• AVEVA P&ID (User) vs Administration: Understanding the Key Differences

    AVEVA P&ID is a part of AVEVA’s engineering and design software suite that supports intelligent schematic diagrams, data-driven design, and seamless integration with 3D modeling platforms such as #AVEVA #E3D and #PDMS.

    Read more: https://www.multisoftsystems.com/blog/aveva-pid-user-vs-administration-understanding-the-key-differences
    AVEVA P&ID (User) vs Administration: Understanding the Key Differences AVEVA P&ID is a part of AVEVA’s engineering and design software suite that supports intelligent schematic diagrams, data-driven design, and seamless integration with 3D modeling platforms such as #AVEVA #E3D and #PDMS. Read more: https://www.multisoftsystems.com/blog/aveva-pid-user-vs-administration-understanding-the-key-differences
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    AVEVA P&ID (User) vs Administration: Understanding
    The AVEVA P&ID (User) is typically a piping designer, process engineer, or instrumentation engineer who utilizes the tool to create and edit P&ID diagrams.
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  • Understanding SPI – SmartSketch Loop Diagram: A Complete Guide

    The software enables engineers to create and manage detailed instrument indexes, datasheets, wiring details, loop diagrams, hook-up drawings, and calibration records. One of its standout features is its seamless integration with SmartSketch, which allows automatic generation of intelligent loop diagrams based on live data.

    Read more: https://www.multisoftsystems.com/article/understanding-spi-smartsketch-loop-diagram-a-complete-guide
    Understanding SPI – SmartSketch Loop Diagram: A Complete Guide The software enables engineers to create and manage detailed instrument indexes, datasheets, wiring details, loop diagrams, hook-up drawings, and calibration records. One of its standout features is its seamless integration with SmartSketch, which allows automatic generation of intelligent loop diagrams based on live data. Read more: https://www.multisoftsystems.com/article/understanding-spi-smartsketch-loop-diagram-a-complete-guide
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    Understanding SPI – SmartSketch Loop Diagram: A Complete Guide
    The SPI – SmartSketch Loop Diagram training functionality is a cornerstone of efficient instrumentation engineering.
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  • Importance of AVEVA P&ID in Process Engineering and Design

    AVEVA P&ID (Piping and Instrumentation Diagram) software is a cutting-edge tool designed to create and manage detailed schematic diagrams used in process engineering. It is part of the AVEVA engineering suite, which is widely recognized for its robust capabilities in engineering, design, and project management. #AvevaP&ID #User #Aveva #Training #Course

    Read more: https://www.multisoftsystems.com/blog/importance-of-aveva-p&id-in-process-engineering-and-design
    Importance of AVEVA P&ID in Process Engineering and Design AVEVA P&ID (Piping and Instrumentation Diagram) software is a cutting-edge tool designed to create and manage detailed schematic diagrams used in process engineering. It is part of the AVEVA engineering suite, which is widely recognized for its robust capabilities in engineering, design, and project management. #AvevaP&ID #User #Aveva #Training #Course Read more: https://www.multisoftsystems.com/blog/importance-of-aveva-p&id-in-process-engineering-and-design
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    Importance of AVEVA P&ID in Process Engineering an
    AVEVA P&ID training amplify their value by offering advanced features such as real-time collaboration, automated validation, and seamless integration with other engineering tools, ensuring success at every stage of a project’s lifecycle.
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  • Introduction to AutoCAD P&ID Essential

    Piping and Instrumentation Diagrams (P&IDs) are foundational to the planning and maintenance of process industries, including chemical, petrochemical, and even wastewater treatment facilities. #AutoCADP&IDEssential #Training #AutoCAD #AutoCADCourse #onlinecourse #training

    Read more: https://www.multisoftsystems.com/article/introduction-to-autocad-p&id-essential
    Introduction to AutoCAD P&ID Essential Piping and Instrumentation Diagrams (P&IDs) are foundational to the planning and maintenance of process industries, including chemical, petrochemical, and even wastewater treatment facilities. #AutoCADP&IDEssential #Training #AutoCAD #AutoCADCourse #onlinecourse #training Read more: https://www.multisoftsystems.com/article/introduction-to-autocad-p&id-essential
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    Introduction to AutoCAD P&ID Essential
    Mastering AutoCAD P&ID is invaluable for professionals involved in the engineering and management of process systems.
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  • Preparing for Heart Surgery: A Heart Surgeon’s Guide to Preoperative Care

    Preparing for heart surgery is a critical step toward ensuring the best possible outcome. A heart surgeon will guide you through the necessary steps to prepare physically and emotionally for the procedure. This may include undergoing preoperative tests, such as blood work, electrocardiograms (ECGs), and imaging studies, to assess your heart's condition. The heart surgeon may also review your current medications and recommend adjustments to minimize risks during surgery. It's important to follow any dietary restrictions and stop smoking to optimize your health before the procedure. Additionally, the heart surgeon will discuss anesthesia options, potential risks, and the expected recovery process. Preparing for surgery involves not only physical preparation but also mental readiness. You should have a support system in place for aftercare and ensure you understand what to expect during the recovery phase. By following your heart surgeon's instructions carefully, you can help ensure a smoother surgery and quicker recovery.

