Positive psychology definition/discussion & a false alarm at the ER last night.

My liver labs were worse which led to an ultrasound -> cysts -> CT scan -> perforated bowel, come in for immediate surgery. Um what? Uh, no, no way. I did go in for more testing though. *post2long4ema

I don’t have a perforated bowel and as I had been eating normally all day, driving myself around and feeling fine in general, compared to my difficult summer. A perforated bowel is a fairly immediate sepsis and death risk, which I knew, and surgery to remove the bad section is performed typically, which I knew. But I also knew there would signs of infection, a fever maybe, and a lot of pain. The ER was expecting a perforated bowel patient and were confused by my not being in abdominal pain at all and looking not-sick.

I let them know my theories - air showing up in the CT scan would be due to the immediate gassy effect the barium sulfate solution had on me - and that turned out to be correct. They thought they were seeing air outside of the bowel which wouldn’t be from dietary sulfate gassiness. The first CT scan showed what turned out to be a folded spot in the colon with air. The air looked out of place - outside of the normal intestinal area. A repeat CT scan was done after my ER drawn blood work came back fairly normal except for the initial questionable liver labs were still elevated, but not even worse.

I share this story as an example of how the nocebo effect might have led someone less familiar with physiology into believing that they did have a perforated bowel and did need immediate life saving surgery. If I hadn’t been as confident and insistent that I didn’t want or think I needed surgery, then exploratory surgery may have happened “Just to SEE what is going on.” The CT scan was supposed to show what was going on - and it did show liver cysts. I was a medical anomaly regarding the suspected perforated bowel though.

Photo by Alexander Grey on Unsplash

The problem with invasive testing is that you are being invaded - things are happening to you that can be causing damage or might lead to mistreatment due to false positives - misdiagnosis.

The plan now is to follow up with my family doctor regarding the liver cysts and enzyme labs will be repeated for a while. And they want an MRI to see better what is going on. Sigh. It is for my benefit supposedly.

Liver cysts can be benign and can be present from birth, but I have never had elevated liver labs before. Something happened to my health this summer and I think the Mucinex might have been the underlying factor - the main new thing I had added. The ER did check my salicylate level at my request and it was ‘negative’ - within normal range. So that was good news, my cutting out favorites did help.

After rereading the info on Mucinex and fibromyalgia, I am going to discontinue it. It is likely making me more salicylate sensitive because it directly adds to acidity in the urine because it is converted to lactic acid and then excreted in the urine. Mucinex does seem to help my chronic low level congestion, but I still had some muscle knots causing painful neck and shoulder muscles and fibromyalgia pain for me is related to retinoic acid excess. If I avoid vitamin A and carotenoids then I am not in severe all over pain - flu-like body ache. The lingering muscle knots or joint pain seem related to increased acidity levels too.

If liver cysts are involved, lack of iodine may be part of my issues, more on that towards the end and its potential role with CYP enzymes and drug detox by the liver. A discussion of Positive Psychology and my view of Toxic Positivity is next along with a little of what was on my mind during my time spent in a patient gown - surprise it wasn’t about filling in the Advance Directive form.

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Our RAS system, patient gowns, and Positive Psychology

I had a reminder to “Be careful what you wish for” -- it is said that we get what we focus on in life. That is a New Age-y theory that is supported by understanding of our brain’s reticular activating system (RAS). What we focus on in our thoughts, is what our RAS will focus our brain on - we will notice those things more and it might seem odd or surreal or special, when it is really just that you are paying more attention to that type of thing because it was on your mind.

More magical beliefs take it a little farther - that we are setting ourselves up to get what we focused on. I had been thinking about recording a video reading in character, like a one person play - and the role could call for a disheveled looking person in a patient gown, in a clinical setting - adding subtle suggestion of a mental health patient in a lock up ward. I actually tried to record it while I was at the family doctor’s but ran out of time and the recording hadn’t started anyway. It left me thinking about how to get a patient gown to have at home, so I could record my skit in privacy and with good internet. It also left me thinking that if I were a patient at the hospital I would have more time in my patient gown to do the recording. Chagrin, later that night when I am in a patient gown again. I thought about trying the recording again but the internet connection was even worse. Many people might just swipe a patient gown as they left, but I didn’t do that either. Maybe I will do the recording, maybe not.

