Prescribing Creativityfiles.academyofosteopathy.org/convo/2020/Presentations/... · 2020-02-25 · 1. Prove you are inherently creative 2. Identify if you’re stressed or burned

Prescribing CreativityHow the 6th vital sign can help you re-energize

your career, decrease stress, and have more fun

1. Prove you are inherently creative

2. Identify if you’re stressed or burned out

3. Discover how stress impacts your body

4. Recognize the prolific power of FLOW

5. Acquire tips to rescue your right brain

6. Put it all together as the 6th Vital Sign

@AmAcadOsteo





5. Recognize the prolific power of flow state


@AmAcadOsteo

Creativity Equation

New + Useful

= Creative@AmAcadOsteo

“The newness in

the individual psyche

is an endlessly varied

recombinationof age-old components.

-Carl Jung

“A good poet will usually

borrow from authors remote in time.

-T.S. Eliot

@AmAcadOsteo






6. Connect to your intuition for happiness


@AmAcadOsteo

@AmAcadOsteo

@AmAcadOsteo

@AmAcadOsteo

The doctor

will see you

now.

Medscape Report 2019

44%

burned out

@AmAcadOsteo

Medscape 2019 review

45-54 year olds

@AmAcadOsteo

Medscape National Physician Burnout, Depression & Suicide Report 2019@AmAcadOsteo

@AmAcadOsteo

DIAGNOSIS:

W55.29 = OTHER contact with a cow

F43.0 = Acute stress reaction

Z73.0 = Burnout@AmAcadOsteo

Recognize the

arrhythmia

before it flatlines

Health Professional

Burnout● Depersonalization

● Emotional exhaustion

● Perceived low personal

achievement

= GRIEF.

STRESS● Over engagement

● Emotionally overactive

● Urgent/hyperactive

● Easy to treat

● Self-recognition

● Damage is physical

● Increased risk of medical

conditions

BURNOUT● Disengagement

● Emotionally blunted

● Hopeless

● Detachment

● Damage is emotional

● Difficult to manage

● Not recognized by self

● Risk for suicide

Gaither, C: Reignite, From Burned out to On Fire. 2018 @AmAcadOsteo

STRESS● Over engagement

● Emotionally overactive

● Urgent/hyperactive

● Easy to treat

● Self-recognition

● Damage is physical

● Increased risk of medical

conditions

BURNOUT● Disengagement

● Emotionally blunted

● Hopeless

● Detachment

● Damage is emotional

● Difficult to manage

● Not recognized by self

● Risk for suicide

Gaither, C: Reignite, From Burned out to On Fire. 2018 @AmAcadOsteo

SO WHAT’S THE BIG DEAL?

● ⬆ medical errors

● ⬆ healthcare costs to public (40% turnover)

● ⬆ medical claims by employees (114%)

● ⬇ patient outcomes, ⬇ satisfaction (27%)

● Estimated shortage of 90,000 physicians by 2025

● Substance abuse, divorce, suicide

Healthcare Staff Wellbeing, Burnout, and Patient Safety: A Systematic Review Louise H. Hall ,et al Published: July 8, 2016

https://doi.org/10.1371/journal.pone.0159015

$630,000to replace 1 PCP

@AmAcadOsteo

AMA “STEPS FORWARD”

@AmAcadOsteo

Academic Hospital

7.4

$3,720,472

500 27

@AmAcadOsteo

@AmAcadOsteo






6. Put it all together as the 6th vital sign

@AmAcadOsteo

DepersonalizationGrief

Automation

Meaningless

Lack of sleep

StressOvereat

CellularPhysiology

Isolation

Prefrontal cortex

@AmAcadOsteo

@IIDA.WI

DNA aged 6 years during the

first 12 months on the job.

Telomere shorteningdirectly proportional to hours worked

and perceived stress

@AmAcadOsteo

ACE studyAdverse Childhood

Events

https://www.cdc.gov/violenceprevention/child

abuseandneglect/acestudy/index.html

“Adverse

Doctor

Events?”

