventing disease. That ship is kind of slow to turn, as we put more resources into preventive medicine now, which is absolutely requisite if we want to be a well society.
Similarly, I think that physicians and others in medicine have focused on disease and finding, taking sort of a reductionist approach to health, I would say, trying to break things down into their component parts and figure out how to cure things. I think, that colors the profession as a whole, and what we need to do is really move much toward prevention in our own wellness, because unless we are, well, it's going to be difficult to take care of others. It's sort of the put your oxygen mask on first. Your own oxygen mask before you take care of the child or someone who's acting like a child sitting next to you on the aircraft. Yes, I think things are changing. But the culture is very well entrenched, and it is a big ship and slow to turn. But I do think things are changing in medicine for the better.
[00:04:43] PF: That's good to hear. And you are so pivotal in this and you teach us so much about what it does to have the right mindset, and what I want to talk to you about today is intentional living. Let's start by making sure we're all on the same page. Tell us what you mean when you say intentional living.
[00:05:03] GH: We can start by just acknowledging that our brains have become hardwired over tens of thousands of years of evolution, in ways that are no longer adaptive, or we might say they're maladaptive. For example, we all have a negativity bias. We tend to focus on the negative and forget about the positive. We get out of bed in the morning, and maybe we have an ache or a pain. Our back is stiff. So, we focus on that and we just initiate the day with a cascade of thoughts about woe is me, this and that, instead of focusing on the miracle of the human body, that we even woke up and could get out of bed at all, and all the good things about our physical state. So, we have a negativity bias.
The other thing is, the way our brains have become wired is we're very distracted with the past and the future. So, we have a hard time being present, which is where happiness lives. It's adaptive to some extent to dwell in the past. We want to learn from our mistakes. We want to savor our good memories. But beyond that, we overthink the past and with our negativity bias, we end up with a lot of shame and regret, low self-esteem and depression. Likewise, we overthink the future, in ways that are maladaptive and we catastrophize with our negativity bias and think of the worst thing that could happen. We generate a lot of fear and anxiety.
So, if we're not intentional, if we don't have a plan, then we're going to simply lapse into our default modes of thinking, and that is negative and other than present. If we want to be more positive, and really focus on all the miraculous things that are happening around us all the time, including inside us, and we want to be more present, and therefore happy. We need to have a plan. We need to be purposeful. That's really where intention is a requisite component of happiness.
[00:07:03] PF: So, when you set an intention, what do you mean, how do you go about doing that?
[00:07:10] GH: Sure. Well, I can just briefly tell you about the gain method, the gain meditation. So, we get up in the morning, we open the blinds, we do our morning hygiene. We find a comfortable place to sit. We close our eyes, hopefully in a quiet place, and we focus on our breath. We slow it down. So, our first intention, actually, with regard to this gain process begins the night before, because we acknowledge we're going to do this gain meditation in the morning. It may take as little as three minutes, we're going to set our alarm three minutes earlier than we otherwise would. So, who's going to miss that three minutes? Or we can go to bed three minutes earlier. Instead of getting up at seven o'clock, we're going to get up at 6:57. We're setting our intention for this whole process the night before.
Then, we were sitting quietly, we focus on the breath, we slow down the inhalation, pause and take a nice slow exhalation without any effort. By slowing our breathing down, we activate our parasympathetic nervous system. We slow our heart rate, lower our blood pressure, our blood sugar, and then we begin contemplation of that for which we're grateful. We all have much for which should be grateful, so we spent 45 seconds or so just focusing on our friends, our family, our loved ones, our relative health, even if it's not perfect. It's miraculous that we're as healthy as we are, and all the other things for which we're grateful. Then, we transition to acceptance, we need to acknowledge that there is pain in life, and pain, and joy are kind of hand in hand. So, we may take something uncomfortable or painful, and actually, imagine bringing it into our bodies, opening our chest, opening our heart, bringing this experience into our heart, and nurturing it, enveloping it with our heart. We find that it's not so bad and we can live with it.
