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The Best Gift Is Presence

Posted By Sabrina Walasek, Friday, December 21, 2018

The unfolding of a conversation is like unwrapping a present.

As someone who works remotely, I have come to value face-to-face conversation. 
The unfolding of a conversation is like unwrapping a present. It sets a vibe and pace to the ritual. While some people have a knack for being really present when conversing, many of us have to work at it. So let’s uncover what it takes to create a real gift of gab.

First, it’s best to share a real space together so you pick up on the full energy of the other person. The nonverbal connection between people has real power. It can cause people to subconsciously adjust their positions, movements, and breathing. When face-to-face, the brain's ‘mirror neurons’ mimic subtleties of the other person. 

While physically showing up is important, the real gift lies in our intention. It not only impacts what is communicated; it also establishes the balance of power. Let’s illustrate with a gift analogy. 

Scenario #1: Envision someone attacking a carefully wrapped giftbox with reckless abandon, snapping off ribbons and shredding paper in pursuit of its contents. No eye contact, no pause to relish the moment. In this scenario, the intent is to self-serve and own the experience.

Scenario #2: Now imagine someone admiring a giftbox, gingerly slipping off the ribbon, massaging the tape loose to preserve the paper. A pause allows for eye contact and a deep breath. Tissue paper is peeled back for the reveal. In this case, the intent is to build rapport and share the experience.

Intent exists in every conversation and it’s often buried deep in our subconscious. It lives in our words, pace, volume, tone, and body language. When we are present, we start to recognize and adjust intent before talking. 

A small-talker is congenial. A great storyteller is compelling. A conversation horder is neither and is likely too wrapped up in his- or herself to notice. We all need to share at length from time to time. However, when taking center stage is habitual, listeners are likely tortured or tuned out. 

Entering conversation to connect is not only about how much talking time you own, but the nature of your speech as well. In the dharma world, there are four common questions suggested to test potential words:

  • Is it true?
  • Is it kind?
  • Is it necessary?
  • Is it the right time?

Passing thoughts through these gates before the words leap off your tongue requires slowing down. This gives time to course-correct. 

Of course, the gift of conversation isn’t just about what you say—it’s also about truly being present for the words, emotions, and subtle communications of your conversational partner.

We all want to be heard, really heard. “Listeners” who are distracted (listening but not engaged) or who reroute the conversation back to themselves are not listening. Active listeners approach a conversation (and a person) with curiosity and the goal of deeper understanding.

According to the Korn Ferry Institute’s The Science of Listening:

“Our listening brain is wired to do exactly what active listening discourages: evaluate input, predict outcomes, make judgments and perform triage, all on a moment-to-moment basis. That mode of functioning, according to recent thinking in cognitive neuroscience, evolved as the brain’s strategy to use its finite neural capacity efficiently. As we take in the stimuli of the speaker’s words, the prefrontal cortex, which enables organizing and prioritizing, lights up with activity as we continually vet the incoming information against what we know, our past experiences and our theoretical construct of the future.”

According to our brain, being fully present all the time would waste enormous time and energy. That’s what makes active listening such a gift! It takes dedication and signals to the other person, “You’re worth it!” 

 

How to Test Your Active Listening Skills

  • Notice your urge to speak and see if you can “bite your tongue” until a natural pause is created by the other person.
  • Fully engage with your eyes and body.
  • Put down your phone or items that may lure you away.
  • Try not to connect what the person is saying with your own experiences.
  • Try not to anticipate what you are going to say next. 
  • Incorporate parts of what the person said in a response back.
  • Ask questions to go deeper without the intent to judge or compete.
  • Approach with curiosity; find out something new.

As you gather for the holidays, it’s likely you will be catching up with folks you don’t see on a regular basis. Now is the perfect time to practice spreading words of kindness and making connections that go a little deeper. Set an intention as a speaker and a listener, to share the space and enhance the quality of your conversations, a gift to yourself and the world.


Sabrina WalesekSabrina Walasek is a long-time educator and lover of exploration and learning. She has traveled to more than 50 countries, embracing humanity and nurturing her sense of curiosity. She facilitates a monthly mindful women's circle and is a contributor to Whole Life Challenge's blog. Her website is www.mindfulspaces.org


Tags:  Active Listening  Conversation  Mindfulness  Presence 

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Improvements to Social Health Insurance

Posted By David Dallas-Orr, MBA, Monday, December 17, 2018

doctors looking at patient on operating tableDo we want to optimize health insurance for the individual given her/his willingness to pay? Do we want to reduce poverty and inequity by prioritizing reduction of inequity in health? These are two questions that face the medical system within every country no matter how developed the country may be. The development of social health insurance, to provide medical care to those that cannot afford it at the expense of tax payers, needs to be controlled by value-based care and increased transparency, while only paying for treatments that have proven to be cost-effective.