    Visit for more info :- https://bookmark-dofollow.com/story21778368/how-a-heart-surgeon-can-help-you-recover-quickly-after-cardiac-surgery
    Preparing for Heart Surgery: A Heart Surgeon’s Guide to Preoperative Care Preparing for heart surgery is a critical step toward ensuring the best possible outcome. A heart surgeon will guide you through the necessary steps to prepare physically and emotionally for the procedure. This may include undergoing preoperative tests, such as blood work, electrocardiograms (ECGs), and imaging studies, to assess your heart's condition. The heart surgeon may also review your current medications and recommend adjustments to minimize risks during surgery. It's important to follow any dietary restrictions and stop smoking to optimize your health before the procedure. Additionally, the heart surgeon will discuss anesthesia options, potential risks, and the expected recovery process. Preparing for surgery involves not only physical preparation but also mental readiness. You should have a support system in place for aftercare and ensure you understand what to expect during the recovery phase. By following your heart surgeon's instructions carefully, you can help ensure a smoother surgery and quicker recovery. Visit for more info :- https://bookmark-dofollow.com/story21778368/how-a-heart-surgeon-can-help-you-recover-quickly-after-cardiac-surgery
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  • https://www.australiafireprotection.com.au/evacuation-diagrams/
    https://www.australiafireprotection.com.au/exit-emergency-lighting/
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    WWW.AUSTRALIAFIREPROTECTION.COM.AU
    Emergency Evacuation Plan Melbourne Diagram | Fire Evacuation Plan
    Easy to read Emergency Evacuation diagrams and plans in Melbourne. Contact Australia Fire Protection Groups today on 1300475715 and get the emergency evacuation diagram and plan during fire emergencies.
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  • cardiologist singapore
    Understanding Heart Health Screening
    Heart health screening refers to a comprehensive evaluation of an individual's cardiovascular health. This process involves a series of tests and assessments that provide valuable insights into the condition of the heart and its associated systems. These screenings are designed to identify potential risk factors, detect early signs of heart disease, and enable timely intervention to maintain optimal heart health.



    By understanding the importance of heart health screening, individuals can take proactive steps to safeguard their well-being. This screening process often includes various diagnostic tests, such as blood work, electrocardiograms (ECGs), and imaging scans, which help healthcare professionals assess the overall health of the heart and its functioning. Through these screenings, individuals can gain a deeper understanding of their cardiovascular health and make informed decisions about their lifestyle choices and medical treatment, if necessary.



    Regular heart health screenings are crucial in Singapore, where heart disease is a leading cause of mortality. By staying informed and proactive about their heart health, individuals can take control of their well-being and reduce the risk of developing life-threatening cardiovascular conditions. This comprehensive approach to healthcare empowers individuals to make informed decisions and prioritize their long-term health and wellness.

    The prevalence of Heart Disease in Singapore
    Heart disease is a significant public health concern in Singapore. According to the Singapore Heart Foundation, cardiovascular disease is the leading cause of mortality in the nation, accounting for approximately one-third of all deaths each year.



    The prevalence of heart disease in Singapore can be attributed to a variety of factors, including the country's aging population, sedentary lifestyles, and the increasing prevalence of risk factors such as obesity, diabetes, and high blood pressure. Additionally, the fast-paced and stressful nature of modern life in Singapore can contribute to the development of cardiovascular problems, as stress and unhealthy coping mechanisms can take a toll on the heart's health.



    The impact of heart disease in Singapore extends beyond the individual, as it places a significant burden on the healthcare system and the economy. The cost of treating and managing cardiovascular conditions can be substantial, both in terms of direct medical expenses and indirect costs, such as lost productivity and decreased quality of life. By prioritizing heart health screening and early intervention, Singapore can work towards reducing the prevalence of heart disease and improving the overall well-being of its population.

    Read more : https://www.hhscsg.org
    cardiologist singapore Understanding Heart Health Screening Heart health screening refers to a comprehensive evaluation of an individual's cardiovascular health. This process involves a series of tests and assessments that provide valuable insights into the condition of the heart and its associated systems. These screenings are designed to identify potential risk factors, detect early signs of heart disease, and enable timely intervention to maintain optimal heart health. ​ By understanding the importance of heart health screening, individuals can take proactive steps to safeguard their well-being. This screening process often includes various diagnostic tests, such as blood work, electrocardiograms (ECGs), and imaging scans, which help healthcare professionals assess the overall health of the heart and its functioning. Through these screenings, individuals can gain a deeper understanding of their cardiovascular health and make informed decisions about their lifestyle choices and medical treatment, if necessary. ​ Regular heart health screenings are crucial in Singapore, where heart disease is a leading cause of mortality. By staying informed and proactive about their heart health, individuals can take control of their well-being and reduce the risk of developing life-threatening cardiovascular conditions. This comprehensive approach to healthcare empowers individuals to make informed decisions and prioritize their long-term health and wellness. The prevalence of Heart Disease in Singapore Heart disease is a significant public health concern in Singapore. According to the Singapore Heart Foundation, cardiovascular disease is the leading cause of mortality in the nation, accounting for approximately one-third of all deaths each year. ​ The prevalence of heart disease in Singapore can be attributed to a variety of factors, including the country's aging population, sedentary lifestyles, and the increasing prevalence of risk factors such as obesity, diabetes, and high blood pressure. Additionally, the fast-paced and stressful nature of modern life in Singapore can contribute to the development of cardiovascular problems, as stress and unhealthy coping mechanisms can take a toll on the heart's health. ​ The impact of heart disease in Singapore extends beyond the individual, as it places a significant burden on the healthcare system and the economy. The cost of treating and managing cardiovascular conditions can be substantial, both in terms of direct medical expenses and indirect costs, such as lost productivity and decreased quality of life. By prioritizing heart health screening and early intervention, Singapore can work towards reducing the prevalence of heart disease and improving the overall well-being of its population. Read more : https://www.hhscsg.org
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  • Dr. Deep Chandh Raja: Chennai's Premier Cardiologist for Leadless Pacemaker Specialist and pacemaker implantation

    https://www.drdcr.com/

    Dr. Deep Chandh Raja – Best Cardiologist and Leadless Pacemaker Specialist in Chennai
    When it comes to heart health, choosing the right specialist is paramount. In Chennai, Dr. Deep Chandh Raja has earned a stellar reputation as one of the most trusted and skilled cardiologists. deep chandh raja/best cardiologist in chennai/best leadless pacemaker specialist in chennai With a wealth of experience and expertise, he is recognized as the best leadless pacemaker specialist in Chennai, offering cutting-edge solutions for heart rhythm disorders.