The text was a reorganization by me, of conversational statements that Demi Pietchell shared in a little Substack contest. It was fun to read aloud and left me wanting to make it into a mini video that opens with little clue as to where or who the person is that is talking, and then as it unfolds, camera pan out shows that the person is likely a mental health patient. (pdf in my Dropbox)

Demi had shared two lists of phrases that were ‘things she never expected to either say or hear said’ and the contest challenge is to use them, ~ one or more — unchanged, within your own written work of whatever sort. I saw some connected themes and started just building a text using exclusively her phrases with no additional words from me - and it really worked in a silly way. It suggested someone tuned into other things than normal reality, or schizophrenic even. Silly phrases though, fun to read aloud.

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Segue to ‘positive psychology’ - there was a caution about ‘toxic positivity’ in my replies and since I have been sharing more on the topic I will add a little background -

According to my understanding on a little reading - positive psychology focuses on the moving forward part of healing and growth. What do positive, healthy, happy people do in life? What is working for humans? How can we learn from what is working to help more people achieve that?

As opposed, or in contrast to, the older standard of psychology which is more like a Freudian couch analysis digging into old deep trauma crud.

In my own health journey, I have had to dig into the old stuff, but eventually you also learn that you really have to let go of the old stuff, stop dwelling on it, start LIVING in the now and working towards your own future goals instead of spinning over the old crud repetitively.

From the physiologic perspective of the RAS system - we REALLY DO NEED TO STOP FOCUSING ON THE OLD CRUD - because that just keeps the RAS focusing the brain on those same old patterns. To get out of the old stuck rut, we need to simply start thinking and doing other things so the brain builds new pathways and habits of thought.

A critique of a critique about Positive Psychology as a new clinical field.

Last night while spending six hours in a patient gown, I found a critique article by van Zyl, et al., 2023 about the new field of “Positive psychology” and it is fairly negative. A main point of the critique is regarding the redefining of “virtues” and focus on “character strengths” as continuums that may be used too little, too much, or normal amounts in a person’s life. The critique talked about how it is going against Positive Psychology’s own basis in Aristotle’s discussion of “virtues” because he didn’t see them as a continuum but only as a “virtue,” a positive. (van Zyl, et al., 2023) Roughly, read it last night.

My response to that would be, um, gee golly gosh, Aristotle is not the only philosopher in the world and more than one person is allowed to have thoughts about topics - it is called freedom and freedom should exist within academic circles too. In other words, I throw out that argument as complete and utter nonsense. If human intelligence is not allowed to grow past the time of Aristotle . . . then why is anyone writing anything about philosophy anymore? We don’t need anyone employed in the field of ‘philosophy’, we should all just read Aristotle . . . as intelligent thought ended with him. Right?

Wrong, complete and utter nonsense. Information is a growing thing that is built on by many people over time. (Although CoV era has led to speculation about the public’s level of intelligence or willingness to believe brain washing tactics.)

Meme repeat:

That’s just how things are done around her.

“The review identified 32 records that posed 117 unique criticisms and critiques of various areas of the discipline. These could be grouped into 21 categories through conventional content analysis, culminating in six overarching themes or ‘broad criticisms/critiques’. The findings suggested that positive psychology (a) lacked proper theorizing and conceptual thinking, (b) was problematic as far as measurement and methodologies were concerned, (c) was seen as a pseudoscience that lacked evidence and had poor replication, (d) lacked novelty and self-isolated itself from mainstream psychology, (e) was a decontextualized neoliberalist ideology that caused harm, and (f) was a capitalistic venture.” (van Zyl, et al., 2023)

Jeepers, seems like someone has hurt feelings. Psychology itself is not that great at a) proper theorizing and conceptual thinking, based on the significant harm that most psychiatric drugs cause and which were often based on the now tossed out theory of “chemical imbalance within the brain”. Or b) measurement and methodologies - it is a subjective field, ask TV Dr. House or Bones about psychiatry. Or c) both of the TV doctors see psychology as a pseudoscience that lacks evidence and has poor replicability. Regarding d) - how can the ‘new’ field of Positive Psychology not have ‘novelty’? And is it really ‘self-isolating’ or is it just not being embraced by mainstream psychology?