@AmAcadOsteo

@AmAcadOsteo

“Intestinal permeability….

..results in metabolic endotoxinemia.”

@AmAcadOsteo

Intestinal

Permeability

You need

some help.

inflammation

inflammation

inflammationinflammation

inflammation

inflammation

@AmAcadOsteo





5. Acquire tips to save your right brain


@AmAcadOsteo

BURNOUT

● Emotional exhaustion

● Depersonalization

● Low perceived

achievement

ENGAGEMENT

● Emotional energy

● Resiliency and vigor

● Sense of significance

● Enthusiasm

● Deeply engrossed

● Selflessness

@AmAcadOsteo

Engagement is also….

Creative

Flow state

@AmAcadOsteo

● Selflessness

● Timelessness

● Effortlessness

● Richness

Mihaly Csikszentmihaly @IIDA.WI

@AmAcadOsteo

The amount of time spent in

a creative task showed DIRECT correlation to

amount of positive affect and wellbeing

long after activity ceased

“Unnecessary Creating”,

creating for ourselves rather

than for others.

When we spend much of our

time in on-demand creating,

we can quickly lose touch with

the passions that fuel our

best work

@AmAcadOsteo

@AmAcadOsteo

80% indicatedthat the music therapist’s practice improved their caregiving experience…

Lowered perceived pain and stress

when surgeons are in “flow,”

…..complex tasks feel effortless;

...highly engaged and less likely to

make errors@AmAcadOsteo

What is happening in

our bodies?

@AmAcadOsteo





5. Acquire tips to GROW your right brain


@AmAcadOsteo

Neuroplasticity

“The enemy of art is

the absence of

limitations.”

--Orson Welles

Creativity needs:

M.I.N.D.

@AmAcadOsteo

Mitochondria

Integrate

Notice

Divergent

@AmAcadOsteo

@AmAcadOsteo

@AmAcadOsteo

@AmAcadOsteo

Flavonoids and Mood

● Flavones bind to GABA(A)

receptors

○ Anti-anxiety

○ Anti-convulsive

● Neuroprotective properties

● Influence mood

@AmAcadOsteo

Carbohydrate enriched diet =

Anxious and depressive

behaviors

@AmAcadOsteo

Alpha

Beta

We crave hypofrontality@AmAcadOsteo

Prefrontal cortex

Alpha Waves =

● Sensory input minimized

● Clear of unwanted thoughts

● Relaxed wakefulness

@AmAcadOsteo

Brain Derived Neurotropic Factor

@AmAcadOsteo

Bilateral exercise promotes

brain plasticity by producing

BDNF

Increased ENERGY

anti-inflammatory

@AmAcadOsteo

Creativity is about living creatively. We all

have the capacity to dream, explore, discover,

build, ask questions, and seek answers…. inviting

us to explore and express our own unique set of

qualities …..and to

connect the dots in a way that

they’ve never been connected before.

—Scott Barry Kaufmann Wired to Create

“

@AmAcadOsteo

significant improvement

in their observational skills

“Ideas arose in crowds,

colliding until pairs interlocked,

and a stable

connectionwas made.”

-Henri Poincaré

@AmAcadOsteo

Sustained

28% reduction in

perceived stress and depression (16 percent) in health-care

practitioners.

Cheng., S., et al. “Improving mental health in health care practitioners: Randomized controlled trial of a gratitude intervention.” Journal of Consulting and Clinical Psychology Vol. 83 no. 1, (2015): 177-186. @AmAcadOsteo

Practicing gratitude led to a

7% reduction in

biomarkers of

inflammation in

patients with CHF

Psychosom Med. 2016 Jul-Aug;78(6):667-76. Pilot Randomized Study of a Gratitude Journaling Intervention on Heart Rate Variability

and Inflammatory Biomarkers in Patients With Stage B Heart Failure.

@AmAcadOsteo

Korb, Alex. The upward spiral: Using neuroscience to reverse the course of depression, one small change at a time. (2015: 194).

