Happiness in this World

Reflections of a Buddhist physician

by Alex Lickerman, M.D.

The Three Realms Of Confidence, Redux

In 1979, as I was about to enter seventh grade, my parents moved our family from one suburb of Chicago to another where we soon discovered anti-Semitism ran rampant. Changing schools for any boy of thirteen is traumatic enough, but finding myself persecuted verbally and physically for belonging to a particular religion made the transition so awful that Read More

A Clinical Psychologist For President

Of all the different criteria people use when deciding for whom to vote in presidential elections, I've never heard anyone talk about the importance of a background in clinical psychology—but it's always struck me as important for a president to have as for a clinical psychologist. Read More

How To Be A Leader, Redux

In 2001, just as I was about to take over as Medical Director of Primary Care at the University of Chicago, I expressed reservations to a previous Director about my ability to run a clinic that included several clinicians who were not only older than I but who had actually been my teachers ten years earlier. Read More

How to Reset Your Happiness Set Point

The set-point theory of happiness suggests that our level of subjective well-being is determined primarily by heredity and by personality traits ingrained in us early in life and as a result remains relatively constant throughout our lives. Our level of happiness may change transiently in response to life events, but then almost always returns to its baseline level Read More

The Double-Edged Sword Of Attachment, Redux

Several years ago, my then 15-month-old son developed a fever to 103.5 F. Usually a champion sleeper, that night he woke several times with a frenetic look in his eyes and a jerkiness to his movements that unnerved me. The heat coming off his little febrile body almost made me start sweating myself. Read More

Why You're Stronger Than You Think

You are far more resilient than you think. In his book Stumbling on Happiness Daniel Gilbert argues persuasively that most of us consistently overestimate the negative impact of adverse events (like being fired) on our lives. When asked to imagine such events happening in the future, we tend to imagine such futures including only the negative emotional impact Read More

How To Remember Things, Redux

I once came up with a metaphor I thought perfectly captured the sheer mass of material my classmates and I were expected to memorize in our first two years of medical school: it was like being asked to enter a grocery store and memorize the names of every product in the store, their number and location, every ingredient in every product in the order in which they appear on Read More

An Alternative To Willpower For Losing Weight

A common belief, even among doctors, is that almost no one succeeds in losing weight in the long term. And for almost two decades, I've counted myself among the skeptics, being able to tally on the fingers of one hand the number of my patients who've managed to do it—literally less than five out of multiple hundreds, if not a few thousand. Read More

Magical Thinking, Redux

One of my patients suffers from chronic constipation due to irritable bowel syndrome. During the twenty years since she was first diagnosed, her symptom pattern has remained remarkably consistent: she has perhaps 1-2 bowel movements per week, occasionally accompanied by some mild cramping. Even she admits the symptoms are more a bother than a worry. And yet, every time I Read More

How To Become Mindful

Research shows numerous benefits to meditation: it reduces stress, increases positive emotion, and even treats acute pain. Commonly, meditation involves focusing on one's breathing as a way to anchor one's attention to the present moment. Practitioners are also frequently taught to separate their experiences (breathing, pain, thoughts) from their judgments about them. Read More

What Compassion Is, Redux

Several years ago, I was out walking my son in his stroller (he was somewhere around six months old) when a homeless woman approached me asking for money. I'd seen her before in the neighborhood many times, including behind our condominium using drugs. So I turned down her request and continued walking as if the wind had blown a newspaper against my leg and I'd kicked it Read More

How To Trigger Others To Trigger The Best In You

In a previous post, How To Pull Good Things Out Of Others, I wrote (to paraphrase): "Who we are turns out to be largely a function of who we’re with. Have you ever noticed, for example, how you feel and behave one way with your family and another with your friends—and yet another with your co-workers and boss? Read More

How To Ensure You're (Almost) Always Right

There are numerous cognitive biases that threaten to lead us to incorrect conclusions as we reason our way through problems: confirmation bias (where we selectively pay attention only to evidence that supports our pre-existing beliefs), non-confirmation bias (where we selectively ignore evidence that contradicts our pre-existing beliefs), and belief bias (which predisposes Read More

Your Neighbor Is An Alcoholic, Redux

My patient smiled a toothless grin and told me, "I feel fine, doc." But he was far from it. His liver enzymes had risen into the thousands, his skin was a pasty yellow I didn't need the benefit of sunlight to see, and his albumin (a protein whose level indicates the liver's functional capacity as well as a patient's degree of malnutrition) had fallen far too low. Read More

The Real Reason Couples Decide They're Incompatible

It may be obvious, but like most wisdom we think we know but which we understand only intellectually, it bears repeating: no two people are the same. We all have different personalities and interests. And even if somehow our personality and interests were identical in all respects to our partner's, it would be even more improbable for us to always react Read More

