MAR 2014

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Page 48 of 210

E W NEWS & OPINION 46 " I can resist everything except temptation. " –Oscar Wilde M arch! The calendar's leaf evokes Julius Caesar, St. Patrick, the steely bespectacled Jack Nicholson at the Oscars, and my favorite, the equinox's mythic egg-standing trick. A nyway, how are those New Year's resolutions working out? Roy F. Baumeister, psychologist, author, and head of the social psy- chology program at Florida State University, and John Tierney, irrev- erent science contributor to the New York Times, have combined to explore the neuropsychology of self-regulation, aka self-control. Published in 2011, Willpower: Rediscovering the Greatest Human Strength spans 10 chapters, each devoted to distinct areas of behavior. Drew Carey, Eric Clapton, and Oprah Winfrey help illustrate the need to add willpower exercises to daily workouts. Targeting the layper- son, the book initially seems too fluffy to qualify for serious study; upon a reread, I changed my mind. The authors posit that willpower is hard currency in the psyche's account. It can be wasted (bad), enhanced (good), conserved (better) and, as good habits germinate, unnecessary (best). After comparing three dozen personality traits, Baumeister found that self-control, not IQ or SAT score, predicted a college student's GPA. Studies claim both nature and nurture important. The classic Walter Mischel experiment involv- ing marshmallows and preschoolers demonstrated that, even at age 4, some kids took the proffered marsh- mallow without consideration of a second if the waited an additional 15 minutes; others distracted them- selves to earn the bonus confection. Later, the children who delayed grat- ification were found to get better grades and were wealthier adults with stable jobs and relationships. The late Patrick Moynihan champi- oned the intact family unit to foster self-control and reduce teen preg- nancy, drug abuse, and incarcera- tion. His crusade affirmed the power of parental nurturing. W illpower is a finite commod- ity. Making decisions, resisting temptation, choosing priorities and other assignments of daily work ex- haust it. Peaking in the morning, it requires a supply of energy to keep neurotransmitters humming. It is victimized by illness and pain. The take-home? It's not a good idea to c onvene that "serious" talk with your significant other about the household's budget after a difficult day at the office, the prior night's tossing, a Snickers for lunch with a cold coming on. In a provocative chapter, the authors skewer the self-esteem movement popularized by psycholo- gists, educators, and governments (California established a task force on self-esteem). Making sure every- one got a trophy for getting out of bed in the morning, researchers found that recipients of their self- esteem efforts "just felt better about doing worse." Narcissism was en- hanced. Citing Amy Chua's The Battle Hymn of the Tiger Mother and Soo and Jane Kim's Top of the Class, the authors show that the high percentage of Asian students in elite colleges (and medical residencies) is not an aberration. While some mothers fear high goals generate distress, the aforementioned authors laud a cultural tradition of disci- pline, standards, earned reward and appropriate punishment. In a chapter devoted to to-do lists, Drew Carey enlists the aid of David Allen, the author of Getting Things Done, to bring some order to his frenetic life. First step? Set a goal—but just one and make certain it is attainable. Do thoughts of incomplete work intrude on your placid moments? The Zeigarnik Effect holds that a pending task will occupy one's thoughts until com- pleted—or until you write it down; a written plan propitiates a nagging conscience. Now, the bad news. That resolu- tion regarding the 20 pounds muf- fin-topping your mid-section and increasing your risk of heart disease, d iabetes and a middle seat in perpe- tuity on Southwest Airlines? Well, fuhgeddaboudit! Not only do diets not work, the "Oprah Paradox" guarantees future attempts to be less successful. The authors stress that being overweight does not imply poor willpower. But too many cycles of famine during the last Ice Age ap- p arently doom moderns to overeat- ing in times of abundance. If diets don't get it done, what can you— and your patients—do? The chapter offers tips, tactics, and strategies including the "Postponed Pleasure Ploy" whereby you allow yourself that triple bacon burger with fries and shake … later! Unfortunately, if you are an emotional binge eater, willpower won't save you. You cannot will yourself out of feeling badly; better to consult cognitive therapists like Albert Ellis. The book is a deceptively easy read; to maximize value, best to make notes. It proffers hope to those who find temptation on the inter- net, in the refrigerator, the wine bar, or like Eliot Spitzer, personal ads. Concluding, I mention a meeting at the Pentagon chaired by a psycholo- gist who asked high-ranking gener- als how they managed their day. Only the lone female general was able to complete the task: "First, I make a list of priorities: one, two, three, and so on. Then I cross out everything from three on down." Sounds like a plan. Just don't think about white bears. EW EditorsÕ note: Dr. Noreika has practiced ophthalmology in Medina, Ohio, since 1983. He has been a member of ASCRS for more than 30 years. Contact information Noreika: JCNMD@aol.com March 2014 by J.C. Noreika, MD, MBA Beware the depleted ego J.C. Noreika, MD, MBA Insights 18-47 News_EW March 2014-DL2 copy_Layout 1 3/6/14 2:48 PM Page 46

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