Gratitude rewires our neurology by

creating a

positive feedback

loop by route of

dopamine.

@AmAcadOsteo

@AmAcadOsteo

“Making stuff” can help students

prepare for such failures in a

controlled environment that doesn’t threaten their

professional identities.

This facilitates resiliency.

@AmAcadOsteo

@AmAcadOsteo

“Editing family movies,

writing a short story or essay,

rearranging your furniture,

songwriting,

developing a concept for a

new business, or

anything that requires you

to exercise a degree of

creative thought can

count.”@IIDA.WI

VISUALIZATION

RED ENERGY BLUE ENERGY







@AmAcadOsteo

WHAT IF I TOLD

YOU

WE CAN MAKE THIS

HAPPEN @AmAcadOsteo

@AmAcadOsteo

The power of….

Prescribing Creativity

@AmAcadOsteo

@AmAcadOsteo

@AmAcadOsteo

ART

HAPPINESS

@AmAcadOsteo

HEALING

@AmAcadOsteo

When the artist is alive in any person,

whatever his kind of work may be, he

becomes an inventive, searching, daring, self-

expressive creature….he disturbs, upsets, enlightens,

and opens ways for better understanding.Where those are trying to close the book, he opens it

and shows there are still more pages

possible.-- AMERICAN PAINTER ROBERT HENRI

“

Mitochondria

Integrate

Notice

Divergent

@IIDA.WI

Dr. Lara Salyer, DO, IFMCPDrLaraSalyer.com

#6thvitalsign

@AmAcadOsteo

AAO2020

© 2020 Lara Salyer, www.RightBrainRescue.com

Prescribing Creativity

Convocation March 2020

#6thVitalSign

Adults who are more playful and creative are reported to feel less stressed, exhibit bettercoping mechanisms, and achieve greater life satisfaction.

By honing our creative skills, we will intuitively: make accurate decisions that align better with our core values find alternative choices that help us live with less stress perform at a higher, more efficient standard have more fun, which benefits our personal health connect on a deeper level with others All day long, we use the executive (pre-frontal) cortex of our brain to analyze and makedecisions. Meanwhile, our creative (default) networks of our brain are dampened. :( This means less spontaneous and effortless thinking happens when we are in a careerthat uses large amounts of executive functioning. It's worse when this same careerautomates many of our duties, leaving little room for innovation and expansion! Fortunately, our brains are neuroplastic and flexible---able to make new connections daily. We can learn and adopt the keystone characteristics of creative individuals!

Keystones of Creativity:

Perceptive to surrounding environmentOpen to self-discoveryAble to extract order from complexityInnate drive for explorationCritical sense of conscientiousnessWilling to take risks for independent thinking © 2020 Lara Salyer, drlarasalyer.com

[ depersonalization + grief ]

burnoutDisengaged ("I don't care about this any more.") Emotionally blunted ("I feel robotic.")Hopeless ("Is this even important? Nothing matters.")Detached ("Who cares about the outcome. I don't.")Physical and emotional exhaustion (".........")

FLO

W

(OPTIMAL ENGAGEMENT )

Creative Flow StateSelflessnessTimelessnessEffortlessnessRichness

© 2020 Lara Salyer, rightbrainrescue.com

Make space to find your stillness Capture and record your ideas

How to start:

User Manual for your Brain

GLUTAMATE

DOPAMINE

GABA

SEROTONIN

Excitatory neurotransmitterInvolved in learning and neuroplasticityImbalance noted with migraines,bipolar, epilepsy, ALS

Motivation neurotransmitterCognition and motivationImbalance causes hallucinations,paranoia, ADHD, fatigue

Mood neurotransmitterInvolved in stabilizing happiness, wellbeing,alertnessImbalance causes anxiety, OCD, depression

Inhibitory neurotransmitterImbalance causes anxiety,seizures.

