I don’t tell lies, because I can look into the future and see that it is more trouble than it’s worth.
—CHLOE, AGE 7
In large part, your behavior is driven by the actual, physical functioning of your brain. When your brain works right, you are more likely to act in thoughtful, conscientious ways that help you live longer. When your brain is troubled, you are much more likely to act in impulsive, careless, thoughtless ways that put you at risk for illness and early death. One of the smartest things you can do to increase the length and quality of your life is to optimize the physical functioning of your brain. Jose’s story is a perfect example.
In early 2010 a producer from the Dr. Phil show called and asked if I would help with a program on infidelity. They wanted me to evaluate and do SPECT scans on Jose, a compulsive cheater. When I first met Jose, he and his wife, Angela, were struggling with his infidelity, lies, and addiction to porn. As far as she knew, in their four-year relationship Jose had cheated on her eight times. On the show, Dr. Phil replied to the eight incidences of infidelity by saying, “My father used to say for every rat you see there are fifty you don’t.”
They had been married three months when Angela found out Jose was cheating on her. She discovered that he had been with another girl when he asked her to marry him, when they were planning the wedding, and two days after they had Bella, their now three-year-old little girl.
“I was devastated and very angry,” Angela said. “I gave my gun to my mom because I thought I was going to shoot him. After I took him back I found out he cheated on me with numerous girls. He is a chronic liar and he is very good at it. One of my friends told me that she saw Jose on a sex tape punching a girl in the face. She was passed out and pretty messed up. He likes rough sex and had tried to have rough sex with me. He tries to push to see how far he can go. He is a thrill seeker and needs constant stimulation. I got involved with Sexaholics Anonymous because I thought he had a problem, but instead he starting using it as an excuse. He would say, ‘It’s an addiction, I can’t help it.’ That’s a bunch of crap. He doesn’t think. He just does things and then afterward says he will find a way to deal with it.”
Jose said, “I have always been the kind of guy who would just hook up when someone comes along. I was out of the home for five weeks before we decided to patch things up. Before we got married I never felt guilt. My father was a cheater. I am worried I have a sexual addiction because I have a need for something stimulating, such as affairs, fast cars, living on the edge. I lost my driver’s license for getting four speeding tickets. In the last year, I have been faithful but had a problem with pornography.”
On the show, Dr. Phil asked Jose, “If this is your proclivity, why not get a divorce and go do what you wanted to do?” Jose replied that it was not what he wanted. He wanted to be married, to have a family, and to raise his daughter. His father was a cheater, which had a negative effect on his family. He wanted to be a positive influence for his daughter.
When I saw Jose he had a number of issues besides the chronic infidelity. He was an adrenaline junkie who had a high need for speed along with excitement-seeking behavior. His brain SPECT scan showed three highly significant abnormalities:
1. Increased activity in a part of the front part of the brain called the anterior cingulate gyrus, which is the brain’s gear shifter. Increased activity in this part of the brain is often associated with compulsive behavior, where the gear shifter becomes stuck on negative thoughts or negative behaviors. In addition to the cheating, Jose compulsively got tattoos. He was tattooed from head to toe. Even though Jose was a smart man, the tattoos had prevented him from getting work.
2. Decreased activity in another part of the front part of the brain, the prefrontal cortex (PFC). The PFC acts like the cop in your head and helps you stay on track toward your goals without going down the wrong path. The PFC is also thought of as the brain’s brake and helps prevent us from saying or acting on the first thing that comes to mind. From Jose’s scan and behavior, his PFC was in trouble.
3. A head-injury pattern. Jose’s scan clearly showed evidence of brain trauma, with areas damaged in the front and back part of his brain.
Initially, I asked Jose if he ever had a brain injury.
He said no.
But as someone who has scanned the brains of tens of thousands of patients, I knew the pattern in Jose’s brain was in part from a head injury, so I persisted.
Again he said no. I have heard this same story so often that it is a running joke at the Amen Clinics. People initially tell us they have not had significant head injuries. Then we see the obvious pattern of a brain injury on their scans and persist in probing further. Eventually they will tell us things like, “I fell out of a second-story window” or “I fell down the stairs” or “I broke my car windshield with my head” in forgotten accidents. Or, as was the case with one of our NFL players, his car crashed through a mountain guard rail and fell 150 feet to a riverbed below, knocking him unconscious.
