Parents Are Hard To Raise® S03 Episode 114 Transcript
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Announcer [00:00:35] Coming up this week on Parents Are Hard To Raise® Diane's guest Dr. Judith Moskowitz talks about the eight positive emotion skills and the benefits they have on our health.
[00:00:49] Join 180 million monthly subscribers who can now listen to Parents Are Hard To Raise® on Spotify.
Diane Berardi [00:01:07] Welcome to Parents Are Hard To Raise®... Helping families grow older together without losing their minds. I'm elder care expert Diane Berardi.
[00:01:16] I'm so very excited to have our guest in the studio today. Dr. Judith Moskowitz is a professor of medical social sciences at Northwestern University's Feinberg School of Medicine in Chicago. Trained as a social psychologist and epidemiologist, she studies the impact of positive emotion on life stress. She is the principal investigator of several NIH funded trials designed to increase positive emotion and improve the well-being in people experiencing different kinds of life stress. In other words, she's looking for ways to help us make it through life despite the stuff that happens to us.
[00:01:58] Her research team is currently conducting trials aimed at improving health in dementia caregivers, high school students,,.
[00:02:05] People with type 2 diabetes women with stage four cancer and people living with HIV. That's quite a full plate. Dr. Judith Moskowitz, welcome to Parents Are Hard To Raise®.
Dr Judy Moskowitz [00:02:18] Thank you for inviting me. Diane I'm happy to be here.
Diane Berardi [00:02:22] I am so excited to have you with us because it's so easy to head into a downward spiral when you're experiencing a lot of stress. We have our everyday stress and then added to that, the stress of caregiving.
[00:02:37] So your work is so important and so needed to all of us.
Dr Judy Moskowitz [00:02:43] Yes I think so. [laughing].
Diane Berardi [00:02:46] Tell us, how did you make the connection between stress and positive emotions?
Dr Judy Moskowitz [00:02:53] Well this this work started probably 20 years ago. I was working as a postdoctoral fellow at the University of California, San Francisco and I was working on a study of men caring for their partners with AIDS.
[00:03:10] And this was the early to mid 1990s, so before there were more effective treatments for AIDS. And so it's essentially a terminal illness. So we were studying the caregiving partners and looking really specifically at the stress of caregiving. And you know in one of these situations that are... it is some of the most stressful life circumstances you can imagine. Right? So, we were studying and we were asking them to tell us about a recent caregiving event that was stressful for them, or for some of them whose partner had died, because they continued in the study even after their partner died, a recent event related to bereavement. So we ask them you know a recent stressful event and had them tell us about it. And then we said, What did you do to cope with it? And then they would they would talk about that. And that was the end of the interview.
[00:04:09] And very shortly after. And then we said, you know, thank you we'll see you in two months and talk to you again and see how things are going. And very shortly after the start of the study the participants started saying, Now wait a minute. You’re not asking us about the good things.
And as researchers we were sort of surprised because they were really coming at it looking out for stress and negative emotion. .
[00:04:31] So... But our participants were telling us what they wanted to talk about. So we started asking them about positive things that were happening. And in and you know we had hundreds of interviews. And in 99 percent of them the caregivers could tell us something positive that happened in the past week, even if their partner had just died. So it was the sort of light bulb moment where you realized that you know maybe we need to be sort of broadening our perspective and looking more and not solely at what stressful but also what the good things that are happening. Because it seemed to be helping people cope better with the stress. So that study sort of launched me on this path of looking at what we ended up calling the Co-occurrence of positive and negative.
[00:05:24] So that even if you're experiencing really significant life stress right you also... You know it's normal to be depressed and distressed in that situation. But there people have the ability to also experience positive emotion along side. So that's what I started researching and how I was set on this path of looking at positive emotion in the midst of stress.
Diane Berardi [00:05:50] And so you develop this program to help people experience more positive emotion on a daily basis.