ACTH Produced by pituitary

Increases cortisol production in adrenals

Sleep deficit, caffeine, Cordyceps, Panaxginseng, insulinMeditation, Ashwaganda, L-theanine,Valerian, magnesium Tryptophan, 5HTP

Alcohol, statin medication,artificial sweeteners

Vit B6, L-Theanine,Taurine, AshwagandaBenzodiazepines(Xanax), Ambien

B6 deficiency, stress, MSG Taurine, L-Theanine,CoQ10, Valerian, Zinc

Tyrosine, exercise,meditationMagnesium deficiency,sugar imbalance

Basic Housekeeping Essential Fatty Acids (EFA) improvemembrane cell transmissionIntermittent Fasting boosts BDNF(growth hormone for the brain)Melatonin (protects brain fromoxidative injury)Regular exercise improvesoxygenation, signalling

drlarasalyer.com

= these things INCREASE levels

= these things DECREASE levels

FATSCARBS

PROTEINS

ENERGY!(ATP)

ATP

ATP

OXYGEN

ANTI-OXIDANTS, ANTI-INFLAMMATORY: TURNS ON NRF-2

Meet Your Mitochondria

INFLAMMATION AND OXIDATIVE STRESS:TURNS ON TNF alpha & NF-kB

Gut bacteria (microbiome)Increasing age

Lipid peroxidasesDamaged DNA

(8 OH-Deoxyguanosine) Free Radicals

UV lightElevated HbA1c

OrganophosphatesHeavy Metal toxicity

Cooking methods (burned food)

Gut bacteria (microbiome)

riboflavinniacin

L-carnitineCoQ 10

Alpha Lipoic AcidVitamin C, K, and E

Phosphatidyl CholineGlutathione

Iron, MagnesiumAcetyl CoA

Flavonoids, GarlicBroccoli, Green Tea

Curcumin, CinnamonTrans-Resveratrol

Gingko Biloba drlarasalyer.com

STRESS AND CORTISOL

LOW CORTISOL

HIGH CORTISOL

S T R E S S

Ashwagandha (2 - 4 g per day)Rhodiola (200-600 mg per day)Cordyceps (1 gram per day)Siberian ginseng (500 mg twice daily)St. John's wort (300 mg three times daily)Phosphatidyl serine (500-800 mg 1 hourbefore bedtime)

Ashwagandha (2 - 4 g per day)Licorice (100-200 mg twice daily)Cordyceps (1 gram twice daily)Asian ginseng (200-400 mg daily)Rehmannia (400-800 mg daily)Possible DHEA (if deficient)Aggressive circadian rhythm

coaching and support

INITIAL STRESSAshwagandha (2 - 4 g per day)L-theanine (200 mg as needed up

5-Hydroxytryptophan (5-HTP) 100-200mg 1 hour before bedtimePassion Flower (1 gram three times daily)Valerian root (100-200 mg twice daily)Kava kava (300 mg twice daily) Schisandra (100 mg twice daily)

to 1200 mg maximum)

HPA axis isactivated and

triggers cortisolrelease

Cortisol in

creases blood pressure,

heart rate, and changes metabolism

biochemistry instantly.

drla

rasa

lyer

.com

This is intended for EDUCATIONAL PURPOSES ONLY. It's strongly recommendedthat you have accurate diagnosis with testing and that you work with yourphysician. Like many pharmaceutical-grade drugs, side effects can occurwith botanical agents. These interactions can cause herb/drug and herb/foodor nutrient interactions from mild to life-threatening. ALWAYS CONSULT AFUNCTIONAL MEDICINE PROVIDER.