Regarding e) “a decontextualized neoliberalist ideology that caused harm” — name-calling is grade school level and really shares very little of critical value. The entire medical industry could be called neoliberalist. Neoliberalism was a term invented to sound liberal while not being liberal. It is about protecting corporate profit and corporate right to monopolize consumer’s purchasing through government controls like requiring pricy licensing or high tech clinics for basic services. “Causing harm” is something the field of psychology excels at so why expect Positive Psychology to be better? or prove it.

Regarding f) “a capitalistic venture” - so is psychology, so is the medical industry, hello. Business is about business and the point of schooling initially was not to forever after work within academic walls, but to train people to go out with useful skills and provide services or products that others would be willing to pay for. Is there a point to writing Systematic Review journal articles besides getting another line on your Curriculum Vitae? Grant seeking is a capitalistic venture, by the way.

The paper is an interesting read in the fine art of saying very little with a lot of words. (van Zyl, et al., 2023) The biggest question should be - are clients gaining better quality of life from working with the Character Strengths or other positive psychology information? Are they really being harmed? Or is that some jealous counselor who has lost clients to Positive Psychology focused clinicians? is this like the “Integrative Medicine” wanting standard medicine to be used along with Alternative methods?

Personally I found the concept of strengths being a continuum as sensible and empowering - with practice I can improve. I may not be as super good at some things as other things, but that doesn’t mean I am only allowed to do the things I am good at. A well-rounded person does a little of everything. The Enneagram theory of personality types also talks about growth and development of our skills within interconnected categories. And it talks about virtues. And was not written by Aristotle.

A different book I looked at yesterday is by a modern day philosopher named Ken Wilber. ‘The Eye of Spirit - an Integral Vision for a World Gone Slightly Mad’, 2001. He is also very wordy - the gist seems to be that he is trying to organize all of human intelligence into some overarching patterns of agreement. Where do the majority of thinkers within a field agree? Which concepts seem most universal to the field? He has a psychological model too:

“The title [of a chapter] “Waves, Streams, States, and Self” is itself a brief summary of the psychological model. Namely: there are levels or waves of consciousness, stretching from matter to body to mind to soul to spirit. Through those levels pass numerous developmental lines or streams of consciousness (the cognitive line, the moral line, the psychosexual, the interpersonal, the affective, the spiritual, etc.) These lines or streams develop in a relatively independent fashion, so that a person can be at a high level of development in some lines (e.g. the cognitive), medium in others (e.g. moral), and low in still others (e.g. spiritual). Thus there is nothing linear about overall development.” - Ken Wilber in The Eye of Spirit,(Preface, vii-viii)

I see nothing to argue with that, but apparently he also has received a lot of criticism of his work based on what I read of the opening sections.

Social research quite clearly shows that on average we do gain skills as we age. Older adults tend to have better social skills than younger adults. I also don’t feel compelled to read the high syllable word count 400 page book to find out more. But I might, it does look interesting. I picked it up from a free shelf. And 400 pages to condense all of human knowledge - seems fair. ;-)

Neuroscience is more condensed than philosophy, which I tend to prefer. Strunk & White - “Omit needless words.” People who do not have a family to feed and wash up after may have too much time on their hands to think. They might consider offering to babysit occasionally just to see how real life works or take a job washing dishes. Everybody needs clean dishes.