Dr Judy Moskowitz [00:05:59] Yeah. So you know I'm trained as you noted as a social psychologist so I'm not a clinical psychologist. I'm not in my office providing counseling to anyone. I'm much more comfortable sort of observing people.
Diane Berardi [00:06:16] Ah. OK.
Dr Judy Moskowitz [00:06:16] And So... But it became clear after a few years of doing what we call observational studies, just seeing and measuring how people cope in stressful situations. After a few years of these observational studies that showed us that positive emotion did occur under these stressful circumstances and that people who were able to have more positive emotion under these circumstances did better. They were able to cope better. They were happier. And long term they were healthier and they experienced less stress and distress from the situation.
[00:06:51] So after a few years of studying this and other, more of this work was coming out in the literature, too. It was really clear to me that someone needed to design an intervention to help people use these positive emotions skills, to then cope better with whatever type of stress they're coping with.
[00:07:11] So I and, you know, social psychologists are used to doing these laboratory studies where you bring people in and do what we call a mood manipulation. So you show them like funny movie clips or you know literally puppies and kittens or things like that, which work in the moment to increase your positive emotion. But I was really looking for things that people could take up as a skill, sort of a tool box of habits they could could take on to help them have more positive emotion in the midst of stress.
[00:07:46] So we went to the literature and found a set of skills that had been shown in previous studies to increase positive emotion. And then I put them all together in a package and then started testing them in various groups experiencing mostly health related stress. Also as you noted people experiencing more sort of everyday stress, as well.
Diane Berardi [00:08:12] And so you developed a positive skills for stress relief. So could you tell us about them?
Dr Judy Moskowitz [00:08:20] Yes. So like I said, these have all been shown to be effective on their own. And what we wanted to do was put together a package, sort of a buffet of skills that people could choose from. So it's not that you have to do all eight of these and that they have some sort of magical synergistic effect. It's that different things work for different people, so we wanted to offer people a number of skills so they could gravitate to the one that worked best for them.
[00:08:52] So the first skill is noticing positive events. And this is especially if you're experiencing chronic stress like caregiving, sometimes it's hard to notice the good things that are going on. So this is just about taking a moment to notice that there are good things.
[00:09:10] And this is something that we learned very quickly from our AIDS caregivers. I mean sometimes when they would report a positive event they would talk about something related to their caregiving, like they were able to make their partner a good meal or something like that. But often the positive event was like a good cup of coffee, or a lovely sunrise, or a stranger smiling at them on the street. It's often something really small you don't have to win the lottery. So it doesn’t have to be this amazing huge thing. It's really just the ability to sort of take a step back and note there are actually good things going on.
[00:09:47] So that's noticing positive events and closely related to that is capitalizing on them or savoring.
[00:09:56] And this is sort of you know telling someone about the positive event. It's putting it in your diary. It's even just thinking about it later on. Putting it on social media. Because that gives you a chance to re experience the positive event. I mean if you've ever had a friend who you know you go out to a movie and have a nice time and the friend is still talking about it the next day back later. That's savoring.
[00:10:24] That's like, Remember that really great time we had? And it just sort of gives you a chance to sort of get ahead of that positive emotion, again.
Diane Berardi [00:10:30] And you get that positive feeling back again.
Dr Judy Moskowitz [00:10:33] That's right. That's right.
[00:10:35] The third skill we teach is gratitude. And you know everyone is familiar with what this is. And we basically teach people that gratitude can be... It can be sort of part of your spiritual or religious tradition, but it doesn't... Absolutely doesn't have to be. It can be gratitude to another person. And it's just again noting something that you're grateful for each day. So it's closely related to positive events, but not completely overlapping.
[00:11:10] The next skill we teach is mindfulness. So this ability to pay attention intentionally and maintain nonjudgmental awareness of whatever is going on in the present moment. So your thoughts, your feelings, physical sensations. It's really a way to sort of avoid rehashing what just happened. "Oh, why did I say that? That was so stupid." Or rehearsing what's going to come up next.