If left unchecked, cortisol willremain elevated and HPA axis

becomes more imbalanced

Chronic stress will cause

severe dysregulation and

cortisol levels are depleted

ALA LA

GLA

AAEPA

DHACold water fish, wild game,

enriched eggs, algae

EicosatetrinoicAcid

Di-homo-gama-linolenic Acid

Adrenic Acid

DocosapentenoicAcid 5n-6

deltade

6

deltade

oxidation

More inflammatoryEicosanoids

Less inflammatoryEicosanoids

drlarasalyer.com

Understanding Fatty AcidsOMEGA 3 OMEGA 6

Canola, soy, flaxchia, hemp, walnuts

Cold water fish, wild game,enriched eggs

Sunflower,peanuts,safflower,

vegetable oils

Borage, blackcurrant seed,

evening primrose

Dairy, shellfish,animal fat

Stearidonic Acid

DocosapentenoicAcid 5n-3

SAT

deltae

deltae

6LONG

5SAT

5LONG


Inhibits


Rate Limiting(alcohol and age blocks)

OMEGA 3OMEGA 6 : RATIO Current population average is 16:1 (ideal is as close to 1:1)

3:1 suppressed inflammation in Rheumatoid Arthritis2.5:1 reduced rectal cell proliferation in those with rectal cancer5:1 had beneficial effects on asthma (10:1 did not)4:1 associated with 70% decrease in mortality with CVD

Rxprescription

M

I

N

D

Mitochondria make their energy from oxygen and quality fats,

carbs, and proteins.

Practice deep breathing to increase oxygen supply

Eat foods that nourish your cells with phytonutrients

Supplement with nutritious fats (walnuts, fish, avocado)

Integrate your brain hemispheres to increase cross-talk and

synthesize material efficiently.

Participate in bilateral activity daily

Try using your non-dominant hand for usual activities

Find repetitive activity to do with both hands

Notice your external environment and internal state of emotions,

as this will hone your intuitive sense.

© 2020 Lara Salyer, www.rightbrainrescue.com

Pay attention to your body's sensations in response to

environmental triggers or food

Utilize all 5 senses to describe your day

Divergent thought patterns with expansive ideas will help form

new connections in your neuroplastic brain.

Practice coming up with 3 possible stories to explain

someone's behavior towards you today.

Try changing up your routine patterns for 24 hours

© 2020 Lara Salyer, drlarasalyer.com

Your Diagnosis: Right Brain Rx:

Insight TimerMeditation app

Trouble focusing

Misinterpreted Emails

Low energy

Sleep imbalance

Poor patient outcomes

Mitochondrial FoodRecommendations

Circadian Code

Group Visit Toolkit

Pomodoro Technique

Loom Video for VisualCommunication

Anxiety and Stress

Creative Apathy Right Brain Rescue

Free guided meditation app for those new andseasoned practitioners. Educational & inspirational

Helpful method to break time into chunks ofmaximum focus with intentional breaks.

Free screenshare video app to help improvecommunication. Can be password protected.

Top recommendations from Functional Physician,Dr. Mark Hyman, MD.

Current research in balancing innate biorhythms torestore sleep and feeding patterns.

Polished templates, Best Practices, and Done-For-You workflows to implement group visits in office

Online creativity incubator that combines functionalnutrition, neuroplasticity and creativity research

Just what thedoctor ordered!

Carry a blank "Jumble Journal" to dump all your random thoughts and scribbles Have a set of ear plugs for instant silence when needed Fuel your brilliant brain with elements from M.I.N.D. method daily Look at the color "values" of your energy. Are you painting from the same tones? Schedule activities to balance your masterpiece using complimentary colors. Use "negative space" in your Life Canvas. The best music is in the silence. Does your painting project the essence of you or are you trying to please themasses with your theme, colors, and image? Reflect on your "masterpiece" often by viewing yourself in a different light,changing scenery and environment. Always keep your eyes open for new shades and textures to add to your life.

1.2.3.4.5.6.7.

8.

9.

PAINTING your most VIBRANT LIFE:

Dr. Lara Salyer, DO, IFMCP [email protected]

www.DrLaraSalyer.com & www.RightBrainRescue.com

Documents

Prescribing Creativityfiles.academyofosteopathy.org/convo/2020/Presentations/... · 2020-02-25 · 1. Prove you are inherently creative 2. Identify if you’re stressed or burned