As compared to the healthcare system in Mexico before and after Seguro Popular, the US government is not subsidizing medical care unequally. To put it more simply, the rich in the US may be receiving much more healthcare, but they are not receiving more government money to do so. Although healthcare subsidies are not favoring people who can more easily afford it, there is still a great need to improve the way healthcare is funded. One of the ways to further increase the equity within health insurance is through value-based insurance design. This does not create all medical treatment coverage as equal, and instead covers the care that produces the best results. The value of care greatly depends on who provides it, who receives it, and where it is received.

Value-Based

In a survey done by the Kaiser Family Foundation, it was shown that a majority of the public believe that it is very important that future healthcare policy includes aspects of the Affordable Care Act that gave protections for people with pre-existing conditions (Kirzinger). However, given that people in the United States spend disproportionately more on healthcare expenditures as compared two other countries, it is clear that the money available needs to be spent more effectively. Healthcare plans in developing countries have become increasingly comprehensive due to the availability of new technologies, now covering a breadth of services ranging from obesity counseling to the morning-after pill. Do all of these healthcare services offer the same amount of benefit to patients? Because healthcare costs are shared amongst everyone in the system, patients do not have to pay the true cost of each medical treatment, creating an incentive to use more of the services available even though they may not be necessary. This has led to many doctors cashing in on the system, favoring volume over value, and offering patients unnecessary treatments and procedures for their own financial gain. An example of a procedure that is commonly overused is the laser ablation of varicose veins. Many times, this is done through embellishing medical records with symptoms that are more extreme in order to justify treatment. A recently published study in the journal Value Health showed that laser ablation for varicose veins showed the third highest cost effectiveness as one of 7 treatments available.

Transparent

compassionate doctor comforting patient

In the same survey by the Kaiser Family Foundation, four in ten insured adults ages 18-64 say there has been a time in the past 12 months when they received an unexpected medical bill and one in ten say they received a “surprise” medical bill from an out-of-network provider in the past year (Kirzinger). This shows the need for the US healthcare system to be more transparent about the costs of care. Transparency is another way to combat the moral hazard that faces a social insurance system. If patients are not being surprised by the already insurance-subsidized medical bills, they will be less likely to seek medical care when they do not need it.

There are many ways to increase transparency. One of the best methods can be borrowed from our neighbors to the North. In Canada, there are many ways to view the costs of medical care, one of the easiest to use being the Alberta Medical Association Fee Navigator. On the site, it can be seen that varicose vein injections have reached their cap for the year and the amount that physicians are able to bill is not even available. This means that the AMA will not pay for this treatment for the rest of the benefit year… which ends on June 30th, 2019.

The AMA Fee Navigator can also give information on cost-effective treatment options. This tool allows us to very easily see what physicians are being paid and clearly shows what services they are incentivized to perform.

Cost-effective

We are in the midst of election season and it is important that we advocate for legislation that leads to the most cost-effective treatments being delivered to patients. One of the metrics that is commonly used to evaluate the cost effectiveness of medical treatments and help control which procedures are covered by insurance is the cost per quality adjusted life year (QALY). One QALY is the equivalent of one lost year of healthy life. If someone had a disease that put them at 50% of their health for the last 5 years of their life and a drug could remove their symptoms and improve their quality of life for those years, the drug would add 2.5 QALYs. If the treatment cost $100,000 over those 5 years, then the cost per QALY is $40,000. In the United Kingdom, the National Institute for Health and Care Excellence sets a limit on average of $25,000, so this treatment would not be available in the UK. In the US, the drug Irinotecan has a cost per QALY of $50,000, yet it is still used for the treatment of metastatic colon cancer (Cohen). In conclusion, our social insurance can be improved and even expanded if the healthcare system moves to value-based care that focused on outcomes as opposed to treatments, transparency to prevent moral hazard and over treatment, and implementation of more strict reimbursement that removes coverage for treatments that are not cost-effective.