To get to a point [a lengthy point :-)] - I did invest in a bunch of shareable material and some books for my use on the topic of Positive Psychology techniques. I find the concepts helpful and I am at a stage where I am ready to move forward and to stop dwelling on the past. The handout exercises could be used by a mental health clinician as part of their services - I could use them for myself or within nutrition counseling when emotional issues are involved in health. But I don’t have a clinic and realistically I am not well enough to cope with running a clinic, nor do I have time while being a caregiver for my mother. My Scope of Practice as a dietitian is also less clinical and more public health and group oriented than the work done by a hospital or private clinic dietitian. I have decided for now to use my new purchases however I want and not worry about it from a business expense perspective. I am still in the expensive hobby phase of my business building maybe or still healing after work burnout. Sharing as you learn can help you remember it better too.

“Toxic Positivity”?

“Toxic Positivity” to me is unrealistic goals or affirmations. Or maybe the misinterpretation by the business community of the Glad Game from the book ‘Pollyanna’. To be a “Pollyanna” in the business world is derogatory - don’t be an unrealistic dreamer. But that is wrong in my opinion - go read the book. Pollyanna’s father taught her the Glad Game when she was young and a missionary supply box arrived. She hoped it contained a doll for her, but instead there were child size crutches. Her father suggested that she look for something to be glad about it anyway - like ~ You don’t need crutches, aren’t you glad! Pollyanna decided, Well, yes, she was really glad to not need the crutches.

She shared the Glad Game later as an orphan with others who were depressed or down about something. The goal is simply to look for something positive about the negative event or feeling so that you can have a positive feeling instead of a negative outlook. Example from the book - a worker at her aunt’s house hated Mondays - a new work week. Pollyanna suggested that she could be glad that it would be another seven days before it was Monday again!

The Glad Game is not about being unrealistically positive, it is simply about looking for any tiny sliver of a silver lining in the thundercloud that you are facing. It is still a thundercloud, but it has a tiny silver lining now. Which is pretty. And we can be thankful for how pretty that storm cloud’s silver lining is. Yes, the crops are flattened and the place is drenched, but life goes on for most of us, and it was pretty for a few moments.

My new email header. I love this photo. My sister’s and I wanted a sky blue pink crayon color but you can use pink and sky blue to recreate the wispy effect.

Yes, I don’t have a perforated bowel needing emergency surgery, I am glad, but also not that surprised. Convinced people can be convincing though. Was my summertime gassiness so bad that it had perforated my bowel and then my body formed a pocket around the area that was so good I had zero signs of infection? I didn’t think so and I managed to handle the whole thing fairly calmly but at previous states of histamine excess I might not have done as well. My mindfulness/meditation practice helped. I was able to stay relaxed during testing and waiting. I do still have the liver cyst issue to figure out but the labs had not gone up further in the last two days. Maybe getting the salicylate issue under control will help but the doctor didn’t think cysts were typical of a drug toxicity reaction in the liver.

When there is a question of health issues without a known cause - lack of iodine is a good place to start looking, in the US and some other nations.

Iodine alternative info would suggest I need more iodine if there are cysts in my body somewhere. And so does toxicity risks to the liver with radioactive iodine treatments. There were a couple other citations I didn’t copy.

“Three cases with unusual false positive radioiodine uptake in three different organs and pathologies (infective old fibrotic lesion in the lung, simple liver cyst, and benign breast lesion) on iodine-131 (¹³¹I) whole body scintigraphy. Clinicoradiological correlation was undertaken in all three cases and the pathologies were ascertained. In all the three cases, single-photon emission computerized tomography-computed tomography (SPECT-CT) and ancillary imaging modalities were employed and were helpful in arriving at the final diagnosis.” (Ranade, et al., 2016)

Seaweed for dinner. If simple liver cysts want iodine, then I think they should have not radioactive iodine. That is my take home point from the above quote.

Iodine can increase immune response to infection, but then there is an increased need for antioxidants to cope with increased oxidative stress chemicals that result from the increased immune response. Iodine may help the liver cope with an increased burden of drug detox or from over eating rich foods, by increasing Cytochrome P450 enzymes (hormonesmatter.com) which are needed to detoxify drugs.