    Expertise in Cardiology
    Dr. Deep Chandh Raja's career spans decades of commitment to diagnosing, treating, and managing cardiovascular diseases. His approach is rooted in advanced medical knowledge, modern technology, and compassionate care. From common issues like hypertension and coronary artery disease to complex heart conditions, his comprehensive treatment plans are tailored to each patient's unique needs.

    He stays abreast of the latest advancements in cardiology to ensure his patients receive world-class care. His expertise includes non-invasive tests like echocardiograms, stress tests, Holter monitoring, and advanced interventions such as angioplasty, stent placement, and minimally invasive cardiac surgeries.
    A Pioneer in Leadless Pacemaker Technology
    One of Dr. Deep Chandh Raja's standout specialties is his proficiency in implanting leadless pacemakers. Unlike traditional pacemakers that require leads (wires) to connect the device to the heart, leadless pacemakers are small, self-contained units placed directly within the heart chamber. This cutting-edge technology offers significant benefits, including a lower risk of infection, no visible scars, and a quicker recovery time.

    Dr. Deep Chandh Raja has performed numerous successful leadless pacemaker implantations, earning him the distinction of being Chennai's foremost specialist in this revolutionary technology. Patients with bradycardia (slow heart rhythm) have greatly benefited from his expertise, as he ensures precise placement and personalized post-procedure care.

    Patient-Centric Approach
    What sets Dr. Deep Chandh Raja apart is his patient-centric approach. He believes every individual deserves holistic care that addresses not just the physical aspects of illness but also emotional and psychological well-being. His consultations are marked by detailed explanations, ensuring patients and their families are well-informed about their conditions and treatment options.
    Dr. Deep Chandh Raja's ability to establish trust and rapport with his patients is widely appreciated. Whether a routine check-up or a life-saving procedure, he prioritizes patient comfort and safety at every step.

    State-of-the-Art Facilities
    Dr. Deep Chandh Raja practices at some of Chennai's most renowned hospitals, which are equipped with state-of-the-art diagnosis and treatment facilities. These centers boast advanced cardiac care units, cutting-edge imaging technology, and specialized teams that support him in delivering exceptional care.

    Recognitions and Achievements
    Over the years, Dr. Deep Chandh Raja has received numerous accolades for his contributions to cardiology. His dedication to excellence has made him a sought-after speaker at medical conferences and a mentor to upcoming cardiologists.

    Conclusion
    For anyone seeking the best cardiologist or a specialist in leadless pacemaker implantation in Chennai, Dr. Deep Chandh Raja stands out as a beacon of hope and expertise. His unwavering commitment to advancing heart care and improving patient outcomes solidifies his reputation as a leader in his field. Whether it's preventive cardiology, advanced interventions, or pioneering heart rhythm treatments, you can trust Dr. Deep Chandh Raja to deliver unparalleled care for your heart.
    Dr. Deep Chandh Raja: Chennai's Premier Cardiologist for Leadless Pacemaker Specialist and pacemaker implantation https://www.drdcr.com/ Dr. Deep Chandh Raja – Best Cardiologist and Leadless Pacemaker Specialist in Chennai When it comes to heart health, choosing the right specialist is paramount. In Chennai, Dr. Deep Chandh Raja has earned a stellar reputation as one of the most trusted and skilled cardiologists. deep chandh raja/best cardiologist in chennai/best leadless pacemaker specialist in chennai With a wealth of experience and expertise, he is recognized as the best leadless pacemaker specialist in Chennai, offering cutting-edge solutions for heart rhythm disorders. Expertise in Cardiology Dr. Deep Chandh Raja's career spans decades of commitment to diagnosing, treating, and managing cardiovascular diseases. His approach is rooted in advanced medical knowledge, modern technology, and compassionate care. From common issues like hypertension and coronary artery disease to complex heart conditions, his comprehensive treatment plans are tailored to each patient's unique needs. He stays abreast of the latest advancements in cardiology to ensure his patients receive world-class care. His expertise includes non-invasive tests like echocardiograms, stress tests, Holter monitoring, and advanced interventions such as angioplasty, stent placement, and minimally invasive cardiac surgeries. A Pioneer in Leadless Pacemaker Technology One of Dr. Deep Chandh Raja's standout specialties is his proficiency in implanting leadless pacemakers. Unlike traditional pacemakers that require leads (wires) to connect the device to the heart, leadless pacemakers are small, self-contained units placed directly within the heart chamber. This cutting-edge technology offers significant benefits, including a lower risk of infection, no visible scars, and a quicker recovery time. Dr. Deep Chandh Raja has performed numerous successful leadless pacemaker implantations, earning him the distinction of being Chennai's foremost specialist in this revolutionary technology. Patients with bradycardia (slow heart rhythm) have greatly benefited from his expertise, as he ensures precise placement and personalized post-procedure care. Patient-Centric Approach What sets Dr. Deep Chandh Raja apart is his patient-centric approach. He believes every individual deserves holistic care that addresses not just the physical aspects of illness but also emotional and psychological well-being. His consultations are marked by detailed explanations, ensuring patients and their families are well-informed about their conditions and treatment options. Dr. Deep Chandh Raja's ability to establish trust and rapport with his patients is widely appreciated. Whether a routine check-up or a life-saving procedure, he prioritizes patient comfort and safety at every step. State-of-the-Art Facilities Dr. Deep Chandh Raja practices at some of Chennai's most renowned hospitals, which are equipped with state-of-the-art diagnosis and treatment facilities. These centers boast advanced cardiac care units, cutting-edge imaging technology, and specialized teams that support him in delivering exceptional care. Recognitions and Achievements Over the years, Dr. Deep Chandh Raja has received numerous accolades for his contributions to cardiology. His dedication to excellence has made him a sought-after speaker at medical conferences and a mentor to upcoming cardiologists. Conclusion For anyone seeking the best cardiologist or a specialist in leadless pacemaker implantation in Chennai, Dr. Deep Chandh Raja stands out as a beacon of hope and expertise. His unwavering commitment to advancing heart care and improving patient outcomes solidifies his reputation as a leader in his field. Whether it's preventive cardiology, advanced interventions, or pioneering heart rhythm treatments, you can trust Dr. Deep Chandh Raja to deliver unparalleled care for your heart.
    WWW.DRDCR.COM
    Dr Deep Chandh Raja: Best Cardiac Electrophysiologist Chennai
    Dr. Deep Chandh Raja is best Cardiac Electrophysiologist in Chennai with over 15 years of experience in diagnosing and treating complex heart rhythm disorder
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  • LONELINESS-
    Are Men Dying of Friendlessness?
    A look at the Surgeon General's report on the epidemic of loneliness.
    Reviewed by Michelle Quirk