References

AMA, “Fee Navigator®.” Alberta Medical Association: Fee Navigator™ | Health Service Code 48.12: Aortocoronary Bypass of One Coronary Artery, 2018, www.albertadoctors.org/fee-navigator/hsc/48.12.

Cohen, J, et al. “Clinical and Economic Challenges Facing Pharmacogenomics.” Nature News, Nature Publishing Group, 10 Jan. 2012, www.nature.com/articles/tpj201163#t1.

Kirzinger, Ashley, et al. “Kaiser Health Tracking Poll – Late Summer 2018: The Election, Pre-Existing Conditions, and Surprises on Medical Bills.” The Henry J. Kaiser Family Foundation, 12 Sept. 2018, www.kff.org/health-reform/poll-finding/kaiser-health-tracking-poll-late-summer-2018-the-election-pre-existing-conditions-and-surprises-on-medical-bills/.


David Dallas-OrrDavid Dallas-Orr, MBA, has a background in wet lab biochemistry research and medical device commercialization experience in the areas of orthopedic surgery and cardiology. He is currently pursuing a Master's in Translational Medicine at UC San Francisco and UC Berkeley in order to learn more about bringing drugs and medical devices from the research stage to making an impact in the lives of patients.


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Energy & Empaths

Posted By Michelle J. Howe , Friday, December 7, 2018
Updated: Thursday, December 6, 2018

image of light in nature representing energyAn empath is an intuitive with higher sense perception. The awake empath is quite aware of the word ENERGY. Energy is not a bad or crazy word. When referring to our energy, it is a term that expresses how physically or emotionally powered up (or down) they feel at any given point and time. We eat food, we exercise, and we even relax to help us manage our energy.

In general, people think of energy as something to be preserved, gained or restored. We then speak of high energy when we attend a fun event or socialize with wonderful people. We speak of low energy or about feeling down when we are at a sad event or around people that are not so wonderful. We feel tired when we lack energy – meaning, we have nothing left to function, no extra to give to others. To most, the word energy is something we must have, get, or maintain. In summary:

We give energy,

We get energy,

WE ARE ENERGY!

This is the brilliant idea the metaphysical world has been trying to tell us about. The concept that we are energy is hard for some to accept, as many see themselves as simply physical bodies. But that physical body runs on nourishment, rest, and exercise. That physical body needs a form of fuel that allows it to function — a sort of "electricity" you can say. Energy is the unseen electricity that allows us to function on a daily basis.

The Word Energy is LOADED for Empaths

The empath knows we are energetic beings, and really “gets” the metaphysical concept that everything is energy. Many empaths feel the energetic body; others can see it. Empaths know that in every interaction with another, there is an energy exchange beyond shaking hands or saying “hello”. They are affected by energy seen and unseen, more than the “average” person. This gift allows Empaths to feel and know things about people on a more intimate level. The gift of knowing and feeling goes hand-in-hand with an Empath’s ability to help others heal emotionally.

Emotional healing involves helping a person understand, release, or see his or her life situation from a higher perspective. Often the people being helped don’t truly understand or see what is happening when they speak to an Empath, but enjoy the connection because they walk away with a smile or at least, feeling better. What happens in this exchange with an Empath? There’s a clearing or transmutation from a merging of energy.

An empath also uses the term energy to describe how someone feels to them. The empath is able to determine via intuitive vibe (knowing or feeling) many things about another person. Most notably, empaths connect with the emotional layer — although they also have the capacity to connect to physical ailments and thought patterns. As an empath, I find it interesting that people are often totally uninterested and/or unaware in knowing, acknowledging, or feeling anything that is inside of them. They often fear negative emotions and refuse to visit uncomfortable situations. As such, negative emotions can remain buried and take up permanent residence within them. Emotions that remain buried in the body cause energetic blocks. As these blocks accumulate, they lead to physical, mental, or emotional issues. It is these issues that empaths are uniquely qualified to help with. When we address issues that arise beyond not just physical, but emotional and spiritual as well, we move into a more holistic level of wellness.


Michelle J. HoweMichelle J. Howe is the founder of Empath Evolution. She is also a graduate of Orin & DaBen’s Awakening Light Body Program, and a certified Reiki Master, Integrated Energy Therapist, Soul Detective Practitioner and Metatronic Healer.