Turning Poison Into Medicine, Redux

What's the worst problem you have right now? Have you lost your home? Your job? Are you worried you might? Or are you facing a terrible illness? From the Buddhist perspective, all people are endowed with the innate ability to create value out of any situation, no matter how awful or tragic. Read More

Leveraging Anticipatory Joy

Having to confront an indeterminate outcome that might be bad seems to cause more anxiety than having to confront an outcome known to be bad. In one study, patients requiring colostomies (a rerouting of the passage of stool from the rectum to an opening in the abdomen) that were potentially reversible were actually found to be less happy six months after their operation Read More

Our Best Defense Against Tragedy

Like most Americans, when I learned that twenty children and six adults had been massacred in Newtown, Connecticut, I recoiled. Like most parents, my next thought was for my own son, the image I retain of his happy, smiling self for one moment replaced by an image of his tiny body lying twisted on the ground. Read More

When Everything Seems To Be Going Wrong, Redux

In a previous post, The True Cause Of Depression, I discussed how having multiple problems at once seems to cause more stress than having only one or two. I likened the handling of challenges to balancing a "plate" of a certain size and suggested if we pile too many problems onto it, not only do we risk having it topple over, we often find ourselves wanting to pitch Read More

Becoming A Citizen

Every member of the armed forces who I've ever questioned about their decision to enlist has expressed a deep and abiding appreciation for the freedoms that American citizenship affords. Sadly, it's a perspective many of us have lost. Read More

Why We Must Actively Pursue Happiness

Recently, I've come across a number of articles—both online and off—warning of the dangers of deliberately aiming to become happy. In Viktor Frankl's book Man's Search for Meaning, for example, he argues that "happiness cannot be pursued; it must ensue." Though I consider Frankl a great thinker and his book a masterwork, on this point I wholeheartedly disagree. Read More

Delivering Bad News, Redux

I was a first year resident, and this was the first time I'd ever had to tell a family member a loved one had died. It had happened in the middle of the night so I'd had no choice but to deliver the news over the phone. Not only that, but because I was covering for another resident and had only met Mr. Peterson (not his real name) that night after his heart had stopped Read More

The Reasons To Avoid Slander

We all do it: not just talk about other people, but talk about them in a derogatory way. Why? According to recent research, it may be because gossip "not only helps clarify and enforce the rules that keep people working well together, but it circulates crucial information about the behavior of others that cannot be published in an office manual." Read More

Cigarette Smoking Is Caused By A Delusion, Redux

Mr. Rodriguez had been a pack-a-day smoker for the past 20 years, something he'd only begrudgingly confessed in response to a standard inquiry I make of all my first time patients. He didn't see it as a problem himself. Or at least he hadn't mentioned it when I'd asked him at the beginning of the visit why he'd come to see me. Read More

The Magical Power Of "Safe" Words To Prevent Harm

Many people have recently become aware of the use of "safe" words in the context of sadomasochistic sexual practices largely due to the popularity of the book Fifty Shades of Grey. In general, a "safe" word is an agreed-upon code word that the "masochist" can say to the "sadist" at any time to halt whatever pain is being inflicted. Read More

The Undefeated Mind

Over the last twenty years, I’ve watched thousands of patients struggle with a variety of ailments, from minor colds to life-threatening cancers. And though the majority of them eventually found relief from their suffering, the suffering of some of them left me breathless: the pilot who became so vertiginous he couldn’t sit up for two years without vomiting Read More

Why I Don't Drink

Once when I was ten I was walking with my brother on a Lake Michigan beach when we came upon a half-empty bottle of beer. Curious, I picked it up and looked inside at the swirling dark liquid. Then, impulsively, I took a sip. It was hot, having baked in the sun for who knows how many hours or days, and tasted awful. Read More

How To Raise Your Good Cholesterol

Most people know it's important to get their bad cholesterol (LDL) down to reduce their risk of heart attacks and strokes. Fewer people know that it's also important to raise their good cholesterol (HDL) for the same reasons. Almost no one knows, however, that a low HDL likely puts them at a higher risk for heart attacks and strokes than does a high LDL. Read More

The Problem With Reincarnation

In this post, I'd like to consider seriously the issue of reincarnation. Or perhaps I should say, the problem with reincarnation. Though I practice Buddhism, I don't actually believe in reincarnation. I suspect that my saying this will irk many of my Buddhist friends, who rightly consider the tenet of reincarnation central to Buddhism. Read More

Unconditional Positive Regard

As the U.S. Presidential race begins to heat up in earnest, the thing that's been mostly on my mind isn't the economy, foreign policy, or the deficit, but rather something that's not just absent between the two candidates but also among the people who support them: what psychologists call unconditional positive regard. Read More

Alex Lickerman, M.D., is a general internist and former Director of Primary Care at the University of Chicago and has been a practicing Buddhist since 1989.

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