Then, we transition to intention, which is where your question originated and we start by having the intention of noticing what's happening in this moment. So, we may just, for example, have the intention of noticing the pressure of the chair against our body, noticing the tingling on the soles of our feet, noticing the sounds that we're hearing as we breathe deeply and slowly. So, for me, I have a meditation room in my home on Stanford campus. I'm sort of halfway between San Francisco and San Jose airports. I often hear a plane going by in the distance –
[00:09:40] PF: It becomes part of the meditation, right?
[00:09:44] GH: It does. It's the part of the intention portion of the gain meditation because I'm setting my intention as you put it with what's happening right now. So, I'm just spending 10 or 15 seconds noticing my bodily sensations, noticing my perceptions, what I feel, what I hear, what I may smell, just the slight sweetness of the air, I'm breathing. So, we spend 10 or 15 seconds being present in this way, really noticing what's happening in this moment. Then, we go to our intention of generally looking at the positive side of things, rather than the negative.
So, what we're doing is we're actually rewiring our brains, because as we focus on our gratitude, acceptance, intention, and then non-judgment in life, we're actually rewiring our brains toward a more positive and present way of thinking and experiencing, and therefore being more happy.
[00:10:48] PF: How long does that rewiring take? Because I know that over time, it does completely start changing the way you look at the world when you get up. The ache and pain that you have, you see it differently. But how long does that take for us to start doing? When do we start seeing results?
[00:11:06] GH: As in life, life is a journey. Really, there's no destination. So, I think we can notice a change in our thought processes very soon, like after days, or a couple of weeks. What happens is, when we, for example, do this gain, practice, we set our intention the night before. We sit, we breathe, we go through our gratitude, acceptance, intention, non-judgement. We return to the breath. We slowly open our eyes. We go out in the world. What happens is, even after a short period of time, in days, maybe a couple of weeks, we noticed that when we're being ungrateful, or resisting, or unintentional, lapsing into our negativity bias, or we're judging. What happens is a light bulb goes off. We just did our gain practice and we notice when we're being ungrateful, we're sort of whining and complaining. Then, we remind ourselves, “Oh, these are first world problems”, as my daughter would say. These are not deal breakers. These are really pretty much small stuff, things.
That light bulb moment actually brings us a bit of a smile, and then we simply redirect our thoughts back to gratitude, acceptance, intention and non-judgment. We do our gain meditation. We go to work, maybe we drive to work, and there's a driver that is in the lane to the right of us, and he or she changes lanes into our lane, without using the turn signal ahead of us. We start to make all these judgments about the driver, and then a light bulb goes off, and we realize, I just did my gain meditation. I dropped the judgment. I realized that things don't have to be good or bad. So, I have some imagery associated with this. A light bulb goes off, and I smile, and I drop the judgment of that driver, and it actually feels good. I get a little dopamine hit.
Instead of getting negative about it, and getting angry, I actually have a smile and a little positive reaction. That light bulb moment where we notice our thoughts and experiences, and we can redirect them. That happens actually just really after a short period of time.
[00:13:24] PF: Yes, and I've noticed, when you start living that way, when you start thinking that way, you do offer people more grace, in situations that come up, some of the things that all have popped into my head unexpectedly and automatically, it's like, “Well, you know what, I've done the same thing.” I start seeing less judgment toward them and more like, “Okay, how many times have I done that?” That's just karma saying, “Hey, remember that time you cut someone off in traffic.” It does, it just starts changing the way you receive the experiences.
[00:13:54] GH: Absolutely. So, just drill a little bit deeper into that judgment process, in the gain meditation, when we do our non-judgement contemplation, I often personally, I do this, and I recommend that others do it. Just picture an image of the Earth, one of these beautiful NASA images where the earth is apparently suspended in space. It's a beautiful planet. It's neither good nor bad. It's just a planet. So, we kind of pronounced to ourselves as we breathe slowly and deeply, and we picture this image of the earth. The earth is just a planet. It's neither good nor bad. It's just the planet that it is. Therefore, it's only rational for me to look at myself the same way. I'm just a human being. I'm neither good nor bad. I simply am the human being that I am. Then, we may repeat I am and link that with our breath. Then, we slowly open our eyes.