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Ripple Effects Mapping: A Holistic Approach for Evaluating Wellness Programs

Posted By Christina Peterson, Monday, December 3, 2018
Updated: Thursday, November 29, 2018

Wellness professionals are increasingly required to demonstrate program impacts. But capturing the holistic impact of wellness programs can be elusive because they are contingent upon dynamic social processes of change that may not be fully understood, controllable, or predictable. In these situations, qualitative evaluation methods like Ripple Effects Mapping are well-suited for constructing information about wellness program outcomes in multiple dimensions. 

Capturing the holistic impact of wellness programs can be elusive.

The Intended and the Unintended

Wellness programs often have outcomes that were not planned. Unintended outcomes can be positive or negative in nature and take two forms: the unforeseen and the unforeseeable. Consequences that are unforeseen arise from insufficient program planning or failure to fully take advantage of past evaluation or research. These types of unintended outcomes may be preventable with intentional planning and use of social theory as a guide. Alternatively, unforeseeable consequences are not predictable through any social theory or planning because change is by nature uncertain and non-linear. To learn from and adapt to these unintended program outcomes, program decision-makers must understand not just what changed, but how and why it changed. Understanding the unintended outcomes and feedback loops of a program is advantageous for providing insight into how a program works or how to improve a program that doesn’t work. Such outcomes may provide justification for budgetary reallocations, expanded funding, program expansion, or strategic redirection. Additionally, program administrators also have an ethical obligation to do no harm. Evaluation that uncovers negative unintended outcomes can help administrators alter strategies that are found to cause harm. 

 

Ripple Effects Mapping

Ripple effect mapping (REM) is a participatory method of qualitative data collection that seeks to identify intended and unintended effects (positive and negative) of a program using Appreciative Inquiry (AI). It is useful in situations where the results of programs occur over time within complex settings and can be used to explore outcomes at both the individual and organizational levels. In REM, participants are asked to consider the social, emotional, physical, intellectual, occupational, and spiritual dimensions of their life as they share their experiences in, and after, the program. This framework makes REM suitable for evaluating wellness programs among employees, youth, college-students, and more.

There are five phases to the REM process: interactive interviewing, group mind mapping, stakeholder interviews, data analysis, and member checking. Ripple-effect mapping may be used on its own or integrated into a mixed-method design that includes additional qualitative or quantitative components. For example, an evaluator may use a survey to examine intended outcomes among a large sample and recruit REM participants. Alternatively, the evaluator might follow the REM process with a survey to assess the theory of change that emerges from REM among a larger sample, allowing for additional revision and refinement.

 

Synergies with Wellness

Wellness is defined by the National Wellness Institute as an active process through which people become aware of, and make choices toward, a more successful existence. It is a process in which the social, spiritual, occupational, intellectual, emotional, and physical dimensions of individuals and groups function in harmony. Wellness promotion is a humanistic practice that leverages methods grounded in salutogenensis, self-determination, authentic relationship, inter-professional collaboration, and an inter-disciplinary knowledge base to cultivate wellness. Like wellness, Ripple Effects Mapping is a holistic, context-responsive, and person-centered evaluation method that can help understand how a program impacts the wellness journey. The Appreciative Inquiry style questioning used in REM is similar in nature to wellness coaching in that it is non-directive, strengths-based, and growth-oriented. Instead of focusing on solving problems, AI seeks to generate new ways of thinking, identify opportunities, and catalyze new patterns of behavior by cultivating "more good" instead of "less bad". Therefore, using REM in evaluation is particularly congruent with the aims of wellness promotion. 

Now what?

Tired of low survey response rates? Need to tell a great story about your program impacts? Is your program not working as intended and you want to know why? Find out more about the REM process in the December National Wellness Institute webinar: Ripple Effects Mapping: A Holistic Approach for Evaluating Wellness Programs.


Christina PetersonChristina Peterson is a PhD student in Evaluation, Statistics, and Measurement at the University of Tennessee. She is passionate about promoting wellness by catalyzing data-informed decision-making in through program evaluation. Her research interests include mixed-method approaches to economic evaluation and evaluation use. Christina has a MS in Nutrition, a BA in Economics. Prior to starting her PhD, Christina worked for the National Wellness Institute as the Professional Development Manager. In this role, she led program evaluation activities for NWI. Currently, Christina works as a Graduate Research Assistant where she provides statistical consulting for research projects.


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Managing Sadness, Anxiety, and Depression over the Holidays

Posted By Lindsay Born, Monday, December 3, 2018
Updated: Wednesday, November 28, 2018

Holidays are often associated with the happiest time of the year, but for some people it is also a difficult time. Some people are worried about time, family, and money or may feel isolated, especially if they recently lost a loved one. Below is a graph from the American Psychological Association showing the leading holiday stressors.