[00:11:47] If you've ever been in a group where you're going around the table and you're introducing yourself and you're so focused on what you're going to say about yourself, sort of rehearsing. You don't hear what anybody else says. So that's like the opposite of mindfulness.
[00:12:02] So actually one of the activities that we do, when we do this in groups, is to do that sort of introduction thing and note, Oh yeah. I didn't even hear what that person before me said, because I was so busy thinking about what I was going to say. And then we go around again we're trying to really listen to the other people and to sort of experience that contrast between being mindful in the moment and not being mindful in the moment.
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[00:16:04] So Judith, we were talking about the eight positive skills for stress relief. And number one was noticing positive events.
[00:16:14] Number two, savoring those positive events.
[00:16:17] Three, expressing gratitude. And four...
[00:16:20] Practicing mindfulness.
[00:16:23] So now, how about the rest?
Dr Judy Moskowitz [00:16:27] So number five is positive reappraisal. And the way you appraise or interpret a situation drives your emotional response to it. So, a positive reappraisal is looking at a stressful situation and seeing ways that it could be interpreted positively.
[00:16:53] So. Maybe... My favorite positive reappraisal is, It could be worse. You can always think of a way that it could be worse. Or maybe there's something good coming out of the situation. You know, I'm learning a lot about myself. Good thing that's happened now is had happened next week, I wouldn't be able to handle it.
[00:17:13] I mean just you know there are sort of infinite ways you can positively reappraise. And this isn't saying that something isn't stressful and being like, Well I actually I'm going to deny that it's stressful. But it's... You can always find a way that something is slightly less bad than you initially thought it was.
Diane Berardi [00:17:31] Yeah. I was telling my husband... You know, my mom has deteriorated quite rapidly. And she's having a little trouble walking and she's now as light as a feather. And so she has to get to the bathroom very quickly, a lot. And so I was with her on Saturday and so, of course her and my father devised that her wheeled walker would now be her car, you know, and used to drive... And so I'm like, Oh my gosh.
[00:17:59] So she's like, Diane I have to go to the bathroom.
[00:18:02] So I'm like, OK.
[00:18:02] So I gotta get her into this, because I'm giving my father a break, I have to get her into this wheeled Walker and I have to try to roll it on the carpet, you know and roll it and try to get it down the narrow hallway, really quick. And I'm having a lot of trouble, because the wheels are just not cooperating. And so we both start laughing. And she said to me, Well if I didn't have an accident before I certainly had one now, it took so long. [laughing].
[00:18:29] I was so stressed about getting her, and I got to do everything right. And then you know I was like, Oh my gosh. But then we just both laughed. And it was so good to laugh and to hear her laugh.
[00:18:43] So I guess I did that, hey?
Dr Judy Moskowitz [00:18:45] You did. You absolutely did.
Diane Berardi [00:18:45] Well... We do need to do that.
Dr Judy Moskowitz [00:18:52] Yeah and it's true that you know a lot of people do this naturally. I'm definitely a natural positive re appraiser. You know much to the annoyance of my children. "I'm sorry you didn't make the football team. But now you have more time to practice math." I mean like so it doesn't go over real well. But it's also a skill that you can learn and get better at.
Diane Berardi [00:19:15] Yeah. Because I was going to ask you that. Because being positive doesn't come naturally to a lot of us. So what does it take to teach us?
Dr Judy Moskowitz [00:19:26] Yeah. I mean I think it does take some awareness that this isn't like a major personality change. It's you know... Any one of these skills are just, it's really just sort of a small tweak to the way you look at things. And then a matter of practicing it be until it becomes sort of your natural way of responding.
Diane Berardi [00:19:49] So it's kind of like, we're going to kind of make it a habit?
Dr Judy Moskowitz [00:19:54] Yes absolutely.
Diane Berardi [00:19:55] Okay.
Dr Judy Moskowitz [00:19:56] That's absolutely it.