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Normal Surface Brain SPECT Scan 
Full, even, symmetrical activity |
Jose’s Surface Brain SPECT Scan 
Decreased activity in the front (prefrontal cortex) and the back of the brain, consistent with a prior brain injury or injuries |
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Normal Active Brain SPECT Scan 
Highest activity at back of brain |
Jose’s Active Brain SPECT Scan 
Increased anterior cingulate activity in front part of the brain consistent with trouble shifting attention (arrow) |
“Yes,” Jose finally admitted. “I played football in high school.” He then told me about a number of times he had concussions. Next, he volunteered that he was a bull rider and a mixed martial artist and had been hit hard in the head many times. And then, almost underneath his breath, he said, “And I am a head banger.”
“Excuse me?” I responded.
With an embarrassed smile, Jose said, “I used to break things with my head. It was like a party trick. I could break cans and beer bottles with my forehead.”
All of us have a running dialogue in our minds whenever we are talking to others. Psychiatrists are no different. When I heard Jose say that he used to break bottles with his head, I thought to myself, “This is not a sign of intelligent life.” But I did not say it out loud, because I have a good PFC and a fairly strong internal brake.
But then Jose added, “When I got drunk I’d often put dents in doors and walls with my head. I can usually find the studs in the walls with my head.”
At this, my own internal brake betrayed me, and I said out loud, “That is not a sign of intelligent life.”
Jose agreed.
The day of the Dr. Phil show taping was emotional. Angela was angry and wanted Jose to change. She thought he could just will it to be so. Angela said, “Unless I see a complete change I am done.”
I knew better. Even the best intentions are thwarted by an unhealthy brain.
On the show Jose said he was excited to see the results of the scans.
In his no-nonsense Texas drawl, Dr. Phil said, “It is odd to hear someone say they are excited to have brain damage. You think this gives you a pass. It is like, ‘Hey, it’s not my fault, my brain’s not right.’ ”
Jose then said something very profound. “I am not thinking of this as an excuse, but I am hoping this might be a key to help change my behavior.”
The show then took an interesting twist. Dr. Phil asked the audience whether they thought sexual addiction was a real biological phenomenon or just an excuse for bad behavior. The audience was of the opinion that it was just an excuse.
I understand why people feel this way, but from the brain scans I have seen and my years of experience in helping people unravel from addictions, I know there are strong brain issues at play. I have seen sexual addictions ruin people’s lives and bring many addicts to the point of financial ruin and even suicide. I also believe that addictions, including sexual addictions, are going to get worse in our society as we are wearing out the brain’s pleasure centers by the constant exposure to highly stimulating activities, such as video games, text messaging, sexting, Internet pornography, scary movies, and highly addictive foods like cinnamon rolls and double cheeseburgers.
There is an area deep in the brain called the nucleus accumbens that is responsive to the pleasure and motivation chemical dopamine. Think of the nucleus accumbens as one of the main pleasure levers in the brain. Whenever we feel pleasure, a little bit of dopamine has pressed on the lever. If the lever is pushed too hard, such as with drugs like cocaine, we can feel a rush of pleasure that causes us to lose control over our behavior, or if it is pushed too often, it becomes sensitized or numb and we need more and more pleasure in order to feel anything at all. Moreover, if you have low activity in the braking activity of the PFC, the nucleus accumbens can literally take control of your life, as in Jose’s case. To live long, it is important to protect your pleasure centers and prefrontal cortex.
Even though it sounds odd, be careful with experiencing too much pleasure. I think one of the reasons actors and high-performance athletes have problems with depression and addiction is because their success can give them free access to anything they want at any given moment, and this often wears out their pleasure centers.
After the show, Jose and Angela agreed to see me for help. He was in enough pain that he was willing to follow my recommendations. Here was his prescription:
Stop drinking alcohol. Alcohol lowers Jose’s PFC function and decreases his brain’s braking power, which makes him less able to say no to his urges.
Get enough sleep to maintain healthy brain function. Getting less than six hours of sleep at night has been associated with lower overall blood flow to the brain, which leads to more bad decision making.
Clean up his diet. Only eat healthy food that serves his optimal brain function. Eat multiple times a day to keep his blood sugar stable. Low blood sugar results in more bad decision making.
Eliminate the caffeine and energy drinks that were a staple of his diet. Caffeine constricts blood flow to the brain. Anything that lowers or constricts blood flow to the brain increases bad decision making.
Add the following supplements to enhance his brain:
• Serotonin Mood Support to support healthy serotonin levels and calm his anterior cingulate gyrus and compulsive behaviors.