“Certainly more studies are underway to define the role of extrathyroidal iodine in all body compartments. For example, the author speculates that iodine is important for liver detoxification. This is because cell culture studies showed that iodine can increase levels of Cytochrome P450 enzymes which is likely to also occur in the liver in response to iodine replenishment.”

• MAHMOOD BILAL PHD, DABCC, TS(ABB), MLS(ASCP), Extrathyroidal Role of Iodine, September 20, 2021, (hormonesmatter.com)

*good overview article. It has disturbing statistics about iodine deficiency in women of childbearing age or who were pregnant - 35 and 38% were iodine deficient. That is 38% of babies at risk for birth or prenatal complications and a need for iodine ASAP after birth. Sadly that is not a standard treatment approach, even though necessary for better development.

The Cytochrome P450 link takes us to this paper:

“In this study we provide the first gene array profiling of an estrogen responsive breast cancer cell line demonstrating that the combination of iodine and iodide alters gene expression. Among the list of altered genes were several genes documented to be estrogen responsive such as TFF1 and WISP2. Furthermore, the list contained several genes involved in the estrogen response including Phase I estrogen metabolizing enzymes (CYP1A1 and CYP1B) and Cyclin D1, a competitive inhibitor of BRCA1 [41].

Consistent with our initial hypothesis that iodine/iodide interacts with the estrogen pathway, we found that iodine/iodide altered mRNA expression of several genes involved in the estrogen pathway and down-regulated several estrogen responsive genes. Furthermore, many of the genes identified contain putative Estrogen Responsive Elements in their promoter region. One potential mechanism in which iodine/iodide can repress the estrogen effect on cellular metabolism is through alterations in the Cytochrome P450 pathway. Our data shows that treatment with iodine and iodide increases the mRNA levels of Cytochrome P450 1A1 (CYP1A1) and 1B1 (CYP1B1), two estrogen phase I estrogen metabolizing enzymes that oxidizes 17β-estradiol to 2-hydoxyestradiol (2-OH-E₂) and 4-hydoxyestradiol (4-OH-E₂), respectively.” (Stoddard II, et al., 2008)

‘Why are CYP enzymes a key focus for liver disease research?’, Published on: 13 Jan 2020, (owlstonemedical.com)

“Cytochrome P450 (CYP450) proteins are a family of approximately 60 different enzymes in humans. These enzymes account for 70 to 80 percent of drug metabolism. The CYP450 proteins are expressed mainly in the liver and gut mucosa, where they oxidize steroids, fatty acids, and xenobiotics, and are important for the clearance of various compounds from the bloodstream, as well as for hormone synthesis and breakdown¹. 

The high expression levels in the hepatic tissue, make CYP450 enzymes excellent targets for diagnostic purposes because their activity changes in liver disease. Furthermore, genetic alterations of CYP450 in certain individuals result in isoforms able to metabolize drugs faster or slower compared to the general population. Therefore, knowledge of these isoforms in each individual is key to identifying optimal drug dosage and minimize the possibility of adverse drug reactions due to overdosage or drugs interactions.”

‘Why are CYP enzymes a key focus for liver disease research?’, Published on: 13 Jan 2020, (owlstonemedical.com)

*This article has a Table of common drugs and the CYP enzymes that can break down the drug. It would be useful when a patient’s genetics are known.

“Table 1: 70% of drugs are metabolized by four CYP450 enzymes (3A4/5, 2D6, 2C9 and 2C19). This shows examples of the major drugs that are processed by CYP450 proteins, their therapeutic use and the number of times each was prescribed in the US during 2015.” (owlstonemedical.com)

These are some of my gene SNPs. A report says these variants have ‘No Impact’ but I would want to look them up.