    KEY POINTS-
    For decades there has been a growing loneliness crisis.
    Friendlessness has contributed to the loneliness crisis, which may lead to despair and the risk of suicide, most commonly for males.
    Focusing on skill-building of the four factors of friendship may offer help.

    The US Surgeon General has recently called our attention to an identified crisis of loneliness in America. In it, he identifies factors such as having very few good friends or colleagues in the workplace, the need for more robust public health, equity aspects, and the role of social media in our lives.

    In the long-range view, it’s been a growing crisis for about 30 years. We all watched it happen, not connecting friendship directly as the most important factor associated with happiness.

    It’s been said that “being alone is different from being lonely.” This means that in being alone, we may be comfortable in who we are and getting some “me” time. When ready, we’ll return to social connection and the goodness of friendship.

    Being lonely implies something additional and more fundamentally destructive within the loneliness than being physically solitary.

    That factor that transforms pleasant aloneness into loneliness is despair.

    The Oxford Dictionary defines despair as “the complete loss or absence of hope.”

    In the "loneliness crisis," we ought to become curious about the causes of despair because it is a far greater concern than being pleasantly alone or somewhat lonely.

    It is the elephant in the room of loneliness: “deaths of despair” and suicide.

    Death by suicide should be our deepest concern about the outcome of prolonged loneliness. The Surgeon General didn’t happen to mention that 78 percent of completed suicides in the United States are males.

    I wish he did because, for the ever-expanding numbers of lonely men who come into my office, ten times more must be out there in the community, not even looking for help. Surveys are showing a marked drop in the size of men's social circles.

    Within loneliness is friendlessness, and from loneliness, we often descend into the hopelessness of despair.

    “Hopelessness about what?” one may ask.
    For nearly all the males that I see with loneliness and depression, there are only two general categories: the absence of romantic love and the absence of meaningful work.

    Clearly, the “at-risk” group the Surgeon General could be looking at are males of all backgrounds (although teen males and middle-aged males are most concerning).

    The purpose of addressing loneliness is not for its own sake but ultimately and obviously to prevent the deaths it may cause.

    New programs exist to prevent depression in males that treat the root factors of male suicide. Some of the most prominent researchers in this area are Dr. John Barry and Dr. Martin Seager at the British Psychological Society.

    Friendlessness Precedes and Predicts Loneliness
    Not long ago, a large research study—The Harvard Study of Adult Development—identified the most significant non-clinical factor affecting mood problems such as depression and anxiety: friendship.

    If we are concerned with the connection between loneliness and depression, then we ought to take a clue from the study showing that friendship mitigates depression.

    Clearly, friendlessness precedes loneliness and all the tormented experiences of isolation that emanate from it.

    We need a lens to look through to see the real causes and answers to the crisis.
    That lens is called the Biopsychosocial Model of medicine and behavioral health.

    The Biopsychosocial Model
    There are three general contributors to behavior, moods, and our problems: the biological, the psychological, and the sociological.

    What is often not described in this model—if one doesn’t make it a diagram—is that there is a major, healthy barrier between our psychology and the sociology we are surrounded by: the personal boundary.

    While the surgeon general’s intentions are beneficent, his toolbox relies on public policy and, inherently, in sociological, public policy solutions outside an individual's personal psychological mechanics.

    This personal boundary means that the only answer to the inner problem of loneliness and friendlessness also may only be found within a person and through actions the individual takes to correct it.

    It would be beneficial for us to go back in history to study philosophers such as Aristotle on the anatomy of friendship, how we experience it, and what elements constitute it psychologically.

