In my clinical experience, most people struggle because their main motivations in life are to:

1) Feel good (addiction)
2) Avoid pain (avoidance)
3) Be right (ego)

Rather, I help people:
1) Be present (mindfulness)
2) Open up (willingness)
3) Do what matters (be effective)
2/ FEEL GOOD (ADDICTION): What's so wrong with pursuing pleasure?! After all, we're biologically wired to enjoy behaviors that promote survival & reproduction. The issue is that hedonism is a wildly bad strategy for living effectively, and paradoxically, enjoying life long-term.
3/ Prioritizing pleasure is chasing a high, spending your time/energy/resources on fleeting feelings. When you don't have it, you're extra unhappy because you expect you SHOULD be happy. When you do have it, you worry about when it'll go away. Thus, you're never stably satisfied.
4/ In fact, the logical extreme for a true hedonist is to use heroin, because there's little in life that is as pleasurable as an opiate high. But obviously that's not sustainable; 'chasing the dragon' requires a greater dose each time to feel the same, leading to overdose.
5/ Heroin is extreme, but I had a 'foodie' friend who would rather die if she could not have desert. Nothing wrong with enjoying food, but with 70% overweight and 88% metabolically unhealthy, most Americans are committing slow suicide by living to eat instead of eating to live.
6/ Thus, the inevitable end for hedonists is behavioral addiction and burnout, whether with food, drugs, sex/porn, shopping, internet/gaming. Think this doesn't apply to you? The average American spends 11 hours & 6 minutes PER DAY interacting with media: https://www.nielsen.com/us/en/insights/news/2018/time-flies-us-adults-now-spend-nearly-half-a-day-interacting-with-media.print.html
7/ This is because media has highjacked your "orientation response", which forces you to pay attention to novel stimuli (e.g. to see whether that's a stick or a snake on the trail). You evolved to pay attention for life or death, but now it’s stolen for page views & ad dollars

8/ You're now addicted to specialized interests that pleases you, sensationalism that scares you, and outrage that angers you. Your dopamine receptors are so overstimulated that normal just doesn't do it for you anymore in this weaponized arms race of digital dopamine triggers.
9/ BE PRESENT (MINDFULNESS): The antidote to this is mindfulness, though I hate the buzzword. You don’t need to meditate to be mindful (like there's many ways of being physically active beyond going to the gym). Just practice giving your full attention to the present moment.
10/ Dr. Jon Kabat-Zinn defined mindfulness as 1. Paying Attention 2. On Purpose 3. Without Judgement. Thus, give full attention to the task you chose (not externally triggered). Let thoughts/feelings/emotions/sensations pass without needing them to be other than what they are.
11/ This is better practiced than explained. Try focusing on your body at the gym instead of scrolling on Instagram between sets (seriously, stop that). The less time you spend worrying about the future (anxiety) or ruminating on the past (depression), the more free you’ll be.
12/ Thus, happiness should be treated as the byproduct of a well-lived life, not the priority or point of it. The best example is raising a child. Studies show that if you ping parents during the day, they are actually LESS happy during the moments they are with their children!
13/ Though few regret it, because most find bringing a child into this world MEANINGFUL, even if diapers/discipline are not very 'fun'. Happiness is a bonus that comes from savoring those fleeting moments of joy in the present moment and be willing to have them slip away as well.
14/ AVOID PAIN (AVOIDANCE): Who likes pain?! But there's so much that Buddhists believe life is suffering. I believe SUFFERING = PAIN X RESISTANCE. There will inevitably be ‘clean’ pain, but when you resist/avoid it, that pain expands into a big ‘dirty’ snowball of suffering.
15/ You may feel natural fear when speaking, but when you start to dread and avoid it, you now have crippling anxiety and can't. But anxiety is a muscle—every time you avoid it, you make the association stronger in your brain through reinforcement. Avoidance makes it worse!
16/ I would argue most psychological disorders are rooted in avoidance. Sadness and worry are natural emotions and not inherently pathological, even if you have a lot of it acutely (e.g. grief is a normal response to loss). It can be problematic when avoidance makes it chronic.
17/ Moods become ‘disorders’ when they cause significant distress (you wish you could avoid feeling that way) or dysfunction (you avoid socializing or working). Thus, if you just felt sad or worried and didn’t dread/avoid it, you by clinical definition, do not have a disorder!
16/ As a clinician, I DO NOT REINFORCE AVOIDANCE. A patient of mine trying to lose weight procrastinated on stepping on his scale last week due to shame/sadness from seeing his weight. Guess what was the first thing on our agenda at our next appointment? Stepping on that scale!
17/ OPEN UP (WILLINGNESS): So he repeatedly weighed for 20 min to expose him to uncomfortable emotions. He predicted he’d feel 9/10 sadness and it would last indefinitely, but it actually dropped to 5/10. It’s never as bad as you think, and you underestimate your ability to cope.
18/ Exposure works through habituation. You can get used to anything if you approach rather than avoid. You can even teach mice to fear a stimuli and then extinguish the fear response. This is neurological—if you can learn a negative habit/emotion, you can unlearn it as well!
19/ Thus, ‘accept’ your emotions rather than avoid them. But I dislike the word acceptance since it implies resignation, as in “suck it up”. That’s why I prefer the term “willingness”. Willingness is being open to having what you’re going to have if it’s going to be there anyway.
20/ Willingness doesn’t mean that you need to like it. But it means that if pain is part your journey towards a well-lived life, are you willing to compassionately bring it? If the prize is valuable enough, you will endure. Find what’s worth it, and you’ll find your willingness.
21/ The secret is that thoughts/feelings/memories/sensations cannot control you. They’re like unhelpful backseat passengers that can only distract and nudge you to drive off course. But guess what? They can’t MAKE you do anything, you're always in charge!
22/ BE RIGHT (EGO): You likely operate almost entirely from ego, meaning your mind has constructed a story of your identity, or “you”. Having an ego (self-as-story) is not inherently bad, but it is if you overly identify with it, as we overly fuse with thoughts, feelings, etc.
23/ That’s why people engage in rage fits when debating online (even I have to check myself), because it’s not about defending your opinion/position, but defending your very sense of self/ego, which we will even do to the death (people suicide to avoid shaming their identity).
24/ Tweetstorm continued here: https://twitter.com/DrSepah/status/1100568875463110656
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