• Focus and Energy Optimizer to support healthy dopamine levels and boost his prefrontal cortex, focus, and impulse control.
• Brain and Memory Power Boost to help restore healthy brain function. This is the same supplement we used in our NFL brain rehabilitation study.
Over the next seven months I regularly saw Jose, Angela, and their adorable daughter, Bella, to monitor their progress. In our sessions we discussed his nutrition, supplements, and strategies to control his urges, which were becoming less and less powerful.
I had Jose plant the question “Then what?” in his head to help boost his PFC by thinking about the future consequences of his behavior. It finally clicked when he heard the chorus of the Clay Walker song “Then What?” Jose realized that if he didn’t ask “Then what?” and make new, better choices he was going to be somebody who “ain’t anybody anyone’s gonna trust.”
Things were going so well for Jose and Angela that they started to discuss having another child. They went to Hawaii on vacation to talk more about their future together. While there Jose saw people jumping off a sixty-foot cliff into the water below. His immediate reaction was that he wanted to do it too. Being a thrill seeker had been part of his life for a very long time. Some would say it was part of his DNA. As Jose hiked up the hillside, Angela rolled her eyes, thinking yet again to herself, “He is such a showoff.” She had seen him do so many stupid things throughout their time together. Would it ever end?
But this time things were different. Very different.
When Jose got to the top of the cliff and looked down, something happened in his mind. He started to feel uncomfortable, even anxious. Even though he saw other people jumping off the cliff, he realized that because he could not clearly see the rocks jutting up in the water, it would be hard to avoid them. He thought to himself, “Then what? What if I land wrong? What if I get hurt? What if I am paralyzed? I have a wife and child and we want another child. Being paralyzed will not help any of us. Do I really need to do this?”
He stepped out of line to think about his next move. This level of thought, pausing to contemplate the consequences of a risky action, was new for Jose. After a minute or so, he decided not to jump. With a sense of freedom, he began walking down the hillside. Angela was stunned. She had never seen Jose do anything like that before. Maybe there was hope.
Shortly after his trip to Hawaii, we did a follow-up SPECT scan on Jose, which showed dramatic improvement from seven months earlier.
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Jose’s First SPECT Scan 
Decreased activity in the front (prefrontal cortex) and the back of the brain consistent with a prior brain injury(s) |
Jose’s Follow-up SPECT Scan Seven Months Later 
Overall dramatic improvement |
By working the treatment plan, Jose literally changed his brain and dramatically improved and likely extended his life. As I write this story it has been over a year and a half since I first met Jose, Angela, and Bella. They remain happy, together, and hopeful about their future as an intact family. Angela no longer feels she needs to give her gun to her mother, and Jose has been faithful and is making decisions that will likely extend his life through better forethought.
I know many researchers are looking for the fountain of youth and hoping to find it in a new medication or natural supplement. I am rooting for these researchers to help us. But nothing will ever be as important to your longevity as the quality of the decisions you make throughout your life in regard to your health and your relationships. The quality of these decisions is a direct reflection of the physical health of your brain.
According to a remarkable longitudinal study, one of the main predictors of longevity is conscientiousness. The study was started in 1921 by Dr. Lewis Terman of Stanford University. He and his team evaluated 1,548 bright children who were born around 1910. Over the course of ninety years, researchers have discovered many fascinating findings that clearly point to healthy brain function and longevity. Here are some of their major findings:
• Hard work and accomplishment (usually associated with good brain function) are strong predictors of longevity.
• Those who were most disappointed with their achievements died the youngest.
• Being undependable and unsuccessful in careers (usually the sign of poor brain function) was associated with a whopping increase in mortality.
• Reaction to a loss with drinking, depression, anxiety, or catastrophizing was associated with early death (further causing poor brain function). On the other hand, those who, following a period of grief and adjustment (using brain healthy recovery skills), thrived after loss, got a “resiliency bonus” and lived an average of five years longer than average.
• An optimistic, carefree attitude encouraged people to underestimate risks and approach their health in a lackadaisical fashion, which decreased longevity. They died more often from accidents and avoidable deaths (behaviors associated with poor PFC function and subsequent poor planning). Some in the media have erroneously interpreted this study to mean that “pessimists live longer than optimists.” This is not true; optimists of the hardworking, careful variety live longer lives than the average person. It is the “carefree” optimists who never worry, plan, or think about future consequences who do not live as long.