    A Definition of Friendship
    One might be hard-pressed to find a definitive source of knowledge on friendship and its psychological workings. Even the area of thought predating the modern sciences—philosophy—can be scanty on the subject.

    One exhaustive source, however, is in The Nicomachean Ethics by Aristotle. In it, he posits different kinds of friendships and their workings.

    He says,
    With true friendship, friends love each other for their own sake and wish for each other good things.

    This kind of friendship is only possible between “good people similar in virtue” because only good people can love another person for that person's own sake.

    Nicomachean Ethics distinguishes three kinds of friendship: friendships of pleasure, of utility, and of virtue.

    The first is about self-gratification that happens to coexist with that of another person.
    The second is about mutual benefits that occur surrounding outer goals.
    The third is a friendship emerging from the maturity of character, optimizing collaboration and committed partnership.

    The third is also supported by the modern models and theories of the likes of George Vaillant and his extensive work with ego defenses, his work in the Harvard Study of Adult Development, and the whole expanding new school of psychology by Martin Seligman called positive psychology.

    There are two concepts derived from evolutionary psychology that are useful in this regard:
    "We like those who like us" (the principle of reciprocal altruism—you scratch my back, and I’ll scratch yours)
    "We like those who are like us" (how we assort into social groups that offer the protections of “power in numbers” and familial-like loyalty to the group)
    If we combine the good boundaries of mature character with these other views of friendship, we may arrive at the following:

    Friendship = Consistent, Mutual, Shared, Positive Emotion
    If you were to solve the “friendship crisis,” at least for yourself, you’d work on these four in yourself and look to find all four in others.

    Evaluation and Improvement of Friendship
    Consistency comes from working on and having a good boundary. This means your word is good, you are reliable and consistent, and you can be counted on even if it takes self-discipline to follow through on your promises. Yes even if you feel exhausted and sad.

    Your friend will be all the more empathic toward your sadness and exhaustion because your "consistency" has a proven track record.

    Mutuality is the fairness of the friendship investment and rewards for both people—being a “we” instead of a “me.” This factor satisfies the reciprocal altruism of “I’ll scratch your back if you scratch mine” or “liking those who like us back.” Yet, the personal boundaries of consistency raise this kind of "liking" to a higher level, akin to Aristotle's "friendship of virtue."

    For example (from Seinfeld), if someone helps you move apartments, you someday owe them help with their own move. Even if you’re sad and lack energy, try to find something to give back from whatever you do have available. No matter how small it will satisfy other friends with "mutuality."

    Sharing fosters an emotional bond between two people through coordinated effort toward a goal or toward fun. It is the spirit of “liking those who are like us,” a sameness of background, beliefs, interests, and goals that only the in-person presence fosters as strongly. The personal boundaries of consistency again raise this other kind of "liking" higher, to Aristotle's "friendship of virtue."

    Even if you don’t have much happiness to share or interests in common, maybe start small. Just share space with others by reading a book at the coffee shop or taking yourself out for a great dinner for one. Soon, you'll see the same people regularly, and that's a chance to introduce yourself based on your "shared" enjoyment of the venue.

    Positive emotion is the fourth factor and definitive of friendship. The more we make people happy, the more valuable we are to them. The less we make them happy, the less valuable we are to them.

    Friends aren't just happy people we know. They intentionally raise each other’s self-esteem. The consistency, mutuality, and sharing you've already cultivated form a perfect environment where positive emotion is taken in, transformed, and held onto as what can now be called self-esteem.

    So what if yours is low?
    Others who have an abundance of happiness just can’t help sharing the excess, and you should place yourself near people with high self-esteem inside, and positive emotion to give.

    Others with an abundance of positivity pass it on to you while you only give a little back.
    That's okay. A back-and-forth of "positive emotion" has begun, and your slight grin at their jokes will soon release the first genuine laughter you've let out in a long time.

    If you work on the four friendship factors we've built, you will most likely see your friendship circle grow and you with them.