Leading Holiday Stress from American Psychological Association

What are ways we can help others or ourselves manage this stress?

Help those around you. Spend time with someone who needs it. An inexpensive way to make a huge difference in someone else’s holiday is to invite someone who may not have family into yours. For example, many years ago, a sweet woman named Edith began coming to our family holidays. She’s an elderly woman who emigrated from Hungary and has no family. Every year, she is delighted to see the children at our holidays and to have people to cook for.

Be realistic. The holidays don’t have to be perfect. They should be enjoyable. Not every single holiday and activity may fit in over the span of a week; there will be a next year, families grow and change, and traditions can change too. Choose which traditions to hang on to and what new traditions to begin.

If you feel isolated, reach out. Try getting involved in a community or religious organization or plan or participate in social events. Volunteering is always a great idea during the holiday season to give back to others. See if a local soup kitchens, fun run, or animal shelter is in need of volunteers.

Holidays are often associated with the happiest time of the year, but for some people it is also a difficult time.

Know that it is okay to not feel the holiday joy or spirit all the time. During the holidays, you are still human and can feel any emotions. Especially if a loved one isn’t there, know it is normal to feel sadness or grief. This can be a good time to start a new or different tradition to have a fresh start.

Save your shopping! Make gift-giving an experience rather than an item. Kids may already have a hundred toys, and teens or significant others can be difficult to shop for. Try getting them something they can do rather than own. This helps make memories! Some examples include tickets or gift cards to a movie, zoo, ski hill, amusement park, show, museum, mini vacation, or other local experience. Classes or lessons for dancing, yoga, instruments, singing, languages, and sports or donating to a charity in the other person’s name are also great ideas.

Budget your money and time. Both of these are valuable resources to keep track of, so plan ahead! Some alternatives are homemade gifts or a family gift exchange. Baked goods are affordable homemade gifts for someone with not a lot of space such as a college student, military personnel, or the elderly. As a college student, I would love is someone made me lasagna! I wouldn’t have to cook for a week! To keep track of your time, list what is important, learn to say no, and plan time for relaxation. Watch out for “FOMO”: the fear of missing out. You can’t do everything!

Save your guilt. Keep your healthy habits continuing into the New Year. Sugar and alcohol are plentiful at this time of year, so make sure to eat nutrient dense foods and to consume the unhealthy ones in moderation. 

Travel safely and wash your hands. Being sick or injured over the holidays is no fun! Prevent this by handling and preparing food safely, using your seatbelt, getting a flu vaccine, and using a designated driver if under the influence. Also, keep an eye on your kids during the hustle and bustle of family gatherings. Beware of choking hazards like coins and hard candy.

For airports and long car rides, make a list and check it twice! Plan to bring reusable water bottles (empty through airport security) and refill them as you travel to save money. Pack plenty of healthy snacks in a backpack or other carryon as well. Wear comfortable clothes and shoes. If you have kids, consider a small early gift for them to open that will entertain them when they get bored. This could be snacks, a book, a blanket, etc.

Six Dimensions of Wellness

Lastly, if you are undiagnosed and think you may have anxiety or depression, see a doctor. Be aware, accept and seek treatment because your emotional wellness impacts all other aspects of wellness, which is also why using the advice above can help anyone grow in all Six Dimensions of Wellness. Being kind, inviting, and helping others all focus in the social dimension. Being creative with gifts, helping others learn, and traveling all impact the intellectual dimension. Continuing or beginning healthy habits with eating and exercise are in the physical dimension. Being wise with money is part of the occupational dimension. Managing stress and sadness, acceptance, and focusing on positivity are the emotional dimension. And, lastly, the spiritual dimension is enhanced by volunteering, sharing joy, getting involved in the community, religion or environment, and feeling universal harmony and connectedness.


 

References

A. Greenberg and J. Berktold. American Psychological Association. (2006, December 12). Holiday Stress [Press release].

Mayo Clinic. (2017, September 16). Tips for coping with holiday stress. Retrieved November 6, 2018.


Lindsay Born is a Health Promotion and Wellness major at the University of Wisconsin-Stevens Point. Her minor is in psychology. Lindsay is currently an intern at the National Wellness Institute, engaging in marketing, writing, planning, and communication projects.


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