• Thoughtful planning and perseverance (usually associated with good brain function) were associated with longevity.
• Prudent, persistent achievers with stable families and social support lived longer (all signs of healthy brain function).
• People with habits, routines, and social networks that encouraged exercise did the best.
• Social relationships dramatically impact health. The group you associate with often determines the type of person you become. For people who want to improve their health, association with other healthy people is usually the strongest and most direct path to change.
• Moderate worry, meaning you care and think about the future, is an important part of staying healthy.
Clearly, this research and my own clinical experience have shown that some anxiety is good. People like Jose, who are risk takers and have low levels of anxiety, take unreasonable risks, which can lead to an early grave. Obviously, too much anxiety is bad. But not enough anxiety has been associated with more faulty decisions about health and safety.
People who are conscientious and “finish what they start” seem to have a reduced risk of developing Alzheimer’s disease, according to a twelve-year study involving Catholic nuns and priests. The most self-disciplined individuals were found to be 89 percent less likely to develop Alzheimer’s disease than their peers. Robert Wilson and colleagues from Rush University Medical Center in Chicago followed 997 healthy Catholic nuns, priests, and Christian brothers between 1994 and 2006. At the beginning of the study, the clergy completed a personality test to determine their level of conscientiousness. Based on answers to twelve questions such as “I am a productive person who always gets the job done,” they received a score ranging from 0 to 48. On average, volunteers scored 34. Over the duration of the study, 176 of the 997 participants developed Alzheimer’s disease. However, those with the highest score on the personality test—40 points or above—had an 89 percent lower chance of developing Alzheimer’s than participants who received 28 points or lower. Dr. Wilson hypothesized that more conscientious individuals likely have more activity in their PFCs, and other researchers have confirmed this finding.
The PFC is larger in humans than in any other animal by far. It comprises:
• 30 percent of the human brain
• 11 percent of the chimpanzee brain
• 7 percent of your dog’s brain (unless your dog is my dog, Tinkerbell, who won’t stop barking at strangers; hers is likely 4 percent)
• 3 percent of your cat’s brain (which is why they need nine lives)
• 1 percent of a mouse’s brain
Neuroscientists call the PFC the executive part of the brain because it functions like the boss at work. It is the CEO inside your head. Comedian Dudley Moore once said, “The best car-safety device is a rearview mirror with a cop in it.” Your PFC acts like the cop in your head that helps to prevent you from making bad decisions.
Prefrontal Cortex
It is like our own personal Jiminy Cricket. If it’s not in good working order, ill-considered decisions can put you at risk for a miserable life, and even an early death.
The PFC is involved with:
• Forethought
• Judgment
• Impulse control
• Attention
• Organization
• Planning
• Empathy
• Insight
• Learning from mistakes
A healthy PFC helps you think about and plan your goals (e.g., “I want to live a long, healthy life”), and it keeps you on track for the long run.
Low activity in the PFC has been associated with:
• Lack of forethought
• Short attention span
• Impulsivity
• Procrastination
• Disorganization
• Poor judgment
• Lack of empathy
• Lack of insight
• Not learning from mistakes
The PFC is not fully developed until people are in their midtwenties. Even though we think of eighteen-year-olds as adults, their brains are far from finished. Scientists are now learning what insurance companies have known for a long time. When do car insurance rates change? At age twenty-five. Why? Because that is when people display better driving judgment and are less likely to get into accidents and cost the insurance companies more money.
Below is a graph of activity in the prefrontal cortex across the lifespan. It is based on over six thousand scans we have done in our clinics. You can see that a child’s PFC is very active, but over time the activity begins to settle down because unused connections are being pruned and brain cells are being wrapped with a white fatty substance called myelin.
Myelin acts like insulation on copper wires and helps our brain cells work more efficiently. In fact, cells wrapped with myelin work ten to a hundred times faster than those without it. The prefrontal cortex is not fully myelinated, or efficient, until we are about twenty-five years old. Anything that disrupts myelin formation can actually delay or damage brain development. All of the following disrupt myelin formation:
• Smoking
• Drinking alcohol
• Drug use
• Brain trauma
• Poor diet
• Too much stress
• Not enough sleep
If we want our children to make better decisions for their lifetime, we need to do a much better job of taking care of their brains, since the PFC provides the horsepower for their decision-making skills for the rest of their lives.
Our research also shows a new burst of increased activity in the PFC after the age of fifty.