• CYP1A1 Ile462 ValA>G AA

• CYP1B1 Asn453 SerA>G AA

• CYP2C9 Ile359 LeuA>C AA — 2C9 metabolizes several of the common drugs. (owlstonemedical.com)

• CYP2C9 Arg144 CysC>T CC — 2C9

• CYP2D6 *1/*3/*10*1/*1 — 2D6 metabolizes a lot of the common drugs. (owlstonemedical.com)

• CYP3A4 –392A>G AA

And these are “Low Impact”

• CYP17A1 34 T>C TC

• CYP19A1 C>T CT

• CYP1A2 –163 A>C AC

• CYP2C19 *1/*2/*17*1/*2 — this one can metabolize Zoloft and Eliquis. (owlstonemedical.com)

• CYP2R1 A>G AG

And “Medium Impact”

• CYP1B1 Leu432Val C>G CG

Clearly, my history of multiple chemical sensitivity is not a mystery. Add glyphosate and no one’s CYP enzymes may be functioning well. (Seneff and Samsel)

Realistic goals your brain will believe are important rather than wishful thinking positivity affirmations or goals.

A coaching tip is to make your goals or positive statements realistic, a challenge maybe, but reachable - or the brain won’t believe it and think you are being silly to keep repeating that saying or goal. “I will make a million dollars this year,” might seem silly when the brain knows that you have only been making a much smaller amount every other year.

SMART Goals - Specific, Measurable, Achievable, Realistic, Timely

Ideally goals should include actionable steps with specific timelines or at least a rough estimate of the time needed, and a way to measure that the desired outcome was achieved — some way to evaluate the progress, and then be able to recalibrate as needed to finetune the outcome. More info here: (corporatefinanceinstitute.com).

A goal of “make a million dollars in a year” has a quantifiable outcome and a timeline, but no action steps - how are you going to do that? Stage a kidnapping with a million dollar ransom? ;-) Rob a bank? Design a widget that people want to buy and then sell enough of them to net a million dollars? How much does it cost to make the widget, market the widget, ship the widget, and provide follow up customer support for the widget? You have to figure out your expenses and cost of the time and supplies needed, etcetera. Actionable goals need specific steps.

Fullscript product update and why a virtual clinic would be nice.

Working towards a virtual clinic might be a more realistic goal for me than starting one right now while I am a caregiver. The Fullscript service is for me to use within my communication with my clients or patients. A virtual office would have interactive services that the Fullscript site does not have and has no plan to add - it isn’t their job. I got into trouble on the Black Friday sale because of the way I share the link with anyone plus not reading the fine print about the discount system that Fullscript has set up for special promotions. One brand, Ortho Molecular Products, is no longer going to allow clients to order without a plan for it written by their practitioner (which would be me in this case - let me know if you want a product from Ortho Molecular Products and I could write the plan for you to be able to buy it.

There is a virtual office company that offers a minimal service free service for start-ups, ten clients or less, but that level of service doesn’t allow setting up courses which is more of an interest. Ethically I still have no guarantee of privacy in my life - from the government but no one else does either in the US.

Disclaimer: This information is being provided for educational purposes within the guidelines of Fair Use and is not intended to provide individual healthcare guidance.

Reference List

(Ranade, et al., 2016) Ranade R, Pawar S, Mahajan A, Basu S. Unusual False Positive Radioiodine Uptake on (131)I Whole Body Scintigraphy in Three Unrelated Organs with Different Pathologies in Patients of Differentiated Thyroid Carcinoma: A Case Series. World J Nucl Med. 2016 May-Aug;15(2):137-41. doi: 10.4103/1450-1147.176884. PMID: 27134566; PMCID: PMC4809156. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4809156/

(Stoddard II, et al., 2008) Stoddard II FR, Brooks AD, Eskin BA, Johannes GJ. Iodine Alters Gene Expression in the MCF7 Breast Cancer Cell Line: Evidence for an Anti-Estrogen Effect of Iodine. Int J Med Sci 2008; 5(4):189-196. doi:10.7150/ijms.5.189. https://www.medsci.org/v05p0189.htm

(van Zyl, et al., 2023) Llewellyn E. van Zyl, Jaclyn Gaffaney, Leoni van der Vaart, Bryan J. Dik & Stewart I Donaldson (2023) The critiques and criticisms of positive psychology: A systematic review, The Journal of Positive Psychology, DOI: 10.1080/17439760.2023.2178956 https://www.tandfonline.com/doi/full/10.1080/17439760.2023.2178956