Diane Berardi [00:19:57] OK. And how about number six?
Dr Judy Moskowitz [00:20:01] Number six. Personal strength. So it's noticing your... What strengths you have in the situation. So, oftentimes when people are experiencing chronic stress they can't see that they've got anything right going for them. Right?
Diane Berardi [00:20:24] Right.
Dr Judy Moskowitz [00:20:25] And you can sort of get into that downward spiral of you know, I'm stressed out. I can't cope with this. I'm an awful person. You know, there's no point. And then they just sort of spiral down. Whereas if they can sort of note some strength that they have, You know, wait a minute. But I have a sense of humor, or I'm a really good friend, or I'm a good caregiver, and it's a good thing that I'm here for my parents. It can sort of help stop that downward spiral that we can all get into.
Diane Berardi [00:20:57] Yes. Very easy to get into it. Yeah absolutely.
Dr Judy Moskowitz [00:21:03] And then number seven is attainable goal setting. So this is based on research that shows that even the perception that you're moving toward a goal, you don't even have to be achieving it. But the feeling of movement is related to more positive emotions.
[00:21:22] So if anyone is a list maker, you know what I'm talking about here. So I am absolutely a list maker, so it's write down all the things that you have to do. And you get ahead of positive emotion when you cross one of those off. Right?
[00:21:36] So for this skill we sort of help people understand how to make attainable goals, how to set them. So that they're not so hard but they'll you know obviously fail or not so easy that there is no effort involved. So there's sort of a sweet spot in there, where you list those things and then as you're accomplishing each of those goals you can cross them off.
Diane Berardi [00:22:00] Yeah. I think probably we oftentimes set unrealistic goals. You know, that they're going to take a while to do. And then you're just like, Forget it. I'll never get you know I'll never be able to do all these things. And so, you have to set realistic goals.
Dr Judy Moskowitz [00:22:17] Yeah. And it's something that we really work on. You know we have versions of this that are delivered by a facilitator. So the facilitator really works with the individual to help them find that sweet spot of not too hard but not too easy. And then we also have some self guided online versions that we're testing, where people go through it on their own. But we have lots of language in there trying to help people sort of find the right level of goal to maximize their positive emotion.
Diane Berardi [00:22:50] Yeah, because it's so easy you know to just say, Oh no, I can't do this, or No this isn't going to work, or you throw your hands up. Or everything just seems to pile on you. So you just experience the more positive emotions on a daily basis. That's... I guess you're reframing your thought process?
Dr Judy Moskowitz [00:23:10] That's a big part of it. Yes. Yes absolutely.
Diane Berardi [00:23:14] And finally, the eighth.
Dr Judy Moskowitz [00:23:16] The eighth skill is acts of kindness. So the first seven skills are very intra individual sort of looking into yourself. And working sort of internally. Acts of kindness is a very externally facing skill, where you do something nice for someone else. You know and it doesn't have to be you know giving a hundred dollars to someone. It can be you know something really small and it doesn't even have to involve money.
[00:23:46] So in this skill we really work with participants to sort of... And we even have sometimes a list of nice things you can do for other people, to help them sort of think about ways that they might be able to do this.
[00:24:01] It's interesting. So we've done versions of this intervention in lots of different stressed groups. Oftentimes people with a significant illness of their own. With the caregivers in in the one study that we've published on it, we did have acts of kindness. But that one... And even though the caregivers loved it and they did it really well. We really felt like they're already giving so much that may be acts of kindness isn't quite the right thing.
[00:24:34] So in subsequent versions of the intervention for caregivers we're swapping out acts of kindness for self compassion. So really having people and this is again something that's come out through multiple iterations of the program. And I mean we think self compassion sort of like, cutting yourself some slack. And you know maybe not having such perfectionistic high standards for yourself in every situation, and being like you know just really treating yourself as you would treat a friend going through a similar situation. We felt that that's always been sort of implicit in the skills, but we in our newer versions have made that explicit, to really help people sort of feel more compassion toward themselves, which I think does increase positive emotion and really helps them cope better with the stress of caregiving.