    It could be your contribution and solution to the “friendship crisis” and a shield against your own loneliness, never to encounter despair. You’ll feel what the ancient philosophers called eudaimonia, or consistently “in good spirits.”
    LONELINESS- Are Men Dying of Friendlessness? A look at the Surgeon General's report on the epidemic of loneliness. Reviewed by Michelle Quirk KEY POINTS- For decades there has been a growing loneliness crisis. Friendlessness has contributed to the loneliness crisis, which may lead to despair and the risk of suicide, most commonly for males. Focusing on skill-building of the four factors of friendship may offer help. The US Surgeon General has recently called our attention to an identified crisis of loneliness in America. In it, he identifies factors such as having very few good friends or colleagues in the workplace, the need for more robust public health, equity aspects, and the role of social media in our lives. In the long-range view, it’s been a growing crisis for about 30 years. We all watched it happen, not connecting friendship directly as the most important factor associated with happiness. It’s been said that “being alone is different from being lonely.” This means that in being alone, we may be comfortable in who we are and getting some “me” time. When ready, we’ll return to social connection and the goodness of friendship. Being lonely implies something additional and more fundamentally destructive within the loneliness than being physically solitary. That factor that transforms pleasant aloneness into loneliness is despair. The Oxford Dictionary defines despair as “the complete loss or absence of hope.” In the "loneliness crisis," we ought to become curious about the causes of despair because it is a far greater concern than being pleasantly alone or somewhat lonely. It is the elephant in the room of loneliness: “deaths of despair” and suicide. Death by suicide should be our deepest concern about the outcome of prolonged loneliness. The Surgeon General didn’t happen to mention that 78 percent of completed suicides in the United States are males. I wish he did because, for the ever-expanding numbers of lonely men who come into my office, ten times more must be out there in the community, not even looking for help. Surveys are showing a marked drop in the size of men's social circles. Within loneliness is friendlessness, and from loneliness, we often descend into the hopelessness of despair. “Hopelessness about what?” one may ask. For nearly all the males that I see with loneliness and depression, there are only two general categories: the absence of romantic love and the absence of meaningful work. Clearly, the “at-risk” group the Surgeon General could be looking at are males of all backgrounds (although teen males and middle-aged males are most concerning). The purpose of addressing loneliness is not for its own sake but ultimately and obviously to prevent the deaths it may cause. New programs exist to prevent depression in males that treat the root factors of male suicide. Some of the most prominent researchers in this area are Dr. John Barry and Dr. Martin Seager at the British Psychological Society. Friendlessness Precedes and Predicts Loneliness Not long ago, a large research study—The Harvard Study of Adult Development—identified the most significant non-clinical factor affecting mood problems such as depression and anxiety: friendship. If we are concerned with the connection between loneliness and depression, then we ought to take a clue from the study showing that friendship mitigates depression. Clearly, friendlessness precedes loneliness and all the tormented experiences of isolation that emanate from it. We need a lens to look through to see the real causes and answers to the crisis. That lens is called the Biopsychosocial Model of medicine and behavioral health. The Biopsychosocial Model There are three general contributors to behavior, moods, and our problems: the biological, the psychological, and the sociological. What is often not described in this model—if one doesn’t make it a diagram—is that there is a major, healthy barrier between our psychology and the sociology we are surrounded by: the personal boundary. While the surgeon general’s intentions are beneficent, his toolbox relies on public policy and, inherently, in sociological, public policy solutions outside an individual's personal psychological mechanics. This personal boundary means that the only answer to the inner problem of loneliness and friendlessness also may only be found within a person and through actions the individual takes to correct it. It would be beneficial for us to go back in history to study philosophers such as Aristotle on the anatomy of friendship, how we experience it, and what elements constitute it psychologically. A Definition of Friendship One might be hard-pressed to find a definitive source of knowledge on friendship and its psychological workings. Even the area of thought predating the modern sciences—philosophy—can be scanty on the subject. One exhaustive source, however, is in The Nicomachean Ethics by Aristotle. In it, he posits different kinds of friendships and their workings. He says, With true friendship, friends love each other for their own sake and wish for each other good things. This kind of friendship is only possible between “good people similar in virtue” because only good people can love another person for that person's own sake. Nicomachean Ethics distinguishes three kinds of friendship: friendships of pleasure, of utility, and of virtue. The first is about self-gratification that happens to coexist with that of another person. The second is about mutual benefits that occur surrounding outer goals. The third is a friendship emerging from the maturity of character, optimizing collaboration and committed partnership. The third is also supported by the modern models and theories of the likes of George Vaillant and his extensive work with ego defenses, his work in the Harvard Study of Adult Development, and the whole expanding new school of psychology by Martin Seligman called positive psychology. There are two concepts derived from evolutionary psychology that are useful in this regard: "We like those who like us" (the principle of reciprocal altruism—you scratch my back, and I’ll scratch yours) "We like those who are like us" (how we assort into social groups that offer the protections of “power in numbers” and familial-like loyalty to the group) If we combine the good boundaries of mature character with these other views of friendship, we may arrive at the following: Friendship = Consistent, Mutual, Shared, Positive Emotion If you were to solve the “friendship crisis,” at least for yourself, you’d work on these four in yourself and look to find all four in others. Evaluation and Improvement of Friendship Consistency comes from working on and having a good boundary. This means your word is good, you are reliable and consistent, and you can be counted on even if it takes self-discipline to follow through on your promises. Yes even if you feel exhausted and sad. Your friend will be all the more empathic toward your sadness and exhaustion because your "consistency" has a proven track record. Mutuality is the fairness of the friendship investment and rewards for both people—being a “we” instead of a “me.” This factor satisfies the reciprocal altruism of “I’ll scratch your back if you scratch mine” or “liking those who like us back.” Yet, the personal boundaries of consistency raise this kind of "liking" to a higher level, akin to Aristotle's "friendship of virtue." For example (from Seinfeld), if someone helps you move apartments, you someday owe them help with their own move. Even if you’re sad and lack energy, try to find something to give back from whatever you do have available. No matter how small it will satisfy other friends with "mutuality." Sharing fosters an emotional bond between two people through coordinated effort toward a goal or toward fun. It is the spirit of “liking those who are like us,” a sameness of background, beliefs, interests, and goals that only the in-person presence fosters as strongly. The personal boundaries of consistency again raise this other kind of "liking" higher, to Aristotle's "friendship of virtue." Even if you don’t have much happiness to share or interests in common, maybe start small. Just share space with others by reading a book at the coffee shop or taking yourself out for a great dinner for one. Soon, you'll see the same people regularly, and that's a chance to introduce yourself based on your "shared" enjoyment of the venue. Positive emotion is the fourth factor and definitive of friendship. The more we make people happy, the more valuable we are to them. The less we make them happy, the less valuable we are to them. Friends aren't just happy people we know. They intentionally raise each other’s self-esteem. The consistency, mutuality, and sharing you've already cultivated form a perfect environment where positive emotion is taken in, transformed, and held onto as what can now be called self-esteem. So what if yours is low? Others who have an abundance of happiness just can’t help sharing the excess, and you should place yourself near people with high self-esteem inside, and positive emotion to give. Others with an abundance of positivity pass it on to you while you only give a little back. That's okay. A back-and-forth of "positive emotion" has begun, and your slight grin at their jokes will soon release the first genuine laughter you've let out in a long time. If you work on the four friendship factors we've built, you will most likely see your friendship circle grow and you with them. It could be your contribution and solution to the “friendship crisis” and a shield against your own loneliness, never to encounter despair. You’ll feel what the ancient philosophers called eudaimonia, or consistently “in good spirits.”
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  • ANXIETY
    A Proven Strategy to Reduce Health Anxiety.
    Cognitive restructuring can help you change your beliefs about health.
    Reviewed by Abigail Fagan