As I looked at this part of the curve, I began to think of the wisdom of age. Have you ever noticed that many “silly” things become less important as we age? We know the difference between “big stuff” and “small stuff”—and most of it really is “small stuff.” We become more thoughtful and more able to focus on what really matters in life, which is why some people make better grandparents than they do parents.
Bill Cosby has a great routine in which he says that his children think their grandmother is the most wonderful person on the face of the earth. “I keep telling my children,” he says, “that this is not the same woman that I grew up with. You are looking at an old person who is trying to get into heaven.” That may be true, but more likely it has to do with the wisdom of age. If you take care of your brain, over time you are more likely to be wiser, because wisdom is a brain function based on intelligence born of many life experiences. Wisdom also helps us keep the Grim Reaper at a distance from our door.
Another way to think of the development of the PFC is to think about maturity. I think of maturity as not making the same mistakes over and over. Mature people have a more thoughtful approach to their lives. As the PFC becomes myelinated, people act with more forethought and are likely to make fewer mistakes.
I, along with my colleagues Kristen Willeumier, Ph.D. (a director of research) and Derek Taylor (a data analyst), published an important study in the prestigious Nature Publishing Group Journal, “Obesity,” which demonstrated that as weight went up in a healthy group of people, the function of their PFC went down in highly significant ways.
Over the last decade there is growing evidence that shows the harmful effects of too much fat on your body. In a study of 1,428 Japanese men, researchers found significant decreases in brain size in the PFC and temporal lobes (learning and memory). Nora Volkow, director of the National Institute on Drug Abuse, and colleagues found that in healthy adults a high BMI (body mass index) was inversely correlated with activity in the PFC. Elevated BMI has also been associated with myelin abnormalities in the PFC of healthy normal and elderly adults.
The goal of our study was to test the hypothesis that an elevated BMI is associated with lower blood flow to the PFC in a healthy group of people on brain SPECT imaging. To that end, we compared our group of “healthy” subjects who had a high BMI with people in our “healthy” group of normal weight. The results of our study were very clear. The high BMI group had statistically significant lower activity in the PFC compared with the normal group.
Obesity is becoming a worldwide epidemic and is a risk factor for many chronic conditions, including cardiovascular disease, depression, and neurodegenerative diseases like Parkinson’s and Alzheimer’s. It has been recently found to be worse for your liver than alcoholism.
We were not able to determine if problems in the PFC led to increased impulsivity and subsequent obesity or if being overweight or obese directly caused brain changes. Both scenarios may be true. The fact that we used a healthy-brain group and specifically excluded ADHD or other behavioral disorders argues against the premorbid hypothesis, but other studies have shown an association between ADHD and obesity. Still other authors report that fat tissue directly increases inflammatory chemicals, which likely have a negative effect on brain structure and function.
One of the major problems with being overweight or obese is that there is evidence that it damages your PFC, which as we have seen is the major decision-making part of the brain. So if you do not get your weight under control, it will become harder and harder to use your own good judgment over time to get and stay healthy. Now is the time to start enhancing your health and longevity, not at some arbitrary point in the future, which most likely will never come.
ADHD is associated with low activity in the PFC. Initially, ADHD was thought of as a childhood disorder that most kids outgrew by the time they turned twelve or thirteen. The hallmark symptoms of ADHD are short attention span, being easily distracted, disorganization, hyperactivity (trouble sitting still), and poor impulse control. People with ADHD, like Jose, often exhibit excitement-seeking or conflict-seeking behavior; they also tend to have trouble with time (they are often late and turn in assignments at the last minute). Over the last three decades it has become clear that many ADHD children continue to have debilitating symptoms for the rest of their lives. They tend to outgrow the physical hyperactivity but not the problems with disorganization, inattention, distractibility, and impulse control. Untreated ADHD has been associated with a higher incidence of:
• Drug and alcohol abuse (impulsivity and to calm feelings of hyperactivity)
• Relationship problems (impulsivity and conflict seeking)
• School failure (attentional problems and impulsivity)
• Job-related problems (problems with time, attention, and impulse control)
• Medical problems (associated with chronic stress, plus more head trauma with the excitement-seeking behavior)
• Obesity (lack of impulse control)
• Depression (chronic failure)
• Lack of conscientiousness (all of the above)
In the book I wrote with noted neurologist Rod Shankle, Preventing Alzheimer’s, we argued that ADHD is likely associated with Alzheimer’s disease because of its connection with many of the illnesses that put people at risk for it, such as alcohol abuse, obesity, depression, and head trauma. This is very important, because when ADHD goes untreated, a person will not be able to control his or her impulses, setting him up for significant health problems, poor decisions, and earlier death. If you or someone you love has symptoms of ADHD, it is important to be treated. Natural ways to treat ADHD, in my experience, include intense aerobic exercise, a very healthy diet, a multivitamin, fish oil, and supplements (such as green tea, rhodiola, L-tyrosine) or medication (such as Ritalin or Adderall) to enhance PFC function.