Again, what happens is, when we find ourselves judging, like that driver, we just discussed, or ourselves, when we find that we're judging ourselves, since we're our own harshest critic, we may notice that what we're doing is judging, and we also notice the fact that we're judging ourselves with this negativity bias. So, we can have that light bulb moment and just drop the judgment and go back to, “I'm just the human being that I am, I'm neither good nor bad.” We learn that we don't have to cast a hue over the world and see things through this veil of negativity. We can look at things just exactly as they are, without judging them to be good or bad. They just are what they are. I think that's such an important change in our thought process.
[00:15:43] PF: It's huge. I want to dig into that a little bit more, because as we've talked about, we do judge ourselves so harshly. Some people – I see people who just beat themselves up over and over. How do we – before we start judging ourselves, how do we start setting our brain up to not do that? How do we get very specific and break that judgment, self-judgment habit?
[00:16:08] GH: I think, when you talk about intention, we need to have a plan, and that really translate into having a practice, right? We need to have a practice that preferably is daily, because our brains are very hard wired. Again, they became this way over tens of thousands of years, and we're not going to change them overnight. So, we have to have a baby step process, preferably a daily plan, where we begin to rewire our brains. That happens only through intention. If we're not purposeful, we just lapse into this negativity, and this very judgmental way of being.
Again, when we have this practice, and we find that we're judging ourselves, we're down on ourselves, we're getting depressed, we can have that light bulb moment and recognize that this is just the way our brains work. This is not something unique to us that we think this way, in this negative way. This is the way we all think. I think that's the first lesson is that this isn't our dirty little secret. We're not the only one that has these thoughts. We all have these thoughts.
I was listening to a wonderful show on NPR called The Hidden Brain, and the host had somebody on who's an expert in the imposter syndrome. The message was that we all feel this way. We all feel like imposters no matter how accomplished we are. This is again that negative voice speaking to us. So, we need to have a plan to change the way we think. When we're having these very negative thoughts about ourselves, I like the cognitive behavioral approach of we're criticizing ourselves for a particular thing or things. Imagine we're talking to a good friend, who's got the same voice, who's criticizing themselves for these things, something they did or said or didn't do, would we be judging them harshly? No, we would probably be reassuring them, and not judging them. Just reassuring them that they're just a human being. We're all mortal, we're all fallible, we're not perfect. Don't be so hard on yourself. So, use that same voice with yourself when you're getting into this very negative way of thinking and judging.
[00:18:24] PF: Over time, it becomes easier to do that. You start recognizing it faster. You correct the behavior sooner, and you just don't go as deep into that judgment. Is that correct?
[00:18:34] GH: Oh, absolutely. One of my heroes in life is Dr. Jon Kabat-Zinn who's really been a leader in mindfulness. He defines mindfulness as awareness of the present moment, on purpose, non-judgmentally. So, there are some of the gain elements. On purpose, we talked about intention. You need to have that purposefulness to have a plan to rewire our brain, because we have this wonderful quality called neuroplasticity. But we have to have a plan. So, awareness of the present moment, which is where happiness lives, on purpose, with intention, non-judgmentally, and we touched on the importance of being nonjudgmental, especially toward ourselves.
[00:19:24] PF: That gives us greater happiness. It gives us greater mental and emotional wellbeing. Talk about what it's doing for us physically. Because you've, you've been so great at bringing those two things together.
[00:19:36] GH: Sure. Well, we're all feeling kind of burnt out. I think that COVID amplified the stress that we all experience, which is just part of life. Burnout is simply the mental and physical exhaustion that we experience related to chronic stress. Chronic stress is a condition where we have an increase in the adrenaline or epinephrine in our bodies, increases our heart rate, our blood pressure. We have an increase in cortisol, which is a hormone that also increases our blood pressure, increases our blood sugar, predisposes to diabetes and other adverse health conditions.
Stress has a number of effect physical effects on our body. It actually shortens these little protective caps we have at the tips of our chromosomes, which I likened to the little plastic protective tips at the end of our shoelaces that keep the ends of our shoelaces from becoming frayed. As we age, we have a shortening of these telomeres and that's been associated with a degradation in the function of our cells, and the aging process. That is accelerated when we're stressed. So, chronic stress actually induces changes akin to aging. There are so many physiologic effects of stress on our bodies, just about on every organ, and tissue, and cell in our body. Really, stress, ages us.