    KEY POINTS-
    People with health anxiety hold maladaptive beliefs about health and illness.
    Core beliefs influence how we interpret and react to symptoms and bodily sensations. Core beliefs aren't permanent; they can be changed.
    Cognitive restructuring is a CBT technique that can be helpful in reshaping maladaptive beliefs about health into adaptive beliefs.
    People with health anxiety have dysfunctional beliefs about health and illness. One common belief among health-anxious people is that they are weak and particularly vulnerable to sickness or disease. They might have the sense that their health is ‘barely hanging on by a thread.’ They are convinced that, because of their presumed weakness, any illness or disease that happens to come along will be what puts them in the grave.

    Now, I want to recognize that in some cases, people are actually dealing with serious or debilitating diseases and have compromised immune systems. And in those cases, of course, one may be particularly vulnerable to illness and the appropriate steps need to be taken to protect their health, as advised by their doctors.

    That said, many people who experience health anxiety and live with this assumption are not weak or vulnerable to disease to the extent they are assuming. And this belief causes them to live in fear of any and all diseases, naturally. Why? Because if they believe that any disease they get will be the end of their life, it is only natural to live in fear of it! Of course they are going to be startled by and concerned about any bodily sensation or symptom that pops up because they are convinced it could be the beginning of the end.

    The whole process can look a little like this:
    They hold the core belief that they are weak and vulnerable to disease, and therefore live in fear of disease because they believe they won’t stand a chance against it.
    This belief leads them to be hypervigilant and on high alert for any potential ‘threats’ (i.e. symptoms or bodily sensations).
    Any time they have a symptom or bodily sensation (even when it is neutral or benign such as due to normal body noise or anxiety), they fear it may be due to a serious disease.
    They then make biased interpretations of the symptoms or bodily sensations (i.e. engage in thinking errors).

    Their misinterpretations make them feel very unsafe and, therefore, they begin to do a bunch of things to feel safer (i.e. engage in safety behaviors like going to the doctor frequently, asking loved ones about symptoms, googling symptoms, incessantly pinching, poking or checking body parts or symptoms).
    It is a miserable cycle! See the diagram below for a visual illustration of this process.

    So, how does one change this cycle?
    The goal is to recognize one's own physical strength, resilience and capability of coping with, treating or overcoming the vast majority of illnesses and diseases. This is where cognitive restructuring techniques can be helpful. Cognitive restructuring is a CBT technique that helps one to examine and challenge their thoughts and beliefs. In this case, one needs to examine the evidence of their belief, that they are weak, vulnerable and prone to sickness. This process allows them to pull out all of their assumptions (i.e. write them down) and evaluate the validity of each one.

    We often don’t question our beliefs but just assume they are valid. This is problematic because our beliefs are the lens through which we see the world around us. If one has illogical or faulty beliefs, they may be interpreting symptoms in a distorted and biased way without even realizing it.

    Challenging core beliefs
    When it becomes evident that a client carries this belief of being weak and vulnerable to disease, I suggest we take a few minutes to challenge it.

    Step 1: We write the maladaptive core belief at the top of the worksheet (I am weak, vulnerable and prone to sickness).

    Step 2: We then come up with a new, more adaptive belief (the goal is for them to learn to believe this more and more over time).

    Step 3: We assess the degree to which they believe both beliefs (0-100, with 100 being the strongest).

    Step 4: We make two columns, one to gather evidence for the old core belief and one to gather evidence for the new core belief.

    Step 5: We begin collecting evidence for the old, maladaptive core belief.

    Step 6: After we are finished, we go through the list of evidence and look for any potential thinking errors or inaccuracies. We write out the reframes next to each piece of evidence.

    Step 7: We then move to the right side to list out all the evidence that contradicts the old core belief and supports the new core belief.

    Step 8: As a final step, we look through all of the evidence on both sides and then assess the extent to which they believe the old core belief as well as the extent to which they believe the new one. If they believe the new core belief even a little bit more (and the old core belief a little less), even if it is only a 10-point difference, I would conclude the intervention was helpful.

    It’s important to keep a few things in mind when completing the core belief worksheet.

    1. When you are identifying evidence for the old/maladaptive core belief, make sure you are including everything. Even if you know the piece of evidence is silly, you still want to write it down. You need to give yourself the opportunity to really challenge this and see how illogical it is. If you don’t, you still may carry it around in your mind as a truth, to some extent.

    2. Make sure you document the extent to which you have both beliefs, before and after the intervention. This will help you to evaluate whether it was helpful. Importantly, don’t discount small changes in your belief after you do this. Even just 10 points can make a difference and mean the intervention was at least somewhat helpful.

    3. You will not change your beliefs entirely during this one activity. Beliefs take time to change. Use this worksheet as a starting point. You will then work to build from there, slowly collecting evidence in your environment to support your new, healthy belief. In addition, you will want to continue to challenge any assumptions you make in your daily life that support your old belief.