Once you realize the absolutely critical role of the PFC to longevity, you then need to do everything possible to protect it and rehabilitate it if necessary.
All of the information in this book is designed to help you win the war in your head between the adult, thoughtful part of your brain (the PFC), which knows what you should do, and your pleasure centers, which are run by a spoiled, demanding inner child who always wants what he wants whenever he wants it.
Your brain’s pleasure centers are always looking for a good time.
• They want to jump off a cliff.
• They love going fast on a motorcycle in the rain.
• They want the double cheeseburgers.
• They will stand in line for the fresh cinnamon rolls.
• They focus on having the second piece of cake.
Left unchecked, your inner child is often whispering to you like a naughty little friend:
“Do it now …”
“It’s okay …”
“We deserve it …”
“Come on, let’s have some fun …”
“You’re so uptight …”
“Live a little …”
“We already had one bowl of ice cream. Just one more won’t hurt …”
“We’ll behave better tomorrow. I promise …”
Without adult supervision, your inner child lives only in the moment and he can ruin your life. I have a friend who shared that her daughter-in-law got sick with the flu and had to remain in bed upstairs. Her four-year-old son decided to “take over” the house while his mother was otherwise occupied with a pounding headache, fever, and vomiting. When his father came home, there was ice cream melting in puddles on the kitchen countertop; the pots and pans were arranged in a pyramid formation in the middle of the floor; cartoons were blaring on TV at full volume; and clothes, toys, and blankets (made into tents and forts) were strewn everywhere. Absolute anarchy and chaos. This is a great visual of what happens to your life when your PFC is not functioning: Your inner child takes over while your inner adult is napping. The resulting mess is something to behold.
To balance your pleasure centers, and tame your inner child, the PFC helps you think about what you do before you do it. It thinks about your future, not just about what you want in the moment. Instead of thinking about the chocolate cake, it is the rational voice in your head that helps you:
• Avoid having a big belly.
• Remember that “food is medicine” and that you’ll be in a sugar-induced, cranky, sleepy mood an hour after eating that cake.
• Remind your inner child of delicious but healthier alternatives that will both taste good and nourish your body.
• Be concerned about your bulging medical bills.
• Say no and mean it.
When your PFC is strong, it reins in your inner child, so that you can have a fun, passionate, meaningful life but in a thoughtful, measured, conscientious way. To live a long healthy life, it is critical to strengthen your PFC and put your inner child into time-out whenever he acts up.
It is also critical to watch your internal dialogue and be a good parent to yourself. I have taught parenting classes for many years and the two words that embody good parenting, even for your inner child, are firm and kind. When you make a mistake with food or with your health, look for ways to learn from your mistakes but in a loving way.
Changing one’s personality traits is never easy. They are thought to be enduring patterns that ultimately come from stable patterns of brain function. But in the Terman study, researchers found that people can indeed increase or decrease their conscientiousness over time. Jose was able to do this, and I have witnessed it in myself. As I have learned more and more about brain function and developed brain envy, I have personally developed better habits and my behavior has been more consistent. I feel much more in control of my own behavior than I did even four or five years ago. I have seen others’ conscientiousness deteriorate after a head injury, binge drinking or drug use, being exposed to an environmental toxin, or at the onset of developing dementia.
Before discussing how to boost your level of conscientiousness, let’s first define what it is. Conscientiousness concerns the way we manage our impulses. Impulses are not inherently good or bad. It is what we do with them that makes them that way. Sometimes we need to make a snap decision and cannot think about it over and over. Other times we want to be spontaneous and fun, especially when we are relaxing. But when it becomes a way of life, it can take a seriously negative toll on your health. Giving in to immediate desires, like the doughnuts, often produces immediate rewards but undesirable long-term consequences. Impulsive behavior can lead to being fired from your job, divorce, drug or alcohol abuse, jail, or obesity, all of which have a negative impact on your health. Acting impulsively often brings regret because you failed to entertain all of your options. The accomplishments of an impulsive person are often smaller, more diffuse, and less consistent.
