July 2023

Napoleon Hill, author of the seminal books "Think and Grow Rich" and "Law of Success", spoke at length about the importance of having a definite chief aim in life. This is the idea of knowing what it is that you want out of life, and knowing how to best achieve it. These two books were originally written during the Great Depression, but the ideas contained in Hill's writings are just as applicable today as they were during the Hoover and Roosevelt administrations. There has to be some reason to get out of bed in the morning, no matter your age. Without purpose, there is no motivation to keep getting better in some capacity, and life is about pushing forward, taking on challenges, and making the most out of each day.

One's definite chief aim in life may be their work. Whether you are a business owner or employee, finding a line of work that interests you and that you enjoy will give you purpose. I believe that in order to truly excel at something, you have to love it, or at least find a way to derive pleasure from it. I consider myself very fortunate to be able to instruct exercise for a living. Being able to work with the amazing clients at Total Results gives me purpose and makes me happy to get out of bed in the morning, plus it spurs me to continue to improve. However, if and when one retires from their primary career it can be a difficult task to figure out what comes next. Professional athletes face a slightly greater challenge when this happens, because their retirement comes at a much younger age than the average accountant, but also because their lives are often even more structured and centered around playing their sport. I think it's important at that point to find a new definite chief aim. Many Total Results clients are retired but still live fulfilling and active lives that involve travel, volunteering, grandchildren, learning new skills, and making the most out of each day. Exercise is a tool to help them accomplish this.

Regular Total Results exercise will help you to become stronger, fitter, better conditioned, more resistant to injury, and more functionally independent. Taking proactive health measures, such as participating in consistent exercise sessions, will mean less reliance on medication, fewer doctor visits, more energy, and less fatigue. You will be able to perform the activities of daily living with less effort, which will enable you to pursue what you want out of life with more vigor. All of this can be achieved in less than one hour per week. As clients become stronger and better conditioned, they often find themselves wanting to be more active. If you want to participate in a specific event or take up a new sport (run a 5K, play pickleball, Tough Mudder, etc.), it's important to understand the principle of specificity. You must train to learn and master the skills that are required for that activity; you can become better at hiking only by hiking, and you must gradually increase your running distance and pace to prepare for a 5K race. I have begun coaching football at Dominion High School, so I witness the principle of specificity on a daily basis. We teach the players the specific skills that their sport and position require to enable them to become the best players they can be.

There are many ways to find purpose and meaning in life. Choose a path that best suits your temperament and drive, and give it your all. Use the sensible and comprehensive Total Results exercise approach to help you achieve your goals!

Rachel Zoffness, MS, PhD, is a Health and Pain Psychologist, and is a member of the faculty at the University of California San Francisco. She has lectured at Stanford University and is a Mayday Fellow, a prestigious position that provides pain care leaders with the skills necessary to advocate for effective pain management. Dr. Zoffness published "The Pain Management Workbook" in 2020 to assist those living with chronic pain to reduce their pain intensity and frequency, limit reliance on pain medications, help them to regain control of their brain and body, and improve their quality of life. She believes that cognitive behavioral therapy can significantly reduce chronic pain and improve one's mental outlook, and several of the strategies discussed in the book are simple and easy to follow. I picked up a copy of this book after skimming through a transcript of a recent podcast interview with Dr. Zoffness that was provided by Total Results client Kathy Jenkins (thank you Kathy!)

We often think about pain as being a purely physical sensation, but according to the author, "When it comes to pain, 'physical' and 'emotional' are inextricably intertwined." It is necessary to target not just biological factors, but also consider emotional, cognitive, social, behavioral, and environmental factors as well. It's important to define what pain is, and according to the International Association for the Study of Pain it is, "an unpleasant sensory and emotional experience." The book differentiates between acute pain and chronic pain. Pain that comes and goes fairly quickly (think of stubbing your toe) is acute pain, while chronic pain typically lasts longer than three months and goes beyond the expected healing time. This is important to understand, and it makes me think about conversations that I often have with Total Results clients about the difference between injurious pain (something sharp and/or sudden) and exertional discomfort (a dull ache that is often present toward the end of an intense exercise). While many of us will experience both acute and chronic pain as we age, it is interesting to learn that pain may or may not be associated with structural degeneration. According to Dr. Zoffness, "Similarly, studies on back pain reveal that there's little to no correlation between back scan 'abnormalities' and pain. In one study, disk degeneration and bulges were found in 80% of elderly patients who had no symptoms or pain (her emphasis). In another, MRI 'abnormalities' were found to be completely unrelated to the degree of disability or pain intensity reported by patients: some people with lumps and bumps had pain, and others with similar back scans had none."

Neuroplasticity is a term that has garnered much attention in recent years; in the context of this discussion it means that you can retrain your brain and body to better deal with chronic pain. By gradually exposing yourself to small doses of potentially triggering stimuli (think of being in a dark room while your eyes slowly adjust to the lack of light), you can reprogram your brain to understand that hurt and harm are not the same thing. The idea is to weaken your brain and body's association with pain and danger. Start by doing low level activities for just a few minutes per bout, stimulating your body and brain and then increasing over time while making sure to still get a proper amount of rest. While it seems counterintuitive (much like when I tell clients the best thing to do is exercise again if they experience adverse muscular soreness), this is the way to go. As Dr. Zoffness says, "But staying home and not moving when you have chronic, long-term pain is a trap (her emphasis). Being sedentary and missing out on life for long stretches of time makes pain worse because your nervous system stays sensitized to, and focused on, the pain. The false-alarm system keeps shrieking loudly with nothing to control its volume. In fact, the longer you stay home avoiding activity, the longer your brain will stay in this sensitive, protective state, and the longer your pain will last."

Cognitive behavioral therapy (CBT) is a very effective strategy for treating chronic pain. We have been taught that our mind and our body are two separate entities, but nothing could be further from the truth. As the author states, "Mind and body are always connected, each constantly affecting the other (her emphasis)." Our thoughts, beliefs, emotions, and behaviors affect how our bodies respond to physical sensations. CBT involves recognizing these thoughts and emotions and understanding them, rather than trying to suppress them, but also acknowledging and anticipating triggers, which are difficult situations or events. People who suffer from chronic pain can experience devastating pain flares as a result of a triggering event (such as receiving an unexpected income tax bill). CBT teaches us to become more self-aware, to process negative events without going into fight-or-flight mode, and to come up with healthy coping strategies to reduce chronic pain.

In addition to CBT and a gradual incorporation of movement and lifestyle tasks, Dr. Zoffness discusses the importance of regulating your sleep cycle as a way of improving chronic pain. Proper sleep hygiene is critically important for all of us, but especially for people living with chronic pain. Some of the helpful tips she provides include limiting screen time before bed, avoiding naps, getting exposure to sunlight, establishing a relaxing pre-bedtime routine, and setting a consistent sleep and wake time (our brains love routine). I was very pleased to see that the author strongly recommends exercise, particularly strength training. Building muscle will reduce fatigue, boost immune function, reduce depression, and decrease stress and anxiety. According to the author, "...Exercise also eats up stress hormones like adrenaline and cortisol that are released during fight-or-flight, thereby promoting relaxation and healing." She also recommends Tai Chi and walking outdoors.

Just because you live with chronic pain doesn't mean you have to be miserable and miss out on life. You can take charge of your life and not be a slave to pain. There is plenty of room inside this workbook to write out your thoughts, feelings, and plan of action to improve your mental and physical well-being. Even if you do not suffer from chronic pain, chances are that you know somebody that does, and this can help to give you a better understanding. Dr. Zoffness has given us a wonderful resource; it's up to you to follow it.