Diane Berardi [00:25:32] That is a tough one because I think as a caregiver we feel like we have to be perfect. We have to get everything done and we have to do it. And it's all these tasks, you know. And you just feel like, Ahh! I didn't do that.
[00:25:46] I feel that way as my mother. You know, if I'm there a certain amount of time and I'm like, Oh my gosh! I didn't get this done for her. And I didn't do this. And I... You know, you just... You just feel, you feel deflated. So that self compassion. Yeah, that is an important one.
[00:26:06] How can our listeners find out more about you know the skills you're teaching?
Dr Judy Moskowitz [00:26:12] So a good place to go is our lab Web site. Moskowitz Lab dot com. And that'll get you to our research studies. Like I said, we are launching another study of dementia caregivers. If your listeners might be eligible, they should email leaf study. That's LEAFSTUDY at U C S F dot EDU.
[00:26:50] I mean we haven't launched yet so it'll be probably another month or so. But at that point will send them the information to determine if they're eligible to be in that study.
Diane Berardi [00:27:02] That's perfect and we will have this information on our resource page as well.
Dr Judy Moskowitz [00:27:06] Great. Great.
Diane Berardi [00:27:08] I know there's two points that you want us to take. You know that you want our listeners to understand and to take away from what you're saying. Could you highlight those for us.
Dr Judy Moskowitz [00:27:18] Yes. Thank you for asking that. The first point is that this is not sort of teaching happiness. We're not promising that practicing these skills will make you happy...will make you find meaning in life. And I think they're often framed that way, in the press. Just because that's sort of easy shorthand for people. But I think that sets up sort of an unrealistic bar. Really, this program and these skills are aimed at helping people experience positive emotion in the midst of stress. And you know very much based on this research showing that people can experience positive emotion in the midst of stress and when they do experience more positive emotion they do better, and they can cope better with the stress.
[00:28:10] So these skills are ways to help people have more positive emotion no matter what kind of stress they're experiencing. That's sort of the first major point.
[00:28:20] The second major point is that these skills, although we've tested them in caregivers, dementia caregivers, people newly diagnosed with HIV, people with type 2 diabetes, people with metastatic breast cancer, these aren't specific to those types of stressors. These skills can help you cope with whatever kind of stress you're experiencing. And I mean to my mind everybody is experiencing some kind of Stress. I mean it might be just a minor hassle to you. But the more you can practice these skills, the more positive emotion you'll bring into your life and the better able you'll be to cope with whatever sort of life throws your way.
Diane Berardi [00:29:06] And you say we need to pick one maybe one or two?
Dr Judy Moskowitz [00:29:11] Yeah. You don't have to do all eight. Just pick one or two that work for you and then make them a habit.
Diane Berardi [00:29:17] Judy thank you so much for being here. And again could you just give us that information again.
[00:29:22] Yes. So you can find out more at MoskowitzLab.com And then if you want to hear more about our upcoming study of dementia caregivers you can find out more or at least study at LEAFSTUDY.EDU
[00:29:43] Thank you. Thank you again, Judy. Thank you so much.
[00:29:47] And Parents Are Hard To Raise® family... I love getting your e-mails and questions, so please keep sending them. You can reach me at Diane at Parents Are Hard To Raise® dot org or just click the green button on our home page.
[00:29:58] Parents Are Hard To Raise® is a CounterThink Media production. The music used in this broadcast was managed by Cosmo Music, New York, New York. Our New York producer is Joshua Green. Our Broadcast engineer is Well Gambino. And from our London studios, the melodic voice of our announcer Miss Dolly D.
[00:30:15] Thank you so much for listening.
[00:30:18] Till next time... May you forget everything you don't want to remember and remember everything you don't want to forget.
[00:30:23] See you again next week.