A hallmark of intelligence and what separates us from other animals is our ability to think about the consequences of our behavior before acting on an impulse. It is the internal dialogue that accompanies “Then what?” Effective decisions usually involve forethought in relation to your goals, organizing, and planning, which helps you not only live in the moment but to continue ten or even fifty years from now. “Being prudent” is another label for conscientiousness. It means being wise and cautious. If you are conscientious, you are more likely to avoid troubled situations and be perceived as intelligent and reliable by others. If you go overboard, of course, others will think you are a compulsive perfectionist or a workaholic.
SIX FACETS OF CONSCIENTIOUSNESS
1. True confidence. You have a true feeling of being self-efficacious. You know you can get things done.
2. Organized, but not compulsive. Keep an orderly home or office and keep lists and make plans.
3. A high sense of duty. You have a strong sense of moral obligation.
4. Achievement oriented. Drive to be successful at whatever you do and have a strong sense of direction.
5. Persistence. You have the ability to stay on track despite the obstacles that might come your way.
6. Thoughtfulness. You are disposed to think through possibilities and the consequences of your behavior before acting.
Here are steps to optimize both your PFC and level of conscientiousness to boost the control you have over your life.
1. “Then What?” Always carry this question with you. Think about the consequences of your behavior before you act.
2. Protect Your Brain from Injury or Toxins This should be obvious by now.
3. Get Eight Hours of Sleep Less sleep equals lower overall blood flow to the PFC and more bad decisions.
4. Keep Your Blood Sugar Balanced Throughout the Day Research studies say that low blood sugar levels are associated with lower overall blood flow to the brain, poor impulse control, irritability, and more unfortunate decisions. Have frequent smaller meals throughout the day that each have at least some protein.
5. Optimize Your Omega-3 Fatty Acid Levels by Eating More Fish or Taking Fish Oil Low levels of omega-3 fatty acids have also been associated with ADHD, depression, Alzheimer’s disease, and obesity.
6. Keep a “One-Page Miracle” On one piece of paper write down the specific goals you have for your life, including for your relationships, your work, your money, and your health. Then ask yourself every day, “Is my behavior today getting me what I want?” I call this exercise the One-Page Miracle, because it makes such a dramatic difference in the lives of those who practice it. Your mind is powerful and it makes happen what it sees. Focus and meditate on what you want.
7. Practice Using Your PFC Self-control is like a muscle. The more you use it, the stronger it gets. This is why good parenting is essential to helping children develop self-control. If we gave in to our eight-year-old every time she wanted something or threw a temper tantrum, we would raise a spoiled, demanding child. By saying no and not giving in to tantrums, we teach her to be able to say no to herself. To develop your PFC you need to do the same thing for yourself, practice saying no to the things that are not good for you, and over time you will find it easier to do.
8. Balance Your Brain Chemistry Illnesses such as ADD, anxiety, and depression decrease self-control. Getting help for these problems is essential to being in control of your life.
Trying to use willpower to control your behavior when your sleep or brain chemistry is off, or when your omega-3 fatty acids or blood sugar levels are low, is nearly impossible.
When I walk down the street and see people who are not healthy, I often say to myself, “That person has made many, many bad decisions.” It frustrates me because I know with the right education and right environment they would be healthier and happier. When I see someone who is healthy I think, “That person has made many, many good decisions.” It is the quality of the decisions you make that helps you live a long time as a healthy human being or kills you early. By applying the principles in this book you can boost your PFC and have much better control of your health and your destiny. You can be the boss of your life, instead of allowing your cravings or the food companies to take your life early. A little forethought and an appropriate level of anxiety are all that is required. When confronted with choices between a spinach salad or a double cheeseburger, between going to a late-night party or getting a good night’s sleep, between going for a hike or jumping off cliffs into the water below, can you step back and ask yourself which choice is really in your best interest? Does the choice you favor make you better, stronger, healthier, more passionate for your life? Or does it steal from your life? Choose to be in charge. Choose to be the CEO of a long, healthy, vibrant, meaningful life.
1. When your brain is troubled, you are much more likely to act in impulsive, careless ways that put you at risk for illness and early death. When your brain works right, you are more likely to act in thoughtful, conscientious ways that help you live longer. Prioritize your brain health and better behavior will follow.
2. Nothing is more important to your longevity than the quality of the decisions you make in your life. And the quality of your decisions is a direct reflection of the physical health of your brain. Taking time to look at and upsize your brain health may be the most important decision you make to live strong and long.