So, the question is, how do we change that? That's really what we're talking about with this gain method, with a practice of non-judgment, with a practice of mindfulness meditation. These are ways of increasing our personal resilience and decreasing the amount of stress that we experience. Lowering our heart rate, our blood pressure, our cortisol, our blood sugar, reversing this process of our telomere shortening, our cells degrading, our genetics, our epigenetics degrading. So, it's so important that we recognize that we have this chronic stress, and what the effects are, and that we really make priority number one in our lives actually addressing this.
[00:21:58] PF: Yes, because I've seen people being a lot less healthy since the pandemic, and of all ages. We have some fairly young friends, they’re in their early 30s, who are talking about these health problems they've started having since the pandemic. Is that an effect of the stress? Or is it because we got so unhealthy sitting around during the pandemic? What has created this? Because I'm seeing it everywhere from, like I said, early 30s, up into their 60s and 70s.
[00:22:29] GH: I would say all of the above. What happens is, the three legs that form the tripod supporting our physical wellbeing, which then supports our mental and spiritual wellbeing, our sleep, exercise, and nutrition. What are the effects of stress on our sleep, exercise, and nutrition? Well, briefly, stress causes a degradation in the quality and quantity of our sleep. So, when we're stressed, we don't sleep as well. Of course, we all have experienced this. We wake up early in the morning and our minds are racing with all kinds of lists of things we have to do and anxieties and stresses. So, stress degrades our sleep, makes us fatigued. When we're fatigued, we tend to be too tired to exercise. Our exercise regimen goes downhill and we saw this in COVID, where gyms were closed, and people spent a lot more time indoors, not only depriving themselves of the magic of nature, but also not exercising very much. They're fatigued. We're not exercising. Our diet actually degrades as well. We're tired, so we reach for these sugary and fatty, so-called comfort foods, to give us a boost of energy.
Of course, then we crash, and these foods are not healthy. So, our sleep, exercise and nutrition are very interrelated. When we're stressed, they all are degraded. Of course, the sleep exercise and nutrition habits and practice that we have are so integral to our health overall, when we're not sleeping well, we're not exercising, we're not eating well. Of course, we're more predisposed to hypertension, diabetes. Again, the effects of stress are magnified when we're fatigued, not exercising, and not eating well. This is all like a self-propagating loop that is causing us to spiral in a downward direction.
[00:24:28] PF: It's difficult to tell someone who's going through that, that doing some meditation, or setting intentions is going to actually turn that around.
[00:24:39] GH: You might advise your listeners, well, if you're tired and feel out of shape, and you're depressed, focus on the basics of sleep, exercise, and nutrition. Just for example, address your sleep hygiene. There's several things, we all know what to do, but we don't do them, typically. But we really want to improve our sleep. So, instead of perhaps recommending something abstract, like setting intentions, you can say something specific, like, let's address our sleep. Focus on your sleep hygiene and start to sleep better. What you're really advising when you ask someone to really focus on their sleep and sleep hygiene, is you're asking them to set their intention, right? That is an intention. It's improving your health by improving your sleep. That's a very tangible, easy to understand concrete bit of advice that does involve intentions.
[00:25:41] PF: Well, Greg, thank you so much for taking this time with me. You're so insightful. A lot we can learn from you. As I said, we're going to tell them how they can learn more about you and your books. I just appreciate you taking time with me today.
[00:25:54] GH: Well, likewise, it's been really a pleasure having a conversation with you.
[END OF INTERVIEW]
[00:26:03] PF: That was Dr. Greg Hammer, talking about how to live with intention. If you'd like to learn more about Greg and his book, Gain Without Pain, or follow him on social media, just visit us at livehappy.com and click on the podcast tab.
That is all we have time for today. We'll meet you back here again next week for an all new episode. Until then, this is Paula Felps, reminding you to make every day a happy one.
[END]
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