    A few final comments
    There you have it! Try this activity out for yourself and see what you come up with. Cognitive restructuring can take time at first. But, as you continue to use these skills, it will take less and less time for you to come to these same conclusions. Remember this: Your thoughts and beliefs about health and illness are not facts! Evaluate their validity and try to come up with new conclusions. It takes work at first but is well worth the effort.
    ANXIETY A Proven Strategy to Reduce Health Anxiety. Cognitive restructuring can help you change your beliefs about health. Reviewed by Abigail Fagan KEY POINTS- People with health anxiety hold maladaptive beliefs about health and illness. Core beliefs influence how we interpret and react to symptoms and bodily sensations. Core beliefs aren't permanent; they can be changed. Cognitive restructuring is a CBT technique that can be helpful in reshaping maladaptive beliefs about health into adaptive beliefs. People with health anxiety have dysfunctional beliefs about health and illness. One common belief among health-anxious people is that they are weak and particularly vulnerable to sickness or disease. They might have the sense that their health is ‘barely hanging on by a thread.’ They are convinced that, because of their presumed weakness, any illness or disease that happens to come along will be what puts them in the grave. Now, I want to recognize that in some cases, people are actually dealing with serious or debilitating diseases and have compromised immune systems. And in those cases, of course, one may be particularly vulnerable to illness and the appropriate steps need to be taken to protect their health, as advised by their doctors. That said, many people who experience health anxiety and live with this assumption are not weak or vulnerable to disease to the extent they are assuming. And this belief causes them to live in fear of any and all diseases, naturally. Why? Because if they believe that any disease they get will be the end of their life, it is only natural to live in fear of it! Of course they are going to be startled by and concerned about any bodily sensation or symptom that pops up because they are convinced it could be the beginning of the end. The whole process can look a little like this: They hold the core belief that they are weak and vulnerable to disease, and therefore live in fear of disease because they believe they won’t stand a chance against it. This belief leads them to be hypervigilant and on high alert for any potential ‘threats’ (i.e. symptoms or bodily sensations). Any time they have a symptom or bodily sensation (even when it is neutral or benign such as due to normal body noise or anxiety), they fear it may be due to a serious disease. They then make biased interpretations of the symptoms or bodily sensations (i.e. engage in thinking errors). Their misinterpretations make them feel very unsafe and, therefore, they begin to do a bunch of things to feel safer (i.e. engage in safety behaviors like going to the doctor frequently, asking loved ones about symptoms, googling symptoms, incessantly pinching, poking or checking body parts or symptoms). It is a miserable cycle! See the diagram below for a visual illustration of this process. So, how does one change this cycle? The goal is to recognize one's own physical strength, resilience and capability of coping with, treating or overcoming the vast majority of illnesses and diseases. This is where cognitive restructuring techniques can be helpful. Cognitive restructuring is a CBT technique that helps one to examine and challenge their thoughts and beliefs. In this case, one needs to examine the evidence of their belief, that they are weak, vulnerable and prone to sickness. This process allows them to pull out all of their assumptions (i.e. write them down) and evaluate the validity of each one. We often don’t question our beliefs but just assume they are valid. This is problematic because our beliefs are the lens through which we see the world around us. If one has illogical or faulty beliefs, they may be interpreting symptoms in a distorted and biased way without even realizing it. Challenging core beliefs When it becomes evident that a client carries this belief of being weak and vulnerable to disease, I suggest we take a few minutes to challenge it. Step 1: We write the maladaptive core belief at the top of the worksheet (I am weak, vulnerable and prone to sickness). Step 2: We then come up with a new, more adaptive belief (the goal is for them to learn to believe this more and more over time). Step 3: We assess the degree to which they believe both beliefs (0-100, with 100 being the strongest). Step 4: We make two columns, one to gather evidence for the old core belief and one to gather evidence for the new core belief. Step 5: We begin collecting evidence for the old, maladaptive core belief. Step 6: After we are finished, we go through the list of evidence and look for any potential thinking errors or inaccuracies. We write out the reframes next to each piece of evidence. Step 7: We then move to the right side to list out all the evidence that contradicts the old core belief and supports the new core belief. Step 8: As a final step, we look through all of the evidence on both sides and then assess the extent to which they believe the old core belief as well as the extent to which they believe the new one. If they believe the new core belief even a little bit more (and the old core belief a little less), even if it is only a 10-point difference, I would conclude the intervention was helpful. It’s important to keep a few things in mind when completing the core belief worksheet. 1. When you are identifying evidence for the old/maladaptive core belief, make sure you are including everything. Even if you know the piece of evidence is silly, you still want to write it down. You need to give yourself the opportunity to really challenge this and see how illogical it is. If you don’t, you still may carry it around in your mind as a truth, to some extent. 2. Make sure you document the extent to which you have both beliefs, before and after the intervention. This will help you to evaluate whether it was helpful. Importantly, don’t discount small changes in your belief after you do this. Even just 10 points can make a difference and mean the intervention was at least somewhat helpful. 3. You will not change your beliefs entirely during this one activity. Beliefs take time to change. Use this worksheet as a starting point. You will then work to build from there, slowly collecting evidence in your environment to support your new, healthy belief. In addition, you will want to continue to challenge any assumptions you make in your daily life that support your old belief. A few final comments There you have it! Try this activity out for yourself and see what you come up with. Cognitive restructuring can take time at first. But, as you continue to use these skills, it will take less and less time for you to come to these same conclusions. Remember this: Your thoughts and beliefs about health and illness are not facts! Evaluate their validity and try to come up with new conclusions. It takes work at first but is well worth the effort.
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