3. Decreased activity in the PFC has been associated with lack of forethought and poor judgment. When it does not get enough blood flow, you don’t have a good working brake on your impulses. Increasing blood flow to this area with brain healthy habits, along with supplements, such as green tea and rhodiola, will help a person make better decisions, leading to a longer and happier life.
4. Head injuries, even minor concussions from the past, show up on SPECT scans and may affect your behavior and feelings years later. We often have to ask people many times, “Have you ever had any sort of injury to your head?” before they recall the incident that hurt their brain. Recognizing and rehabilitating these injuries will dramatically increase the quality of all of your decisions.
5. Addictions, including sexual addictions, are made worse when we literally “wear out” the brain’s pleasure centers by the constant exposure to highly stimulating activities, such as video games, text messaging, sexting, Internet pornography, and scary movies. Take inventory of the adrenaline-producing activities in your life: Eliminate the unhealthy ones, and take breaks from those activities (even good ones) that are becoming compulsive.
6. An overly optimistic, worry-free attitude (without forethought and planning, which are PFC activities) leads people to underestimate risks and approach them in lackadaisical fashion, decreasing longevity. Be optimistic, as this is good for longevity; but balance this trait with a healthy level of anxiety and careful thinking.
7. People who were persistent achievers with stable families, habits, and routines did the best in longevity studies. Consider your daily and weekly routines: Can you make them more brain friendly? For example, can you walk somewhere that you always drive to? Can you exchange an hour of TV for playing brain games?
8. To make better decisions, make sure to optimize the blood flow to your brain by stabilizing your blood sugar (make sure you eat healthy and often), getting good sleep, limiting alcohol and caffeine, and eliminating nicotine.
9. If we want our children to make better decisions for their lifetime, we need to do a much better job of taking care of their brains. The brain is not fully efficient until we are twenty-five years old. To avoid disrupting early brain development, help young people avoid smoking, substance abuse, brain trauma, a lousy diet, stress, and poor sleep.
10. Our research shows a new burst of increased activity in the PFC after the age of fifty. We become more thoughtful and more able to focus on what really matters in life. Have a few wise friends over age fifty who can give you valuable insight when making decisions.
11. When fighting addictions or everyday temptations of any kind, always keep this question in mind: “Then what?” Whenever you think about doing or saying something, ask yourself about the consequences of your behavior. This question can serve as a caution or stop sign to a brain that is about to take you down a bad path.
12. A hallmark of intelligence and what separates us from other animals is our ability to think about the consequences of our behavior before acting on an impulse. It is the internal dialogue that accompanies “Then what?”
13. A high percentage of people who struggle with addictions also have ADD or ADHD. When left untreated, a person has less ability to control his or her impulses, setting him up for significant health problems, poor decisions, and early death. Natural ways to treat ADHD include intense aerobic exercise, a very healthy diet, a multiple vitamin, fish oil, and supplements (such as green tea, rhodiola, L-tyrosine) or medication (such as Ritalin or Adderall) to enhance PFC function.
14. Being overweight is damaging to your PFC and can have a negative impact on the decision-making part of the brain. Getting your weight under control, starting now, will help you enhance your health and longevity.
15. Practicing self-control is a good exercise to strengthen your PFC. The more you use it the stronger it gets. To develop your PFC you need to practice saying no to the things that are not good for you, and over time you will find it easier to do.
16. Low levels of omega-3 fatty acids have also been associated with ADHD, depression, Alzheimer’s disease, and obesity—all brain issues that lead to poor decision making. You can optimize your omega-3 fatty acid levels by eating more fish or taking fish oil.
17. Keep a One-Page Miracle. On one piece of paper write down the specific goals you have for all the main areas of your life. Then ask yourself every day, “Is my behavior getting me what I want?” This simple but profound activity can be of tremendous help in encouraging better daily choices that add up to a better life.
18. On occasion, we all need to rein in our inner child who wants to eat junk, avoid sleep, or “play with fire.” But it is important to be a good parent to yourself, which means being firm and kind. When you make a mistake with food or with your health, look for ways to learn from your mistakes but in a loving way. Emotionally healthy people deal with mistakes by acknowledging them, learning from them, and moving on from them as soon as possible.
19. Hard work and accomplishment (usually associated with good brain function) are strong predictors of longevity.
20. The quality and length of your life are direct reflections of the quality of the decisions you have made.